TB and MRSA and Ronald Reagan

I will always think of Ronald Reagan as the president who brought back tuberculosis.  I think of all the evil he did, corruption at home and abroad, his legacy should most appropriately linked to inflicting disease on America.

I thought I had remembered Reagan cutting of the tuberculosis funds in the eighties, but I could find so little reference to this political crime, I began to doubt my memory.  Ironically, when you run a search of "Ronald Reagan and tuberculosis" you mainly get an outbreak among the sailors on the USS Ronald Reagan in 2006.  

My memory in this case was correct.  These are from a publication of the Johns Hopkins University Press in 2004 (click the title):

        Unlike the outbreaks of “emerging” diseases like Ebola, Hanta Virus or AIDS, when New York City faced an epidemic of resurgent tuberculosis in 1990-91 the famous disease detectives of the CDC  faced the challenge, not of identifying a new pathogen, but of developing policies to correct a breakdown in institutional disease control that had been more than a decade in the making. The few remaining tuberculosis specialists in the United States had warned for years that a TB resurgence was likely due to the dismantling of the city’s public health surveillance and treatment programs since the 1960s. One of those critics was Dr. Lee Reichman, Executive Director of the National Tuberculosis Center in Newark, N.J., who in 1992 described the upsurge in TB cases as “horrendous” to a New York Times reporter, remarking that, “This was a 100% preventable and curable disease.”

And,

   The rightwing political climate had generated an atmosphere of retrenchment in the public health community. Every year from 1981-87 the Reagan Administration called for repeal of the federal tuberculosis program (Ryan 1992).  Ironically, in 1986, the year when New York City’s TB case rates suddenly rose by 20% over the previous year, the federal-supported TB surveillance program for drug resistance was discontinued (Berkelman 1994). 

Of course, in the early eighties, tuberculosis was not much of a problem, but Reagan guaranteed it would become one.  I first started seeing tuberculosis during about the same time in Brownsville in the jail when the jailers were getting sick and calling about workers' compensation claims.  Of course, we could then still blame the problem on sick people coming across from Mexico.  Not anymore.

Now we are hearing about MRSA or the antibiotic resistant strains of staph.  These have been around for a while.  I had a case involving an infection in a local hospital about 15 years ago.  My client had gone into the hospital for a knee replacement.  The radiologist had burned him and then the burn was infected with an drug resistant staph infection.

The expert witnesses gave information about the disease, but the facts that struck me were the origin of the disease and why it sticks around.  As I recall from the expert testimony, MRSA arose in Detroit among drug users who were passing needles around and treating themselves with antibiotics, but not allowing a long enough course of treatment to cure the disease.  Soon, though, it was in hospitals all over the country.  The problem is that modern hospitals don't have windows that will open.  The bug is killed with fresh air and sunlight.

Now, the bug sits in wait in almost every hospital, jail, military base and school.  About a third of us would show positive for some staph infection if we all got our noses swabbed.  Many people don't get sick, but some are more susceptible than others.  Especially those with open wounds or compromised immune systems.

What does this have to do with government?  First, this is not even a disease that requires reporting to the CDC, so we don't know how many have it or how many have died.  However, it is generally believed as infectious diseases go, to be the biggest killer in the country.  Second, it is a disease perpetuated by a large poor, sick, incarcerated population.  

Twenty eight years of Reaganism has taken a toll.  I hope it ends this year.