With MERS and company in our world, infection control must be a habit for us all

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Have you heard of MERS yet?  If not, you likely will soon.  The Middle East Respiratory Syndrome Novel Coronavirus (MERS-nCoV) was in the news over the last year as the number of people across the globe affected by it slowly grows.  At the time of writing, there have been fewer than 100 cases worldwide, with about half of those causing death.  It is a virus that has some similarities to SARS.

The World Health Organization (WHO) stated in mid-July that while MERS was a great concern, it is not an international public health emergency. Not yet, and perhaps not ever.  The CBC recently reported on a study that found there are important differences between MERS and SARS that mean it is, presently, unlikely to spread as easily as SARS did.  Things may change; mutations happen.
There is also another virus lurking in the world, the H7N9 influenza virus, presenting the possibility of becoming a much bigger problem than it has been so far. And new viruses can become a worry at any time, as did H1N1 a few years ago.

In the end, these sorts of health concerns illustrate our communal responsibility for infection prevention and control.  All hospitals are constantly dealing with many potential ‘superbugs’ – such as MRSA, VRE, and C. diff. – and all of us must observe the precautions to help prevent spreading them.

It is not always easy to keep vigilant about something that we can’t see or hear – these little bugs that bring particularly dangerous consequences to patients in hospital who are not otherwise healthy.  But donning those annoying gowns, the awkward gloves and even uncomfortable masks is a must…ethically and clinically.

The nurturing of good habits around more common bugs will only serve us well if others like MERS or H7N9 become bigger problems.  When we are automatically observing good infection prevention habits we are poised well to respond to those truly scary viruses.

This always seems somewhat akin to safe driving practices.  Keeping a ‘two second’ distance from the car in front of you, limiting even (hands-free!) cell phone use and, of course, not drinking and driving – these are as simple and straightforward as washing your hands and donning a gown and/or a mask.  The trouble is, if you take a risk and decide everything ended up just fine, you develop a false sense of security that your shortcut – your shortcoming – is acceptable.  You experience a bit of luck – there may have been no accident when you drove after you took liberties.  Until, of course, your luck runs out and there is an accident of your doing.  Or there is an outbreak of MRSA or C. difficile because of the risks you chose to take.

The reasons why it is ‘good’ and ‘right’ to wash your hands regularly apply at all times and in all places – just like the reasons to refrain from texting while driving or from drinking and driving hold true always and everywhere.  In all these cases, we might make a judgement for ourselves that the risk is acceptable…but we have not asked the others we are also putting at risk.

Managing risk is much easier with good information, and keeping informed of global health concerns is really too simple to overlook.  Whether you are planning international travel or just wanting to be aware of what is happening, it takes little time to check the WHO website for the latest information.

For Ethicists, the prospect of a serious pandemic raises highly controversial issues of deciding who gets scarce healthcare resources like ventilators or ICU beds or vaccines, if they end up being in short supply.  The film ‘Contagion’ explores these possibilities in a very engaging drama based on the SARS experience.

Happily, there is rarely a shortage of hand soap or sanitizer or other essentials of infection prevention and control, including winter flu vaccines…but there is a shortage of the habits around using them. Again, the ethical issue revolves around the risks you take when your actions or inactions put others are at risk, too.  There are usually only very minimal risks associated with the flu vaccine; but the same cannot be said for the risks posed by the flu we might pass on to many of those for whom we care.  Vaccination ought to be a habit for most of us, just like routinely washing our hands.  (For more on the ethics of vaccination at work, see Jonathan Breslin’s November 2012 column here

The habits we form now will help protect us during the next inevitable winter flu season, due in the next few months.  These habits do save lives…now …and will save even more when some more deadly infectious threat fully develops in the future.