Highly-Infectious Disease And Hospital Workers

By Karl Denninger, The Market Ticker

Folks, we have to cut the bull**** right now.

We do work with very dangerous viruses all the time.  We have to.  We use truly extreme measures in doing so too, because the risk of a mistake, if made, is catastrophic to the person involved and, if the virus is person-person transmissible the outcome could be horrifying.

We do this sort of work in labs where strict controls are found.  Think “Andromeda Strain” sort of lab.

There is not a hospital in the world that can maintain that level of isolation successfully.

Hospitals, generally, are not set up much to deal with highly-infectious and serious disease.  Blood-borne diseases are one thing; there you need direct exposure, which means needle sticks and things like that. Diseases where vaccinations are available are another; health workers can be required to have proved immunity in the form of proof of vaccination.  That works.

There are a handful of hospitals that are capable of treating Ebola patients.  So far none have had a breach.  But their capacity is very, very low.  In addition Ebola is not generally airborne and that makes it materially easier.  Ebola-level isolation is actually not enough for this virus to stop transmission to the health care workers yet even that level of protection is simply impossible to provide for thousands of people.  For a handful that present while returning from the US, yes.  For the general US population?  Not a snowball’s chance in Hell; we have neither the facilities or the staff.

There is no vaccine for this and one is never likely to work, despite the screaming.  We’ve heard that lie out of the NIH, CDC and medicine before.  There are times it is truthful but coronaviruses are not one of those areas.  There is no record of such a successful vaccine with permanent immunity for coronaviruses and despite “the flu shot” that fails an awful lot of the time too.

Reliance on such is just flat-out insane.

There’s some evidence that the method of action of this virus in the body leads to the potential for extraordinarily contagious “windows”, likely coinciding with active symptoms, and low but non-zero infection capacity otherwise, at least in droplets.  There is also plenty of evidence this virus is fecal/oral transmissible going all the way back to the first reports out of Wuhan, and that’s nasty because some of the higher R0 viruses historically have been transmitted in such a fashion (e.g. Polio, R0 of approximately 5.)

Health care workers cannot social distance and do their jobs.  PPE is not a panacea; other than a “moon suit” with positive-pressure ventilation it’s inadequate when you have an actively-infectious patient and an easily-transmissible infectious agent.  There’s no way in hell you can run a hospital with everyone kitted up in a moon suit, connected to positive-pressure clean air sources.  Forget it.

We keep seeing the same stats.  A small number of cases which do not follow the expected geometric progression, then a sudden explosion.  When reporting is actually done we see patterns where a huge percentage of the “first infected reports” are in hospitals.  Medical workers in hospitals are a tiny fraction of the entire population and yet they often make up 1/5th to a 1/6th of the original infected population sample.  This has happened repeatedly, beginning in Wuhan.

(FOX 9) – State health officials say one in five of the confirmed cases of COVID-19 in Minnesota are health care workers. 

Of the state’s 503 confirmed cases of the coronavirus, 133 are health care workers, according to the Minnesota Department of Health. 

The data says that what is happening is that this virus spreads in the population but slowly until health care workers get it in a hospital, pass it around and then back into the general population as they are exempt from all of the social mandates.  In cities with strong public transportation systems it’s even worse as they can spread the love on buses and trains.  While doctors may drive their nice cars orderlies and nurses are another matter, never mind that some of them are likely coming to work while sick and thus transmit back to the patient and other worker population, if any don’t already have it, whether they realize it or not.

Minnesota is almost-certain to get reamed

The data proving this is clear.  When New York implemented its “shelter in place” and other towns and cities implemented “social distancing” we should have seen an immediate collapse in the R0 in those areas.  We did not.  We’ve seen a change — about 0.4-0.5 on a national basis and approximately the same in NY, but out of 2.5-3.0 it’s clear that casual social interaction being cut by 90% or more for the common person on the street is not stopping the transmission.

You can work in a warehouse and not get within 6′ of anyone.  You can stock grocery shelves and do likewise.  And if you’re laid off and staying mostly at home, since everything you want to do is closed, well, it’s you and your cat. And so on.

So who’s that leave?

HOSPITAL WORKERS who by definition cannot socially distance and do their jobs.

Singapore identified this immediately and stopped the madness by mandating washing of hands with soap and water, not so-called “sanitizers”, before and after each contact with a person or thing that could potentially be infected.  By doing that they dropped the infection rate of their hospital staff to a statistical zero and almost immediately thereafter the outbreak there was under control.  They still get a case here and there, but the simple fact is that despite the screams of horror about community spread the facts are that it isn’t that easy for social transmission of this bug to take place, except through super-spreading events.

If it was then the mitigating factors would have had an immediate and dramatic impact, and they have not.  Further, Singapore couldn’t have stopped transmission to health care workers by mandating strict hand hygiene standardsbut they did.

We have repeatedly seen this pattern — where you have a case here and there, a few people show up in the hospital and then the sudden exponential explosion occurs after failing to follow the predicted geometric progression for weeks — and it happens in city after city.  “Social distancing” doesn’t stop or reverse it and neither do “stay at home” orders, even when backed up with the threat of fines or worse. 

We must stop the madness; the data on where the spread is happening is clear.

I have posted several times the basic mantra from what Singapore learned: ******n it, wash your hands!

Well, that apparently doesn’t even manage to register.  It also gets me hate mail since I’m “attacking” the “heroes.”

You’re not a hero if you’re contracting, and thus becoming infectious, in a hospital from the bugs the patients have.  You’re a zero because by definition you can be, and probably are, giving it to others — and quite probably a lot of of others.

And don’t tell me medical workers, including doctors and nurses, wash their hands in hospitals generally.  They most-certainly do not.  My dentist’s office is better at it (and yeah, I pay attention to it too) but in no hospital I’ve ever been in attending to family members and friends has every doctor and nurse, when entering the room, washed their hands right there, done whatever, and then done it again on the way out.  Never once.  Not when my mother was in having cancer surgery (!!!), not when I was visiting my sister in step-down, not when other family members and friends have been in a hospital, never, ever, anywhere with that protocol, period.

The only other way to stop this transmission is to arrange so all Covid patients go to hospitals (whether field expedient or otherwise) where nobody is allowed in the building unless actively ill, in which case they can’t leave until not, or proved seroconverted by antibody test and thus immune.

We will not stop the outbreaks until we stop this.  If we’re not going to do it here and now we’re far better to take the hit now coming into the spring and summer than to get hammered in the fall when co-infection with ordinary influenza will kill many more than would otherwise die.

Karl Denninger