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Hepatitis A scare: shame on city, county of San Diego

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A week ago, The San Diego Union-Tribune Editorial Board advocated for a faster, broader response to the horrendous Hepatitis A outbreak plaguing San Diego that had led to 352 cases, 264 hospitalizations and 14 deaths since late November. Ten of those deaths had come in the past two months.

By Thursday, as questions multiplied about what it’s increasingly clear has been an inadequate response from city and county officials, the tally had grown to at least 379 cases and 15 deaths.

Finally on Friday, after damning media reports in The Guardian and Voice of San Diego shone a light on government agencies’ lack of urgency and a bungling bureaucracy that has made a terrible situation worse, the first of 30 hand-washing stations began to appear on city streets to improve sanitary conditions in places where the at-risk homeless population has become the epicenter of this public health disaster.

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The first station was installed at the Neil Good Day Center on 17th Street, one of the heavily traveled downtown areas where street dwellers have spread the virus through fecal contamination and then person-to-person transmission and close contact. Other hand-washing stations are headed to Balboa Park and other parts of the city as part of a one-two punch of vaccinations and improved hygiene, two of the best defenses against infection.

To date, county health officials have vaccinated nearly 19,000 people against the virus in direct response to the outbreak, including 7,145 vaccinations for people who are homeless or illicit drug users. Another 1,400 hygiene kits have been distributed among that at-risk population.

Spokesmen for county government and the Mayor’s Office both stumbled their way through interviews with a Union-Tribune editorial writer Friday. Neither had good answers for why there wasn’t a more concerted effort to prevent the spread of this potentially deadly virus weeks ago. An overview on Hepatitis A on the Centers for Disease Control and Prevention website estimates there were 2,500 acute Hepatitis A infections in the entire United States in 2014 — the most recent year information is available — and that rates of Hepatitis A infections are the lowest they’ve been nationally in 40 years.

That’s all the more reason city and county officials should be ashamed they let San Diego’s outbreak become as severe as it has. The county first asked the city about a hand-washing station permit on Aug. 7. Twenty-five days later, stations are set up? That’s ridiculous. San Diego schools ordered mandatory half-days for students at dozens of schools on Friday because of the heat, disrupting thousands of families’ lives on short notice by notifying the families of the decision late Thursday night. On a far greater scale in a disaster that has devastated so many, Houston and federal officials acted with even greater speed and synchronicity.

Public officials can move fast and effectively when they want. They just didn’t with this Hepatitis A outbreak.

As Voice of San Diego’s Lisa Halverstadt notes, Friday’s flurry of government activity came more than two months after the county first announced plans to put hand-washing stations in places where homeless San Diegans tend to gather. Since that announcement, 11 people are dead and the number of Hepatitis A cases has more than doubled.

“It’s a fair assessment to say that the people involved needed and still need to get in a room and figure it out,” county spokesman Michael Workman said. “I think it’s happening now.”

Think? It better be, at last. Lives are at stake.

Twitter: @sdutIdeas

Facebook: San Diego Union-Tribune Ideas & Opinion

Twitter: @sdutIdeas

Facebook: San Diego Union-Tribune Ideas & Opinion

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