Covid-19 and Legionnaires’ Disease in Healthcare : Prevention is better than cure
Amid the multiple lessons we have been learning globally from the COVID-19 pandemic one lesson is very old, tried and true: Prevention is better than cure. Or in simpler terms ‘it’s better to be safe than sorry’
Looking at the global tragedy that is COVID-19 it is clear that those who put effort into prevention have suffered less pain and suffering. Even countries with limited public health resources have succeeded in containing the damage by taking preventative measures – whilst some highly developed countries have suffered and are suffering catastrophic consequences.
“Out here, it's better safe than sorry, because generally speaking, too much of the time sorry means you're dead.”
- Patricia C. Wrede - Across the Great Barrier.
The Cure
The ‘cure’ approach is typified by statements like ‘it's not the problem it's how we fix it!’ and ‘we’ll deal with that when we come to it’. In the end you’ll need to ask yourself – ‘how did it get to be in need of a fix?’ and ‘how did it come to this?’ Often the answers to both questions are very expensive.
Lots of businesses make lots of money from providing cures for preventable problems. Vultures need a carcass!
Prevention
Prevention is always a hidden cost. It is really hard to put a value on things that you have prevented from happening. But in our everyday lives we often get glimpses of this.
For Instance: “I’m so glad I brought the washing in, before the storm”. At little cost – but the savings in time, effort, (soap, water - agitation - of both kinds!) are what you immediately realise and the prevention gives you peace of mind.
In the current COVID-19 climate we can all easily see that a vaccine (prevention and herd immunity) would be fantastic. Business would resume, people could interact – but we would never be able to calculate how much it saved us – financially, personally, economically.
It is interesting to find that financial institutions put a lot of time and effort into Risk Management. Corporate decisions in the business world are always informed by their Risk Management Strategies. They understand the value (economically) of prevention.
Prevention is cheap compared to cure, but often it can look like you’re paying for nothing.
Risk Management
In the discipline of risk management there is a term called ‘risk appetite’. It describes how far you want to bet on things going your way. A high risk appetite means you like to gamble, and a low risk appetite means the opposite. There are obvious parallels with financial markets - and how you invest your super!
In the current Pandemic environment most of us are risk averse (we’ve lost our appetite - and some of us are losing weight!). If that is true then prevention is a good option.
Taking it from a health risk management point of view (as opposed to financial risk), was your environment always high risk? If Health or Aged Care are your focus then it would be good to look at your risk appetite.
If you look at statistics on fatalities in Aged Care in Australia during the Covid-19 crisis (see below) there is little doubt you would be risk averse (lost your appetite?). The data below shows that the fatality rate in aged care is almost 50% - this is more than 10 times higher than the rate in the wider community. There is no sensible 'cure' option in these facilities - prevention is a 'no-brainer'.
If you were to look at Legionnaires' disease in aged care for the last 10 years you would find the statistics disturbingly similar, though the number of cases is much lower (fatality rate roughly 40% in health an aged care, 5-10% in the wider community).
So what has this to do with Legionnaires’ disease??
Susceptible populations
If you understand that your clients are high risk – then you must understand your own risk. In Health and Aged Care it is always, without doubt, high risk. There are little or no options for ‘Herd Immunity’ in these situations (see Blog on Herd Immunity).
The only option available in these scenarios is prevention. Recent reports globally suggest that the risk from Legionnaire’s disease in health and aged care has increased in recent years. Current reports are that these risks have increased further as a result of the Pandemic. Maybe we can explore why in another Blog.
ESGLI /US CDC / Australian Master Plumbers advisories
In the past couple of months reports from the ESGLI (European Study Group for Legionella Infections), the US Centers for Disease Control and the Master Plumbers association of Australia and others have all warned of the increased risk of Legionnaire’s disease cases in Health and aged care during the pandemic. All have urged facilities to pay attention to their Water Safety and Risk Management Plans.
So if you have a Health Risk Management Plan (or Water Safety Plan) make sure it is active and current. If you don’t have one, then work out your risk appetite. No-one expected COVID-19 – and in our experience no-one expected Legionella contamination and Legionnaires' disease.
Just so you don’t think this is a ‘scare tactic sales pitch’ we’ve attached the relevant documents. Read them at your leisure. As an ISO accredited organisation we are accountable for the veracity of anything we present to our clients.
Further Reading
Centers for Disease Control. https://www.cdc.gov/coronavirus/2019-ncov/php/building-water-system.html
ESGLI (European Study Group For Legionella Infections).
Aged Care:
https://www.health.gov.au/resources/publications/covid-19-national-health-plan-aged-care-aged-care-preparedness Accessed 19/6/2020
Master Plumbers Association of Australia. https://www.mpasa.com.au/feature-stories/?/i/766
