THE PROBLEM
“In the middle of a two-year trial period, the Lancaster County Health Advisory Board has issued two reports to the public — one on the outbreak of measles in Ohio and the other on the wave of respiratory syncytial virus (RSV) infections that occurred earlier this winter, ” LNP | LancasterOnline’s Tom Lisi reported last Sunday. “That is the scope of the work of the nine-member board in relation to the public. The two brief summaries can be found in documents posted on the county’s website, but are nowhere to be seen. The volunteer board is made up of health professionals and local authority representatives. Of Pennsylvania’s seven counties with populations over 500,000, Lancaster County is the only one without a public health department.
When the county health advisory board was first proposed as an alternative to an actual public health department, we believed it was the wrong recipe for Lancaster County.
That is still our belief.
Council members include some experienced local health experts. But the advice itself is an empty gesture, a toothless body. It was designed to take heat off Republican County Commissioners Ray D’Agostino and Josh Parsons, who have faced calls from some local municipal leaders and medical professionals to create a county health department. They were philosophically opposed to such a department.
They still are.
D’Agostino would not even commit to supporting the existence of the advisory board beyond the two-year period.
And when asked if Lancaster County residents can trust the health information produced by the council — which commissioners approve before releasing it to the public — D’Agostino said there are plenty of resources and information about public health issues.
“So I’m not going to judge who has the best information, I think people should be able to do their own research and come to their own conclusions,” he said.
Coincidentally last Sunday LNP | LancasterOnline also included an article about hospital ratings and the lack of reliable tools “to compare hospitals and find where to go for the best and safest care.” Somehow, despite hard-to-interpret data, patients must be able to become health care experts.
In addition to that, according to D’Agostino, they also clearly need to do their own research on treating infectious diseases, opiate addiction, exposure to polluted air and toxic substances like lead, maternal health and other health issues that would could be addressed by a county public health department. How exactly will this work for people who have not attended medical school or nursing school? For busy parents? For rural Lancaster County residents who don’t have access to broadband?
As Dr. Jeffrey T. Kirchner, a Lancaster physician who worked during the HIV/AIDS epidemic, wrote in Wednesday’s LNP | LancasterOnline, “This approach has led to misinformation, discord and unnecessary deaths during this COVID-19 pandemic. This is one of the most compelling reasons to rely on trusted medical experts.”
We couldn’t agree more.
The cavalier, do-it-yourself approach is why the death toll from COVID-19 has passed the 1.1 million mark in the United States, and millions of Americans have been affected by prolonged COVID. Too many Americans have outsourced their medical matters to Internet charlatans and unscrupulous partisans.
In last Sunday’s Perspective section, Dr. Leon Kraybill, a Lancaster geriatrician, wrote the following: “In matters of health and death, we should look to the best available, reproducible scientific data, not to opinion based on the experience of a few individuals.”
Kraybill has previously written about how we should prepare for the next pandemic. Among his proposals was to create a district health department.
As of last Sunday, the health advisory board had met just six times in the past year and, due to member scheduling conflicts, is scheduled to meet just four times in 2023.
As LNP | LancasterOnline’s Lisi reported that D’Agostino and Parsons say the council serves an important function by bringing together the leaders of the area’s four major health systems to discuss public health challenges.
This is good. But whether the public is informed about these challenges is up to Parsons and D’Agostino. The lack of independence of the advisory board was one of our main concerns about this; this concern appears to be justified.
The Council has produced several guidance documents for various disease outbreaks, including COVID-19 and mpox (formerly known as monkeypox). The RSV and measles reports are on the county website, but the other reports are not.
Lancaster County Health and Medical Preparedness Coordinator Violet DeStefano told the council last year that the county’s emergency management agency is working on a comprehensive review of the county’s handling of COVID-19, according to meeting minutes. But the county decided not to release the report and instead plans to keep it for internal review only.
LNP | LancasterOnline has filed a public records request for the report. Why wouldn’t county officials release this report to the public?
As we have stated many times, the idea of politicians making public health decisions and controlling the flow of public health information is appalling. They are not qualified to do so. And they tend to put political interests before the well-being of their constituents.
In his column last Sunday, Kraybill asked why only 17 percent of people in Lancaster County had received one of the latest bivalent COVID-19 vaccines, despite evidence that vaccination significantly reduces hospitalizations and deaths.
We assume this is because some people are still getting misinformation and disinformation. And since there is no county public health department to promote vaccination. Childhood immunization rates in Lancaster County are also relatively low, a serious issue that the county health department could address while collecting valuable health data not currently available to the county.
Effective and efficient government does not create phantom committees. And the best political leaders are smart enough to know what they don’t know — and what they should and shouldn’t control.
As you study the candidates in this year’s county commissioner race, please keep this in mind.