This article has been updated to reflect the situation as of midday Friday, Oct. 4.
Saint Elizabeths Hospital, D.C.’s only public psychiatric hospital, has been operating without running water for eight days. The outage is due to evidence of dangerous bacteria in the hospital’s water supply, and Phyllis Jones—chief of staff for the Department of Behavioral Health, which runs Saint Elizabeths—says there is now a plan in place to treat the contagion. However, the hospital expects the treatment to take seven days, plus another 48 hours for testing.
This is Saint Elizabeths’ second extended water outage in three years—a potentially perilous situation that increases the risk that patients will contract dangerous infections. As of 2018, the hospital had an average of 270 patients on any given day. In a statement, Jones wrote, “We are grateful to patients for their resiliency and to staff for continuing to provide quality care during this inconvenient and stressful time.”
Jones says that last Thursday, the hospital received preliminary lab results for a routine water quality test. And what the lab found was seriously concerning: evidence of pseudomonas and legionella bacteria in the facility’s water supply. Pseudomonas infections are generally mild in people with healthy immune systems, but legionella, which causes Legionnaires’ disease, can be far more dangerous. Healthy people generally survive Legionnaires’, but it still can send them to the hospital. According to the Centers for Disease Control and Prevention, one out of four people who contract Legionnaires’ in a healthcare setting die because of it. Jones says that no patients or staff have shown signs of illness. But in order to protect patients, she explains, Saint Elizabeths immediately implemented its “water emergency protocol” and “is working with DC Water and DC Health to evaluate options and solutions.”
According to a Saint Elizabeths staff member, staff were informed about the contamination last Friday, and told that patients and staff should not wash their hands, shower, wash clothing, or drink from the water fountains. (The staff member did not have permission to speak publicly about the water outage and so wished to stay anonymous.) Until the water is safe again, Jones says the hospital is using “an extensive supply of bottled water, hand sanitizers, personal care body wipes, and body wash spray” to keep patients clean and hydrated. She also says portable showers are now available.
Andrea Procaccino, staff attorney at Disability Rights DC, visited the hospital Wednesday and says she spoke to two patients. They told her the outage has been taking its toll. They were particularly distressed by not being able to wash their hands after using the bathroom, and they both complained that they had not been able to shower for days.
“Some patients have contracted pink eye,” the Saint Elizabeths staff member tells City Paper. “And the ones that have colds can’t wash their hands on the regular, so it’s going to get worse.” (Jones claims there have been no reported cases of pink eye.)
Without water, the risks to patients go far beyond pink eye. Whenever a hospital loses its water supply, it’s a crisis. Dr. Adam Kushner, a Johns Hopkins-affiliated surgeon who has studied hospitals operating without water in developing countries, says that since patients and staff may not be able to keep themselves or their linens as clean as usual, it can lead to nosocomial infections (the name for infections generally contracted in hospitals). One common nosocomial infection is MRSA. According to the CDC, MRSA killed 20,000 people in the U.S. in 2017.
Jones says the hospital is working hard to contain those risks until their water is safe to use again. “Disinfecting wipes and industrial level cleaning supplies are [being] used for cleaning equipment and other surfaces,” she says. She thinks that between that strategy, the wipes, and the hand sanitizer, the hospital is minimizing the risk of infection. But to keep patients safe, she says, “as with any water outage, infectious disease staff are monitoring closely to address potential infection risks.” The hospital is still accepting new patients.
The staff member City Paper spoke with is worried these new patients will lead to outbreaks that are less dangerous but still painful for patients and staff alike. They say that normally, when patients are admitted, they have to take a shower and are treated for bedbugs and lice. Now, they say, new patients are just coming straight in, without that treatment.
Saint Elizabeths already went through this sort of ordeal before, quite recently. On the evening of Aug. 6, 2016, the hospital cut off its water after an old pipe ruptured, contaminating the supply. It was five days before patients could wash their hands again, and six before they could drink out of the taps.
Kushner thinks the fact that this happened two times in just three years points to a much larger problem with healthcare inequality in America, and with the underfunding of hospitals like Saint Elizabeths that serve low-income communities. “This is the United States,” he says. “We’re supposed to have the best healthcare system in the world. And there’s a major public hospital in our capital, and it doesn’t have any water.”
“Not having any running water is horrible, and patients could get sick. Can anyone imagine Johns Hopkins or Mass General [the teaching hospital of Harvard Medical School] not having water?” Kushner asks. “Maybe for a day. But then it happening again? It just wouldn’t happen.”