I have a lot of sympathy during these trying times, but there’s a reason for all this, and we should be clear about it.
Five years ago, Melanie Richburg used a roll of duct tape, a HEPA filter and a portable fan to draw contaminated air out of a hospital room where patients were tested for the coronavirus.
Now, as the state’s largest measles outbreak in three decades sickens an increasing number of Texans in the South Plains region, the Lynn County Hospital District, where Richburg serves as the chief executive officer, is still without specialized isolation rooms to treat patients.
So, she’s prepared to bring out the duct tape again.
“If we see the volume of patients exceeds the number of beds available at children’s hospitals, we’re going to need a contingency plan,” said Richburg, whose county is 30 miles south of Lubbock and has had two measles cases. “The biggest struggle we have is the same struggle we had during COVID.”
The coronavirus pandemic underscored the need for robust public health infrastructure. And it brought to light a remarkable urban-rural divide in access to basic health services. In the months after the virus ravaged the country, federal dollars flowed to local public health districts, and policies targeting health care deserts saw a renewed push.
Yet as a disease that had been declared eliminated from the U.S. in 2000 makes a resurgence, rural West Texas communities and state officials are scrambling to respond. Aging infrastructure, a dearth of primary care providers and long distances between testing sites and laboratories plague much of rural Texas, where the measles outbreak has concentrated.
At least 198 people in Texas have been infected with measles since late January, and one child has died from measles, the first such death in the country in a decade.
More measles cases are expected, and the outbreak could last for months, state health services commissioner Jennifer Shuford told lawmakers last week.
Though different from COVID in many ways, measles is similarly revealing how a lack of public health resources leaves rural communities vulnerable. What’s left are local leaders forced to scrape together the few tools they have to respond to an emergency, contending with years of lackluster investment from the state and federal level to proactively prevent emerging public health threats.
“We’re in a public health shortage area,” said Gordon Mattimoe, director of the Andrews County Health Department.“ You have to think outside the box.”
Some 64 Texas counties don’t have a hospital, and 25 lack primary care physicians, according to the Texas Department of Agriculture. Twenty-six rural Texas hospitals closed between 2010 and 2020, according to a rural hospital trade organization, and although closures slowed in the years since, those still standing are often in crumbling buildings with few medical providers.
Swaths of Texas have scant resources for public awareness campaigns. And they lack sufficient medical staff with expertise to provide the one-on-one education needed to encourage vaccination and regular visits to the doctor.
“We have a difficult time in our area finding pediatricians for our newborns,” said Sara Safarzadeh Amiri, chief medical officer for Odessa Regional Medical Center and Scenic Mountain Medical Center. “That’s a problem. If you can’t find a pediatrician, then when a serious question comes up, who do you ask?”
I have nothing but respect for the healthcare professionals and local leaders who are doing their best to cope with this situation. But this is a situation that has happened entirely on the watch of the unified Republican government in Texas. They have had plenty of time to take action to ameliorate the lack of rural hospitals, lack of doctors and labor and delivery rooms and prenatal and obstetric care if they wanted to. They haven’t, and the people who live in these affected areas overwhelmingly support them anyway. At some point, one wonders what if anything could change the status quo.
Anyway. The official case count jumped quite a bit last Friday, but there’s reason to believe it’s a serious undercount.
It’s very hard to say whether we are at the beginning or middle of the outbreak, mostly because I don’t trust the numbers. everal signs suggest substantial underreporting:
- Death ratio. We’ve seen two deaths so far, yet only 228 cases have been reported. Measles typically kills 1 in 1,000 unvaccinated individuals. They were either extremely unlucky, or there are more cases than reported.
- Very sick hospitalized patients. By the time these hospitalized children get to the hospital, they are very sick, meaning parents may be delaying care. The second measles fatality (which was an unvaccinated adult) never even went to the hospital.
- Epidemiologists are encountering resistance to case investigations.
- We don’t just have a murky numerator (case count)—we also have a murky denominator (population size). The community at the center of this outbreak is likely far larger than official U.S. Census figures suggest.
I wager the “true” count is much higher than reported. A CDC response team is now on the ground, working directly with local and state epidemiologists to help get this under control.
We may never know the true case level, but whatever it is, it’s going to keep going up for the time being.
And then there’s this:
Instead of focusing on the growing outbreak, Kennedy, a rabid anti-vaxxer and conspiracy theorist, is using taxpayer dollars to direct the Centers for Disease Control and Prevention to conduct needless trials on a disproven link between vaccines and autism. To the chagrin of “crunchy” pseudoscience advocates, numerous studies found no link between vaccines leading to autism.
That hasn’t stopped Trump’s public health goons from continuing to parrot junk-science talking points.
“As President Trump said in his Joint Address to Congress, the rate of autism in American children has skyrocketed. CDC will leave no stone unturned in its mission to figure out what exactly is happening,” a spokesperson for the Department of Health and Human Services said in a statement to ABC News.
It’s unclear how the study would be conducted, who would take part in it, and how it would be different from numerous previous studies of the same topic.
Public health experts are denouncing the decision. Others are afraid of the impact Kennedy is already having on waning public health trust.
“The announcement that CDC will look at potential links between vaccines and autism means that significant federal resources will be diverted from crucial areas of study, including research into the unknown causes of autism, at a time when research funding is already facing deep cuts,” said Tina Tan, president of the Infectious Disease Society of America.
Where there’s a circus, there’s clowns. I don’t know what else to say.
Sorry. I have no sympathy. These folks live in West Texas for the solitude and perceived less government. They signed up for this. I only hope they’ll stay there and not get on a plane or come to the cities.