Not Yet Scared Enough
During the early days of the AIDS crisis, attempts to close or even regulate bath houses in San Francisco faced strong opposition. So did attempts to protect the nation's blood supply, even when there was evidence that AIDS could be transmitted through transfusions. As a consequence of the blood banking industry's attempts to reassure the public that the blood supply was safe, thousands of people died unnecessarily as blood banks and hospitals resisted taking preventive measures to better screen blood donors.
In the domain of public health, the U.S. has drastically underinvested. Most public hospitals are underfunded and public health departments at the state and local level also don't have the resources necessary to adequately do their jobs. We have forgotten that public health is everyone's business and that disease can spread regardless of social class or economic standing.
The current swine flu scare should not be a crisis that goes to waste. First of all, if panic sparks precautionary measures, all the better. Hand washing, even among health care professionals, is still not where it should be--some 60% of the transmission of SARS occurred through health care workers. Public hygiene is a good thing--and if it takes panic to promote more public attention to preventive habits, that is not such a bad outcome.
Second, we should be using the swine flu scare to reassess the capabilities of our public health infrastructure--not just at the federal level but at state and local levels as well, which provide the first line of discovery and defense against threats to health. And if investments need to be made, we should be using this crisis to argue for the funding required. Tuberculosis is a case in point. Because of inadequate investment in public health efforts, multiple drug resistant TB has become an increasing scourge in many large U.S. cities. Although largely confined to poorer and other at-risk populations, there is no guarantee the disease won't spread to the broader society and in any event, a humane and just society is concerned about the health and well-being of all of its citizens.
Sooner or later some epidemic will overwhelm the capacity of our poorly staffed and funded public health system. If some panic causes citizens to demand more investment in public health and to engage in better habits of personal hygiene, then the cost of panic may be a small price to pay for changes that can help prevent a truly catastrophic disaster from eventually occurring.
Posted by: svreader | April 27, 2009 2:19 PM
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