In 2008, a homeless man contracted tuberculosis. He should have been sent to the hospital, but something went wrong. Now, nearly 100 people have the same strain of TB. And this outbreak isn't happening in the third world. This is happening in Florida.
In past years, these patients would be sent to A.G. Holley State Hospital, the only hospital in the state specializing in tuberculosis treatment. But only nine days before the CDC called the outbreak the worst in 20 years, Governor Rick Scott signed a bill closing its doors.
What's strangest isn't what happened before the alarming report. It's what happened after. Which is to say, nothing. Not only was the governor's office unaware of the report (they later asked a reporter for a copy), they sped up the process to close the hospital. It was permanently shuttered on July 2.
Stacey Singer, the reporter for the Palm Beach Post who broke the story and provided that report to the Governor's office, explains what's going on in Florida. The patient, a man with schizophrenia, was allowed to cycle for eight months between mental health institutions, prisons, and homeless shelters. In every instance, his hacking cough was detailed, but nothing was done to diagnose or contain him from the general population of these facilities.
"Now we have an estimated 750 to 1,000 people who were probably infected with tuberculosis and don't know it right now," Singer says. So far, 18 people have presented symptoms, and two have died as a result of the outbreak.
The disease is challenging to cure, requiring 3-4 antibiotics over six months of treatment in the best of cases. A drug-resistant strain can take much longer to recover from. According to Singer, an advanced case can cost a staggering $275,000 to treat. Successful treatment relies on patients taking their medication consistently, but as the majority of cases have been homeless people, it requires increased resources to make sure they remain on the course. It will be even more difficult without the facilities at A.G. Holley State.
Legislators, including Rep. Matt Hudson, the leading supporter of the hospital's closing, did not have the CDC's report at the time of the vote to close the hospital. As a result, lawmakers are calling for Governor Rick Scott to investigate the lack of information provided. “As far as I’m concerned, I did not know about (the outbreak) but it would not have changed my opinion," Hudson told local news Channel 5. "We simply made a decision on how best to treat people. That treatment is not best in a 60-some-odd year facility that was falling apart." Patients that would have been treated at A.G. Holley were transferred to other hospitals in Florida, and, according to Hudson, TB cases continued to drop.
Singer believes that the breakdown in communications was intentional. "They believed that the only people who needed to know there was TB in Duval County were the people who served the homeless, mentally ill, [and] incarcerated populations in Duval County," she says. "Unfortunately, the CDC report makes it quite clear that about a third of the cases had no connection whatsoever to those communities."