Did California plastic bag ban result in San Diego's current hepatitis outbreak? | Hacker News Reader

Did California plastic bag ban result in San Diego's current hepatitis outbreak?

sandiegoreader.com

59 pointssubroutine79 comments

No. Lack of universal health care and a proper social safety net resulted in the Hepatitis outbreak.

Hepatitis can be prevented through vaccination, which a universal health care system would provide. Through treatment, which a universal health care system would provide. And proper sanitary conditions, which taking care of people so they don't have to live on the streets would provide.

Exactly! We need better homeless support. Day centers with real bathrooms and showers, better public bathrooms, and better safety nets for those who are struggling. We need more programs like Utah's where they try to get homeless people into homes first, then work on job training, drug addiction and integration into society. If we had housing first, many of these people could have accessible toilets.

Plastic bags are terrible for the environment. They're not recyclable unless that type of plastic is in demand. Even then, it's often shipped to China. Most companies don't touch it because there is so little return and things like staples or food particle can contaminate whole batches if they get through sorting.

We still get hepatitis outbreaks here in Canada despite our universal healthcare. Universal healthcare does not automatically solve the problem of getting vaccinations to vulnerable populations or prioritizing the right interventions at the right time given limited resources.

Maybe our situation is better here in this regard, I don't know the statistics, but it's demonstrably false that universal healthcare automatically prevents hepatitis outbreaks.

Some people might not vaccinate their kids for dumber reasons than not having insurance.

Part of my point was that the homeless are a particularly difficult population to reach with health interventions like vaccinations even with universal healthcare.

Some people might do so if the alternative is going to jail.

So I take it you implicitly agree with the original article's thesis?

I think the original article makes a plausible case that the plastic bag ban was a contributing factor to this outbreak. That's irrelevant to the point I was making in the comment however.

For whatever reason Canada doesn't require childhood HepA vaccinations, though they could.

>Universal healthcare does not automatically solve the problem of getting vaccinations to vulnerable populations

A well functioning society, where people don't live like dogs in the street, does.

>or prioritizing the right interventions at the right time given limited resources.

I doubt nations that can spend billions on pet food have "limited resources" for things as insignificant budget-wise as hep vaccines.

> A well functioning society, where people don't live like dogs in the street, does.

I guess I've never lived in or visited a well functioning society then. I have lived in two countries with universal healthcare and visited many more and they all have homeless populations living on the streets. Whether they live "like dogs" would be a subjective call I guess.

I don't think you understand the term 'limited resources'. The opposite would be 'unlimited resources', not 'a different allocation of limited resources than I would prefer'.

>I don't think you understand the term 'limited resources'. The opposite would be 'unlimited resources', not 'a different allocation of limited resources than I would prefer'.

Then you maybe don't understand that it doesn't take "unlimited resources" to vaccinate people, and that not all "allocations of limited resources" make sense or are to be respected or are inevitable like the laws of physics.

Like one can't use the excuse that they have "limited resources" for feeding themselves if at the same time they spend 10 times the money in trivial BS like fancy clothes or the latest and greatest smartphone -- they'd be (rightly) laughed off. Sure, they can spend their money wherever they want (it's a free country, after all) -- they just don't get to invoke "limited resources" afterwards as the reason they didn't do something that should have gotten a much bigger priority.

The same goes for societies. They can opt not to vaccinate people, but unless they are some dead poor developing world country, they don't get to use "limited resources" as the reason for doing so. Twisted sense of priorities would be a much better fit.

Those things could have prevented it, like giving everyone housing could solve homelessness.

But given the actual conditions San Diego started in, did the lack of plastic bags cause this specific outbreak? Which is the actual prompt. Seems inconclusive from the article, but not casually dismissable.

They tried that in SLC, but it turns out that not everyone who is homeless wants to live in a home. I would imagine this is related to mental illness, but you can't just force people to move into a home who don't want to just so homelessness is "solved".

Actually you can. That's what they do in the rest of the western world. Not saying it's a good idea, but it's far from impossible. It's more of a "do you want to".

Vaccinations are free, per TFA.

Were not before the outbreak.

I guarantee every person living and defecating in the street in San Diego is eligible for MediCal or MedicAid - the very programs Sen. Sanders is touting as a panacea for single payer healthcare.

Or aim lower and just build and maintain some proper public toilets we all can use. One shouldn't be guilted into purchasing more diuretic just to relieve themselves while out.

If we just had the right system we could solve the problems.

Some people just don't want us to have the right system.

The right system is the solution.

Completely agree. Future generations will marvel at the fact that we didn't figure out that having large populations living in poverty would create hot zones for contagious disease to spread from. The Ebola outbreak that showed up in Dallas a few years ago comes to mind. Poverty needs to be eliminated worldwide ASAP to prevent the next pandemic.

They may also look back and marvel at our inability to implement even simple solutions because they fail to seem optimal. It's debatable whether the hepA outbreak is due to the scarcity of plastic bags the homeless were accustomed to using to do their business. But it's plausible; and it's an easy fix. But it's possible that future generations will look back and wonder- why did they spend all that time debating 1000-lightbulb ideas about how to care for the homeless, never reaching any consensus, when they could have just hung up plastic bag distributors downtown.

US's positive view of globalization after World War II did wonders in reducing extreme poverty (via our aid programs, charities, etc). Sadly, many in our country are turning their backs to globalization when the world really needs more investment.

I'm standing here, in awe, that you literally wrote that on a comment.

Like... you actually believe merely having UHC will somehow stop stupid people from either 1) being disgusting or 2) being too stupid and forgoing vaccinations.

Like, you actually think that EVERYONE who suffers is doing it simply because they can't walk into their local hospital and be like "hook me up with them needles." People like Jenny McCarthy talking about how vaccinations cause autism don't actually exist.

And I say all this as a freakin' liberal. Come on guys. Up your brain game. Because this is one step above the political discourse equivalent of a a bumper sticker. Just chant and shoehorn in whatever catchphrase / slogan that's barely applicable into the conversation.

A bumper sticker has never changed the world.

You're clearly being intentionally provocative. I don't even know what you're railing against. Vaccinations have basically eradicated many diseases in the Western world. Certainly if these people were vaccinated a hep outbreak would not have occurred. Furthermore, if these people had access to proper facilities thru social safety nets, they also wouldn't be in situations where the loss of plastic bags means increased risk of hep A. UHC and more resources for the homeless would have helped prevent this, objectively.

You rant about changing the world yet propose no solution or alternative of your own.

vaccination doesn't have much to do with universal health care. About half of states currently require childhood HepA vaccinations, the others don't http://www.immunize.org/laws/hepa.asp

> Hepatitis can be prevented through vaccination, which a universal health care system would provide.

Most of the the homeless people are likely eligible for California Medicare.

> Most of the the homeless people are likely eligible for California Medicare.

“California Medicare” is not a thing that exists. You are perhaps thinking of Medi-Cal, which is California’s Medicaid program (Medicaid is for the medically indigent, and is partly federally funded and administered by the states; Medicare is federally administered, and for seniors and certain disabled.)

I stand corrected, yes, the Medi-Cal program that covers the low-income Californians.

How many public health crises in the USA can be boiled down to "the USA fails to provide a safety net that ensures a certain standard of living"? If this plastic-bag hypothesis bears out, it'll be yet another.

There people living in the streets pooping in bags.

And you think we just need more safety nets?

....Yes?

The support system in the US is drastically underfunded, which leads to it being understaffed and underprovisioned for the tasks it tries to accomplish. There's a second layer of ideological opposition to helping poor people that exacerbates the problem.

Proper funding and removing ideology-driven sabotage for safety nets would remove a sizable amount of street bag pooping.

You could boil them down to "prefers to spend it's money on other things"

CA fails to provide a safety net that ensures a certain standard of living

CA prefers to spend its money on green energy.

Does it seem to anybody else that having widely available public restrooms would be a way better (including way more hygienic) way to address this issue?

But nobody wants to build (and keep clean) a bathroom in their backyard (the for homeless people is implied). And anyone who did would have protests from their neighbors.

Lava Mae addressed this by building portable showers out of old buses (to the tune of ~$1M per bus) and trailers (cheaper).

That makes me think of Rick and Morty:

Beth, do you still love me?

Ugh, what kind of question is that?

The "yes or no" kind?

Jerry, do you want homeless people to have homes?

Yes.

Are you gonna build them?

No.

Then what good was the "yes"?

Wait, is loving me the house or the homeless people?

Loving you is work, Jerry hard work, like building a homeless shelter nobody wants to say no to doing it, but some people put the work in. So, what do you say? Do you see me working here? Does this conversation seem tedious to me?

Sort of.

Then I obviously sort of love you, don't I?

While we are on jokes about this, could you imagine if someone raised the argument back in November... "If California bans plastic bags obviously bums will poop everywhere, and hundreds of people will get Hepatitis until we bleach the streets."

I would think hygiene should be part of the government's responsibility.. like security (police) or clean water.

But oh well, at the moment the philosophy is Make America Great Again by defunding everything...

I would include public showers, and public baths like some parts of France.

Edit: Actually wouldn't public washrooms, showers, and baths help everyone in that if they are located frequently enough, businesses wouldn't have to be built with public washrooms in mind, or pay for the cost of cleaning and maintenance. They would have to pay for the public washrooms through taxes though.

At the train stations in Paris, they have pay toilets and people beg for change outside them so they can use them.

Great way to be hospitable to the foreign tourists who don't carry coins...

To be fair, if you just stepped out of a train or are about to board one, the restroom inside the train is free.

Santa Monica and Venice have those and "hygienic" is rarely the word used to describe them. The handicapped ones are usually overtaken by homeless as an impromptu residence, the rest have various amounts of dirt, toilet paper, drug paraphernalia, broken glass, urine and feces spread throughout the floor.

Related: Plastic Bag Ban Responsible For Spike In E. Coli Infections, Study Says

http://www.huffingtonpost.com/2013/02/07/plastic-bag-ban_n_2...

Wait until the first flu season in Chicago with the bag tax it will be this year.

The politicians will have dead babies and elderly on their hands. It will be obvious in 5 years when some researchers realize that suburbs nearby don't have the bag ban vs other idential demographically areas within city limits do but somehow flu rates are statistically significantly higher and since they won't be able to find any other explanatory variable. ... oh shit.

I just watch people for 30 mins and saw some crazy ass shit so people could save themselves 7c.

and the rebuttal, which argues that nearly all of the increase in infections is due to a bacteria wave that started before the ban and was international in breadth:

http://berkeleyblog.wpengine.com/wp-content/uploads/2013/02/...

From the article:

The best defense is getting vaccinated — which is free because of the epidemic. The vaccine used to cost about $100. If you’ve traveled to the third world, you’ve probably gotten the two injections a month apart. It’s good for life — no boosters needed.

Grumble grumble grumble... the description of Hepatitis A as a 'hardy virus' and claims "It thrives in cold temperatures and you have to heat it to 185 degrees to kill it" are idiotic and contribute to ignorance. Viruses are not alive. You can not kill a virus. You can destroy it, but it is already dead. All viruses are this way.

"It can live for months outside the body." is simply straight-up patently false. It is not alive, and unless it is somehow destroyed, it can remain infectious effectively forever. This is how viruses work. They can't move, they can't reproduce, they have no metabolism. They are not living things. They are merely a fortuitous compilation of parts that, if put in contact with a particular kind of cell, cause that cell to begin producing copies of the jumble of parts until the virus explodes.

I'm sorry, but this sort of thing bugs me to no end. We can never expect people to learn the basics of infectious disease if we actively lie to them. And no, the intent of making it 'easy to understand' by lying is no excuse. "Good intentions are the opposite of good actions."

Define 'life'. (bonus points for not using wikipedia)

Maybe bio-degradable bags would work for the purpose referred to in the article? The kind from a material that can be used for kitchen waste (food scraps).

Seems like a good opportunity to design and distribute plastic bags specifically for people poops (sort of like the bags for dog poops).

from the article, that seems to be exactly what some of the groups are doing. I have to believe there's a better way to deal with this but I'm not sure what it is. I know other places (notably europe) it's more common to have public restrooms but I don't know how they deal with the problems associated with them (perceived or real).

Unfortunately, the plastic bag ban is only a side effect of the real problem. California has a homeless problem and there aren't enough resources made available in California to address this. The homeless don't have access to resources to readily dispose of waste.

One of the richest and largest polities on earth doesn't have the resources to guarantee basic sanitaion for all residents.

One of the richest and largest polities on earth has a large number of mentally-ill people who would befoul basic sanitation facilities were they given access to them.

The definition of rich is "having a great deal of money or assets", California's tight budget doesn't leave much room for a large reserve - what comes in gets spent the same year, and it's always a mystery whether or not the state will be solvent next year.

Thank prop 13 for that.

Or high-speed rail. Or unreasonable pension obligations.

Just prop 13. If a less well off Europe can handle all 3 so can the richest state in the richest country.

While statutory property tax increases are exclusive to California, homeless populations are not.

Being so spectacularly wealthy and having such a large homelessness problem at the same time is unique to California though.

Hence "wealth distribution" problem, not "not having enough wealth" problem.

Again, what number are you looking at to call California wealthy? California state budget revenues are $4,366 per capita, which is fairly low-end. North Dakota, Wyoming, Washington, Kentucky, Minnesota and Oregon are all in solid five digits a head. California's is richer than Georgia's $2,320 per capita for sure, but if it were a person in a company of 49 other friends, it would be a low-income friend always trying to borrow money.

A GDP of $2.6 trillion, highest in the US and 14% of the US total. Deliberate starvation of state and city budgets doesn't stop California from being the richest state.

Or maybe fix the low cost housing problem and maybe create better homeless day centers and public bathrooms? Just an idea...

Hang up doggy bag distributers on telephone poles downtown - sure just give me an afternoon.

Also, fix the homeless problem. - https://imgs.xkcd.com/comics/tasks.png

It's interesting to me that now the "figure out if the picture is of a bird" task is becoming "gimme a few hours"

Anaheim has decent homeless day centers and has actually invested into container-based housing to accommodate the homeless population by the riverbed, but the issue is not as binary. It also has a decent share of large churches doing all sorts of outreach programs to help the poor.

For a variety of reasons - fear of government control, previous negative experience, fear of harassment or violence, conspiracies conjured up by someone with a mental condition - many homeless refuse "the system" and prefer the riverbank.

As usual the answer to the question in the headline is no. You can read the article for more.

If enough people are sleeping rough, Hep A is an issue among others.

/me search thread for "paper"

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