Government can’t cut corners on health care

I read in your paper that there has been a case of active TB discovered in one of the schools in Harford County, recently (”Harford County health department, public schools confirm active tuberculosis case at Joppatowne High,” April 24).

The Harford County Health Department will take over from this point forward, as it should, in properly testing the reported case. After enrolling the concerned patient in the Direct Observation and Treatment program, applicable medications will be administered to said patient under direct observation, and the health department will follow the patient’s laboratory tests and clinical findings to prevent resistance and achieve cure. It will also track, trace, test and treat all contacts.

Cooperation with the nurses who do this yeoman work is of the utmost importance. Resistance to treatment will result in resistant TB bacteria in the index case and contacts, with the unfortunate spread of lethal TB in the community.

During the COVID outbreak, nurses in health departments across the U.S. had the duty to trace and track contacts of COVID cases, and this was not a pleasant experience for many of them. From hanging up on these nurses to calling them unacceptable names, some of the contacts indulged in reprehensible behavior, with nurses persisting despite the resistance and obstruction from contacts. The resistance and obstruction come from fear of discovery, fear of vaccines and other preventive measures, and fear of treatment.

In some states, in the matter of COVID-19, politicians aided and abetted uncooperative patients by vilifying health care workers as too intrusive. They politicized and undermined health departments as curtailing individual freedoms, and health department workers were hounded and threatened by some members of the public.

The common good receded. Common sense retreated and public health was jeopardized because the knowledge and goodwill of scientists and medical workers were placed under a shadow of mistrust and misunderstanding. Conspiracists and opinion makers dominated social media and news sites with blatant lies about health care workers, vaccine makers and folks who supported them, as having ulterior motives.

While some concerns may have been legitimate and some needed scrutiny and further investigation, many were fabrications and outright laughable superstitions and old wives tales — or worse. There was one that claimed COVID vaccines magnetize people. Another maintained that the vaccines were ploys from Bill Gates to kill people and prune the global population. Yet another claimed that if you were in the presence of someone who received the COVID vaccine, you would be contaminated by the vaccine.

Let’s remember, this was not too long ago. Fanning the flames of hatred while scapegoating health care workers and health care itself became a game for the demagogues of right-wing politics. Here was an opportunity they couldn’t pass up. Illiteracy and mob hysteria are giant gifts to politicians who want to fan the flames of fear and anger in their constituents to reap the rewards of such negative emotions.

The protests about masks made me think I didn’t need to visit Salem, Massachusetts, for a re-enactment of the witch hunt trials of yesteryear. They unfolded right here against education department officials who mandated masking.

On the subject of TB, the disease is deadly, and it is airborne just like COVID-19. But unlike COVID, it is spread by prolonged contact, not by fleeting encounters with people who have open TB.

Not many people are aware that in 2016, in Marion, Alabama, there was an outbreak of tuberculosis. This is a predominantly poor African American community in a state that has not accepted the expansion of Medicaid under the Affordable Care Act. Poverty, malnourishment — especially in children — living in rundown housing and in crowded quarters, homelessness, drug addiction, alcoholism, HIV, cancer, diabetes and other conditions create populations highly susceptible to TB, right here in the U.S.

In Marion, many of these factors met and created the perfect storm. In the most advanced country on earth, health officials documented in Marion in 2016, 27 patients with active TB and an additional 100 cases of latent TB. The Centers for Disease Control and Prevention policy of mandating testing for only high-risk populations was blamed as the cause for those people falling through the cracks, but that was empty finger-pointing because the poor and malnourished are high-risk populations.

To those Republicans who want to cut Medicare and Medicaid, and narrow the scope of food and other help for the poor, I say they are cutting off their noses to spite their faces. Also, when you spite the poor, you invite communicable diseases into your homes, for such diseases don’t discriminate. The state of Alabama rushed to treat the neglected poor of Marion because it knew the open TB there would not be contained.

What starts with the homeless can reach the rich, hence rich Republican lawmakers must not be indifferent to the poor. They should overcome their native antipathy for the poor to allow for government programs that assist and uplift the poor, instead of cutting those programs to reduce the government deficit.

Private charity is not enough for the gargantuan task of eradicating poverty. When welfare and food programs have been outsourced to private entities, the latter have made money out of the business of poverty while the poor have benefited little.

Government should be fearless about taxing the ultra-wealthy to help the poor directly, not through third parties. When it comes to communicable diseases that affect rich and poor alike, this is sound government policy.

I return to TB to say, we should thank our lucky stars we don’t have the same nonsensical sentiments about TB that we had and still have about COVID-19. Imagine where we would be if that were the case. TB would become endemic once more in the United States, or even an epidemic as it was in Marion, Alabama, in 2016.

Usha Nellore

Bel Air