Sunday, October 21, 2012

The TB Outbreak Cover-Up

The Centers for Disease Control and Prevention warned Gov. Rick Scott to not the AG Holley State Hospital in Lantana. AG Holley was Florida's only state-run tuberculosis clinic. Scott was obsessed with privatizing Florida's health care system. An ideas about privatization saves money goes out the window when the numbers of TB outbreak are revealed.

At that point, a disease that can cost $500 to overcome grows exponentially more costly. The average cost to treat a drug-resistant strain is more than $275,000, requiring up to two years on medications. For this reason, the state pays for public health nurses to go to the home of a person with TB every day to observe them taking their medications.

It is estimated that 3,000 people during a two year time span in the Jacksonville area contracted TB. Duval County failed to to heed the advice of the CDC.

At the end of the first Epi-Aid in 2009, the CDC’s high-priority list was 440 names long. Finding them was important, because a high percentage were testing positive, some with the contagious, active form of the disease. Without treatment, they could make many more people sick.

Apparently, that’s exactly what happened.

On its return trip this year, the CDC found its high-priority contact list as of April had grown sixfold to 2,488 people, a daunting number for a cash-strapped public health agency to track down and monitor. And so within the high-priority list, it created a “hot list” of must-test contacts.

CDC epidemiologist Dr. Kiren Mitruka had investigated both outbreaks. By June 20, her frustration was clear.

Since (the Duval County Health Department) currently has no epidemiologist or data manager focusing on TB issues, something we recommended and funded after the 2009 Epi-Aid as well, it will be very important to ensure any funding we provide for that purpose is clearly designated,” she told Florida officials

“As we saw during our return tech assist earlier this month, work to date has only been able to identify 25 contacts from the outbreak investigation ‘hot list’ …”

Duval County did not have a person qualified to screen for TB. The reason was the health care budget cuts by Gov. Scott and the Florida legislature. The Scott administration's response was to cover-up any news about a TB outbreak. Former Scott spokeman Brian Burgess made the rare mistake of using his public email account. The Scott administration have used private email accounts to skirt Florida's Sunshine law.

It was Burgess who in July accidentally used his state email account — rather than the personal account he preferred to use — to direct Department of Health communications staff that it was “time for some serious debunking” of The Post’s July 8 report on Jacksonville’s TB outbreak.

What he most objected to was the argument that the state intentionally had kept the outbreak under wraps until after the closure of A.G. Holley.

He also repeatedly has objected to the use of the word “outbreak,” a word he associated with disaster movies, not illnesses that affect several hundred people. Burgess said the word “cluster” should be used to describe Jacksonville’s problem. However, the CDC’s emails and reports all use “outbreak.”

This is what happens when conservative ideology takes precedent good governing.

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