The death of Ms. MacNeil, a remarkable woman who overcame poverty, sexual and physical abuse, depression, addiction and obesity to become a star, should not only make us sad – it should make us angry.
Angry because it underscores the scourge of hospital-acquired infections; angrier still because we have missed a glorious opportunity to take a larger lesson from her death, one that is a fitting tribute to a singer who was a social activist.
Hospital-acquired infections sicken 250,000 patients annually and kill between 8,000 and 12,000 Canadians. The bugs patients catch while in care are one of the leading causes of death in this country; they kill twice as many people as breast cancer.
Many, but not all, of the deaths are preventable. After all, people who are in hospital are often gravely ill; they are susceptible to infections. Sometimes, an infection can even bring about a merciful death: For a long time, physicians called pneumonia the “old man’s friend” because it is a relatively painless death.
But people dying of hospital-acquired infections are not all frail seniors and not all are dying painlessly. They are suffering – and suffering horribly – from increasingly difficult-to-treat bugs like Clostridium difficile (where you essentially defecate to death) and methicillin-resistant Staphylococcus aureus (MRSA), which causes painful boils and can lead to the shutdown of your organs. These pathogens are increasingly resistant to treatment.
We need to be careful not to point fingers of blame but, at the same time, we cannot simply ignore some damning facts.
One of the greatest dangers after surgery is infection. The surgical wound can be a point of entry for a lot of nasty bugs. This is particularly true for patients with cellulitis. Their wounds must be cared for meticulously because, paradoxically, when you are being treated with antibiotics, you become more susceptible to infection.
During Ms. MacNeil’s stay, part of the hospital was closed because of an outbreak of Norwalk virus. In that same period, several patients contracted MRSA.
These are not airborne infections. There are two principal routes of spread of hospital-acquired infections: shared toilets combined with inadequate housekeeping and health professionals who don’t adequately wash their hands.
The Cape Breton Regional Hospital, where Ms. MacNeil was treated and died, has a troubling patient safety record.
When the Canadian Institute for Health Information published the first hospital standardized mortality rates (a comparison of expected deaths and actual deaths), the CBRH had the worst record in the country – with a mortality rate 37 per cent above average. (And let’s not forget that the average rate in Canada is pretty poor to begin with.)