In the jet age we live in, just which states would be most prone to be hospitiable to breeding an epidemic of an infectious disease?
Viruses like Eboloa or SARS or Enterovirus D68 are not detectible in people when initially infected. In the 21st century a person with a highly infectious and/or deadly disease can board an airplane from anywhere in the world and be anywhere in the USA in a matter of hours.
Is there a worse breeding ground in the USA for highly contageous infectious diseases than Texas?
Containing an infectious epidemic, and doing so quickly, is a doable thing. Especially in a wealthy nation.
One of the very well known problems with containing the current Ebola outbreak in West Africa has been the poor state of available resources (hospitals, doctors, public education...) in this impoverished part of the world. An inability to react quickly due to lack of resources and lack of public health infrastructure costs lives, and increases the risk of an epidemic or pandemic.
Remember this exchange in September 2012 between W. Blitzer and Texas Congressman Ron Paul during a GOP presidential debate?
BLITZER: Ron Paul, so you’re a doctor. You know something about this subject. Let me ask you this hypothetical question.
A healthy 30-year-old young man has a good job, makes a good living, but decides, you know what? I’m not going to spend $200 or $300 a month for health insurance because I’m healthy, I don’t need it. But something terrible happens, all of a sudden he needs it.
Who’s going to pay if he goes into a coma, for example? Who pays for that?
PAUL: Well, in a society that you accept welfarism and socialism, he expects the government to take care of him.
BLITZER: Well, what do you want?
PAUL: But what he should do is whatever he wants to do, and assume responsibility for himself. My advice to him would have a major medical
policy, but not be forced –
BLITZER: But he doesn’t have that. He doesn’t have it, and he needs intensive care for six months. Who pays?
PAUL: That’s what freedom is all about, taking your own risks. This whole idea that you have to prepare and take care of everybody –
AUDIENCE: (APPLAUSE)
BLITZER: But Congressman, are you saying that society should just let him die?
AUDIENCE: (YEAH!) {at 0105 in the linked video}
What the DKos audience understands that alledged physician Ron Paul and Texas governor Rick Perry do not understand, is that public health cannot be the financial responsibility of freedom loving risk taking Glibertarians with contageous deadly diseases.
Freedom loving, risk taking Typhoid Mary is presumed to have infected 53 people with the pathogen associated with typhoid fever. In 1907 we understood public health, and took care of EVERYBODY when Typhoid Mary was forcibly isolated by public health authorities. PUBLIC HEALTH.
We don't yet know all of the details about what happened with Thomas Eric Duncan, first patient diagnosed with Ebola virus disease in the United States, when he first arrived at the Texas Health Resources administered Texas Health Presbyterian Hospital Dallas.
This alone should be very disconcerting.
We do know that Duncan reported to the Texas Health Presbyterian Hospital Dallas Emergency Room without an ability to pay, a fever, and reported he had recently traveled to Dallas from Liberia. And we know Duncan was released and later returned with full blown Ebola.
We know that subsequent to Duncan's discharge he potentially infected more than 40 people.
We know that after Duncan's return to the hospital and diagnosis of Ebola, he probably infected a Texas Health Presbyterian Hospital Dallas healthcare worker.
What do we know about Public Health in Texas?
We know that Texas in 2012 had the highest rate of nonelderly uninsured in the nation: 26.9 percent [pdf].
In Dallas, the rate of uninsured is higher; 28.9% or 635,112 are uninsured.
We know that the body politic in Texas has refused MedicAid expansion offered by the Patient Protection and Affordable Care Act (a.k.a. ObamaCare) to cover the uninsured.
What do we know about Texas Health Presbyterian Hospital Dallas?
In accordance with the philosophy, eloquently expressed by former Republican Texas Congressman Ron Paul, the hospital in Dallas, Texas where Duncan was first not treated for Ebola is not a government run hospital dispensing welfare.
No, Texas Health Presbyterian Hospital Dallas is part of a “not for profit” healthcare conglomerate, Texas Health Resources (THR).
Dallas County Commissioner John Wiley Price has said race and a lack of insurance played into Presbyterian’s decision not to admit Duncan when he first showed up at the hospital’s emergency room on September 26. How might that be possible?
According to a D(allas) Magazine article of November 2013, THR is a “very profitable not-for-profit system” where “eight executives made more than $1 million in 2011.”
How does THR, the not-for-profit conglomerate managing the hospital which somehow inexplicably discharged an Ebola patient from its ER and failed to contain the virus from one of its workes do it? According to the article "by turning attention away from hospitals".
None of the above is conclusive.
But it certainly should not surprise anyone that when the first known person in the US with the Ebola virus disease arrived in Dallas, Texas needing health care that the public health care system was unable to do what must be done with highly infectious diseases; quarantine the patient immediately and protect those healthcare workers responsbile for the patient.
Texas is woefully unprepared to manage public health, intentionally.
Unless dramatic changes occur very quickly in Texas, don't be surprised if Ebola spreads in Texas.
The conditions for effectively containing an infectious epidemic are only slightly better in Texas as they are in Liberia.
Death Panels indeed.