By all accounts ACT health authorities dealt with the HIV scare at Canberra Hospital by the book, insofar as there is a book by which these things can be dealt with.
The health worker who found out he or she was subject to exposure to the HIV and the hepatitis C virus acted promptly by notifying the hospital and withdrawing from work in any area which might pose a risk. The health worker later was tested positive.
Health authorities then very quickly assessed the risk and quickly came to the correct conclusion that it was better to notify the 250 new mothers who had undergone any procedures involving the health worker and to make the incident public. (It would, of course, inevitably have become public given the number of people involved.) It notification came by phone and then follow-up letter and came with an offer of fast-track testing and counselling. As it happens none of those tested have proved positive and only 10 of the women have yet to be contacted. In all, it is difficult to see what other steps the hospital could have taken.
It was unfortunate that the event occurred at this time of year when families usually are celebrating life — particularly this group of young mothers — rather than contemplating a life-threatening disease. Concern and support must go out to the health worker and all the women involved. But there are sound arguments that that is where the matter should rest. Certainly there should be no room for lawyers to get involved in class actions for pain and suffering on behalf of the women. There must come a time when society can say that misfortune just happens and there is no-one to blame and no-one to seek compensation from.
As to further preventative measures at the hospital, risk has to be balanced with cost, convenience and effectiveness. If one thing, this episode has shown that the hospital’s infection-control procedures have obviously worked. The Minister for Health, Michael Moore, has called for a debate on whether there should be compulsory testing of health workers. Maybe there can be a debate, but most of the arguments lie against testing. For a start, this case illustrates that health workers who find they might be at risk are almost certain to withdraw immediately from work that might bring them into dangerous contact because they are aware of the risks they pose others and are aware of their legal liability (both civil and criminal) if they continue.
In any event routine testing would not eliminate the risk. The HIV virus takes several months to cause testable anti-bodies to emerge in an infected person’s blood. They could be infected yet test negative.
Doctors, nurses and other health workers should not have to undergo routine blood testing — with its inconvenience, cost and danger of false positives — despite this case. Rather the case emphasises the need to remain ever vigilant about infection-control procedures and needle stick injuries. The case at Cooma Hospital involving poorly sterilised equipment posed greater risk and was a matter for greater concern than the events at Canberra. One danger of routine testing is that it might set up a false sense of security. In the knowledge that every health worker is being test, people might think there is no-one infected and might become less vigilant about infection control.