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Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.
-
Rogue Medic
How does your employer handle those who refuse to get the flu shot, or those who cannot get the flu shot for medical reasons?
For those who who have contact with patients, the approach taken by some employers is to require that unvaccinated employees wear a mask and gloves to protect patients.
What rules your employer have to protect patients?
Does anyone know of any research comparing the infection of patients by vaccinated health care workers and unvaccinated health care workers?
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RogueMedicBlog@gmail.com
If we are interested in the truth, we should question everything - especially anything we take for granted.
"Don't you believe in anything?"
"Yes", I said. "I believe in evidence. I believe in observation, measurement, and reasoning, confirmed by independent observers. I'll believe anything, no matter how wild and ridiculous, if there is evidence for it. The wilder and more ridiculous something is, however, the firmer and more solid the evidence will have to be."Isaac Asimov
The Roving Mind (1983) p. 43
-Bigotry and science can have no communication with each other, for science begins where bigotry and absolute certainty end. The scientist believes in proof without certainty, the bigot in certainty without proof. Let us never forget that tyranny most often springs from a fanatical faith in the absoluteness of one’s beliefs.
Ashley Montagu.
-Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
Thomas Jefferson
Notes on the State of Virginia (1781-1783)
-We are drowning in information, while starving for wisdom. The world henceforth will be run by synthesizers, people able to put together the right information at the right time, think critically about it, and make important choices wisely.
Edward O. Wilson.
Consilience: The Unity of Knowledge (1998)
-Old beliefs die hard even when demonstrably false.
Edward O. Wilson
Consilience: The Unity of Knowledge (1998)
-There is no expedient to which a man will not resort to avoid the real labor of thinking.
Sir Joshua Reynolds*.
* Quote Investigator page on this quote
-Today we rely less on superstition and tradition than people did in the past, not because we are more rational, but because our understanding of risk enables us to make decisions in a rational mode.
Peter L. Bernstein
Against the Gods: the remarkable story of risk (1996)
-Mark my word, if and when these preachers get control of the [Republican] party, and they're sure trying to do so, it's going to be a terrible damn problem. Frankly, these people frighten me. Politics and governing demand compromise. But these Christians believe they are acting in the name of God, so they can't and won't compromise. I know, I've tried to deal with them.
Barry Goldwater.
-I think every good Christian ought to kick Falwell right in the ass.
Barry Goldwater
Said in July 1981 in response to Moral Majority founder Jerry Falwell's opposition to the nomination of Sandra Day O'Connor to the Supreme Court, of which Falwell had said, "Every good Christian should be concerned." as quoted in Ed Magnuson, "The Brethren's First Sister," Time Magazine, (20 July, 1981)
-What do you think science is? There's nothing magical about science. It is simply a systematic way for carefully and thoroughly observing nature and using consistent logic to evaluate results. Which part of that exactly do you disagree with? Do you disagree with being thorough? Using careful observation? Being systematic? Or using consistent logic?
Dr. Steven Novella.
-What progress we are making. In the Middle Ages they would have burned me. Now they are content with burning my books.
Sigmund Freud (1933)
Today the samizdat is digital and burning a copy has the opposite meaning. A little later, persecution of the Jews was once again the law - four of Freud's five sisters died in concentration camps, although not by burning.
-"Can you prove that it’s impossible?” “No”, I said, “I can’t prove it’s impossible. It’s just very unlikely”. At that he said, “You are very unscientific. If you can’t prove it impossible then how can you say that it’s unlikely?” But that is the way that is scientific. It is scientific only to say what is more likely and what less likely, and not to be proving all the time the possible and impossible. To define what I mean, I might have said to him, "Listen, I mean that from my knowledge of the world that I see around me, I think that it is much more likely that the reports of flying saucers are the results of the known irrational characteristics of terrestrial intelligence than of the unknown rational efforts of extra-terrestrial intelligence." It is just more likely. That is all.
Richard Feynman.
The Character of Physical Law (1965) chapter 7, “Seeking New Laws,” p. 165-166:
It has been over half century since Feynman explained this. The reports of flying saucers have continued, but there is still no valid evidence to support belief in flying saucers. Feynman's explanation is a good definition of unlikely. -An ignorant mind is precisely not a spotless, empty vessel, but one that’s filled with the clutter of irrelevant or misleading life experiences, theories, facts, intuitions, strategies, algorithms, heuristics, metaphors, and hunches that regrettably have the look and feel of useful and accurate knowledge.
David Dunning - explaining the Dunning-Kruger effect.
-Treat beliefs not as sacred possessions to be guarded but rather as testable hypotheses to be discarded when the evidence mounts against them.
Philip Tetlock.
-Squatting in between those on the side of reason and evidence and those worshipping superstition and myth is not a better place. It just means you’re halfway to crazy town.
PZ Myers
-The legitimate powers of government extend to such acts only as are injurious to others. But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg.
Thomas Jefferson.
-Imagine a world in which we are all enlightened by objective truths rather than offended by them.
Neil deGrasse Tyson
-Education is a progressive discovery of our own ignorance.
Will Durant.
-You don't use science to show that you're right,
you use science to become right.
Randall Munroe
-Just because science doesn't know everything doesn't mean you can fill in the gaps with whatever fairy tale most appeals to you.
Dara O'Briain
-The basic trouble, you see, is that people think that "right" and "wrong" are absolute; that everything that isn't perfectly and completely right is totally and equally wrong.
Isaac Asimov.
-There appears to be in mankind an unacceptable prejudice in favor of ancient customs and habitudes which allows practices to continue long after the circumstances, which formerly made them useful, cease to exist
Benjamin Franklin.
-If science proves some belief of Buddhism wrong,
then Buddhism will have to change.
Tenzin Gyatso, 14th Dalai Lama.
-Ridicule is the only weapon which can be used against unintelligible propositions. Ideas must be distinct before reason can act upon them;
Thomas Jefferson.
-Science doesn't make it impossible to believe in God.
It just makes it possible to not believe in God.
Steven Weinberg.
-There are no forbidden questions in science,
no matters too sensitive or delicate to be probed,
no sacred truths.
Carl Sagan.
-Religion is an insult to human dignity. With or without it you would have good people doing good things and evil people doing evil things. But for good people to do evil things, that takes religion.
Steven Weinberg.
-It is better to not understand something true, than to understand something false.
Neils Bohr.
-God does not play dice with the universe.
Albert Einstein
Stop telling God what to do with his dice.
response by Neils Bohr.
-All things are poison and nothing is without poison, only the dose permits something not to be poisonous.
Paracelsus.
-What is not true, as everyone knows, is always immensely more fascinating and satisfying to the vast majority of men than what is true.
H.L. Mencken.
-Every valuable human being must be a radical and a rebel, for what he must aim at is to make things better than they are.
Niels Bohr.
-How wonderful that we have met with a paradox. Now we have some hope of making progress.
Niels Bohr.
-An expert is a man who has made all the mistakes which can be made in a very narrow field.
Niels Bohr.
-Every sentence I utter must be understood not as an affirmation, but as a question.
Niels Bohr.
-Some subjects are so serious that one can only joke about them.
Niels Bohr.
-I have no special talents. I am only passionately curious.
Albert Einstein.
-Few people are capable of expressing with equanimity opinions which differ from the prejudices of their social environment. Most people are even incapable of forming such opinions.
Albert Einstein.
-Never memorize what you can look up in books.
Albert Einstein.
-The prestige of government has undoubtedly been lowered considerably by the prohibition law. For nothing is more destructive of respect for the government and the law of the land than passing laws which cannot be enforced. It is an open secret that the dangerous increase of crime in the United States is closely connected with this.
Albert Einstein.
-the chance is high that the truth lies in the fashionable direction. But, on the off-chance that it is in another direction - a direction obvious from an unfashionable view of field theory - who will find it? Only someone who has sacrificed himself by teaching himself quantum electrodynamics from a peculiar and unusual point of view; one that he may have to invent for himself. I say sacrificed himself because he most likely will get nothing from it, because the truth may lie in another direction, perhaps even the fashionable one.
Richard Feynman. - Nobel Prize speech
-So we really ought to look into theories that don't work, and science that isn't science.
Richard Feynman. - Cargo Cult Science
-I call these things cargo cult science, because they follow all the apparent precepts and forms of scientific investigation, but they're missing something essential, because the planes don't land.
Richard Feynman. - Cargo Cult Science
-If you've made up your mind to test a theory, or you want to explain some idea, you should always decide to publish it whichever way it comes out. If we only publish results of a certain kind, we can make the argument look good. We must publish both kinds of results.
Richard Feynman. - Cargo Cult Science
-If a reasonable launch schedule is to be maintained, engineering often cannot be done fast enough to keep up with the expectations of originally conservative certification criteria designed to guarantee a very safe vehicle. In these situations, subtly, and often with apparently logical arguments, the criteria are altered so that flights may still be certified in time. They therefore fly in a relatively unsafe condition, with a chance of failure of the order of a percent (it is difficult to be more accurate).
Official management, on the other hand, claims to believe the probability of failure is a thousand times less. One reason for this may be an attempt to assure the government of NASA perfection and success in order to ensure the supply of funds. The other may be that they sincerely believed it to be true, demonstrating an almost incredible lack of communication between themselves and their working engineers.
Richard Feynman. - Rogers' Commission Report
-For a successful technology, reality must take precedence over public relations, for nature cannot be fooled.
Richard Feynman. - Rogers' Commission Report
-Science is a way of trying not to fool yourself. The first principle is that you must not fool yourself, and you are the easiest person to fool.
Richard Feynman.
-Science alone of all the subjects contains within itself the lesson of the danger of belief in the infallibility of the greatest teachers in the preceding generation ... Learn from science that you must doubt the experts. As a matter of fact, I can also define science another way:
Science is the belief in the ignorance of experts.
Richard Feynman.
-The only way to have real success in science, the field I’m familiar with, is to describe the evidence very carefully without regard to the way you feel it should be. If you have a theory, you must try to explain what’s good and what’s bad about it equally. In science, you learn a kind of standard integrity and honesty.
Richard Feynman.
-Some people say, "How can you live without knowing?" I do not know what they mean. I always live without knowing. That is easy. How you get to know is what I want to know.
Richard Feynman.
-I don't know anything, but I do know that everything is interesting if you go into it deeply enough.
Richard Feynman.
-So, to test the prevailing intellectual standards, I decided to try a modest (though admittedly uncontrolled) experiment: Would a leading North American journal of cultural studies . . . publish an article liberally salted with nonsense if (a) it sounded good and (b) it flattered the editors' ideological preconceptions?
The answer, unfortunately, is yes.
Alan Sokal - A Physicist Experiments With Cultural Studies.
-Medicine is a science of uncertainty and an art of probability.
William Osler.
-Common sense in matters medical is rare, and is usually in inverse ratio to the degree of education.
William Osler.
-The greater the ignorance the greater the dogmatism.
William Osler.
-The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.
William Osler.
-One of the first duties of the physician is to educate the masses not to take medicine.
William Osler.
-In the fields of observation chance favors only the prepared mind.
Louis Pasteur.
-Science knows no country, because knowledge belongs to humanity, and is the torch which illuminates the world. Science is the highest personification of the nation because that nation will remain the first which carries the furthest the works of thought and intelligence.
Louis Pasteur.
-Not far from the invention of fire must rank the invention of doubt.
Thomas Henry Huxley.
-The great tragedy of Science — the slaying of a beautiful hypothesis by an ugly fact.
Thomas Henry Huxley.
-The foundation of morality is to have done, once and for all, with lying; to give up pretending to believe that for which there is no evidence, and repeating unintelligible propositions about things beyond the possibilities of knowledge.
Thomas Henry Huxley.
-My business is to teach my aspirations to conform themselves to fact, not to try and make facts harmonise with my aspirations.
Thomas Henry Huxley.
-There must have been a time, in the beginning, when we could have said – no. But somehow we missed it.
Tom Stoppard
-All men can be criminals, if tempted; all men can be heroes, if inspired.
G. K. Chesterton
-There is no such thing on earth as an uninteresting subject; the only thing that can exist is an uninterested person.
G. K. Chesterton
-Good taste, the last and vilest of human superstitions, has succeeded in silencing us where all the rest have failed.
G. K. Chesterton
-Men become superstitious, not because they have too much imagination, but because they are not aware that they have any.
George Santayana
-If we are uncritical we shall always find what we want: we shall look for, and find, confirmations, and we shall look away from, and not see, whatever might be dangerous to our pet theories. In this way it is only too easy to obtain what appears to be overwhelming evidence in favor of a theory which, if approached critically, would have been refuted.
Karl Popper
-It is difficult to get a man to understand something, when his salary depends upon his not understanding it!
Upton Sinclair
-Freedom is what you do with what's been done to you.
Jean-Paul Sartre
-Where goods do not cross frontiers, armies will.
Frédéric Bastiat
-The ultimate result of shielding men from the effects of folly is to fill the world with fools.
Herbert Spencer
-Political language — and with variations this is true of all political parties, from Conservatives to Anarchists — is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind.
George Orwell
-Facts are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.
John Adams
-We're not presuming the answers before we ask the questions.
Lawrence Krauss explaining how science works
-Malo Periculosam Libertatem Quam Quietum Servitium.
Better freedom with danger than peace with slavery.
-Whatever inspiration is, it's born from a continuous "I don't know."
Wislawa Szymborska
-All sorts of torturers, dictators, fanatics, and demagogues struggling for power by way of a few loudly shouted slogans also enjoy their jobs, and they too perform their duties with inventive fervor.
Well, yes, but they "know." They know, and whatever they know is enough for them once and for all.
They don't want to find out about anything else, since that might diminish their arguments' force.
Wislawa Szymborska. -Theory helps us to bear our ignorance of fact.
George Santayana
-Miracles are propitious accidents, the natural causes of which are too complicated to be readily understood.
George Santayana. -Fanaticism consists in redoubling your efforts when you have forgotten your aim.
George Santayana
-There is a fundamental difference between religion,
which is based on authority,
and science,
which is based on observation and reason.
Science will win because it works.
Stephen Hawking.
-The truth, indeed, is something that mankind, for some mysterious reason, instinctively dislikes. Every man who tries to tell it is unpopular, and even when, by the sheer strength of his case, he prevails, he is put down as a scoundrel.
H.L. Mencken.
-It is the natural tendency of the ignorant to believe what is not true. In order to overcome that tendency it is not sufficient to exhibit the true; it is also necessary to expose and denounce the false.
H.L. Mencken.
-I am attempting to make it easier, when I use footnotes, to navigate to the information in a footnote, look at the information, and return to where you were before you clicked on the footnote. If you click on the number of a footnote in the text[1] <- click on the bracketed and underlined number - in this case [1], it will bring the footnote to the top of the screen.
A blog post that has been very helpful in teaching me this is How to make real footnotes from TypePad versus WordPress.
[1] If you click on the bracketed and underlined number of a footnote in footnote section, the [1] at the beginning of this paragraph, it will take you to where you clicked on the footnote in the text, with the footnote along the top of the screen. [To top of footnotes]
If you wish to modify the size of the text, you can press the CTRL key and roll the mouse wheel forward or back, or you can press the CTRL key and the + or - keys to make text larger or smaller. Another way is to adjust the font in your browser controls.
This is a mostly medical blog, so here is the HIPAA incantation to ward off evil whiny HIPAA-obsessed spirits.
HIPAA (Health Insurance Portability and Accountability Act of 1996) is generally misrepresented by those in health care, but there are no violations of HIPAA here. There are some patients I could not discuss without changing details, so details may be omitted, or changed. That may decrease the dramatic effect of some of what I write, but patients are entitled to their privacy and have been since before HIPAA became the ignorant administrators' justification for imitating a two year old yelling NO!
I am not dispensing medical advice. If you get your medical advice off of a blog, instead of consulting a physician (such as your medical director), you probably should not be treating anyone, not even yourself. I could include your dog, but that would suggest that veterinarians do not provide excellent care. The veterinarians I know take pride in the care they deliver and deliver excellent care, more so than many people I know in EMS.
I do point you to research to support what I write, but you still need to make sure that you have the authorization of your medical director before changing any of your treatments. If your medical director does not agree, you can point to the research I write about. Most doctors do understand research, they just have trouble keeping up with the amount of research that is produced.
What I write does not change your protocols. If you do not like a protocol, take it up with the medical director. I have several inadequate protocols, too. I call medical command and attempt to persuade the physician that what I am requesting is in the best interest of the patient. It is rare that I am turned down, but the dose is often inadequate. I call back before I need more, so the patient does not have to put up with the On Line Medical Command delay in treatment. Health care providers should be anticipating where the care of the patient is headed - both for good and for bad.
I do not have any connection to the products I mention, other than using them and being satisfied, dissatisfied, or some combination of the two. If I have any potential conflict of interest, I will mention it clearly.
If I write about a book by an author I know, I will encourage you to buy the book from the author's web site. This means that any money goes to the author (or to where the author wants the money to go, such as a charity) and you have an opportunity to sample the author's writing for free on the author's blog before buying the book.
I may be blunt, but I do not intend it personally. There are few mistakes that can be made that I have not made. I continue to try not to be stupid; you may conclude that I fail.
I welcome any relevant comments and much that is not relevant. I reserve the right to delete any inappropriate comments. I decide what is appropriate based on my own nebulous standards. Criticism of ideas is expected. Criticism of writing style is appreciated.
I avoid obscenity because I believe that the English language provides enough opportunities for creativity that resorting to the words that may not be said on TV (and a growing group of words that may) is unnecessary. I may quote something that contains some of these words, or I may link to something that does, but that is as bad as I expect to be with these words.
On the other hand, you may feel that the ideas I present are offensive. My aim is to encourage thought, dialogue, and creativity - not to tell you everything is OK. You may leave this blog at any time and bury your mind in comfortable, familiar ideas.
If you feel that the ideas I present are not challenging, please encourage me to address whatever you feel I do not adequately address.
see also -
Do My Posts Authorize Protocol Violations
Protocol Problems
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Seems like this would be difficult to study with any degree of scientific rigor. I think you’d have identify patients whose *only* exposure to flu was from an unvaccinated health care worker, as well as those whose *only* exposure to flu was via vaccinated health car workers.
When you’re already dealing with a relatively low population (previously-uninfected flu patients who are “exposed” to health care workers prior to onset of symptoms) the power of your study isn’t going to be all that great.
I guess the bigger question is why (absent a known contraindication) anyone would decline a flu shot?
PJ,
This is the way epidemiologic studies work. We try to get enough people that the populations are roughly similar, except for the variable. Things like smoking, alcohol consumption, diet, recreational drugs, prescription drugs, genetics, and many other variables are documented and everything is recalculated taking these variables into account individually and in combinations. However, the more control there is over the variables, the smaller and more accurate the study.
There is a lot of misinformation about vaccination. People do not understand it, so they expect vaccination to be perfect. If it is not perfect, according to their mistaken expectations, then there is something wrong with vaccination. Vaccination is not and never will be perfect. Nothing involving humans is. For many people, it is easier to criticize, than to understand and/or to accept uncertainty.
I know how epidemiological studies work. My point is that the tough part would be getting enough candidates.
For comparison, there are ~30 million smokers in the US (2004 numbers put it at 36 million, so I may be underestimating) so you have a large group of potential candidates if your study is simply smoking vs. not smoking.
In the 2007-08 flu season (do they have playoffs? wildcards? the mind boggles), there were ~225K tests done, of which ~40K were positive (source ). So you’d have to drill down further into that ~40K and see how many of those had as their *sole* possible exposure source an unvaccinated health care worker (HCW). That’s probably unrealistic, but you could presumably identify a subset who had an encounter with a HCW in the 7-14 days before onset of symptoms, and then try to find out if that HCW was vaccinated or not. Still, this is a tough study to do.
Plus, that doesn’t account for those who never sought medical treatment. My family (two males, four females) had a flu experience during the 08-09 season in which all four females go sick with flu-like symptoms, but neither male did (all six subjects were vaccinated). I told Mrs. G it was because of lamb’s blood I had smeared on the front door. She was not amused.
PJ,
I have trouble remembering what I know.
It isn’t the sole possible source, but an increase in probability with exposure to unvaccinated HCWs. Maybe the study never reaches significance, but it would be good to know.
That is another cause of the distrust of vaccines. Many do not know the difference between the flu and other illnesses.
And apparently, she was not protected. If she had been the first-born male, she might not have that problem. She might have plenty of other problems.
I can’t get the flu shot; many moons ago I had a nasty reaction, so I can’t get the shot even though I’d like it. I haven’t dealt with any employeers who have demanded I do anything outside of normal, state required protocol (Any patient with 2 or more flu like symptoms required that the patient wear a mask and we had an N95 mask. The ambulance had to be deconed before it could go back in service)
Medic Trommashere,
There are valid reasons for not getting a flu shot. That is one. Future flu shots may not use eggs, so there may be a shot that is available to you (assuming that is the cause of the reaction).
That is one way of cutting down on contact and residual droplet transmission to patients, but we may be most infectious before we show any symptoms.
One reason is that the obvious flu symptoms helps to remind us that we do transmit germs.
Even a thoroughly washed asymptomatic human body is covered with germs.
I have been trying to get my company to adopt a policy of completely scrubbing our bodies (especially the eyes and mouths), then dousing us in iodine (again, especially the eyes and mouths), between patients. Ditto for the ambulance. 😉
Back in the early 90s, this was not that ridiculous compared to some of the rules coming from regulators (Department Of Transportation?).
We do need some sort of research into the ways that we make things worse for our patients. I see far fewer AIDS patients than I used to, but many patients have weakened immune systems and it is not always clear that this is the case. Even a collection of case studies with DNA evidence that the infectious agent came from the same source would be helpful in evaluating possible risks.
Of course we don’t even know if the flu shot matters. For the employer it’s a matter of not losing employee days and having to pay overtime to fill shifts. It’s less a matter of protecting employees from patients or patients from employees.
Does the Vaccine Matter
Too Old To Work,
It would be nice to know more about the benefits of the vaccination under different circumstance.
As the anti-viral medications seem to promote drug resistance pretty quickly, prevention becomes much more important, especially for those who are already sick.
Well we already know that you and I don’t agree about vaccination (and by the way i am a good army medic and have all my smallpox, anthrax MMR etc) however this is my 25th year and i have had only one flu shot and never again. I have never had the flu been exposed a number of times i am sure. i have always isolated when i was sick with my annual cold ( yes i am pretty lucky that i only get really sick once a year in the summer of all times). Now did i not get the flu because i am naturally immune? was i not exposed? am i just really really lucky? trying to double blind study this would be next to impossible given the massive variables in the equation every person i have come into contact with at work home play grocery store etc plus all their variables factored in as well. Now to complicate things even more during last years flu scare the OK Department of health stopped testing for the flu and said that everybody that came to a medical facility with any sort of symptoms had the flu and treated them all. Now i know that not everybody that flooded the Er’s and urgent care clinics across the state had the real live (bird/Swine/lizard/mad-cow) flu.
Now for the actual answer to your questions. My employer does not have any sort of policies regarding sick medics. in fact our attendance policies are such that unless your dead and can show an obituary and a casket you better be on a truck regardless of your health. Which now exposes all my patients to my illness and once i start getting better it exposes me already being compromised to more sick persons to keep me sick for longer. I would also love to say that we drench the back of the truck with cleaner after each call and clean each piece of equipment to CDC standards but that does not happen with every crew. I would really like the CDC / state health departments across the nation to go to each ambulance in the country and culture the door handles, steering wheel, radio Mic, cot, computer / MDT , pt compartment floor and behind the squad bench then publish those results. I am thinking it would scare the snot out of you.
Now for the policies regarding required shots we offer and you have to decline in writing. Thats it no requirements for masks for the pt or the provider gloves are a necessity for all calls already.
Raymond Farrow,
I do not know why, but this is well within the expected range of responses in any large group.
Trying to do these studies is far from impossible. Many have been done on many interventions. The relevance of the results depends on many things, such as the size of the group, the number of variables that are not controlled for and the number of variables that we are not even aware of. Therefore, these studies should always be thoroughly examined to see how the limitations affect the results.
The rapid test for influenza was not very accurate, so relying on that would not have produced reliable numbers, either. There will also be political and administrative decisions made about the way to treat patients.
I think that the use of anti-viral medication to treat the flu is generally a bad thing. For most people, there is very little expected benefit from the medication. There is the huge side effect of drug resistance, which seems to develop quickly with influenza.
This rapid adaptation is not surprising, since the flu mutates frequently. The frequent mutation is the main reason that we have different flu vaccines every year. The flu vaccine also generally covers a few different strains of influenza, because we do not know which will be the best adapted to travel to the US and infect large numbers of people.
We have problems with the over-use of antibiotics. We seem not to have learned from that. If they were treating everyone with amantidine, rimantadine, zanamivir, or oseltamivir, that only increases the problem of drug resistance. If they were treating symptoms (nausea, vomiting, dehydration, aches, pains, et cetera) and advising people that they probably have the flu and how to minimize transmitting it to others, that is not a problem, medically.
As you point out, this is not just a problem with influenza. This is the reason we observe (or are supposed to observe) isolation precautions with patients with drug resistant infections. The isolation precautions are not really to protect us, but to protect those with weakened immune systems. Most healthy people will not become infected, but I transmit the bacteria to the next patient I come into contact with. Some ICUs have developed the practice of using requiring isolation gowns for all staff when they are at the bedside.
To a limited extent, this has been done.
They only were looking for MRSA, so we do not know what other germs might have been found. There have been several studies of the staff in emergency departments. They seem to find between 10% and 20% nasal swabs are positive for MRSA.