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“Ebola Doesn’t Abide By Borders”: Ensuring Our Public Health System Is Adequately Funded And Allowed To Do Its Job Is Key

The U.S. should not implement travel restrictions on countries impacted by the Ebola crisis and here is why. The Ebola outbreak has reminded the world what public health officials have known for centuries: Infectious disease does not respect geographical borders.

There was a time when we travelled the globe in ships and across land. In those days travel took months and diseases died out or were easy to contain using quarantine measures and broad travel restrictions.

We now live in a global society during a time when the variables we are trying to compute are numerous and complex. The vast number of people traveling around the world, the speed of travel, the large number of conveyances and the presence of multiple ports of entry into our country argues for a focused, well-tested and science-based approach to reducing the risk of exposure to this highly lethal infectious disease.

I’ve just returned from South Africa with a connection through Amsterdam, Netherlands. While this is far from West Africa, I saw a system of health and customs officials on high alert looking for ill passengers, passenger screenings using temperature monitors at airports and health advisories in airports to inform passengers how to protect themselves. What I saw, in fact, was a responsive, competent public health approach at work.

Preventing travel from affected countries is an inadequate measure. Not only do we need to ensure rapid passage of people in and out of the area for response purposes, but we also need to ensure the continued flow of supplies desperately needed to address the outbreak at its source, which is the best way to break the chain of infection. With the number of people passing through airports all over the world, identifying those who could have come into contact with people from affected countries is an impossible task. Multiply this by the number of connecting flights through European or other international hubs and it becomes even harder.

While we are appropriately worried about Ebola, enterovirus-68 has sickened more than 628 people in 44 states and the District of Columbia, a severe coronavirus – the Middle East respiratory syndrome – is circulating in the Middle East and chikungunya virus has entered our country. We have many significant biological threats, and they are all managed best through proven public health measures.

I have yet to hear calls to quarantine our borders between states while these serious diseases are already here because such a measure, of course, would be ineffective. Sound disease surveillance, case finding, monitoring and treatment is the appropriate approach. Ebola, although highly lethal, can be managed using these proven methods. We know its epidemiology, its biology and how to defeat it.

A strong, well-developed and adequately funded public health system is the key to containing Ebola and all of these other infectious threats. Unfortunately, ongoing budget cuts to the Centers for Disease Control and Prevention and other health agencies continue to put a strain on resources. Policymakers who want to be part of the solution need only to support ensuring our public health system is adequately funded and allowed to do its job.

Yes, we should screen travelers, but restricting travel is not the solution. A focused, robust and science-based public health response is.

 

By: Georges Benjamin, M.D., Executive Director, American Public Health Association; Publisher, Control of Communicable Diseases Manuel; Debate Club, U. S. News and World Report, October 10, 2014

October 13, 2014 Posted by | Congress, Ebola, Public Health | , , , , , | Leave a comment

“Ebola And The 41 Million Uninsured Americans”: Political Failure’s That Have Left Americans More Vulnerable To Deadly Diseases

With the first diagnosed case of the deadly Ebola virus in the United States located in Dallas, Texans are understandably alarmed. The patient just died. Gov. Rick Perry has established a taskforce to address the Ebola threat.

Not a bad idea but still a feeble response coming from a governor who refused to expand Medicaid in his state, leaving millions of his people outside the health care system. About 6 million Texans are now walking around without health insurance. That’s almost 1 in 4 residents — the highest rate of uninsured in the country.

Of course, those without health coverage are least likely to have a relationship with a health care professional, someone they could contact about worrisome symptoms. And because vomiting and other signs of Ebola could indicate something far less serious, these mostly low-income people might put off going to a hospital until it’s too late.

But Perry was among the large group of so-called conservative governors deeming it was more important to stick it to President Obama than to broaden health coverage in their states. Not surprisingly, the sharpest drops in the rates of the uninsured are in states that went along with the expansion. The rates remain nearly unchanged in the 23 nonparticipating states.

There was always a humanitarian reason for supporting the Affordable Care Act. Now we are seeing the self-interested reasons, which have been missing in most of the Obamacare debate. Covering all is essential to public health. Even the rich don’t enjoy divine protection from deadly infectious diseases. That the federal government is covering nearly the entire cost of the Medicaid expansion makes the excuses for not joining the program especially ugly.

And this is not just about Ebola. The flu is a communicable disease that typically kills 30,000 Americans a year, mainly the very old, the very young and the frail. Universal coverage can help contain that, as well.

The Ebola scare has overshadowed another frightening virus that has been diagnosed in hundreds of children since August — and that has just claimed the life of a 4-year-old in New Jersey. Enterovirus-68 has been found in 48 states, with significant numbers reported in Colorado, Illinois and Missouri. This respiratory illness, which has been associated with partial paralysis, spreads the same way colds do, through saliva and other bodily fluids.

Controlling these diseases requires early quarantine of those infected, and how are you going to find people who would test positive if they don’t go to a medical facility? Politicians who irresponsibly passed up an opportunity to bring such health services to their people are currently grasping at useless proposals.

Louisiana Gov. Bobby Jindal thinks the answer is to “stop accepting flights from countries that are Ebola stricken.” But what about the two nurses in Madrid who tested positive for the virus after treating a Spanish priest? The priest and one of the nurses have already died of the disease.

Do we stop accepting flights from Spain, which has a pretty good health care system, of course covering everyone? Not unexpectedly, the Texas governor opposes the flight ban idea.

Jindal was inexplicably proud to decline $6 billion in federal money to expand Medicaid coverage in his state. Nearly 900,000 Louisianans currently lack health insurance.

“Expansion would result in 41 percent of Louisiana’s population being enrolled in Medicaid,” Jindal explained at the time. “We should measure success by reducing the number of people on public assistance.”

There are many ways of measuring success in a society, widespread health coverage being one. Instead, we see a political failure that has left Americans more vulnerable to a deadly disease than they had to be. It’s really something.

 

By: Froma Harrop, The National Memo, October 9, 2014

 

October 10, 2014 Posted by | Infectious Diseases, Medicaid Expansion, Uninsured | , , , , , , | Leave a comment

   

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