TB or not TB
Last month a very stupid, very inconsiderate and very dangerous man boarded a transatlantic flight knowing that he had infectious tuberculosis. He flew from Atlanta to six different countries, including Paris, where he took a bride. He also visited Rome where Georgia health officials caught up with him via cell phone and told him to report to a US Embassy hospital for isolation. TB man (his identity was initially protected by patient privacy) refused to go to the hospital, and continued to elude authorities as he globetrotted his way back to Canada, then rented a car and drove into New York State. The infected man, who we now know as Andrew Speaker, claims he was never told not to travel, but that’s like a drunk telling police he didn’t know he wasn’t supposed to drive while intoxicated. Over 80 passengers and nearly 30 crew members are being tested for TB, and those are just the folks we know had contact with Speaker. Who knows how many people were exposed to him in the six countries he visited?
Back here in the land of the free, people are screaming for justice, even calling for Speaker to do jail time. Such punishment would not be without precedent, given that we can imprison a terminal AIDS patient for deliberately and maliciously infecting an unknowing victim. At any rate, the TB man’s behavior has served to point up a number of problems.
First and foremost, where was Homeland Security throughout this saga? Health officials knew that Speaker had TB, yet no one prevented him from traveling in the first place. Only after he was overseas did the government put him on a no-fly status. Of course, once that was done, there were more foul-ups, including a border inspector ignoring computer transmitted instructions to detain Speaker.
The implication is that America is so inept at interagency cooperation and communication that Osama bin Laden could easily recruit a martyr to infect himself with a deadly virus, then enter the US unabated where he can kill thousands of people.
While searching the internet for more information on this column, I came across an unrelated yet ironic story. In late August 2006, an Orthodox Jewish man was removed from a commercial airliner because the flight attendant mistook his demonstrative praying as some sort of terrorist ritual. The crew later apologized to the man for their ethnic blunder. Anyway, I feel safe knowing that commercial airlines are protecting me from a praying man who might convert me, but don’t care to protect me from an infected man who might kill me.
Speaker, the airlines, health officials and Homeland Security all have a lot of explaining to do, but this debacle has also served to remind us of another health and safety problem, that of recirculated air in commercial jets.
Years ago, airlines routinely pumped 100 percent fresh air into the cabin. But newer planes now re-circulate as much as 50 percent of cabin air in order to save on fuel. Conservation is a noble cause, but I’d rather use more fuel and not be sick.
However, according to a November, 2006 report by ScienceBlog.org, the mixture of fresh to re-circulated air is only part of the problem. Cabin air also contains ozone, as well as vapors from hydraulic fuels and engine oils. These, combined with low humidity, significantly reduce overall air quality. Add to that reduced oxygen levels while flying at high altitudes, and we’re all at greater risk of getting sick, especially people with heart and lung problems.
An August 2002 study published by the Journal of the American Medical Association disputed that any of these factors contribute to a higher incident of colds and viruses and, instead, attribute such illnesses to dry air conditions. But that study didn’t take into account people with infectious diseases coughing and sneezing on or near other passengers. Clearly, we now know the risks of airborne bacteria in commercial jets, the spread of which is aided by the circulation system inside planes. What many of us might not know, however, is that while we continue to be exposed to all sorts of diseases, pilots are fully protected. That’s because the FAA mandates that cockpits have a separate ventilation system that can pump in 100 percent fresh air. But shouldn’t passengers be afforded the same protection as pilots? According to the Air Travelers Handbook website, pilots on some planes can actually control the mix of fresh to re-circulated air for the rest of us, but choose not to do so.
Last week’s TB incident should be a wake-up call for all of us, and it should prompt swift reform in a number of areas.
First, Congress should make it illegal to travel through, or exit or enter America for those who have been diagnosed with infectious diseases. Further penalties and even prison time should be added if the traveler deliberately eludes authorities.
Second, Homeland Security must revamp its communications process with local, state, federal and international health officials, and commercial airlines should have immediate access to that information.
Third, acting on that shared data, airlines should restrict any infected passenger from boarding a plane. Moreover, the airlines should detain anyone who displays obvious symptoms of cold or flu, and restrict them from travel. If you are coughing or sneezing uncontrollably before you board, you have no business flying, and that includes infants and children. It is unfair and even dangerous to fellow passengers.
Fourth, the FAA should require all airlines to return to the old system of pumping 100 percent fresh air into cabins so there is less risk that passengers will catch colds and viruses from other people. Again, I don’t care how much more fuel has to be expended to provide fresh air, our health is more important.
Finally, I’m tired of how the names of idiots and criminals are always protected. We hide the identity of kids who murder because they are just kids, and now the man from Atlanta can expose hundreds of people to TB, but we can’t expose his identity because of patient privacy laws?
Anyone who flaunts the law and travels about freely infecting other people must forfeit his or her right to privacy. In fact, I’d like to go one step further. I think we should mandate that these reckless individuals wear a scarlet letter “A” on their chest at all times. The letter “A” would stand for “A-hole”. Granted, it’s a crude method, but at least we’d know who to protect ourselves from.
One final note about that Orthodox Jewish man who was ejected from a plane for praying. He’s the lucky one. Next time I board a plane and see some guy coughing on me, I’m just going to start praying so that the flight attendant will remove me, and hand me over to Homeland Security. I might spend the night in jail, but at least I’ll breathe a little easier.
Jim Longworth is host of “Triad Today,” which can be seen Friday mornings at 6:30 a.m. on ABC 45 (cable channel 7), and Sunday nights at 10 p.m. on MY48 (cable channel 15).