Amateur hour

SO, a mere 30 years after Federal health authorities identified the cause of Lyme disease and began a complete program of education, monitoring, and prevention, our very own top leading medical authorities here in Loudoun County—I am, of course, referring to newly elected Republican supervisors Professor Geary Higgins (R-Catoctin), Dr. Janet Clark MD (R-Blue Ridge), and Herr Doktor Doktor “Ken” Reid (R-Leesburg)—have swung into action with their own “10 Point Action Plan” to combat this terrible scourge, proclaiming 2012 “Lyme Disease Awareness Year.”

“This has been neglected way too long,” Reid declared in one of a series of self-congratulatory pronouncements he made to fellow board members while the matter was being “debated” Wednesday night.

“Ken,” when he isn’t cracking us all up with yucks about circumcision, can always be counted on to utter a few off-key, smarmy, and unctuous religious pseudo-pieties, and he did not disappoint: Reid intoned that he believed his colleagues were truly “doing God’s work” in passing his fearless 10 Point Action Plan designed to overcome the national health authorities’ shameful 30-year, $100 million neglect of this problem.

The leading sign of this neglect is on display for all to see at the Center for Disease Control’s comprehensive website on Lyme disease containing accurate information on prevention, diagnosis, treatment, statistics, and research, as well as an abundance of specialized information on Lyme disease for health care professionals. Alas, the CDC website does not offer a special section of “Information for Local Politicians Desperately Trying to Call Attention to Themselves.”

So our fearless local politicians, buttressed by testimony solicited from hysterical suburbanites (“A lot of us live in fear, fear just of walking on the grass”), boldly voted 9–0 to tackle this problem “head on,” as they are fond of saying. They intend to boldly create a “Lyme Disease Commission,” conduct a “Lyme disease survey,” “place” articles every month in local newspapers to “raise awareness,” and in a desperate attempt to come up with 10 separate bulleted items to complete their list, since a “10 Point Action Initiative” sounds so much more impressive than a “3 Point Action Initiative,” then simply repeated several of these same bold initiatives in slightly different wording.

The board’s proposed “Lyme disease survey” will in particular surely fill an important gap in existing knowledge—even though Lyme disease since 1992 has been a nationally reportable disease, meaning that every individual case has to be reported to the CDC, and the data is available in one click from the CDC’s Lyme disease website. It turns out that Virginia, by the way, ranks 14th among the states in Lyme disease incidence, with an incidence rate 1/7th that of Delaware, 1/6th that of New Hampshire, and 1/4th that of Wisconsin. Just thought I’d mention this in case the board doesn’t want to wait for the results of its unfunded-mandate “survey.”

And, unsurprising if you consider that 99.99% of people who live even in high-incidence areas have never had the disease, it’s remarkably easy to prevent and treat. As the CDC’s website and every article, brochure, and pamphlet for the last 30 years has accurately noted, applying an insect repellent containing DEET is almost completely effective in preventing tick bites; checking yourself for ticks every day when you’ve been outdoors is completely effective in blocking transmission of the bacteria that cause the disease, even if you have been bitten, since a tick must be attached for 36–48 hours for transmission to occur; and simple treatment with a short course of appropriate antibiotics even after symptoms appear offers complete and quick recovery for 80–90% of patients.

But none of that reassuring information was to be heard from the distinguished medical authorities on our board Wednesday night. Instead they gabbled about controlling deer population (which by the way, supervisors, has been proved to be ineffective in preventing transmission of Lyme disease, since (a) ticks attach themselves to alternate hosts such as raccoons when deer populations are low (b) deer carry the ticks but do not transmit the Lyme bacterium to the ticks themselves and (c) controlling mouse populations, which do transmit the disease organisms, is the only effective environmental control measure to reduce disease incidence); they proposed dousing parks and athletic fields with insecticides; and they promised to “establish a list of doctors who specialize in the diagnosis and treatment of Lyme disease,” though in fact any doctor on earth can diagnose and treat the disease (diagnosis is by a universally available lab test and the only effective—and almost always completely effective—treatment is a short course of one of several commonly available antibiotics) and the only doctors who claim to “specialize” in Lyme disease “diagnosis and treatment” are almost always quacks promoting ineffective and dangerous lengthy courses of antibiotics which the CDC warns have been proven to offer no benefit whatsoever for the small number of patients who claim to be suffering from “Post-Treatment Lyme Disease Syndrome.”

What this is all about of course, is political exploitation and grandstanding, pure and simple. The very board that has been slashing effective programs such as the county energy-reduction office and the Loudoun Drug Court, for supposedly being not sufficiently effective or not being a “core function” of local government, turns on a dime and embraces this bit of pseudo-policy initiative playing directly to the uninformed fears of the public while offering not a thing that isn’t done better by the people who actually know something about public health—primary care doctors, public health officials, and the CDC.

Despite “Ken”‘s fearless rhetoric, the only thing that has been “neglected” about Lyme disease is the Virginia Republic Party’s poll-driven ploy to exploit the issue to help their election campaigns this past year. The steps everyone can take to learn about and protect themselves against Lyme disease have been well established for decades; only AIDS has received more attention from public health outreach efforts of the last 30 years. (And, by the way, about that “placing” articles business: do these guys honestly think that the subject has been ignored by the media? A search of the Washington Post website reveals that since 1987 that newspaper has run 1,072 articles about Lyme disease.)

Presumably we can expect the board to follow up on its highly successful Action Plan on Lyme Disease with additional Loudoun County 10 Point Action Plans on space exploration, cancer research, and national energy independence.

Meanwhile, though, in the name of the businesslike efficiency that they are so keen on, the board at least ought to consider trimming down its 10 Point Lyme Disease Action Plan to its essentials. Here is my modest proposal for a substitute motion for the board to consider when the Lyme disease plan comes up for a final vote of approval:

Loudoun County Republic Board of Supervisors 2 Point Action Plan for Crass Political Exploitation of a Sensitive Issue

1. Needlessly duplicate information about Lyme disease already available in far more accurate and convenient form from Federal health authorities who actually know what they’re talking about

2. Spread misinformation and fear, combined with showy but ineffective measures—along with the usual dose of unctuous piety

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