Billions were spent on coronovirus fighting, but what happens next?

Congress poured billions of dollars into state and local public health departments in response to coronovirus epidemicContact masks, tractors and education campaigns to persuade people to get vaccinated.

Public health officials, who have made fun of bare-bones budgets for years, are happy for the extra money. Yet they worry that it will soon dry up, as the epidemic will continue, a boom-bust funding cycle that has damaged the American public health system for decades. If the budgets are dropped again, they warn, it may leave the nation where it was before the coronovirus: not ready for a health crisis.

Health Commissioner of Columbus, Ohio, Drs. “We need funds that we can depend on from year to year,” said Meshika Roberts.

When Roberts debuted in Columbus in 2006, an emergency preparedness grant for more than 20 employees was paid. By then the coronovirus epidemic hit, It paid for about 10.. The relief money that came through last year helped department employees in their coronovirus response teams. While the funding has helped the city deal with the immediate crisis, Roberts wonders if history will repeat itself.

After the epidemic is over, public health officials across the US fear they will return to return money together from a patchwork of sources to provide basic services to their communities – such as the September 11 attacks and SARS and After the Ebola outbreaks.

When mosquito borne virus Through South America in 2016, due to causing severe birth defects in newborns, members of Congress could not agree on how, and how much they would spend in the US for prevention efforts such as education and mosquito eradication. The Centers for Disease Control and Prevention took funding from their Ebola efforts and funding from the state and local health departments to pay for Zika’s initial response. Congress eventually allocates $ 1.1 billion for Zika, But by then, the mosquito season was over most of the US

“Something happens, we throw a ton of money at it, and then in a year or two we go back to our shrunken budget and we can’t do the minimum things that we have to do day in and day out, Let alone be prepared. For the next emergency, “said Chrisis Juliano, executive director of the Big Cities Health Alliance, which represents the leaders of more than two dozen public health departments.

Funds for public health emergency preparedness, which pays for emergency capabilities for state and local health departments, fell by almost half between the fiscal years of 2003 and 2021, according to inflation, America’s trust for healthA public health research and advocacy organization.

Even the federal Prevention and Public Health Fund, Which was established with the Affordable Care Act to provide $ 2 billion per year for public health, was raided for cash over the past decade. If the funds were not touched, the local and state health departments would eventually have an additional profit of $ 12.4 billion.

Many legislators, led by Democratic US Sen. Patty Murray of Washington, want to end the boom-bust cycle law Which would ultimately provide $ 4.5 billion annually in core public health funding. Health departments perform essential government functions – such as managing water safety, issuing death certificates, tracking sexually transmitted diseases and preparing for infectious outbreaks.

From 2010 to 2019, the state’s public health departments declined by 16% per capita and spending for local health departments declined by 18%, KHN and the Associated Press A july check. At least 38,000 public health jobs were lost at the state and local levels between the 2008 recession and 2019. Today, many public health workers are hired on a temporary or part-time basis. Some are paid so poorly that they become eligible for public assistance. Those factors reduce the ability of departments to retain people with expertise.

Comparing those losses, the coronavirus epidemic has led to the exodus of public health officials due to harassment, political pressure, and exhaustion. A year-long analysis by AP and KHN saw at least 248 leaders from state and local health departments resign, resigning or fired between April 1, 2020 and March 31, 2021. About 1 in 6 Americans lost a local public health leader. Ubiquitous epidemic. Experts say this is the largest exodus of public health leaders in American history.

Brian Castrucci, CEO of the De Beaumont Foundation, an advocate for public health, called the Congress’ huge influx of cash in response to the crisis-ridden “wallpapers and drapes” as it does not restore the collapsing foundations of public health.

“I’m worrying at the end of this that we’re going to hire a group of contact trailers – and then close them soon,” Castrucci said. “We continue to go from disaster to disaster without talking about real infrastructure.”

Castrucci and others say they need reliable funding for high-skill professionals, such as epidemiologists – data-driven disease detectors – and for technology upgrades that track outbreaks and provide information to the public Will help in achieving

In Ohio, the computer system used to report cases to the state dates back to the invention of the iPhone. State officials had said that for years they wanted to upgrade it, but they lacked money and political will. Many departments across the country have relied on fax machines. Reporting of COVID-19 cases.

During the pandemic, Ohio’s state auditor found Nearly 96% of local health departments surveyed said they had a problem with the state’s disease reporting system. Roberts said workers interviewing patients have to handle 500 cases, a major burden when handling 500 cases daily.

The system was so old that some information could only be entered into a non-searchable comment box, and officials struggled to pull data from the system to report to the public – such as how many people tested positive that one Black Lives had joined the Matter rally, an important question for people trying to understand last summer whether the protest contributed to the spread of the virus.

Ohio is working on a new system, but Roberts worries that without a dependable budget, states will not be able to keep that one either.

“You need to upgrade it,” Roberts said. “And you need dollars to support you.”

In Washington, Patty Hayes, director of public health for Seattle and King County, said she is asked all the time why there is no central location to register for a vaccine appointment. The answer comes down to the money: There are archaic computer systems across the state with many years of under department computers that were not meant to function when coronaviruses were hit.

Hess recalls a time when his department used to conduct mass vaccination exercises, but when the money dried up after the September 11 visit, the system was demolished.

Roughly six years ago, an analysis found that his department needed about $ 25 million annually for core public health work. Hess said that the past year has shown that it is inferior. For example, climate change Public health concerns, such as the impact on residents in the fire in much of the Pacific Northwest in September, are further exacerbated.

Public health officials in some areas may struggle to make a case for more stable funding because a large contingent of the public has questioned – and often openly held hostility to – mask mandates and occupational sanctions that the public Health officials have planted through the epidemic.

In missouri, Some county commissioners who were frustrated with public health restrictions, withdrew funds from the departments.

In Tennessee County, Tennessee, Mayor Glenn Jacobs heard a video A picture of health officials appeared after referencing “horrifying forces” posted in the fall. Later, someone sprayed “DEATH” on the department office building. The Board of Health stripped him of his powers in March and was given the role of an advisor. A spokesman for the mayor’s office declined to comment on the video.

Head of the Department of Health, Drs. Martha Buchanan said, “This is going to change the state of public health and we cannot do that across the country.” “I know it’s going to change it here.”

A KHN and AP investigation in December Legislation was drafted in at least 24 states that would limit or remove public health powers.

Back in Seattle, locally based companies have pitched money and staff members for vaccine sites. Microsoft is hosting a venue, while Starbucks offered customer service expertise to help them design. Hess is ungrateful, but she wonders why an important government function did not have the necessary resources during an epidemic.

If public health was receiving reliable funding, its employees could work more effectively with the data and prepare for emerging threats in the state where First American COVID-19 case was confirmed.

“He must have seen this reaction back to the epidemic in this country, as a great example of a country’s failure to prioritize the health of its citizens because it was not committed to public health,” she said. “This will be part of the story.”


KHN senior correspondent Anna Maria Barry-Juster and Montana correspondent Catherine Houghton contributed to this report.


Follow Michelle R. Smith on Twitter @MRSmithAP, Lauren Weber @LaurenWeberHP And Hannah Reicht @ Shehna_recha.


The story is a collaboration between The Associated Press and KHN (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Along with policy analysis and voting, KHN is one of the three major operating programs of KFF (Kaiser Family Foundation). KFF is a thriving non-profit organization that provides information on health issues to the nation.

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