The limitations of technology

We've posted here often on the limitations of ADI in infection control. You can throw lots of money and technology at problems and see few benefits. Mike's posting from a few days ago was a perfect example of this - yes you can do ADI for MRSA but if you don't have adequate hand hygiene adherence, you're cooked. There was a recent article in the New Yorker which highlights this problem, which unfortunately now requires a subscription to read in its entirety, but even the available abstract is interesting.

The article discusses Saul Griffith, an inventor extraordinaire, who won a a MacArthur Fellowship (Genius grant) for an invention of a complicated, advanced device to rapidly custom-manufacture low-cost eyeglass lenses. His invention would save the world by making glasses available to all poor citizens. However, the problem wasn't that poor populations couldn't afford lens, those were available from China for pennies. The problem was that there weren't enough people trained to test people's eyesight! So after all of the effort, there was little to show for it.

Griffith has also spent a lot of time trying to develop new sources of renewable energy, creating flying wind turbines that float high in the air, where the wind speed is more reliable. During the process and looking at all of the data, he realized that current and likely immediate-future technology wouldn't be enough. The math just doesn't work. We would have to build wind turbines every second and nuclear power plants every week for years. It's just not going to happen. We have to actually cut individual consumption. So now, he is "selfishly" working to cut his own consumption; he estimated that he would have to cut his own energy use by two-thirds or more to have an impact. We all will. It will be difficult.

With infection control, we're in the same situation. Resistant bacteria are spreading everywhere. The easy answer is to hope science and expensive "easy" solutions will save us. We can just swab everyone's nose (and butt and throat and axilla and groin) pop it into a machine that will tell us what they are colonized with and boom - no more resistance!! Well, if history, and Saul Griffith's experience is any guide, it won't work. We are all faced with his "cheap-glasses conundrum: the inadequacy of addressing complex societal issues with technological ingenuity alone." I think we all need to realize, as Mike has written, that we are all individually responsible for the resistance problem. We can't wait for a technological savior. Like Saul Griffith, we need to look at ourselves and get others to look at themselves. And we need to get people to wash their hands.

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