Audit Critical of City and County Over Hepatitis Outbreak

(CNS)  San Diego County could have reduced the risk of the spread of hepatitis a last year with better organization and hastened vaccination efforts, according to a report released Thursday by California State Auditor, Elaine Howle.

According to the report, the county failed to set appropriate targets to vaccinate at-risk county residents and did not determine the amount of  resources such as nurses that would be needed to fulfill vaccination efforts.  While an average of 20 new hepatitis a cases were confirmed each week from may  to mid-September 2017, vaccinations only increased significantly by September.

According to the auditor's report, vaccinations in September and October totaled more than 41,000 compared to about 7,700 in August. The spike  in vaccinations led to a decrease in new cases, suggesting that the county could have limited the outbreak earlier in the year.

The city and county of San Diego also failed to improve sanitation conditions in a timely manner, failing to increase access to hand-sanitizing  stations and public restrooms until September 2017.  According to the audit, such dysfunction was due to the county's failure to inform the City of San Diego how severe the outbreak became. 

"While i am still evaluating the extremely thorough report from the state auditor, one thing is clear: lives could have been saved,'' said Assemblyman Todd Gloria, a Democrat from San Diego. ``We now know that the county and the  city could have planned better and acted sooner to contain the spread of this  disease. unfortunately, that was not done until it was too late.'' 

Howle's office suggested multiple recommendations to the city and county to improve their responses to public health outbreaks.  

The auditor's  office advised the county to update its emergency operations plan by April 30,  2019, share relevant data with its local jurisdictions and come to an agreement  with the city by March 31, 2019 to clarify how each entity should  respond to future public health problems. Howle's office also advised the city to examine its actions during the outbreak prior to the emergency declaration on Sept. 1, 2017.  The city is then recommended to fix any weaknesses found during the review.

"We agree with the recommendations, particularly that the city and  county should strengthen their relationship as it relates to responding to  regional emergencies,''  City of San Diego Chief Operations Officer Kris Michell said. ``We look forward to working in partnership with the county on this recommendation.''

San Diego County Board of Supervisors Chair Kristin Gaspar issued this statement:

“There are no words that could possibly ease the pain of a death or serious illness. I am still incredibly saddened by the many lives affected by the hepatitis A outbreak. It WAS an unprecedented case and because of that there was no playbook to turn to for immediate answers on how to handle something of that magnitude. This is the third “audit” of this outbreak and it restates many of the issues raised in the County’s own after action report. The importance of immediate collaboration between the County, the City of San Diego and the State cannot be underscored enough. I am optimistic that the State’s sudden interest in this matter will result in a much stronger partnership in the future. More important than pointing fingers and laying blame, is taking the lessons learned from this incident and using them to be better prepared for future health emergencies. The County is committed to protecting the health of all of its residents and has taken several crucial steps to ensure this does not happen again.”

(Photo credit 10News)


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