Corona Virus Sars 2 COVID Koan Prelude:Consumer Service over Contagion Paradigm, Global Body Warning

Corona Virus Sars 2 COVID Koan Prelude:  Consumer Service over Contagion Paradigm

Global Body Warning

2/15/2020

I got the text “can you work tomorrow?” That hooked me into the reality of why I would say no. I love my work in health care. But the trade off is too risky. This year I have battled against the ignorance of our health care system which forces clinicians to be stupid about Public Health Policy and contagious diseases in relationship to what I call the “consumer service over contagion” paradigm. The patient comes first and what they and their families want takes precedent over what is safe for us and the general population.

Autumn 2019 I was at work in a nursing home. We were beginning to have a couple of C. Auris patients. I had treated one of the first in greater New York City a number of years ago. That was in Queens. At that time, I didn’t know what it was. A very kind and knowledgeable physical therapist saw the affected patient’s name on my treatment roster. She grabbed me by the arm and told me the name of this new disease and to be extremely careful. The patient was marked for contact isolation, which is nothing unusual in nursing homes. You gown, glove and mask up. But the physical therapist said keep your distance this is not safe for you or any of us. If it hadn’t been for her I would not know anything. She instructed me to look it up as soon as I got home. I did. Life on the front edge of new diseases is precarious for all clinicians, if they are not told what they are dealing with by administrators and other leaders. I often cite this example because we now know how dangerous C. Auris is for staff and how deadly it is for patients. It is highly resistant to antibiotics and is a fungus that sheds off from a person’s body into the air through air exchanges and lives fairly long on all surfaces.

By 2019 I knew what to and what not to do with C. Auris patients. The first is to wear all protective equipment and limit exposure time with the patient and keep them inside their room. Yet what happened is almost impossible to describe. All kinds of protocols were breached. I blew the whistle about it and other clinicians where actually going to bring this sick C. Auris patient to the public treatment gym. I said no, no, no she can’t come to Rehab. One therapist brought this deathly ill, highly contagious person down to the gym. Everyone just cleared a path filled with horror, amazement, incredulity and disgust among other revulsions. This supposed highly trained therapist was wearing a yellow gown, facemask and gloves. She clearly did not know public health, this disease, and did not want to listen to me. I also had the same patient but insisted on seeing her in her room. This therapist was pissed at me and wanted me to accompany her in her stupidity. That did not happen. I stood my ground and I was right to do so. In a short time, the New York Times had a front-page story on Nursing Homes and C. Auris infections. The administration and therapists quickly snapped out of their ignorance. The learning curve was high for some of them.