BREAKING NEWS : Hank Aaron, baseball legend and former home run king, dies at 86 Full Story

The surgeon general needs to step up for migrants

This is an open letter to Surgeon General Dr. Jerome Adams on the health crisis faced by hundreds of childre...

Posted: Aug 7, 2018 7:22 AM
Updated: Aug 7, 2018 7:23 AM

This is an open letter to Surgeon General Dr. Jerome Adams on the health crisis faced by hundreds of children, including some infants, whose parents are seeking asylum in the United States.

You don't know me, Dr. Adams, but we have met once, at the National Public Health Week event held this April in Washington, sponsored by the American Public Health Association. You gave a great talk about our responsibilities as physicians working in public health. Now it's time to discuss your responsibilities as the US surgeon general to respond to this public health emergency.

Accidents, disasters and safety

Business and industry sectors

Business, economy and trade

Children

Continents and regions

Demographic groups

Diseases and disorders

Epidemics and outbreaks

Families and children

Family members and relatives

Federal Emergency Management Agency

Government and public administration

Government bodies and offices

Government organizations - US

Health and medical

Health care

Health care professionals

Hurricanes

Natural disasters

North America

Physicians and surgeons

Population and demographics

Public health

Public health administration

Severe weather

Society

The Americas

Tropical storms

United States

US Department of Health and Human Services

US Department of Homeland Security

US federal departments and agencies

US federal government

Weather

Immigration

Immigration, citizenship and displacement

International relations and national security

Though the policy of separating children from asylum-seeking parents at the border has ceased, we learned in a Senate hearing this week that hundreds remain separated, including from parents who have been deported or are elsewhere in the United States. This situation is particularly troubling because some of these children are being housed in facilities in several states that are not suitable for young children. Hundreds of adults are also being held in unsuitable facilities. As they have been shown in the media and described in reporting, some of these facilities are unacceptably crowded. Organizations like RAICES have reported poor conditions and treatment. Photos and video of the tent city in Tornillo, Texas, show people housed in canvas tents. As a native Texan, I know that the climate there would make it difficult to control temperatures in those tents, putting everyone there at risk for heat stroke and heat exhaustion. And everyone in an overcrowded facility faces unacceptable risk of communicable diseases like skin infections, norovirus, and respiratory viruses.

You must insist on and organize adequate medical screening and care for people who seek asylum in this country. You can offer to take charge of and coordinate the public health response. You can pressure HHS and DHS to change their approach, and you can use your moral authority as a physician to speak out, and you can send the expert members of the Commissioned Corps to work with local public health agencies to help these people.

It is clear to me that these facilities lack sufficient public health standards and resources; there are no reports that the FEMA National Incident Management System incident command structure is in place and no adequate medical oversight and intervention in the "shelters" in which these children and adults are being detained. The risk of communicable disease outbreak in what are essentially make-shift prisons is high, as is the risk that undetected medical illness will progress and place these people at risk for serious illness, disability and death. Communicable disease could be transmitted by staff in these crowded facilities into the communities in which these facilities are located.

Since these are mass sheltering events, situations in which large groups of people are in close proximity in small spaces for days to weeks at a time and which are usually seen after a natural disaster like flood or hurricane, as the nation's lead public health physician it is your job to declare a public health emergency and apply political pressure for public health and medical oversight. By following the Federal Emergency Management Agency Incident Command System, you should order and permit local public health departments to work with local emergency management departments to set up emergency operations centers with mass sheltering oversight that includes medical and public health branches.

FEMA has the ability to respond to both natural and man-made disasters when requested by local or state officials, or when a federal official declares an emergency. You, as surgeon general, lead the National Prevention Council, which provides coordination within the executive branch with respect to prevention, and you oversee the US Public Health Service Commissioned Corps, charged with protecting, promoting and advancing the nation's health. Because the people who are detained in these facilities as well as the communities around them are at risk for disease outbreaks, you have the responsibility and authority to declare this an emergency and call for FEMA to work with your Commissioned Corps and to coordinate with local public health departments to protect the people being held, as well the public.

Commander Jonathan D. White of the Commissioned Corps told senators on Tuesday that he was unsure whether his department had enough resources to handle large numbers of detained immigrants alone.

In a July 16 statement to the press, an HHS spokesperson said, "Our interpretation of the court's order is that HHS must make a determination of parentage, fitness, and safety before reunifying families, but that HHS need not undertake the fuller process of vetting for children's safety that HHS would ordinarily conduct in its operations." Having reviewed all the news releases on HHS website about this issue, I have seen nothing addressing the suitability of facilities and no response to criticisms of the facilities that have been shown in news photos such as the chain-link fences and the reports of 24-hour lights on situations.

In fact, FEMA has an excellent guide for these mass sheltering events posted on its website. And, after Hurricane Harvey last August, I was a member of the medical team at the Dallas MegaShelter that published our experience sheltering thousands of people at considerable distances from their homes in the journal Disaster Medicine and Public Health Preparedness. You can seek guidance from both these documents.

Texas did a great job after Hurricane Harvey in caring for people displaced into large shelters. Some commissioned corps officers came to the shelters and provided assistance and expertise.

Dr. Adams, you can reach out to the public health leaders in Texas for guidance, and you have experts in the federal government as well whom you can direct to collaborate with local public health departments to ensure adequate medical staffing, resources and support. You can bring your commissioned corps into every one of the facilities holding these children and adults and get the necessary public health interventions and safeguards in place.

You must get to work today. I'll help you, as would thousands of US physicians, nurses and public health and other health care professionals. You hold a sacred office and ethical duty to the people of this nation and those who seek help from us, as our surgeon general, our chief physician.

I know you are capable of handling this crisis because during your tenure as Indiana state health commissioner, you led Indiana's successful response to deal with the largest HIV outbreak related to injection drug use in the history of the state. You are showing passionate and innovative leadership in promoting solutions to the opioid epidemic. Your skills in motivating and education the public and public officials are strong, and your knowledge of public health principles and how to apply them to real-world challenges is evident.

It's time for you to take immediate action to remedy this current massive public health crisis. Please do it today.

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 601937

Reported Deaths: 9593
CountyCasesDeaths
Marion831111322
Lake44972678
Allen32498545
Hamilton29039315
St. Joseph27133380
Elkhart24291343
Vanderburgh19160246
Tippecanoe17799130
Johnson14871292
Porter14631167
Hendricks14188247
Madison10851219
Vigo10636178
Clark10520137
Monroe9299110
Delaware9055134
LaPorte8972160
Howard8134142
Kosciusko800382
Warrick665197
Hancock6575103
Bartholomew637999
Floyd6322109
Wayne6076161
Grant5937113
Dubois552578
Boone544967
Morgan530594
Henry503464
Marshall499884
Cass478663
Dearborn470745
Noble468357
Jackson420747
Shelby410781
Lawrence387478
Clinton370642
Gibson365559
DeKalb344264
Montgomery340754
Harrison340544
Knox333139
Miami317344
Steuben311545
Whitley301725
Wabash299747
Adams299035
Ripley296545
Putnam292049
Huntington288659
Jasper287634
White270340
Daviess266073
Jefferson257938
Fayette245148
Decatur244883
Greene238162
Posey236927
Wells233350
LaGrange226361
Scott221838
Clay220932
Randolph212148
Jennings195836
Sullivan190833
Spencer188019
Fountain182127
Washington182022
Starke174443
Jay166322
Owen162837
Fulton162330
Orange156333
Carroll155415
Rush153318
Perry151227
Vermillion147334
Franklin146933
Tipton130932
Parke13018
Pike115626
Blackford110522
Pulaski96137
Newton90521
Brown86833
Benton85910
Crawford7839
Martin72313
Warren6757
Switzerland6455
Union6227
Ohio4787
Unassigned0375

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 849704

Reported Deaths: 10518
CountyCasesDeaths
Franklin100046706
Cuyahoga845231068
Hamilton63092447
Montgomery42660405
Summit34405754
Lucas31041611
Butler30546229
Stark25443429
Warren19436140
Lorain18767223
Mahoning17163337
Lake15882153
Clermont15697110
Delaware1422678
Licking13067137
Trumbull12680313
Fairfield1262180
Greene11915136
Medina11439167
Clark10802265
Wood10230158
Allen9774126
Portage9163107
Miami907373
Richland9035117
Marion7420113
Tuscarawas7280179
Columbiana7263124
Pickaway719550
Wayne6954169
Muskingum690741
Erie6090127
Hancock547590
Ross543487
Scioto533664
Geauga501155
Darke465591
Ashtabula449373
Lawrence447053
Union444928
Sandusky433062
Mercer432088
Huron423541
Seneca423465
Auglaize419662
Shelby419421
Jefferson415469
Belmont411240
Washington383340
Athens37379
Putnam372674
Madison349929
Knox347922
Ashland342538
Fulton335243
Defiance327782
Crawford319472
Preble318437
Brown307121
Logan304132
Ottawa289243
Clinton286643
Williams275866
Highland271818
Jackson261345
Guernsey249825
Champaign249328
Fayette234429
Morrow23014
Perry228318
Holmes222864
Henry216849
Hardin210133
Coshocton203521
Van Wert200545
Gallia194726
Wyandot193851
Pike172417
Adams172015
Hocking169824
Carroll153216
Paulding143221
Noble119940
Meigs106823
Monroe100331
Harrison87821
Morgan82229
Vinton68913
Unassigned00
Fort Wayne
Cloudy
26° wxIcon
Hi: 27° Lo: 26°
Feels Like: 16°
Angola
Cloudy
23° wxIcon
Hi: 24° Lo: 23°
Feels Like: 10°
Huntington
Cloudy
26° wxIcon
Hi: 26° Lo: 25°
Feels Like: 18°
Fort Wayne
Cloudy
26° wxIcon
Hi: 28° Lo: 27°
Feels Like: 16°
Lima
Partly Cloudy
28° wxIcon
Hi: 29° Lo: 28°
Feels Like: 17°
Colder Friday
WFFT Radar
WFFT Temperatures
WFFT National

Community Events