A few weeks ago, my blood boiled.

If you hadn’t heard by now, the Toronto’s Women’s College Hospital decided to ban magazines from their waiting rooms.  The reason was, as apparently posters around the hospital declared:  “reading material spreads viruses and infections.”  (CBC News article here)

I understand the need to reduce infections in the hospital and the fact that community introduced infections are becoming a greater priority, even though few would dare to blame visitors for bringing infections into a healthcare facility.  However measures such as banning reading material, which for some is the only respite from the emotional suffering that is waiting, are at odds with the concept of health and hygiene promotion as well as the understanding of corporeal ecology.

In essence, the authorities are rebuking the efforts of the majority who practice good hygiene and capitulating to a minority who believe in what can be best described as rugged individualism.  This mindset is based on the knowledge that an individual knows better than the experts and that they can do a better job making decisions and taking actions. Not surprisingly, rugged individuals have been around since the dawn of health care and continue to hamper and put obstacles in the way of progress.

To be honest, this aspect of the decision making process wasn’t the reason I got angry.  In fact, I can appreciate that in some cases, one bad apple can mean changing an entire system.  We’ve also seen that in Ontario at least, strict and severe measures have been necessary.  Just think of the SARS outbreak and it becomes evidently clear that we do live in a “new normal“.

It was another facet of this decision that sent me over the edge:  as far as I could tell, there existed little to no science to support it.

Based on the comments from the authorities, there is apparently a significant risk of pathogen transmission from magazines.  A quick search of the literature suggests otherwise.  In fact, in 2005, a group in Norway thought the same but actually conducted a study to find out whether there was a risk.  Not surprisingly, waiting room magazines had low risk of transmission.  But that’s not all, just this year in June, a well-regarded team out of North Carolina published a paper that looked at the gambit of environmental surfaces in the hopes of looking for the risk of transmission of the two most egregious pathogens, human norovirus and Clostridium difficile.  Yet even this study did not even think to look at magazines as a potential surface for transmission.

So, why then did the Toronto authorities make this decision?  I wish I could tell you.  All I can suggest is that there exists a culture in where decisions that impact the public can be defended without any actual proof.  And while this example may only lead to a few more people bringing their i-machines to their doctor’s appointment, there are potentially more severe consequences.

In Ontario, there exists an advisory board for the prevention of infections in hospitals called the Provincial Infectious Diseases Advisory Committee (PIDAC).  Last year, PIDAC released a document outlining how cleaning should be done in hospitals.  What I found was that in places, the same kinds of decisions without proper scientific evidence were being made.  I actually had a chance to challenge the PIDAC members on this and to my surprise, there was little to no care for my concern.

To put it more concretely:  The same rugged individualism that led to the decision to remove the magazines from waiting rooms was being demonstrated by the decision-makers themselves.

That’s why I lost it.

I understand that there is a system and a process for decision making and I am more than happy to get involved in the process, make contributions and abide with whatever decisions are made.  But the fact is that both in the PIDAC situation and now with the magazine ban, I don’t see any real attempt to ask the true experts in the field. Many individuals have a good understanding of a topic; but the true experts are the ones who should be made available and asked to contribute so that every possible question could be asked, answered and documented.  And while I may seem like I am griping here, I want people to understand that I’m grateful for any involvement that I am afforded yet understand at the same time that in so many arenas of infectious disease, I’m not the expert.  But I know that those experts are out there and that they are willing and able to help.

Sadly, as long as the rugged individualism that I witnessed continues to rule the roost I’m afraid that the true experts will continue to be forgotten and that unfortunate decisions such as the magazine ban will be made much to the ire of those who know better.