A more liberal policy of testing people when they are admitted to hospitals might be a way of reaching "the thousands" in Maryland who are infected with the AIDS virus and getting them care, says Dr. John G. Bartlett, the director of AIDS patient care at the Johns Hopkins Health System.
"We have a real problem finding these people," Bartlett said yesterday. "In Baltimore city alone, there are thousands of kids that have HIV infection and could die a morbid death and we aren't able to cope with that.
"Every major urban center has the same problems as Baltimore," he said. "First, you have to find the people who are infected and then get them counseled and cared for. Maybe we haven't found a way to reach them. Maybe there ought to be a more liberalized testing policy that would test people when they are admitted to hospitals."
The big problem, in at least the inner city, Bartlett said, is that people infected with the human immunodeficiency virus, or HIV, "don't have access to AZT they die fast." There simply are not enough people delivering care, he stressed.
AZT is the only government approved anti-AIDS drug.
But Bartlett turned thumbs down on another proposal that would test health-care workers recently advocated in an editorial by Dr. Marcia Angel, the executive editor of the prestigious New England Journal of Medicine.
"The reason to test hospital admissions is because we want to find people who are infected," said Bartlett, a member of the journal's editorial board. "The reason we want to test health care workers is because people are nervous. That's a very inefficient way to spend precious resources."
And, if the purpose is to find health-care workers who are infected, they are just not going to find that many, he said. "That's testing a low-incidence population. You might as well test Congress."
The Governor's Advisory Council on AIDS, which is leaderless and has not met since March, should be discussing pertinent issues like wider testing for AIDS, said Bartlett, an outspoken member of the council.
And, he believes the large, unwieldy group could operate more efficiently if it divided into task forces that could hone in on the complex issues of acquired immune deficiency syndrome instead of pulling decisions from wide-ranging discussions by the entire group.
Bartlett said he believes the state health department should take a closer look at the way some of its AIDS dollars are spent, suggesting that the use of generic drugs could be substituted for some antibiotics that would bring down costs.
In addition, he said, "It is ridiculous that there is still only one nursing home in the state, Seton Hill Manor, that provides care for chronically ill AIDS patients.