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The Wages of Austerity: Superbug Runs Wild in Greek Hospitals

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Many writers tend to depict the effects of austerity in purely economic terms: loss of wealth and income, lesser income/social mobility. But depressions and accompanying changes in social norms can and do have more serious consequences.

A story in Bloomberg illustrates how the combination of budgets slashed thanks to austerity policies leads directly to deaths. The Wall Street Journal described last year how distress in the Greek economy had produced a significant increase in suicides. A new Bloomberg story recounts how severe cutbacks in hospital staffing have enabled superbugs that is hard to combat even under normal circumstances to inflict even more fatalities than usual in Greek hospitals. An ugly side to this problem is that overreliance on antibiotics in Greece created the conditions that helped these potent infectious agents to develop.

From Bloomberg:

Greek doctors are fighting a new invisible foe every day at their hospitals: a pneumonia-causing superbug that most existing antibiotics can’t kill.. The hospital-acquired germ killed as many as half of people with blood cancers infected at Laiko General Hospital, a 500-bed facility in central Athens.

The drug-resistant K. pneumoniae bacteria have a genetic mutation that allows them to evade such powerful drugs as AstraZeneca Plc’s Merrem and Johnson & Johnson’s Doribax. A 2010 survey found 49 percent of K. pneumoniae samples in Greece aren’t killed by the antibiotics of last resort, known as carbapenems, according to the European Antimicrobial Resistance Surveillance Network. Many doctors have even tried colistin, a 50-year-old drug so potent that it can damage kidneys…

Greece has the lowest nurse-to-patient ratio in Europe and one of the highest rates of antibiotic use — and abuse — on the continent, hindering the attack on the infection…

The superbug, dubbed KPC, first appeared in Greece in 2007 after spreading through the U.S. and then Israel. By 2010, Austria, Cyprus, Hungary and Italy were also experiencing an increase in cases, the European Centre for Disease Prevention and Control said in a surveillance report in December.

In the worst outbreaks, as many as half of the people who develop a blood infection due to KPC are killed…

While Greece is striving to curb KPC, the country faces fewer problems with multi-drug resistant, so-called Gram- positive bacteria such as methicillin-resistant Staphylococcus aureus, the superbug better known as MRSA, than do other nations, said Spyros Pournaras, an associate professor of medical microbiology at the University Hospital of Larissa…

“We have problems,” he said in an interview in Athens. “But let’s not generalize that we’re a threat for Europe.” Greece also doesn’t have so-called Gram-negative bacteria with gene mutations known as NDM, IMP and OXA-48, which are common elsewhere, Pournaras said…

Another issue is the lack of nurses, Dimopoulos said. For example, an overworked nurse might change a catheter or a wound dressing without washing her hands, he said — a prime opportunity for bacteria to hop from one patient to another.

He held up his hands. “This is number one,” Dimopoulos said, for transmission of the bacteria. “This and the stethoscope.”

I don’t know about you, but this has a Dickensian sound to it. People dying in due to chronic hospital understaffing sits uncomfortably with the pristine, efficient image of modern medicine. But this is far from the only instance where the crisis has served to reinstitute a more brutal social order.

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46 comments

  1. Sy Krass

    We’re all screwed. Total morons are in charge. Don’t for a second believe its a conspiracy, it’s total and complete incompetence. That and politicians lining up to bend over and get a bankster’s tiny little pr!@k shoved up there collective a$$.

    HAHAHAHAHA!!!!!!!

    1. scraping_by

      I think the phrase you’re looking for is “criminal indifference.” Which is not an oxymoron.

      When you’re crushed beneath the Marquis Evrémonde’s carriage wheels, it doesn’t matter they weren’t aiming for you.

      1. Praedor

        “Criminal indifference” is just that, criminal, and is an offense the deserves/must have arrest, conviction, and internment as a punishment.

        Plus the confiscation of all personal ill-gotten wealth the convicts acquired via their criminal indifferent policies.

    2. Maximilien

      @Sy: Incompetence? Yes, but a special kind of incompetence. At the very highest levels of governance (public and corporate) there are no incompetents of the stupid, bumbling sort. Those were long ago weeded out.

      The ones that are left are the more dangerous, because they exaggerate their competence. They harbor grandiose and unrealistic ideas of it. They refuse to admit they don’t know. They lie to hide the fact. Thus they move blindly but confidently toward catastrophe, unmindful of consequences. They are, in short, psychopaths.

      For the curious, the Hare Psychopath Check List (Revised):

      Factor 1: Personality “Aggressive narcissism”
      Glibness/superficial charm
      Grandiose sense of self-worth
      Pathological lying
      Cunning/manipulative
      Lack of remorse or guilt
      Shallow affect (genuine emotion is short-lived and egocentric)
      Callousness; lack of empathy
      Failure to accept responsibility for own actions

  2. Jeffrey

    “Go ahead, wash your hands, I’ll wait”

    That’s a phrase that could save your life.

    It’s the line that I use on anyone first walking into an examination room prior to touching me in a medical situation.

    Another thing, NEVER EVER let a nurse give you an injection unless you see them withdraw the liguid from the bottle in front of you. Ask her to read the bottle label to you.

    Had a nurse walk into the examination room with a syringe already drawn lying on her tray. Just as she was about to inject it, I asked, “what’s that”…Oh it’s XYZ”
    “I’m supposed to get TUV”…
    “Oooohhhhh…sorry”.

    1. LAS

      That’s good practical advice to apply. Seems simple, but controlling for other people’s action is tricky.

    2. Ken W

      When someone in my family has to spend time in the hospital, we take turns being with them. We know the nurses are short staffed. This enables us to help with the patient’s comforts and to eliminate delays when a nurse is actually needed. It also helps to make sure that all the questions get asked and answered.

  3. Francois T

    I’ll bet my last n’gwee that Greek elites go to well staffed hospitals and never see that kind of problem.

    1. Mark P

      Many of the Greek elite took the money and ran with it to places like London — as one finds out when one talks to Londoners about who’s buying up prime London property — and so they won’t have to worry about using _any_ Greek hospitals.

      1. Another Gordon

        And even when the elite stay in Greece their experience is comfortably different.

        I have a distant connection with an expatriate Greek whose family lives in one of Athen’s best ssuburbs – just down the road from a couple of cabinet ministers in fact. When I asked him a few weeks ago how his family were affected by the situation his replied, “I don’t think it’s made any difference really”.

  4. Zhu Bajie

    Expect all kinds of water-borne and mosquito-borne diseases to make a come-back in the US. You can be sure that lots of tea-bagger-type local governments won’t want to spend money on cleaning water, disposing of sewage safely, mosquito control, etc. After all, only bad people get sick! Once sick, they can get treatment by their local Benny Hinn/Oral Roberts imitators!

    1. pws

      In the documentary, American Casino, they were showing how large, abandoned, foreclosed homes in California were becoming breeding grounds for West Nile virus because no one was taking care of the swimming pools in the backyards.

      If God decides to laugh at all us sinners, the Apocalypse will come in the form of a superbug that gets into the world population due to Greek austerity.

    2. bluntobj

      Indeed, god forbid that we are able to actually use effective and inexpensive chemicals that can quickly kill harmful insects!

      You know, the kind that tree-hugging liberals banned because they were harming the environment? (And it’s a good thing they did so.)

      Perhaps less sarcasm about “tea baggers” concerned about spending the dwindling financial resources effectively would be warranted. Especially since the majority of government costs are driven by employee expenditures stipulated in union contracts which take money away from disease control efforts you cite.

      Culling stereotypes from thought processes will make the thinker more resistant to AF memes and norms that are being pumped out into the mediasphere, and more responsive to the early stages of collapse that we’re in now.

      1. different clue

        Are you not even aware that the superbugs of which this comment speaks are drug immune bacteria called into existence by the misuse and abuse of modern antibiotics? How did you confuse yourself to think we were talking about insects here? Do you really believe that the display of such thoughtless confusion on your part will enhance the percieved credibility of your comments here on these threads?

  5. scraping_by

    The difference between the “developed” world and the “developing” is a lot thinner than popular attitudes suggest. It’s a difference of material economy, no matter how much the talk about social capital comforts liberal arts professors. Making bricks without straw, indeed.

    It’s latest example of moving money around affecting the real economy, and thereby, the real world. More to follow.

    Them today, whom tomorrow?

    1. j.grmwd

      Indeed, people don’t realize how quickly and easily an economy can be comprehensively trashed. I think the example of Mongolia is instructive. In 10 years, starting from 1989, industrial production in most sectors declined by over 90%. Agricultural productivity declined 50%. And 10% of the population returned to a completely pre-modern nomadic herding lifestyle. That’s the fate in store for Greece if it doesn’t stop the rot. Once an economy is that far gone the path to redevelopment becomes almost impossible.

  6. j.grmwd

    It’s the illogic of austerity that makes me want to scream. One attempts to correct a 20 billion imbalance of imports over exports ( representing only 6-7% of GDP) by deflation, foregoing several times more domestic economic activity in the process. Some of it literally life-saving, and requiring nothing more than a mop, a bottle of dettol, a pair of willing hands, and a sovereign currency to perform.

    1. bluntobj

      “Sovereign Currency”

      Hit it on the head there. A default and an ejection of the Euro would give Greece the best chance of survival.

      Unwillingness to let elites take their losses will be the ultimate cause of collapse in any civilization.

  7. Middle Seaman

    Both the US and Europe have slipped easily into oligarchies controlled by banks and other moneyed honchos. The needs of the 99% are ignored and the services provided to us either froze at a decade ago levels or even decreased. This implies a lot of suffering by many.

    In all likelihood, it’s neither criminal neglect nor incompetence. Obama, for instance, was and is the ambassador of the 1% to the 99%. His job is to protect and defend the privileges of the 1%. He does it well. The same is true, with some country differences, of Europe.

  8. A.Lizard

    Public health services were essentially created by elites who realized that diseases allowed to run loose in the lower classes would inevitably wind up attacking the elites.

    Where did the elites of today get the idea that diseases respect social classes? It’s only a matter of time before those superbugs follow them wherever they go and regardless of how good or expensive their hospitals are.

    While the elites may have only the best doctors, the nursing assistants and janitors are part of the 99% they’re encouraging the spread of disease among through malign indifference.

    Call it Darwinian incompetence among the elites.

    1. Praedor

      When one’s slaves/servants contract a plague, it must (and should even be encouraged by the sick) eventually reach those who own the slaves/servants. The 1% needs to be plagued out of existence so productive people can finally get somewhere.

    2. pws

      I think the elites figure that their own extinction and that of the whole human race is preferable to them having to give up one penny of their ill gotten gains.

    3. Jean

      I frequently wonder how the 1% believe they can eliminate medical care for the 99% and still maintain it for themselves. The elite seek out the best talent/experience, but that level can only be reached by long years of work on the multitudes, including lots of the unwashed masses.

      And lurking in the wait will be the recurrence of the air-borne disease, tuberculosis.

  9. lambert strether

    Well, putting on my tinfoil hat, and making the obvious joke, some might regard this as a feature.

    Life expectancy dropped drastically in the Soviet Union when the oligarchs took over, so why shouldn’t we regard this as a desired policy outcome, like permanently high unemployment in this country?

  10. Jean

    Americans are still facing many critical shortages of injectable generics, seriously compromising effective treatment. We continue to pay massive amounts of money for our insurance coverage, but should the need arise, we may find the medicine we need is simply unavailable at the time we need it.

    It is a complicated issue, with no clear cut answers, but increased public attention to the problem is absolutely necessary.

    http://www.nejm.org/doi/full/10.1056/NEJMp1112633

    1. Praedor

      There ARE some clear-cut answers: ban drug advertising on TV. What the F*CK are big pharma companies doing advertising drugs that only doctors can prescribe to regular people?! BULLSHIT.

      Ban the creation of new diseases that “need” pharmaceutical treatment. Big Pharma has orphan drugs that are less useful than old, non-patent-protected (patents ran out) drugs, or no more useful, and they keep peddling them or creating new “diseases” to get people to “ask your doctor about X”. No more.

      Mandate that Big Pharma GUT their marketing departments and expenditures. They actually spend far more on marketing than they do on drug development. Worse, MOST drug development is done in public universities using PUBLIC monies (grants) that Big Pharma then has the audacity to claim (and whine) that THEY spend bazillions on drug development. NO THEY DON’T. Public funded research is NOT an expenditure for Big Pharma to claim for its own purposes.

      Mandate that drug companies, for the PRIVALEDGE of selling their drugs in the market MUST produce a certain amount of generic, no-longer-patented-but-no-less-needed drugs.

      Allow Medicare to negotiate drug prices. Period. End of story.

      Finally, NO MORE CHARGING AMERICANS MORE THAN EVERYONE ELSE.

    2. bluntobj

      Given that only 2 nations in the world do not regulate drug prices, I would wonder what the price of drugs would be if two things occurred:

      1. The price of pharmaceuticals could float freely.
      2. Certified Pharmaceuticals could cross borders easily.

      Boy, that resembles most economic issues today, doesn’t it? Price controls, restrictions on imports and exports, only one market to actually make your money in…

      Just as we subsidize world military expenditures by (wrongly) acting as “world peaceforcers”, we also subsidize the cost of pharmaceuticals for the world by putting up with their subsidies of their drug programs that, in part, leave our people caught in a skyrocketing costly medical system.

      Control, mandates, subsidies, torts, legal, insurance, regulation = formula for unaffordable and deadly medical care.

      Cash basis medicine, and I mean purely cash basis medicine, is the only path of hope. Depending on state run medicine is a prescription for death, especially in the throes of collapse or decline.

      1. Jean

        Let’s do it … cash for care, at a negotiated price between motivated seller and motivated buyer.

        “Mr. Koch, I’d love to be able to help you with that crushing chest pain and shortness of air. I think I can do a great job for you, for I dunno, say $10 billion. But you’ve got about 5 seconds to decide”.

        “Mr. Walton, Your grandson is unconscious, bleeding, it was an ugly accident. What do you say, $12 billion”. Take all the time you need.

      2. j.grmwd

        Ten countries with primarily or completely state-run health care : Japan, Hong Kong, Macau, Singapore, Switzerland, Spain, Iceland, Sweden, Israel, Australia.
        Ten countries with the highest life expectancy in the world : ditto.
        State-run medicine – a real prescription for death.

  11. Don't GS me please!

    The SYSTEM is corrupt to the core, here and elsewhere!

    So what else is new? Keep ranting every day but 1% make sure NOTHING changes.

    Till a critical portion of 99% rise up in ‘arms’, NOTHING, repeat absolutely NOTHING will change!

    Meanwhile, come here keep ranting!

      1. different clue

        Create little survival-lifeboat mini-systems to retreat into, to the best of our ability.

        Eventually, one has to “do”, but first one has to “know how”. There are dead tree books on different aspects of personal and group survivalist economics, and there are numerous interwebnet writers and interwebnet resources which should be read over the next few years before the interwebnets all start going dark.

  12. different clue

    I have speculated before that the Global OverClass wants to kill about 5 or 6 billion people if they can figure out how to make it look like a slow motion accident. This could be a tiny little testbed demonstration of how to get the job done.

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