HIV, hepatitis up, but Florida buries its head
The Indianapolis Star recently called one of its rural counties “The face of the nation’s opioid addiction epidemic” because so many drug addicts were injecting themselves with liquefied painkillers while sharing needles. This led to an unprecedented surge of 150 new HIV cases, and many hepatitis C co-infections, all in one county. It resulted in national news attention, U.S. Centers for Disease Control and Prevention involvement, and a state-of-emergency declaration from Indiana’s governor.
Data obtained by The Palm Beach Post Editorial Board suggests our own community is grappling with a significant number of new cases of HIV and hepatitis C. But instead of rapid action here, health officials in Tallahassee are “locking down” information while planning for more state budget cuts.
Time and again, under Gov. Rick Scott’s administration, health officials have been reluctant to acknowledge serious contagious disease problems, and even slower to tell the public. That’s always a mistake. The local data: ■ Newly diagnosed chronic hepatitis B cases in Palm Beach County are up 60 percent, to 181 cases, compared with this time last year.
■ Newly diagnosed chronic hepatitis C cases in Palm Beach County are up a whopping 73.5 percent, to 1,060 cases, compared with this time last year.
■ Florida HIV cases, meanwhile, are up 27 percent over three years, increasing from 4,593 in 2012 to 5,821 in 2014.
Hepatitis C is a contagious viral disease that infects the liver, and is spread primarily by contact with blood, as well as through sex. It’s a sneaky, silent virus that can produce no symptoms for years, yet be contagious. Eventually, it can cause chronic severe liver disease, and sometimes cirrhosis or liver cancer, requiring a transplant.
The new hepatitis C drugs are so effective, they’re essentially a cure. But the cost is stratospheric, between $65,000 and $100,000 per patient. The Palm Beach County Health Care District doesn’t cover them. Medicaid rarely does. And if the reason for infection is drug abuse, then treatment may need to be covered, too.
The CDC has asked local health departments to notify them of suspected clusters of recent HIV or hepatitis C infection. The Palm Beach County Health Department has not sent such notification, said Director Dr. Alina Alonso, because she is confident the increase reflects a greater focus on testing, not a new disease cluster.
It also may reflect Palm Beach County’s new role as a destination for drug and alcohol treatment. If people who test positive here return to their home states, their numbers will be removed from the count, Alonso said.
What’s troubling is that Tallahassee officials aren’t allowing a look at data from the other 11 Florida counties that share a CDC grant to conduct “enhanced surveillance” for hepatitis C. “All I have been told is that it’s locked down and we can’t see it. I said, ‘How can I not have access to my own data?’ ” Alonso said Thursday, four days after The Post placed a records request asking for the data. “The answer now is, ‘It is locked down.’ ”
She notes that in addition to the surveillance grant in place since 2012, there are other reasons for increased reporting. Labs are electronically sending notices of positives into the state’s database. Plus, ads for the new hep C drugs urge people to get tested.
“I think we are going to need to give this a little more time,” Alonso told The Post Editorial Board. “We don’t think there is an epidemic going on.”
In the midst of this, Alonso has just received word that her budget is being cut again. She must find $300,000 to trim starting in July. She’s had to slash the budget every year since Scott took office.
For all the shoulder-shrugging from the Department of Health, addiction and recovery professionals say needle use is trending.
“Roxies. Dilaudid. A lot of women shoot up their pills,” says Lisa McWhorter, clinical director at Wayside House for Women in Delray Beach. “They crush them, cook them, get them into a liquid form and inject. Once they can’t get that, then it’s usually heroin. That’s usually last.” The consequence? “So many girls are coming in here and finding out they are (positive for) hep C,” McWhorter says.
Treating drug addiction, HIV and hepatitis C infection are hugely expensive. Perhaps that’s the state’s real reason for “locking down” its data. If so, shame on the state, shame on Surgeon General Dr. John Armstrong, and shame on Gov. Rick Scott. Hiding public health problems only causes them to grow more costly.