NOTE: This article was originally published in April 2003 and remained on the website for well over a decade. It was archived and not carried over during a website update a few years ago. It is being republished March 2020 in light of the Coronavirus COVID-19 pandemic. Other than this paragraph, adding the words “Coronavirus COVID-19”, and updating the links at the bottom of the page, the article is exactly as it first appeared in April of 2003.
Long before September 11, 2001 experts were warning that the greatest post cold war threat to America was unlikely to be nuclear annihilation, war, or conventional terrorism, but an intentionally caused or naturally occurring biological outbreak or epidemic.
Anthrax and now more alarmingly SARS (Severe Acute Respiratory Syndrome) serve as chilling proof-of-concept examples of just how accurate medical experts and authorities have been. Even though the terrorists attacks of 9/11 took us “by surprise” the agents and instruments of those attacks, hijackers intent on flying commercial airliners into buildings, were visible and thus “controllable.” The attacks of 9/11 were quickly contained once the public, passengers, and government authorities realized what was happening.
In contrast to traditional threats, biological agents can be difficult or impossible to detect in the context of people going about their daily routines at work and at home. Recent experience with Anthrax and SARS demonstrates that we can come into contact with and be infected by a biological agent, but that considerable time may pass before symptoms appear. During that time many other people may become infected.
The Anthrax attacks proved that a biological agent could spread with relative ease before being contained. Fortunately those attacks were “small” in scale. In today’s environment of global business and travel SARS has demonstrated that a biological agent can quickly spread Worldwide. Only weeks after SARS first came to the attention of World health experts the WHO (World Health Organization) has, for the first time in history, recommended a ban on unnecessary travel to those areas in China considered to be high risk.
The most unique thing about experts’ warnings of America’s vulnerability to biological outbreaks is that a major reason for their concern rests not with federal, state, or local authorities, but with our own actions as individuals. Three factors are frequently cited to illustrate why a biological outbreak could spread easily:
Our poor track record when it comes to hand washing.
Our habit of continuing to show up at work and visit others when sick.
Thanks to modern transportation: the ease of travel, and thus the ability to spread infections across the country.
Anthrax traveled across the country and abroad via the mails. SARS has been spread Worldwide by business and leisure airline travelers. On the other two points: it is up to employers to stop the common practice of expecting or allowing sick employees (or those with symptoms) to come to work where they can spread infections to others. It is up to each one of us as individuals to practice preventative hygiene and especially to wash our hands, often. It is also up to us as individuals to recuse ourselves from going to work or visiting others when we are sick, or suspect that we might be.
Sick workers cost employers more than $250 billion annually in lost productivity. AdvancePCS is just one organization that has researched this issue. According to a recent study the majority of that cost, over $180 billion, is attributable not to sick employees absent from work, but from employees who continue to report to work even though they are sick or otherwise unable to perform at peak efficiency.
Research by the IHPM (Institute for Health and Productivity Management) indicates that respiratory illnesses like the common cold, flu, and pneumonia are the third leading cause of workplace sickness. SARS also happens to be a respiratory illness.
The CDC (Centers for Disease Control and Prevention) estimates that more than 2 million Americans acquire an infection in hospitals each year and that half of these infections are preventable by proper hand washing. Hospital-acquired infections cause or contribute to almost 100,000 deaths annually.
Other studies by the CDC show that when asked via survey doctors and nurses claim they wash their hands up to 80 or 90 percent of the time. But when observed in the workplace, they actually wash their hands only 30 to 40 percent of the time.
A careful study by the Chicago Tribune found that since 1995 more than 75 percent of all hospitals have been cited for serious cleanliness and sanitation violations. The same study indicates that the estimated figures from the CDC, cited above, may be too conservative. Even using the more conservative figures from the CDC, at least one person dies every 6 minutes due to an infection that could have been prevented.
Each year an estimated 80 million Americans fall victim to food poisoning. Foodborne illness kills more than 10,000 people each year according to the FDA (Food and Drug Administration). Seventy percent of all outbreaks originate in foodservice operations, and up to 40 percent are the result of poor hand washing and cross-contamination.
There has been a 58 percent increase in infectious diseases in the United States over the last two decades, according to Elaine Larson, PhD, RN, a professor at Columbia University’s School of Nursing and School of Public Health in New York.
The American Society for Microbiology studied people using restrooms at New York’s Grand Central and Penn Stations and found that only 49 percent washed their hands. As was the case in the surveys of doctors and nurses, there was a big disconnect between how often people say they wash their hands, and how often they actually do. In a random telephone survey conducted at the same time, 95 percent of Americans claimed they wash their hands after using public restrooms, and about 75 percent claimed to wash before handling food or after changing a diaper.
It is now a well known fact that people should wash their hands often. The majority of people say they do, but study after study indicates that in practice we fail to wash our hands when we should. Worse, the situation hasn’t improved. People, whether at home, in the workplace, or at the hospital, aren’t washing their hands any more often than they did when earlier studies were conducted a few years ago.
Taking all of these well studied and well documented facts into consideration, is it any wonder that when it comes to the potential outbreak of an infectious agent we may very well turn out to be our own worst enemy? The American Medical Association (AMA) put it this way: ‘What are the ten most deadly weapons?” the answer wouldn’t be “guns” or “drugs” or “knives.” It would be “hands.’
CDC Director Dr. Julie Gerberding put it no less directly when she was quoted as saying: “Your hands are the most important means from which germs travel from one person to another,” and “Handwashing is the single most important means of preventing the spread of infection.”
Besides not going to work or visiting others when we are sick or think we might be, and employers recognizing the costs and dangers of encouraging sick workers to continue to report to work, the following suggestions from the CDC and the AMA may very well mean the difference between America’s survival or downfall in the event of an outbreak of a serious infectious agent.
If your hands haven’t been washed, try to avoid unnecessarily touching your eyes, nose, or mouth, especially if you know you’ve touched a potentially infected person or unclean surface. Wash your hands often, especially before, during, and after you prepare food; before you eat, and after you use the bathroom; after handling animals or animal waste; when your hands are dirty, and even more frequently when someone in your home (or workplace) is sick. Don’t cough or sneeze into your hands. Also remember that if you wash your hands and then turn off the bathroom faucet or open the door with your “clean” hands you’ve just defeated the purpose. Use your elbow or a paper towel instead.
You may learn more by visiting the Internet links below:
Handwashing - Clean Hands Save Lives | CDC:
https://www.cdc.gov/handwashing/index.html
Henry The Hand Foundation - True Flu Prevention:
https://www.henrythehand.com
Clean Hands Campaign | Florida Department of Health in Sarasota:
http://sarasota.floridahealth.gov/programs-and-services/wellness-programs/clean-hands-campaign.html
The article “When You Can’t Win For Losing!” was also originally published in April 2003 and is a companion piece to this one.
This article was originally published in April 2003 at a different (shorter) URL and title:
Preventing What Comes Next: Anthrax, SARS, And The Role Of Employers And Individuals
https://www.grpmax.com/oped/handwashing1/