Santa Clara County Public Health Workers to Monitor Swine Flu Threat
Santa Clara County is facing a major budget crisis that will put the health and safety of its residents at risk.
– Public health workers to Board of Supervisors on 4/21/2009
2 California deaths may be due to swine flu;
Schwarzenegger declares state of emergency
– San Jose Mercury News, 4/28/09
SAN JOSE, CA – Public health work generally doesn't make headlines. Until there is a communicable disease scare – such as now – and then the job of these frontline community workers is to help assess when a fever is a seasonal bug or the sign of a deadly epidemic hop-scotching around the world.
In the coming days, Santa Clara County public health workers are being dispatched to airport terminals and inside family rooms, screening recent travelers from Europe and Mexico, the latter country being the place where the swine flu has caused more than 150 fatalities.
"We are the first-line mandated responders for any kind of communicable diseases in the community," said Aida Peña, a 30-year Registered Nurse, with 10 years in the Santa Clara County Public Health Department. "We organize, assess, prioritize and make referrals. We have the knowledge and skills to help prevent an outbreak from escalating to an uncontrollable situation."
In this suddenly dangerous context, Santa Clara County, faced with a $230 million deficit, is considering slashing its public health department workforce by two-thirds, from 103 to 43 personnel. Of 65 Regional Public Health Nurses, 29 would be left to serve a county of 1.75 million people.
Next month, county officials will be voting on cutting or eliminating the very public health programs that over the past ten years have proved successful in reducing the incidence of the most serious communicable diseases in the county.
During this swine flu threat, the county is mobilizing public healthcare workers to provide outreach, education and surveillance to hospitals, schools, farm workers and airline passengers arriving from Mexico. Let's hope these workers are there in July.
Public Health Nursing in Santa Clara County
Public health nursing advances the well being of communities and seeks to promote health and prevent disease, disability and premature death
Santa Clara County is considering closing two regional offices out of four currently serving the county. The offices provide essential services, addressing health concerns such as child and infant health, disease control and prevention, including tuberculosis.
Santa Clara County predicts that the proposed cuts will lead to increases in incidents and spread of TB, HIV and Hepatitis B. According to the county:
· Over the past four years, the incidence of the leading nine communicable diseases increased by 33%.
· The county's TB rate has increased between 2004 and 2007, with new TB cases reported last month.
Last year, 6,970 referrals were received and of those referrals, 1,493 were for mandated disease control services.
The Regional Public Health Nursing staff conducted more than 26,000 home visits in 2008.
According to the 2000 Census, there is one Public Health Nurse per 16,495 residents in Santa Clara County. California's average is 1 PHN per 12,251 residents.
With the proposed budget cuts, Santa Clara County will have one field-based Public Health Nurse for every 31,746 residents. This would be the worst ratio of all counties in California.
Reduced staff could impact effective response to disease outbreaks or disasters that involve the public's health; reduced staff in Public Health Nursing limits services to everyone including services to the safety net population, the most vulnerable.
Reduced staff will increase the use of emergency services and hospitalizations, costing the county more money in the long term.