What’s Crawling on That White Coat?

According to the Society of Healthcare Epidemiology (SHEA) guidelines:

Health care personnel (HCP) apparel can hypothetically serve as a vector for pathogen cross-transmission in healthcare settings; however, no clinical data yet exist to define the impact of HCP apparel on transmission.

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Does the absence of evidence equal evidence of absence?

Eli Perencevich and Mike Edmond, physicians at the University of Iowa, have studied this issue in depth. They admit that while transmission to patients hasn’t been definitely proven, there is strong circumstantial evidence that it could occur. But no one has ever funded the necessary studies to find out for sure.

Unfortunately, a randomized trial of white coats would cost upwards of $20 million, and this money has not been budgeted by the National Institutes of Health, the premier research organization of the federal government. In the bigger picture, Perencevich and Edmond argue that just like we don’t need a randomized trial to prove that parachutes save lives, we also don’t need a trial of white coats. The circumstantial evidence that many of them are covered in germs is sufficient.