August 05, 2016

Public health experts: US not prepared to tackle Zika crisis

Director James G. Hodge Jr. of the Network for Public Health Law makes no apologies for being an alarmist. So when he talks about the Zika virus, he wants to make sure you understand the urgency of this fast-spreading mosquito-borne disease that has affected infants and adults.

An expert panel addressed the Annual Meeting program, “Legal Issues Arising from the Zika Virus – Are We Prepared?”

“This thing is for real. This is a global menace. We emphasize it because what you don’t see under the headlines from the way the CDC [Centers for Disease Control and Prevention] is framing this, is that this is a serious public health crisis,” Hodge told an attentive audience during the August 4 CLE program, “Legal Issues Arising from the Zika Virus – Are We Prepared?” at the 2016 ABA Annual Meeting in San Francisco.

“It may not impact every American. In fact, most of them silently won’t have any clue that they have Zika infection,” he continued. “But there are tens of thousands of infants and pregnant women who will be directly impacted in serious longstanding and long-term ways. This thing is for real and we are taking it very seriously both internationally as well as  at the U.S. level from the White House level on down.”

Hodge, who is also a professor at the nationally-ranked Public Health Law and Policy Program at the Sandra Day O’Connor College of Law, Arizona State University, was joined on the panel by Capt. Kenneth L. Dominguez, U.S. Public Health Service, Centers for Disease Control & Prevention, who talked about the history of the Zika, the spread of the virus, prevention and treatment; and Paul Henderson, deputy chief of staff and public safety director for the San Francisco Mayor’s Office, who talked about the city’s preparedness and response to Zika. Michelle Oberman, professor of law at Santa Clara University School of Law, served as moderator.

From its discovery in Uganda in 1947, the Zika virus has emerged as a worldwide public health crisis, with diagnosed cases in more than 40 countries in the Americas and the Caribbean. According to Dominguez, prior to 2007 only a few cases were noted in Africa and Southeast Asia, but from 2013-2014, there were more than 28,000 suspected cases reported from French Polynesia.

Shortly thereafter, the World Health Organization declared Zika a severe public health crisis -- but without the resources and proper funding, only made recommendations for prevention.

Zika continued to spread and has exploded across the Americas. There have been more than 7,000 cases diagnosed in Puerto Rico, and in just the past few weeks, a total of 15 diagnosed cases in the Miami area of Wynwood.

“There is a need for public health urgency with what’s happening in Puerto Rico,” Dominguez said. “We are at the peak of the epidemic. Between Nov 1, 2015 and July 7, 2016, we have diagnosed Zika in 24 percent of 23,000 people that were tested, almost 1 in 4 persons tested for Zika tested positive. And 7 percent of the women tested positive.”

The Miami cases prompted the CDC to take the unprecedented step on Aug. 2 of issuing a travel advisory to pregnant women traveling to the Wynwood area. The advisory marked the first time the CDC has asked people to avoid an American neighborhood because of an infectious disease.

Funding for the virus is essential to fill major gaps in knowledge and medical technologies, the panelists say. Funding is crucial to tracking the virus, abatement of the mosquitoes, development of vaccines and proving health care services to those affected. In the United States, President Obama requested $1.86 billion to fight the virus, but Congress pushed back and went on summer break without committing the dollars to fight the virus, due in part to whether federal resources would be used to fund contraception or abortions abroad.

Legally, the panelists say we have to prepare to deal with the civil suits that might arise from the medical and environmental consequences of the virus. Environmentalists are concerned about the long-term effects of the pesticides that might be used to combat the Zika virus. What of the long-term birth defects arising from the disease? What are the legal hurdles of abortion in the U.S. and internationally for infected pregnant women who might consider aborting the child?

So, is the United States prepared?

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“No. We are not prepared because we have not put significant funding into Zika-specific prevention efforts,” Hodge explains. “We are not prepared because we don’t yet have sufficient epidemiologic data to even know where to apply some of those efforts. And we’re not prepared because legally we have specific barriers in place right now that until we go forward with varied states of emergencies at certain levels we will not get past those barriers fast enough. If we get a federal emergency declared we would get emergency funds immediately. We could get access to the funds and go from there and that would make a big difference.”

Hodge also says a federal declaration could also authorize certain things for the use of specific mosquito abatement techniques more expeditiously. “This comes with risks but right now we are facing a major risk, and lot of people would say the major risk is Zika. The subsidiary risk, we might have to work with. But as these mosquitoes spread into the southern parts of the United States in the fall you are going to see this sort of ball drop in regards to just how much effort we are going to put into fighting this disease.”

But proper funding is crucial, Hodge reemphasized. “All we are asking Congress for is $2 billion to do six to eight months of Zika prevention,’’ he says. “It is absolutely pathetic what Congress is doing. You have a known absolutely preventable condition spreading across the country and you’re still sitting on your hands waiting for what?”

The program was sponsored by the ABA Commission on Hispanic Legal Rights & Responsibilities.