In January, the Centers for Disease Control and Prevention sent out an urgent public alert about a deadly bacteria, resistant to virtually every known antibiotic, that sickened more than a dozen Americans who had surgery at Grand View Hospital in Tijuana, Mexico.
But when similar outbreaks take place at U.S. hospitals, the CDC makes no such announcement. That is because under its agreement with states, the CDC is barred from publicly identifying hospitals that are battling to contain the spread of dangerous pathogens. The rise of a deadly drug-resistant fungus called Candida auris has raised fresh questions about such secrecy.
Patient advocates say authorities are often slow to alert the public about drug-resistant germs, potentially endangering patients. “Patients and their families have the right to know when they are at a hospital where an outbreak is occurring,” said Lisa McGiffert of the Patient Safety Action Network.
The CDC has declined to comment, but in the past has said its approach is necessary to encourage the cooperation of hospitals and nursing homes.
Hospital administrators and public health officials say the emphasis on greater transparency is misguided. Dr. Tina Tan, the top epidemiologist at the New Jersey Department of Health, said that alerting the public about hospitals where cases of Candida auris have been reported would not be useful because most people were at low risk for exposure and it could scare people away from seeking care. “That could pose greater health risks than that of the organism itself,” she said.
Art Caplan, a bioethicist at New York University School of Medicine, said the issue of full disclosure can be tricky, especially when large hospitals that see huge numbers of seriously ill patients are compared with smaller institutions. “If you’re a hospital of last resort, you’re going to see repeat customers with tough infections, many of them drug resistant,” he said.
Still, he said there was a greater value in promoting transparency. Public awareness about the lives lost to drug resistant infections, he said, could change the way hospitals deal with infection.
“Who’s speaking up for the baby that got the flu from a hospital worker or for the patient who got MRSA from a bedrail?” he asked, referring to a potentially deadly bacterial infection. “The idea isn’t to embarrass or humiliate anyone, but if we don’t draw more attention to infectious disease outbreaks, nothing is going to change.”