Giving thanks to America’s medical community for life-saving vaccines

School children wait in line for immunization shots in the 1940s at a child health station in New York City. (Courtesy of Library of Congress)

If we were not still in the grip of a deadly pandemic, with the seven-day average U.S. death toll from the coronavirus hovering just over 1,100 a day, I probably would not have thought of giving thanks this year for the medical researchers who have given this country protection against many life-threatening illnesses.

Back in the late ’40s and early ’50s, when I became aware of vaccinations, my thoughts were anything but thankful. When a doctor or nurse brought out a needle, they had to pry me out from behind the furniture to administer a shot. I refused Novocain in the dentist’s office.

Then came the 1952 polio epidemic, which was the worst outbreak in the nation’s history. We saw pictures of kids in iron lungshuge mechanical devices to help kids breathe.

We did not know what caused polio, but we were told not to gather together or drink from public fountains or swim in public pools. My uncle, Uli, got polio and his legs withered, bringing the disease close to home. When the Salk polio vaccine became available in about 1955, everyone in our community and across the country could not get shots fast enough.

That softened my fear of needles. It further softened over the years when the effectiveness of various vaccines was proven time and again — measles, mumps, rubella, diphtheria, tetanus, and so on. When I developed hay fever, it was a mixed blessing. I did not have to work in the hay, which was the worst work on the farm, but I did have to get regular injections, which my mom did very slowly so as not to hurt. Yikes!

Then, in 1968, I volunteered to fight in Vietnam and had to get a long list of vaccinations. Everyone had to take the vaccinations for the protection of the entire unit the old thing about the chain breaking at the weakest link, obviously the unvaccinated one. They included plague, yellow fever, typhus, typhoid fever, cholera, and the very worst, gamma globulin in the posterior for hepatitis. It left a big bump in the rear that slowly dissipated over a week or so.

As one continues through life, it is easy to take for granted the fact that you don’t have to worry about the dread diseases that our ancestors had to face on practically a daily basis. Plague and smallpox wiped out entire populations before the scientific community developed means of prevention that could be administered in a painless injection.

We don’t know how very fortunate we are and how thankful we should be.

When I was a kid and we learned that someone in the community had been diagnosed with cancer of practically any variety, we all thought it was a death sentence. When Dr. Gupta called on Jan. 13, 2017, to say that I had pancreatic cancer, that was my very question: “Is this a death sentence?” His response was, “Not necessarily.” I was told later that chemotherapy would increase my chances of survival to 30%.

In order to get chemo, you had to get a whole range of shots, which I gladly accepted and would have taken many more. It was not a question as to whether the Food and Drug Administration or anyone else had given its blessing to any of them. My trusted physicians had said they were necessary, and that was enough. They put a port in your chest so they could mainline it, and you were happy to put up with all of it for a chance of survival.

You see many other dear souls in the injection lounge taking in stuff that some would call poison, just for the chance of more life with their loved ones not a lot of bellyachers and dissidents in that venue. I’m now four years cancer free.

So, let me raise a toast this Thanksgiving weekend to the doctors, nurses, medical researchers and other medical personnel who have strived so hard over the many years to find ways of saving the public from illness and death at the hands of deadly diseases such as COVID-19 and all of the other scourges I’ve previously mentioned.

We owe you, we salute you, and we thank you from the bottom of our hearts, which are still beating because of you.

Jim Jones served as Idaho attorney general for eight years (1983-1991) and as a justice of the Idaho Supreme Court for 12 years (2005-2017). His columns are featured regularly in the Idaho Capital Sun, which first published this essay.

Another sewage and water crisis in Currituck County; state files notice of contempt to private utility

Not water, but sewage: A photograph of a roadside swale, or ditch, taken in October in Eagle Creek. Sewage is spilling from the metal pit and flowing toward the swale. Residents have been dealing with sewage backing up into their homes for more than 14 months, most recently over the weekend and just days before the Thanksgiving holiday. (Courtesy photo from Eagle Creek resident)

Raw sewage is again backing up into homes in the Eagle Creek community, while the private utility’s equipment failure has also prompted a water conservation advisory.

Residents of the Currituck County neighborhood told Policy Watch via email today the entire neighborhood of 420 homes is without sewer service. Based in Virginia Beach, Va., Sandler Utilities owns the sewage system and the wastewater treatment plant to which it flows; Envirolink, a North Carolina company with a mixed track record, manages the system on Sandler’s behalf.

“We just had a major sewage overflow that came out our downstairs toilet into the hall, closets, den,” wrote one Eagle Creek resident.

Critical portions of the sewer infrastructure are overflowing, Stephanie Harlow, another resident, told Policy Watch. “It’s a freaking mess and nightmare.”

Mike Myers, president of Envirolink, did not return an email seeking comment.

However, an email to residents from Deborah Massey, Envirolink’s billing and customer service manager, stated that “crews worked through the night to start bringing system back on line. Techs are on-site continuing to work on bringing all lines up. An update will be sent out as soon as we can get a complete assessment of each pit with a timeline of complete service. We understand showers and laundry need to be completed but please conserve water as much as possible today.”

Eagle Creek is on a public water system, but when residents shower, wash dishes or flush the toilet, that sends wastewater into the sewer system, which then backs up and overflows.

Policy Watch reported on Nov. 10 that the neighborhood had been plagued by sewage issues from the failing sewage system for 14 months, including over Halloween.

Within the past 18 months, the NC Department of Environmental Quality has issued four Notices of Violation and fined Sandler more than $62,000 for water quality violations. Treated wastewater, also known as effluent, from the sewage treatment plant is sprayed on the Eagle Creek golf course to irrigate it. In October 2020, records show wastewater contained levels of fecal coliform bacteria more than 15 times legal limits. 

Water samples from a ditch on Eagleton Circle contained bacteria from fecal matter “that were too numerous to count,” according to court records. In January 2021, fecal coliform levels were 100 times higher than legally allowed, along with exceedances of nitrogen and ammonia. 

DEQ fined Sandler another $1,200 this year for failing to keep legally required sampling records.

A DEQ spokeswoman said the agency filed a notice of contempt to Sandler in Currituck County court on Nov. 16. The contempt notice is related to a consent judgment between DEQ and Sandler, effective last July. It notes that “the current state of the collection system presents an ongoing threat …” The judgment requires Sandler to submit written plans for system upgrades and operator training. It also requires Sandler to “maintain the collection system that prevents discharge of waste onto land or surface waters.”

Envirolink also has a checkered history. Although the company has not been cited by DEQ for any violations, many systems they manage have been. A review of DEQ enforcement records shows that at least 15 systems that Envirolink manages have racked up 90 violations since 2018. These violations accounted for more than $91,000 in fines.

Envirolink manages the public Moyock Regional Water System, which serves parts of Currituck County. That system accumulated 20 violations in 2018, before Envirolink took over. Since then, Moyock has totaled 23 violations since 2019 and received fines of more than $35,000.

Another resident posted on the community’s private Facebook page, “I really hope that they get this fixed soon with Thanksgiving just in a few days. We just had sewage spew all out of our shower. I really don’t want my family to have to smell sewage while eating their turkey dinner.”

New state-by-state scorecard gives NC failing marks for racial and ethnic disparities in healthcare

Image: AdobeStock

Researchers at the Commonwealth Fund released a new national report this morning (“Achieving Racial and Ethnic Equity in U.S. Health Care”) that looks at how each U.S. state is performing in providing access to healthcare to people of different races and ethnicities.

The disappointing, but unsurprising, conclusion: just about everyone is doing a lousy job. And while North Carolina comes in somewhere around the middle of the pack in most categories, that’s only because a lot of other states are failing even more miserably.

This is from the release that accompanied the report:

A new health equity scorecard released today by the Commonwealth Fund finds deep-seated racial and ethnic health inequities in all 50 states and the District of Columbia — disparities that have been exacerbated by the COVID-19 pandemic.

Achieving Racial and Ethnic Equity in U.S. Health Care: A Scorecard of State Performance is a comprehensive examination of how health care systems are functioning for people of color in every state. Part of the Commonwealth Fund’s ongoing series examining individual state health system performance, the report uses 24 measures to evaluate each state on health care access, quality and service use, and health outcomes for Black, white, Latinx/Hispanic, American Indian/Alaska Native (AIAN), and Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations.

The health equity scorecard reveals that even among high-performing states, racial and ethnic health disparities can be dramatic. For example, Minnesota’s health care system, which has historically performed well in Commonwealth Fund state scorecard rankings, has some of the largest health disparities between white and nonwhite communities. Maryland, Massachusetts, and Connecticut are other traditionally high-scoring states where white residents receive some of the best care in the country but where quality of care is far worse for many populations of color. Similarly, in states like Mississippi and Oklahoma whose health care systems have historically performed poorly for both white and Black populations, white patients still received markedly better care.

In addition to showing how people of different races and ethnicities fare within each state, the Fund’s scorecard ranks how well each state’s health system is working for each racial and ethnic group. For instance, the health care system in California works better for Latinx/Hispanic people than the Texas health care system. In both Texas and California, however, the health system benefits white people more. Among states with large American Indian populations, South Dakota, North Dakota, Montana, and Wyoming have the worst-performing health systems for these communities while California’s system ranks at the top — though there are still wide disparities with other populations in the state.

For North Carolina, researchers found that when they looked at overall healthcare system performance based on an assessment of 24 indicators, the state received a 79 for white residents, but only a 61 for Asian American, Native Hawaiian, and Pacific Islander residents, a 33 for Black residents, a 14 for American Indian/Alaska Native residents and a 12 for Latinx/Hispanic residents.

Similar racial disparities were frequently detected in several specific areas, including deaths from conditions that are treatable with timely access to high-quality health care, deaths from complications due to diabetes, deaths for women afflicted with breast cancer and overall healthcare access.

Medicaid expansion — while not a panacea for the problem — clearly makes a difference in narrowing the gap. Of the states rated above North Carolina, all have expanded Medicaid except the much less racially diverse state of Wisconsin.

Click here to explore the report.

Health care advocacy group: Cooper should veto any budget that does not include Medicaid expansion

Image: AdobeStock

Some recent news reports indicate that Gov. Roy Cooper may be softening is longstanding opposition to any new state budget that does not provide for North Carolina to close the state’s health care coverage gap by joining 38 other states and expanding Medicaid under the terms of the Affordable Care Act.

Associated Press reported last night that:

North Carolina’s extended budget negotiations will come to a head next week with the House and Senate voting on a final spending plan, officials said Wednesday. Gov. Roy Cooper has suggested he could sign it into law, even though he wouldn’t get everything he wants, in particular Medicaid expansion.

A statement posted on Cooper’s Twitter handle Wednesday said that Republican leaders have informed him that the budget being released early next week will contain a “number of the governor’s priorities that were proposed in his budget and discussed in negotiations over the last few weeks, including increased education funding.”

But it will leave out the wholesale expansion of Medicaid coverage to hundreds of thousands of low-income adults that Cooper’s has sought since taking office in 2017, according to the tweet. House Speaker Tim Moore had already said his caucus wouldn’t support expansion, even as Berger was ready to accept it given the right situation.

The news is not sitting well with advocates at the Care4Carolina, one the largest and most bipartisan coalitions fighting for Medicaid expansion. Today the group’s executive Director, Erica Palmer, issued the following statement:

“On behalf of hundreds of thousands of hardworking North Carolinians in our small towns, suburbs and cities, the nonpartisan Care4Carolina Coalition is gravely disappointed that the budget apparently hammered out by legislative leaders does not close our state’s deadly health insurance coverage gap — and we encourage Gov. Roy Cooper to veto the bill.

We appreciate the willingness of the Senate to include Medicaid expansion, but with our state struggling to emerge strong from the COVID-19 pandemic, the federal government making closing the gap more attractive than ever, our coffers filled with a $7 billion budget surplus, and support from red and blue counties there is no reason for the House to insist North Carolina remain one of only 12 states refusing to support the health and productivity of its citizens. Gov. Cooper, please continue to fight for our citizens and refuse this budget until it keeps faith with hardworking North Carolinians by closing the coverage gap. We know you want what is best for the people of North Carolina, and closing the coverage gap is the best thing we can do for all our people.”

Having waited this long for such a vitally important action, it’s hard to see how Cooper can abandon the cause now unless he has obtained (or obtains) some concrete commitment from legislative leaders to approve expansion via another means in the very near future. Stay tuned.

Greensboro releases yet another slug of 1,4-Dioxane into Haw River, Pittsboro’s drinking water supply

Update Nov. 10, 9:30 a.m.: Cory Saulsbury, superintendent of Pittsboro’s water plant told Policy Watch that sampling from from Nov. 3 to Nov. 8 showed levels of 1, 4-Dioxane at 1.07 ppb. Saulsbury said the town will “continue to monitor the situation by pulling samples every day this week with a rush order.” 

Greensboro’s wastewater treatment plant illegally discharged high levels of the likely carcinogen 1,4-Dioxane into the Haw River, the drinking water supply for the Town of Pittsboro and other downstream communities along the Cape Fear River.

Adam Pickett, Pittsboro’s public utilities director, confirmed to Policy Watch that there had been a discharge. Emails obtained by Policy Watch show that the discharge occurred on Nov. 3, and Greensboro notified downstream communities, including Pittsboro, on Nov. 8. The amount of 1,4-Dioxane in the original discharge was 767 parts per billion; that’s more than 2,100 times the EPA’s and the state’s health advisory goal for surface water.

The discharge violates the terms of a  Special Order by Consent between DEQ and the City of Greensboro, which set a maximum daily level of 45 parts per billion of 1,4-Dioxane in wastewater. The Haw River Assembly, represented by the Southern Environmental Law Center, has challenged the terms of the order, saying they are not protective enough. Haw Riverkeeper Emily Sutton told Policy Watch that Greensboro had not contacted the group directly about the latest discharge, “even as negotiations are underway regarding the Special Order by Consent triggered by major 1,4- dioxane releases” that occurred in 2019 and 2021.

1,4-Dioxane is a toxic chemical used in degreasers that the EPA has classified as a likely carcinogen. There is no regulatory standard for 1,4-Dioxane, but the EPA has set a health advisory goal of 35 parts per billion for drinking water, which equals a 1-in-10,000 lifetime excess cancer risk. The surface water goal is more stringent, at 0.35 ppb, a 1-in-1 million lifetime excess cancer risk.

Emails show that Pittsboro’s latest sampling through Nov. 2 showed levels of 4 parts per billion. It’s still unknown how much 1,4-Dioxane entered the town’s drinking water, but results should be available this afternoon.

Elijah Williams, water reclamation manager for the City of Greensboro, told Policy Watch that utilities staff has notified the NC Department of Environmental Quality (NCDEQ) and downstream utilities and is actively investigating possible sources of the substance.

This is just one of several illegal discharges from the Greensboro plant. The most recent one occurred in July 2021; sampling results showed that levels from in wastewater ranged from 543 parts per billion to 687 parts per billion. Greensboro officials said they had not identified the source.

In August 2019, Greensboro’s discharge contained levels of 1,4-Dioxane ranging from 705 ppb to 1,210 ppb. The source of the contamination was Shamrock Environmental, an industrial customer that discharges its wastewater to the Osborne plant.

The TZ Osborne Wastewater Treatment Plant in Greensboro receives discharges from both residential and industrial customers in Guilford County. From there, the plant treats the discharge before sending it into South Buffalo Creek, which feeds the Haw. However, conventional treatment systems don’t remove 1,4-Dioxane.