‘No need’ to tell the public(?!?)

When Andrew and I wrote The New School, and talked about the need to learn from other professions, we didn’t mean for doctors to learn from ‘cybersecurity thought leaders’ about hiding their problems:

…Only one organism grew back. C. auris.

It was spreading, but word of it was not. The hospital, a specialty lung and heart center that draws wealthy patients from the Middle East and around Europe, alerted the British government and told infected patients, but made no public announcement.

“There was no need to put out a news release during the outbreak,” said Oliver Wilkinson, a spokesman for the hospital.

This hushed panic is playing out in hospitals around the world. Individual institutions and national, state and local governments have been reluctant to publicize outbreaks of resistant infections, arguing there is no point in scaring patients — or prospective ones…

Dr. Silke Schelenz, Royal Brompton’s infectious disease specialist, found the lack of urgency from the government and hospital in the early stages of the outbreak “very, very frustrating.”

“They obviously didn’t want to lose reputation,” Dr. Schelenz said. “It hadn’t impacted our surgical outcomes.” (“A Mysterious Infection, Spanning the Globe in a Climate of Secrecy“, NYTimes April 6, 2019)

This is the wrong way to think about the problem. Mr. Wilkinson (as quoted) is wrong. There is a fiduciary duty to tell patients that they are at increased risk of C. auris if they go to his hospital.

Moreover, there is a need to tell the public about these problems. Our choices, as a society, kill people. We kill people when we allow antibiotics to be used to make fatter cows or when we allow antifungals to be used on crops.

We can adjust those choices, but only if we know the consequences we are accepting. Hiding outcomes hinders cybersecurity, and it’s a bad model for medicine or public policy.

(Picture courtesy of Clinical Advisor. I am somewhat sorry for my use of such a picture here, where it’s unexpected.))

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