The upswing in tuberculosis cases in the infamous Skid Row region of downtown Los Angeles is doing more damage than to the disease itself. Despite the fact that the increase in this communicable disease has been ongoing since 2007, it has only lately caught the attention of local leaders. The numbers of those suffering from TB vary according to which article you read, ranging from several thousand to less than one hundred. Considering there are roughly five thousand known homeless individuals living in Los Angeles at any given time, credibility of some sources of information can certainly be questioned.
What has been determined, no matter who gives the details, is that some of the homeless have indeed died from tuberculosis, which is now being found to have developed resistance to the antibiotics traditionally used in its treatment. No longer are TB patients isolated in sanitariums for at least a period of one year. They are generally medicated for a six to nine month course of medications, remaining in their homes if they have any. For those who are living on streets or in cars, keeping track of them is a difficult task for local community health workers. Many, because of their mental condition, possible other health issues and in many cases, addictions, are not cooperative where taking any sort of medication is concerned. Others lack any health insurance or means to buy the medication. In such instances they also are not aware of free community health coverage for the indigent such as Healthy Way LA.
Now, the ground covered in the past two years by homeless people in Los Angeles and their advocates where cessation of confiscation of their personal belongings is in jeopardy. Some local leaders are crying that the blankets, tents, and other goods of the homeless which are left on the sidewalks, in alleys and parks are the source of this so-called “Skid Row strain” of TB. They have petitioned the U.S. Supreme Court to overturn the ruling of 2011 forbidding police or other authorities to seize and remove personal belongings of the homeless without due process, without any warrant or other legitimate cause. Advocates for the homeless had sued the City of Los Angeles successfully because of the frequent practice of confiscating and throwing out all personal belongings including clothing, documents, medication, bedding, whatever they could find.
The truth is that this is just another step by the city to harass the homeless out of the area. Clothing and blankets, etc., laying on the ground are not breeding the tuberculosis bacteria. This disease is spread by coughing/sneezing, causing droplets of saliva to become airborne. Close contact in places like emergency shelters and schools are the prime locations for the spread of this (among many others such as meningitis) illness. Not all shelters require TB testing for residents or staff. Schools do not always insist on this procedure, either. Illegal immigrants, no matter how politically incorrect this may sound, do not generally have the greatest hygiene when they arrive in the United States from countries with poor sanitation and widespread disease. Add to the problem the mistaken notion many people have that the skin test is an actual vaccination, and you have the perfect situation for spread of a serious ailment.
Prevention of tuberculosis can only be achieved by locating active cases and treating them before they become more rampant. As well, more education of both homeless and other residents is a must. Teaching of good hygiene practices such as hand washing, covering coughs and sneezes, and cessation of public spitting (which is done by many who live in homes) as well as routine testing in all institutional settings will work. Harassment of those who have already lost everything but what they carry is not the answer.