On July 2, the state surgeon general’s office issued a happy-talk press release celebrating the closing of the state’s last tuberculosis hospital. As if this were good news. “An important day in Florida’s history of TB control.”
Six days later, a headline across the front page of the Palm Beach Post suggested that closing the old A.G. Holley State Hospital was indeed important, but for the wrong reasons: “Worst TB outbreak in 20 years kept secret. State rushes closure of its only TB hospital in Lantana.”
Last February, even as Duval County was struggling with a burgeoning tuberculosis crisis, our oblivious lawmakers were debating a bill that would massively downsize the Florida Department of Health, cut 12,000 public health jobs, eliminate preventive care and environmental health programs and close Florida’s last TB hospital. They weren’t told that Duval health officials had just asked the federal Centers for Disease Control and Prevention for help.
The controversial bill passed and was signed by the governor on March 27. Nine days later, the CDC issued a 25-page report, describing the Duval crisis as the largest outbreak of TB that the agency had encountered over past two decades. The investigation tallied 99 illnesses and 13 deaths in 2010 and 2011 from tuberculosis, including an antibiotic-resistant strain that public health officials fear most. The CDC calculated that the TB victims, many of them homeless and in and out of Jacksonville’s homeless shelters and assisted-living facilities and jails, had exposed more than 3,200 others to the lung disease. So far, only 253 of those potential new victims have been tracked down. The outbreak isn’t contained. And it has moved beyond Jacksonville.
The outbreak and the CDC report made for an explosive contradiction to the upbeat spin coming out of Tallahassee. The governor’s office denied a cover-up, but if not, the bad news was sure as hell muffled. Other agencies may have been notified, but there was no public warning. And the Palm Beach Post was only able to pry the CDC report loose after invoking the state’s public-records laws.
“The most serious outbreak of tuberculosis in the nation in 20 years and they kept it under wraps,” Dr. Marc J. Yacht, former president of the Florida Association of County Health Officials, said Wednesday. He was already angered by the gutting of the state’s public health service.
The Lantana hospital, Yacht explained, was designed not only to treat TB but to protect the public from the carriers. Sixteen of the 37 patients at A.G. Holley State Hospital had been placed there by court order, uncooperative and obstinate cases, deemed public risks. It takes two years of very expensive (about $275,000 a year) treatment to beat down antibiotic resistant TB.
Yacht said the state’s public and private hospitals don’t have the facilities or the money to take on these difficult cases. Worse, some TB patients have been relegated to hotels. He’s sure they’ll drift back into the streets.
“They’re going to lose track of these people,” he said. “They’ve created a serious public health problem. I don’t know why the hell they did this.”