The likelihood that any of the patients treated in Limerick or Letterkenny by a doctor who subsequently tested HIV positive will be infected, is small and can probably be fully discounted. The assurances given by the North Western and Mid Western health boards are categoric and backed by research which shows a negligible statistic for infection by health care workers, which vanishes to almost zero when others sources of infection in individual cases are taken into account.
This is good news for the 105 people involved who may have the additional reassurance that, whatever the statistics say, the specific circumstances of their operations will be known and thus whether there was any conceivable chance of transmission of the HIV virus. Though great strides have been made in understanding the nature of HIV, and the initial fears: that it could be passed on by casual contact or even by way of objects used by an infected person, have been long disproved, there is an understandable terror of a hidden disease which takes months to become evident and for which no cure is yet available. Myth can shape belief as powerfully in these days of high technology as it did in times of greater credulity.
To say that, is not to dismiss the anxiety of the hundreds of people who, according to reports, have telephoned the hospitals involved though they were not treated by the infected doctor. The two healthboards have contacted those directly concerned with an offer of counselling, and have taken the necessary steps to advise their GPs and allay the patients fears. Unfortunately, it will be several months before tests will be able to dispel these fears beyond any question.
However, there are a number of related matters which need to be resolved. The two boards did not arrange a press conference or release a public statement until after they had been contacted by The Irish Times which had received information about the incident. Even then, the statement referred only to a doctor, and the fact that he was a surgeon emerged in response to media questioning. Nothing could have been gained by failing to inform the public fully and at once in a society such as ours, rumour spreads like wildfire, and delay in publishing the facts adds to public confusion, besides being open to misinterpretation.
The Minister for Health, Mr Noonan, announced in the Dail yesterday that health boards will be required to test new health care employees for Hepatitis B. A vaccine is already available for this disease, and so legal problems that might arise in the case of other diseases, including HIV, do not prevent the test from being applied compulsorily. Infection is also more likely with hepatitis (B and C) than with HIV. The Minister said that legal and ethical questions were to be considered before extending compulsory tests. Obviously anything that can increase public confidence will be welcomed, though individual rights must also be protected.
Health workers are more vulnerable to infection than patients, and precautions to avoid it are routine. But inevitably some will become infected, through their work or otherwise. Is another potential employer entitled to know if a positive test takes place? However small the risk, patients, as in the Glasgow case reported yesterday, have a right to be properly informed.