Attitudes changed, changed utterly – a new culture is born

We would do well to remember Joseph Lister on April 5, the anniversary of his birth. After graduating in Medicine from University College London in 1852, Lister trained as a surgeon. Convinced of the need for cleanliness in the operating room (a revolutionary idea at the time), Lister developed antiseptic surgical methods using carbolic acid to clean wounds and surgical instruments with an ensuing marked improvement in mortality from infection. His well-received paper, On the Antiseptic Principle in the Practice of Surgery, was published in 1867. Around this time Louis Pasteur and Robert Koch established the germ theory of disease. Prior to this, a doctor might perform an autopsy on a person who had died of an infectious disease and then proceed to care for a living patient without first washing their hands, thus unwittingly transmitting bacteria.

The work of Lister, Pasteur and Koch undoubtedly had a profound influence on clinical outcomes, but in many ways attitudes to hand hygiene only developed recently. Barely a few years ago hospital clinical governance committees were racking their brains for ways to encourage clinicians to apply rigorously and regularly the soap and water. Attitudes were likely the real problem, or culture, if you like. In the words of Peter Drucker: “Culture eats strategy for breakfast”. 

Enter Covid-19 in early 2020 and we got the needed wake-up call. Attitudes suddenly changed, with clean hands, face masks and coughing etiquette the order of the day. Since then, we have endured restrictions that were inconceivable before. According to Prof Pete Lunn, ESRI head of behavioural research, (RTE 1, Morning Ireland, March 2, 2021), the Social Activity Measure examining how people are coping with prolonged restrictions tells us that 79% of people believe that preventing the spread of Covid-19 is more important than the burden imposed by restrictions. Only 10% of those surveyed do not concur. Prof Lunn also pointed out some misperceptions held by most people surveyed in relation to social activity – not least the erroneous view that everyone else is having more fun. While half of the population surveyed had not met anyone outside their household in the previous 48 hours, less than a quarter had met with three or more people outside their household. Curiously, those least compliant with the restrictions believe that other people are less compliant than themselves.

With the government promising to ramp up vaccine rollout in the coming months, it is noteworthy from the Department of Health’s Amárach survey that, of those who have not yet received the vaccine, 72% will “definitely” accept it when it is offered. A further 17% of those surveyed will “probably” accept it, while 3% will “probably not” and a further 3% will “definitely not” accept it. (The remaining 5% didn’t know). Curiously, almost a quarter of those surveyed state they believe that, once people start getting the Covid-19 vaccine in Ireland, the government should lift Covid-19-related restrictions for everyone, including for those who have not yet been vaccinated.

Naturally, a fatigued population are keen to get away on holiday this year and, in this regard, the EU has voiced some enthusiasm for the introduction of electronic ‘vaccine passports’. A poll reported on RTE’s Claire Byrne Live (March 1, 2021) asked people: “Are you in favour of vaccine passports being introduced to allow people travel around Europe once they have been vaccinated?” Of those polled, 75% said yes, with 16% saying no and 9% stating they don’t know. Time will tell if such an approach is feasible.