Wednesday, July 15, 2020

ADA and Other Groups Send Letter to Congress Requesting Investment in Public Health




As if it's not readily apparent enough, the catastrophe that is Covid-19 caught the world flat footed.  For years an educated, and occasionally vocal, minority had been warning of the fears of a rapidly spreading infectious disease that *might* occur at any moment.


The problems with these types or warnings are many.  Which disease?  Where will it come from?  How will it spread?  How widespread will it be?  How many fatalities?  It is difficult to state with any degree of certainty the answers to *any* of these questions, let alone all of them.  Preparing for disasters is difficult AND expensive.  Trying to see the future and then spend money on a “maybe” problem is hard to justify when there are other problems that can be easily seen that demand funding to help stop.  


So… the world did nothing.  And when SARS-CoV-2, the virus that causes the illness called Covid-19 hit, no one had spent money on a plan or anything that could be used to help stop the spread.  The thing about all this is, that an ounce of prevention is worth a pound of cure.  Now, the American Dental Association along with many other groups are hoping to encourage the United States Congress to spend money to help prevent future, and potentially more lethal, pandemics when they occur in the future.  And trust me… they WILL occur again.

Here is what the letter had to say:


As Congress undertakes the next iteration of legislation to speed the response to the COVID-19
pandemic, the undersigned organizations urge you to include a significant, long-term investment
in public health infrastructure. This investment is critical to support the public health system as it
rebuilds from the COVID-19 response, but also to strengthen it before the next pandemic hits
and avoid the loss of life and social and economic disruption we are facing today. The
importance of strong, predictable federal investment in this system is even more vital now as the
economic impacts of the pandemic are felt nationwide. State and local governmental budgets,
and therefore public health budgets, are likely to be devastated. This will leave our nation even
more vulnerable to emerging health risks. By building the core public health infrastructure of
states, localities, tribal governments and territories, as well as the Centers for Disease Control
and Prevention (CDC), the nation will be better prepared for the next threat.

Our groups recommend $4.5 billion in additional annual funding for CDC, state, local,
tribal and territorial core public health infrastructure to pay for such essential activities as
disease surveillance, epidemiology, laboratory capacity, all-hazards preparedness and
response; policy development and support; communications; community partnership
development; and organizational competencies.

For too long, the nation has neglected basic public health capacity. More than 56,000 local Public Health departments are still dependent on archaic methods of tracking diseases, including phone, health jobs were eliminated between 2008 and 2017—nearly one quarter of the workforce.

 Health departments are still dependent on archaic methods of tracking diseases, including phone, fax, and paper.  CDC’s funding remains just above level with FY2008, when adjusting for inflation, and funding specific to state and local public health preparedness has been cut from  $939 million in FY2003 to $675 million in FY2020. That means there has been little room to modernize, retain skilled workforce, and address emerging threats. In fact, only 51 percent of the U.S. population is served by a comprehensive public health system, and the estimated gap infunding foundational public health capabilities is about $13 per person per year, yielding the requested $4.5 billion.

The COVID-19 pandemic is illustrating in the direst terms the consequences of underfunding public health. The delays in diagnostic testing are hampering communities’ ability to suppress the virus. Public health departments are attempting to conduct statewide situational awareness and management of medical supply shortages. The response is personnel-heavy – investigating cases, managing supplies and volunteers, conducting risk communications, coordinating with governmental and healthcare partners, and planning for the next phase of response.

The U.S. has followed a pattern of underfunding of vital public health services, followed by a crisis,a quick infusion of cash,and then dwindling investments overtime. This pattern is placing American lives at risk. We must think not just of the short-term needs of this pandemic, but the long-term readiness of our nation. We applaud Congress for taking quick action to provide funding for the initial response, including for the state and local public health response. However, short-term, supplemental funding does not allow public health to recruit and retain the expert workforce needed for protecting the nation against emerging threats. We urge you to do act now to prevent and prepare for the next pandemic.

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