Sunday, March 15, 2009

D.C. HIV rate hits 3%; H5N1 pandemic fears may be overblown; Metro safety issues

There are at least three important stories regarding public health or safety this morning, Sunday March 15, 2009.

First, on page B03, The Washington Post runs “5 Myths About Pandemics” by Philip Alcabes. The link is here. The general tone of the argument is that past is not prologue. The conditions that led to the 1918 Spanish flu pandemic probably will never occur again. H5N1 seems to be remaining in the sphere of animal-to-human transmission, not human-to-human. Tuberculosis is rarely transmitted in public spaces, despite the alarmist measures taken by public health officials, as with the 2007 passenger and the forced lung surgery. SARS, while arising suddenly, was relatively easily kept from spreading overseas from China.

What is more likely is that some new, bizarre disease will come out of nowhere. Maybe the best predictor of what could happen in the future really is you sci-fi horror films, like last year’s “Blindness” (from Brazil) and “Quarantine”. Keep paying attention to those new horror novels in supermarkets, and skim the web for the really innovative self-published horror. One of these imagined scenarios will happen some day.

Actually, regarding the tuberculosis issue, Scientific American has a Feb. 2009 article by Clifton E. Barry and Maija S. Cheung, "New Tactics in the Fight Against Tuberculosis," here. The March 2009 version in print also has a similar article.

Then Jose Antonio Vargas and Daniel Fears have a headline story in The Washington Post about the District of Columbia population: “HIV/AIDS Rate in D.C. Hits 3%:Considered a 'Severe' Epidemic, Every Mode of Transmission Is Increasing, City Study Finds”. The link is here. Although male homosexual transmission seems to still be the leading mode, heterosexual transmission and i.v. drug abuse are catching up quickly and will probably overtake, bringing the District into a pattern like that found in sub-Saharan Africa. In Washington, 7% of African-American men are infected, 4% of African-Americans as whole, and 1.4% of whites. It is true that among more affluent populations, life spans have increased enormously with antiviral drug treatments, making HIV a chronic but manageable disease. Side effects of the drugs (especially protease inhibitors) are serious but have become more manageable, too.

In several wards with the highest rates of HIV, 60% had never been married, and about that percentage had incomes under $10000 a year.

All of this is reported while the Whitman Walker Clinic faces budget cuts and layoffs and facility closings.

One other noteworthy safety problem has occurred this weekend: there have been two deaths with passengers on the tracks of the Metro. Generally officials don’t like to give out a lot of details or speculation. Maybe the DC Metro needs to consider installing plexiglass safety panels like those found in many stations in London and Paris.

March 18, 2009

The Washington Post today has an editorial on p A12, "From Bad to Worse: The HIV/AIDS epidemic is ravaging the District", link here.

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