After 17th court hearing, woman with TB ordered to jail for refusing treatment
A judge in Washington issued an arrest warrant Thursday for a Tacoma woman who has refused to have her active, contagious case of tuberculosis treated for over a year, violating numerous court orders. The judge also upheld an earlier order to have her jailed, where she can be tested and treated in isolation.
On Thursday, the woman attended the 17th court hearing on the matter and once again refused a court order to isolate or comply with testing and treatment—an order that originally dates back to January 19, 2022. Pierce County Superior Court Judge Philip Sorensen rejected her objections to being treated and upheld a finding of contempt. Though it remains unclear what her objections are, the woman’s lawyer suggested it may be a problem with understanding, according to The News Tribune. The Tacoma-Pierce County Health Department, however, argued that she “knowingly, willfully, and contemptuously violated this court’s orders,” noting the lengthy process and numerous proceedings and discussions in which interpreters, translated documents, and speakers of her native language were made available.
Sorenson ordered a civil warrant for her arrest, to be enforced on or after March 3, and again ordered her to jail to undergo involuntary testing and treatment until health officials deem it safe to release her. The order also authorized the Pierce County Jail to place her in a facility equipped to handle her isolation, testing, and treatment.
In a statement emailed to Ars and posted in an online blog, the Tacoma-Pierce County Health Department noted that the woman “is still refusing to isolate and get the treatment she needs to treat her tuberculosis. … We will continue to work through the court and to pursue all our options to protect the community and persuade the patient to voluntarily seek the life-saving treatment she needs.”
As Ars previously reported, the court had renewed orders for her isolation and treatment on a monthly basis since January 2022. The health department had always said it was approaching the problem cautiously, working to keep a “balance between restricting somebody’s liberty and protecting the health of the community.” It sees detention as the “very, very last option.”
But, the department seemed to reach a breaking point this January. In addition to the woman’s defiance hitting the one-year mark, on January 11 she was involved in a car accident as a passenger. The incident clearly showed the woman was violating her self-isolation order, which put the driver at risk of infection. Additionally, the woman went to the emergency department a day later complaining of chest pain and did not tell doctors about her active tuberculosis case, putting them and other hospital staff at risk. When they did lung X-rays, they initially suspected she had cancer. But in fact, the images showed that her tuberculosis case was worsening.
Last, she also tested positive for COVID-19, “which also strongly suggests that she is not isolating as per this court’s order,” a court filing from the health department said.
Tuberculosis is a potentially deadly bacterial infection caused by Mycobacterium tuberculosis. It’s mostly associated with lung infections, but the bacterium can invade many areas of the body. M. tuberculosis spreads through the air via coughing, sneezing, and other respiratory emissions. People at highest risk are those with close, prolonged contact with an infected person. But inhaling just a few germs is enough to seed an infection.
Once established, clearing the infection is not easy. A standard treatment for an uncomplicated tuberculosis case is a four-month or six-month course of four types of antibiotics. Failing to follow through with the treatment can spur drug resistance. In cases where the bacterium has developed drug resistance—which is on the rise globally—treatment can take up to 20 months, and the alternative antibiotic courses can be expensive and toxic.
In all, tuberculosis is one of the deadliest infectious diseases in the world, causing 1.6 million deaths in 2021, according to the World Health Organization. And the rise of multi-drug-resistant and extensively drug-resistant tuberculosis (XDR-TB) are considered a global public health crisis and health security threat.
https://arstechnica.com/?p=1921546