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New York-area hospitals redouble efforts in face of anthrax death

New York City’s first case of inhalation anthrax last week killed a female hospital worker, shut down 30-bed Manhattan Eye, Ear and Throat Hospital (MEETH) and further challenged the nation’s already taxed public health system.

Setting aside concerns that they might be a terrorist target, New York hospitals stepped up their state of alert and focused even more intently on distinguishing early symptoms of the deadly disease from the everyday aches and pains of a terrified public. And, as in the days immediately following the attack on the World Trade Center, hospital officials hadn’t begun to assess the economic or emotional toll on their own operations. “We need to be very cognizant (of the dangers), as we were before,” said Susan Waltman, senior vice president and general counsel at the Greater New York Hospital Association. “Every case adds a level of knowledge that improves our ability to understand.”

Kathy Nguyen, 61, a supply room worker at MEETH died from anthrax in Lenox Hill Hospital, three days after she was admitted. She was already much too ill to help criminal and health investigators determine the source of her infection.

Nguyen worked in the basement supply room at the low-profile, primarily outpatient facility on the wealthy upper East side. Her case bewildered criminal and medical investigators searching for evidence that might link it to the random scattering of anthrax outbreaks in New York, New Jersey, and the district of Columbia and Florida. Until she fell victim, the investigation was focused on media and government offices and the US postal service. Now, all bets are off.

Erring on the side of caution, city health officials distributed antibiotics to more than 1,100 people, including more than 300 workers and patients who spent at least an hour in the hospital since Oct. 11. Nasal swabs were given to 28 employees who worked in the basement area near Nguyen. They all came back negative for anthrax.

Despite the negatives in all the testing performed, city health commissioner, Neal Cohen, MD, said recently that it would be at least ‘a couple of days’ before health officials even considered reopening the hospital. Whether the not-for-profit hospital has the wherewithal to bounce back from the loss of revenue after last week’s shutdown remains a question. In 1999 it was a hair’s breadth away from closing and selling itself off as real estate when the state attorney general’s office weighed in, saying the specialty hospital was too valuable a public health asset to lose. That year the hospital lost $16.8 million on $27 million in revenue, the most recent financial data available from its Internal Revenue Service filings. In 2000 MEETH discharged 1,458 inpatients and 7,385 outpatients, according to filings with the state health department. Through July of this year, it discharged 798 inpatients and 6,313 outpatients. Lenox Hill officials did not respond to requests for comment. Although the latest case hit one of its own, New York hospitals took the scare in stride, a measure of how much they have been through since Sept. 11. The city’s health department continued to pump out regular alerts apprising clinicians of guidelines as they developed. Doctors were advised that there were some occupational risks associated with the disease and to give more thorough work-ups to those patients. Earlier in the month, New York Mayor Rudolph Giuliani advised people to get flu shots to minimize confusion because symptoms of the viral infection have similarities to the early onset of pulmonary anthrax. The closest hospital neighbour to both Lenox Hill and MEETH, New York-Presbyterian provided some anthrax screening for MEETH patients in the first hours after the newest case was announced. At week’s end, Local 1199 of the Service Employees International Union, the state’s politically powerful healthcare union-which counted Nguyen as a member-briefed some 3,000 delegates representing its 220,000 members on anthrax and bioterrorism. The event was meant to allay fears and give frontline healthcare workers a chance to ask questions of public health officials and infectious disease experts. The healthcare union has taken a leadership role in the wake of the Sept. 11 terrorist attack, which has economically devastated several New York hospitals.

(Source:modern Healthcare Magazine)

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