Thursday, January 10, 2013

The Epidemic around the corner

The outbreak of Norovirus in the UK has been greeted with the customary restraint and good sense we know so well from the British press. It is certainly an unpleasant infection, and anecdotal evidence suggests that it has been particularly nasty this year. Yet in fact the disease is relatively safe in that, in almost all cases, the symptoms will clear up quite quickly by themselves. 

However, the breakdown in several areas of the healthcare system that have come as a result of the outbreak should absolutely terrify us. If the infection was one that needed medical intervention in order to treat, then it is clear that the British NHS would struggle to cope. The benefits of large, centralised hospital centres of excellence, that are much touted for the treatment of non-infectious diseases, such as heart conditions or cancer, become huge liabilities when trying to contain a large scale outbreak of infectious problems, such as Norovirus. Healthcare professionals are amongst the first to succumb in such outbreaks, and this can lead to dramatic knock-on effects across the healthcare system.

Chronic infections, notably TB, are growing ever more difficult to treat, since they have developed resistance to a huge spectrum of anti-biotics. In some cases TB is becoming difficult, if not impossible to treat. We already have an increasing collection of multi-drug resistant pathogens. What happens if one of these drug resistant strains of virus or bacteria becomes as infectious as Norovirus? The answer is clear- an outbreak like the Spanish Influenza epidemic of 1918

The British NHS has been designed to a budget- and healthcare costs in the UK are rising significantly, both in absolute terms and in relative international terms. Yet the basic structure- larger and larger entities, both at primary care level and hospital level- is increasing the risks that a major outbreak of an infectious and difficult to treat pathogen could lead to a major public healthcare crisis. Already these large hospitals are reservoirs for drug resistant diseases, such as MRSA. It may not be long before the centralised model of healthcare in the UK leads to a meltdown.

The Norovirus is the writing on the wall, and the politicians are not nearly scared enough about what could happen. 

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