State, local, and federal officials apparently did not want the story of the TB outbreak to break out in public, and gave Singer a hard time when she pushed them for records, data, and even the simplest of comments. She had no luck getting the CDC expert who is the main author of the Journal article to talk, or even TB experts at the University of Florida. When it became clear that only two-thirds of active cases of the disease could be traced to places where the homeless and the mentally ill congregated—suggesting that the strain had spread to the general population—the paper asked for a state database showing where every related case has appeared. Singer reported in her piece this past Sunday that the database still “has not been released.”
But she finally got the CDC report last week after interviewing Florida’s newly appointed surgeon general and secretary of health, John H. Armstrong. What shocked her, she said, was that she had not understood— until she finally saw the report—that this was the most active outbreak in the past 20 years.
And “What surprised me most is the CDC’s role in allowing the cover-up to happen,” she said. “They were not willing to inform the public if the local health department decided it was not the right thing to do.” Singer speculated that since Florida depends on tourism, perhaps the state did not want the public to see that Florida is a state with TB. “Maybe the CDC went along with that.”
But because of some old-fashioned muckraking journalism the world now knows Florida is a state that has a TB problem, and has undercut its ability to contend with that problem. The story raises profound questions about the effect of continued government cost-cutting on public health, historically an underfunded stepchild of the healthcare system.
Beyond Florida, will cost cutting in state capitals reach a tipping point at which the public’s health and safety is in jeopardy? Will the public see the link between public health services and the ongoing rhetoric about taxes and spending? Those are questions for the Post to work on, and other outlets too.
The arrogance of Science, Medicine, Politics, and Business (and Big Business Education) is going to get us into a terrible fix.
Every medical student in America should be studying Mann's sharp novel:
The Magic Mountain: Course of Illness - Lapham's Quarterly
www.laphamsquarterly.org/.../the-magic-mountain-course-of-illness....
(Even today, despite the drugs available to treat it, TB remains a
major public health problem in many developing countries.) Mann sets
The Magic Mountain in ...
They should also assimilate this sharp editorial:
The [Washington] Post’s View July 10
Resistance to antibiotics is becoming a crisis
--Some bacteria, such as those causing tuberculosis and gonorrhea, have become resistant to multiple antibiotics. In the past few years, researchers discovered a new enzyme known as NDM-1 that can confer resistance to antibiotics on bacteria and can easily jump among different species. As the first-line antibiotics are lost, the replacement treatments are often more expensive, and more toxic.
There is just no excuse for this state of affairs.
Medical faculties should be sharp in practice so that every medical student in America would absorb the most fundamental contribution in psychology, Mark Ashcraft's "Cognition."
There is just no excuse for lazy bad practice. If instead of deleting comment to protect a friend, the monolithic and somewhat obtuse Science were to get on top of these issues, we might be able to deal with them.
Textual and discourse cohesion and coherence are subjects in linguistics. You might think that in undergraduate programs the students would be swarming the COBUILD English Grammar, chapter 10, to learn.
#1 Posted by Clayton Burns, CJR on Wed 11 Jul 2012 at 12:43 PM
For several years my colleagues and I have argued that the social determinants of health and the operational viability of health systems are threatened by peak oil, which is the lead but not the only resource scarcity issue facing the human world as it reaches the limits to growth. The end of perpetual growth coupled with the inability to perceive it leads to governments protecting elites and imposing "austerity" on the common citizen in the name of restarting growth.
#2 Posted by Dan Bednarz, CJR on Thu 12 Jul 2012 at 07:28 AM