BREAKING NEWS : Butler man dies after off-road vehicle collides with car 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.

Confirmed Cases: 36578

Reported Deaths: 2258
CountyConfirmedDeaths
Marion10188604
Lake3876207
Allen181071
Cass15919
Elkhart158528
St. Joseph135838
Hendricks120478
Hamilton119194
Johnson1125113
Madison60061
Porter56233
Clark53942
Bartholomew53139
LaPorte44824
Howard44236
Tippecanoe4344
Jackson4012
Delaware39741
Shelby39722
Hancock35427
Boone32436
Floyd31941
Vanderburgh2913
Morgan28626
Noble27821
Montgomery24917
Clinton2471
White2399
Decatur23132
Grant22923
Dubois2113
Kosciusko2052
Harrison19622
Marshall1872
Henry18512
Vigo1828
Greene17226
Dearborn17122
Monroe17113
Lawrence17124
Warrick16729
Miami1461
Putnam1427
Jennings1324
Orange13122
LaGrange1282
Scott1263
Franklin1168
Ripley1086
Daviess10416
Carroll952
Wayne906
Steuben902
Wabash812
Newton8010
Fayette797
Jasper741
Jay580
Clay533
Randolph523
Rush513
Fulton511
Washington501
Pulaski500
Jefferson491
Whitley453
DeKalb451
Starke423
Perry390
Huntington382
Sullivan371
Wells350
Owen341
Brown331
Benton320
Knox310
Blackford272
Tipton261
Crawford250
Adams231
Switzerland220
Spencer221
Fountain222
Gibson202
Parke180
Posey160
Martin140
Warren131
Ohio130
Vermillion100
Union100
Pike60
Unassigned0180

Ohio Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 37758

Reported Deaths: 2357
CountyConfirmedDeaths
Franklin6323295
Cuyahoga4789265
Hamilton2811171
Marion268832
Lucas2329263
Pickaway209938
Summit1529181
Mahoning1486191
Butler97532
Columbiana89453
Stark803102
Montgomery73417
Lorain73061
Trumbull60052
Belmont44915
Warren40721
Medina37624
Tuscarawas3714
Ashtabula36938
Miami36730
Delaware36014
Portage33557
Lake32512
Clark3237
Fairfield3188
Wood30649
Geauga30334
Wayne29651
Licking27110
Mercer2278
Richland2224
Allen22133
Clermont2195
Darke19023
Erie18416
Madison1647
Washington11819
Crawford1184
Morrow1081
Ottawa10717
Greene1065
Putnam9514
Sandusky9112
Monroe8015
Auglaize773
Hardin730
Ross732
Hocking705
Jefferson672
Huron611
Williams581
Holmes573
Union561
Muskingum561
Hancock531
Coshocton480
Wyandot482
Clinton471
Shelby473
Fulton450
Logan430
Fayette410
Preble391
Guernsey382
Carroll353
Defiance342
Brown311
Lawrence301
Highland291
Champaign281
Seneca262
Knox251
Ashland230
Vinton212
Perry191
Athens181
Scioto180
Henry170
Jackson150
Paulding140
Adams111
Harrison100
Pike90
Gallia81
Van Wert70
Meigs60
Noble60
Morgan50
Unassigned00
Fort Wayne
Clear
79° wxIcon
Hi: 86° Lo: 55°
Feels Like: 79°
Angola
Clear
77° wxIcon
Hi: 82° Lo: 55°
Feels Like: 78°
Huntington
Clear
79° wxIcon
Hi: 84° Lo: 55°
Feels Like: 79°
Decatur
Clear
82° wxIcon
Hi: 87° Lo: 56°
Feels Like: 82°
Van Wert
Clear
82° wxIcon
Hi: 86° Lo: 55°
Feels Like: 82°
Sunny Sunday
WFFT Radar
WFFT Temperatures
WFFT National

Community Events