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Why public health professionals fail the nation

Doctor-Globe

If you want the explanation in a nutshell of our haphazard response to the appearance of a single Ebola case in Dallas only need to view the first view this video of a debate between Bill Maher and Ben Affleck on HBO’s “Real Time.” It is a sad state of affairs when you have to rely on Bill Maher for the intellectual content of a program but when you invited a slack-jawed know-nothing actor on that is what happens.

Via Politico:

Maher, the show’s host, pointed to such principles as freedom of religion and speech as well as equality for women, minorities and homosexuals.

“These are liberal principles that liberals applaud for but then when you say in the Muslim world, this is what’s lacking, then they get upset,” Maher said.

Harris added that, “I would argue the liberals have failed us. The crucial point of confusion is that we have been sold this meme of Islamophobia where every criticism of the doctrine of Islam gets conflated with bigotry towards Muslims as people. That is intellectually ridiculous.”

Affleck interjected, “So you’re saying that Islamophobia is not a real thing.”

“I’m not denying that some people are bigoted against Muslims as a people and that’s a problem,” Harris replied.

“That’s big of you,” Affleck shot back.

Maher asked Affleck, “But why are you so hostile about this?”

“It’s gross, it’s racist,” the actor said. “It’s like saying you’re a shifty Jew.”

Maher said Affleck wasn’t listening to the argument he and Harris were making.

So, you are rightfully asking, what does radical Islam, the liberal love affair with anything remotely anti-American or anti-Western, and Ebola have in common?

Let’s start from the beginning. The public health establishment is Democrat and progressive to its core. In schools of public health, which churn out the nannies and bureaucrats that populate public health organizations, the idea of “public health” is inseparable from “social justice” and political liberalism (see, for instance, http://goo.gl/cJGx9A). This is not to say they are dumb, they aren’t. But they are overly earnest and given to doing stuff that makes Captain Obvious seem oblique and inscrutable. One of my favorite articles of all time is this, from the American Journal of Public Health, which proves that Americans have better health than Pakistanis:

CONCLUSIONS: There are major inequalities in health within Pakistan and between Pakistan and the United States. Standardized national health examination survey methodology can be used to monitor health status and plan health transition policy in developing countries.

As has been shown time and again, liberals are all in favor of civil liberties so long as the civil liberty cuts their way. They’d go to the gallows for the right of a Muslim to say prayers at the requisite intervals in public school but Christian prayers and religious displays are routinely met by court challenges. You can’t wear the American flag to school in some California schools because it may offend someone, but wearing a veil to get your drivers license picture is just peachy.

Ebola is one of those curious diseases that has a liberal constituency abroad but not domestically. Let’s turn to the press conference Saturday by CDC Director Thomas Frieden. I’ve had the occasion to work with Frieden professionally in his days as health commissioner in New York City and I have no doubt about his underlying competence.

In this country, we have health care infection control and public health systems that are tried and true and will stop before there’s any widespread transmission.  The core of that, the way to stop Ebola in its tracks is contact tracing, and follow-up.

This is true. And Ebola more likely than not will not spread in Dallas because Texas health officials did an admirable job of tracking down everyone the Ebola patient had come into contact with. Other than the world class goof when the patient first presented himself at a hospital emergency room the actions of the CDC and the State of Texas have been pretty solid… though their communication of those actions leaves a lot to be desired.

So why if, as Friden says, “…our number one priority is the safety of Americans.  Full stop,” are their still direct flights every day from Lagos, Nigeria, the current Ground Zero of the Ebola epidemic to the United States. To answer that Frieden uses this mind-numbingly stupid non-sequitur:

And finally, in terms of the entry process, we really need to be clear that we don’t inadvertently increases the risk to people in this country by making it harder for us to respond to the needs in those countries by making it hard for us to get assistance in and therefore those outbreaks would become worse, go on longer and paradoxically, something that we did to try to protect ourselves might actually increase our risk.  I’ll end with one example along those lines from the time that i was in Liberia.  The African union is quite willing to send hundreds of health workers in to help fight the outbreak in these countries, and they today have folks on the ground caring for patients.  That’s a terrific development.  But their ability to get there was delayed by about a week because their flight was canceled and they were stuck in a neighboring country.  So that neighboring country had taken — Senegal, had taken that action in order to protect themselves, stopping all flights, but that action ended up making it harder to stop the outbreak in Liberia and elsewhere and potentially increased the risk to that country.

There is absolutely no relationship with stopping entry of passengers from nations with a current Ebola outbreak and our ability to assist those nations in combatting the disease. For decades, the staff of what is now Immigration and Customs Enforcement have checked passports and visa stamps at air and sea ports of entry. This is not rocket science. No, we can’t be 100% certain but what we can be is about 99.99% certain. And that counts. If we had that basic policy in effect, there would be no Ebola scare in Dallas. The patient would have been denied entry to the United States and put on the next flight back to somewhere that would take him. Failing that, he would have been held one of the existing CDC quarantine facilities. If we need to help a nation in west Africa there is nothing that prevents the US government from chartering an aircraft or using a military aircraft.

Why do we think that is? Let’s go back to the Bill Maher segment. Do we seriously think that had Ebola originated in, say, Italy that we would have had any compunction at all about slapping on a travel ban? Thought so. The reason that a travel ban is not slapped on the affected nations is because liberals, like Frieden, like everyone in leadership at HHS, will not single out a sub-Saharan African nation as a health threat any more than the same people will do more than avert their eyes at what goes on in the Islamic world.

Let’s return again to Frieden: “…core of that, the way to stop Ebola in its tracks is contact tracing…

That is true but what happens when a disease has a liberal constituency? Like HIV/AIDS. When AIDS was first documented in 1981 or 1982, depending upon what you use as your criteria, the logical thing to have done would have been to treat it just like we treat syphilis or whooping cough or tuberculosis or Ebola. Determine the contacts of the people who have the disease, find those people, and examine them for the diesease. If they have it, find the people who have been in contact with them, etc., etc.

How did the public health community react when presented with a disease that affected a minority for which they had sympathy? Silence. And legal gibberish. Note the short shrift that health risk to others is given in this discussion:

A core legal dilemma in the case of HIV/AIDS is determining when the need to protect others, such as sex partners to whom the patient is likely to transmit HIV, supersedes the patient’s right to confidentiality. Public policy encourages high-risk groups to submit to HIV testing because those individuals who know they are HIV-positive are more likely to seek treatment and take precautions that may prevent transmission of the virus. However, if HIV-related information is readily disclosed by health care providers, individuals may become more reluctant to seek testing. When does the protection of others through a breach of patient confidentiality, ie, reporting cases to the authorities, become worth the risk to that individual who may be HIV-positive will avoid testing in order to avoid being reported?

And inevitably needless death, disability, and fear.

The gymnastics that enabled the public health community to ignore the very basic principles of combating an epidemic when confronted with a sexually transmitted disease affecting homosexuals it pretty much how they’ve reacted to a deadly, infectious disease originating in the Third World.

The current low-level panic over Ebola is due to just one thing. The United States government, via the actions of HHS and CDC, has totally abandoned their own policies for dealing with a potential epidemic. This is not the first time they have done so. So long as the public health community is more beholden to its own liberal orthodoxy than it is to science and medicine, the nation will never be very safe.

 

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