sunshine

Sunshine law helps reporter expose major TB outbreak in Florida

lborkowski — Thu, 12 Jul 2012 05:41:16 +0000

Sunshine law helps reporter expose major TB outbreak in Florida

I wrote last week about the importance of the Freedom of Information Act, and Stacey Singer of The Palm Beach Post has just published a piece that shows how important sunshine laws can be for public health. Singer revealed that Florida is in the midst of tuberculosis outbreak that's claimed 13 lives and sickened at least 99 people, six of them children. Another 3,000 people may have been exposed to the bacterium through close contact with contagious sufferers. "Fortunately, only a few of the cases have developed drug resistance so far," Singer reports.

State health officials explained that they had not alerted the public to the outbreak because the disease was largely limited to the homeless population. But Singer reports that "only two-thirds of the active cases could be traced to people and places in Jacksonville where the homeless and mentally ill had congregated," suggesting the bacteria had spread from this population into the general population. Such findings came from a CDC report that reached Duval County health officials in April.

Meanwhile, state health officials faced with budget pressures sped up the closure of A.G. Holley State Hospital, which had cared for some of the hardest-to-treat TB cases in the state for decades. (It closed its doors last week, sending to Jackson Memorial Hospital 16 TB patients who courts had ordered to be confined for treatment because they were unlikely to adhere to treatment otherwise.) The lawmaker who'd pushed for the health agency consolidation that led to the hospital's closure said he hadn't been aware of the outbreak. The Duval County Health Director conceded to Singer that "in retrospect, it would have been better to inform the general population" in 2008, when the outbreak began.

You can (and should) read the whole article here. What caught my attention in particular was Singer's description of how the newspaper obtained the CHC report from the state:

[Duvall County health officials] spoke about CDC’s report Friday, only after weeks of records requests from The Palm Beach Post. The report was released late last week only after a reporter traveled to Tallahassee to demand records in person. The records should be open to inspection to anyone upon request under Florida Statute 119, known as the Government in the Sunshine law.

Without the state's sunshine law, Singer might never have gotten access to the CDC report that details the Florida tuberculosis outbreak. Her reporting performs two services: First, it alerts people who may need to get tested for TB -- in particular, people who are homeless or are in frequent contact with homeless people. Second, it helps move TB up the priority list of lawmakers and executives who are making decisions about where to direct their limited resources.

Speaking of limited resources, this TB outbreak gives yet another example of how "saving" money by cutting public health can end up costing far more in the long term, in terms of both dollars and health. Singer writes (emphasis added):

Treatment for TB can be an ordeal. A person with an uncomplicated, active case of TB must take a cocktail of three to four antibiotics — dozens of pills a day — for six months or more. The drugs can cause serious side effects — stomach and liver problems chief among them. But failure to stay on the drugs for the entire treatment period can and often does cause drug resistance.

At that point, a disease that can cost $500 to overcome grows exponentially more costly. The average cost to treat a drug-resistant strain is more than $275,000, requiring up to two years on medications. For this reason, the state pays for public health nurses to go to the home of a person with TB every day to observe them taking their medications.

... Harmon said the Duval County Health Department will need more resources if it is to contain the current TB outbreak. In 2008, when the TB outbreak hit, his department employed 946 staff with revenues of $61 million. “Now we’re down to 700 staff and revenue is down to $46 million,” Harmon said. “It has affected most areas of the organization.”

If he can raise at least $300,000, he will use the money to hire teams of experts — epidemiologists, nurses, outreach workers, to look under bridges, in fields — in all the places where Jacksonville’s estimated 4,000 homeless congregate, to track down the people who may still be infected unknowingly.

The county and state could have saved money by preventing the initial 2008 outbreak from going on to become much more extensive in 2012. (Officials told Singer that they'd initially thought they'd contained the outbreak; only recently did several new cases emerge and turn out to be from the same strain, dubbed FL 046.) Perhaps the problem would be getting worse, though, if lawmakers and the public had remained unaware of the tuberculosis outbreak for another year. Thanks to Stacey Singer, The Palm Beach Post, and Florida's sunshine law, all eyes are now on Duvall County and Florida health officials.

lborkowski Thu, 07/12/2012 - 01:41

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infectious diseases

Public Health - General

Journalism

sunshine

tuberculosis

Having all eyes on them never has made Duval county do the right thing -- it's good ole boy central, rife with corruption and graft. And that's on a good day.

Gosh, I miss my hometown! Not.

Back and Thanks!

sastyk — Mon, 11 Oct 2010 07:51:20 +0000

Back and Thanks!

First and foremost, thank you so much to John Bell, Molly Davis and Niepoliski for their aid and comfort while I was head down in the conference. I admit, I had no idea that I would be going every single second of each day, and running on quite so little sleep. I think realistically, being on the board and being able to blog the conference are fundamentally incompatible, and next year, I probably won't try it. But thanks to my friends and allies, you at least got the beginnings of a picture of what was happening. There's so much information being shared there - someone called it "like drinking from the firehose" and I suspect some of what I learned will appear gradually over the next month or two as I begin to process it.

I should, of course, be taking up the mantle of my blog again today. But it is really beautiful out right at the moment, and I've spent four straight days either in a hermetically sealed train or a hermetically sealed hotel, forgetting that there were things like "sun," so I fear I'll leave you with some music and go outside and play. I feel like I'm back out on the earth after a long stay on another planet. But hey, I got faith in the sky, faith in the sun, faith in the people...

Back tomorrow!

Sharon

sastyk Mon, 10/11/2010 - 03:51

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Wait, is that a Michael Franti reference, slightly paraphrased?

Welcome back. I'm curious to hear about the ratio of practical to theoretical during the conference.

I thought the guest blogging went very well, and was a perfect embodied example of "adapting in place" to a changing circumstance. Hats off to all who made it happen!

Airlock examples

rallain — Wed, 14 Apr 2010 10:30:09 +0000

Airlock examples

I was going through and tagging some old posts. While looking at a post attacking the movie Sunshine, I accidentally found something else on youtube.

Gravity in Sunshine

I could not find a clip online of the scene I want, so I made a cartoon. Basically, (oh - spoiler alert) some guys are trying to get from one spaceship to another by shooting out of the airlock and into the other. They fly through space and into the other airlock, close the door and emergency pump the air in. When the closed air lock fills with air, they all fall down. Since there was no online video version, I made a cartoon.

Gravity in 2001 a Space Odyssey

Another spoiler alert - but really, if you haven't seen 2001 yet, are you going to? Well, you should. Something similar happens in this movie. Going from one airlock to another and then filling with air. Check it out.

Which one was better?

rallain Wed, 04/14/2010 - 06:30

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The first is better...it's common knowledge that creating a breathable atmosphere turns on the 1g artificial gravity field.

2001 entry sequence was marvellous...the lack of sound until their was enough air and Dave's flailing around in free fall. The whole movie (apart from the whimsical end-of-movie acid trip) seemed to have got all its science right.

There was an old movie, the thieves had to steal an object in a turkish museum without touching the floor, so they pumped all the air out of the room, put on spacesuits, and then floated into the room ...

That was not "Topkapi"

@_Arthur

Wow - I am going to have to find that video. I wonder if NetFlix has it.

It was a end-of-the-70's crime movie, B series, probably european, I didn't even bother watch the whole movie. The museum robbery was just plan silly.

In all seriousness, my high school geography teacher insisted that gravity was caused by air pressure. She got really upset when I tried to correct her...

Gravity is one of those weird sci-fi geek blind spots. The world is full of assholes who'll moan endlessly about the impossibility of FTL travel, but very few complain about the fact that the gravitational field from a nearby finite plate of uniform density would be completely the wrong shape... Or that 99 times out of 100, the magic gravity keeps working even when nothing else is.

Dunc, it's not so much a blind spot, as just really hard to film any other way than at constant 1G.

Air equals gravity in movies (again)

rallain — Fri, 13 Feb 2009 11:08:04 +0000

Air equals gravity in movies (again)

The local Society of Physics Students invited me to watch the movie Sunshine and then participate in a post movie discussion. There was one thing in the movie that really got me. Of course the movie made many of the common space mistakes. But this one didn't seem necessary. Let me outline this part of the movie (I guess I should say spoiler alert - although this isn't central to the main plot). Here are three frames of a comic I drew to reproduce the scene.

After watching Sunshine, the astronauts try to go from one ship to another without space suits (well, one of them had a suit). After getting in the air lock and closing the door, air is added and they fall to the ground! (note, this is my first comic strip)

No WAY. Air = gravity. No air = no gravity. How clearer could it be? This also happened in the movie Wall-E and I posted about it then. Basically, many people think that if there is no air there is no gravity. It sort of makes sense - if you are in space, there is no air and no gravity. Except that there IS gravity in orbit. And what about the moon? There is no air there, but clearly there is gravity.

After my initial rage, I settled down. I thought of a couple of good points to consider.

It is difficult to act while pretending to be in a 'zero-g' environment (I am not sure what the best thing to call apparent weightlessness other than apparent weightlessness - again, I talked about this in detail before). So, as a film maker, what are the options? You could go the apollo 13 route and film inside the vomit comet in real apparent weightlessness. However, you can't fit a very big studio in a jet. Also, it is expensive. Also, you can only film like 30 seconds at a time. Also, the vomit. The other option would be to suspend people from wires to simulate apparent weightlessness. The big problem there is that it looks dumb.

So, the movie maker is left with the choice of making fake gravity. Really, the movie is not about science, it is about people - right? So maybe it isn't a big deal that they just say "oh, hey - there is some gravity here". But here is the problem. Gravity inside - check. No gravity outside - or that would be real stupid, right? Now, how do you make the transition from outside to inside? I think the air-gravity option is one clear way. And really, how many physicists watch movies anyway?

Shouldn't they have lost gravity when they lost power? Well, I don't know how their gravity stuff works. But they did remove all the air from the spacecraft and there was still gravity. Although, it seemed like gravity was much less without air. It sucks being a physicist and watching movies.

It is fun to look at other movies and how they dealt with gravity and space. As I said already, Apollo 13 did it right. I saw no mistakes there. 2001 A Space Odyssey also did a fairly good job. I can see Stanley Kubrik now "I want it to be real. They should be apparently weightless, but that would be difficult to film. Oh! Velcro Shoes! And then we can just rotate the ship to create artificial gravity."

One of those asteroids hitting the Earth movie (I think Armageddon) tried to do the spinning space ship thing also, but it didn't turn out pretty.

Final Fantasy did apparent weightlessness, but I guess it was easy for them since it was an animation.

Oh, last thing. I give more points to Wall-E for their air-gravity mistake. It was a much advanced technology. Maybe they just happened to turn on gravity and air at the same time. And it was an animation.

rallain Fri, 02/13/2009 - 06:08

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