This article is from the source 'nytimes' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at https://www.nytimes.com/2020/03/14/us/coronavirus-health-departments.html

The article has changed 30 times. There is an RSS feed of changes available.

Version 9 Version 10
The Coronavirus Swamps Local Health Departments, Already Crippled by Cuts The Coronavirus Swamps Local Health Departments, Already Crippled by Cuts
(about 13 hours later)
CHICAGO — A widespread failure in the United States to invest in public health has left local and state health departments struggling to respond to the coronavirus outbreak and ill-prepared to face the swelling crisis ahead.CHICAGO — A widespread failure in the United States to invest in public health has left local and state health departments struggling to respond to the coronavirus outbreak and ill-prepared to face the swelling crisis ahead.
Many health departments are suffering from budget and staffing cuts that date to the Great Recession and have never been fully restored. Public health departments across the country manage a vast but often invisible portfolio of duties, including educating the public about smoking cessation; fighting opioid addictions; convincing the reluctant to vaccinate their babies; and inspecting restaurants and tattoo parlors.Many health departments are suffering from budget and staffing cuts that date to the Great Recession and have never been fully restored. Public health departments across the country manage a vast but often invisible portfolio of duties, including educating the public about smoking cessation; fighting opioid addictions; convincing the reluctant to vaccinate their babies; and inspecting restaurants and tattoo parlors.
Now, these bare-bones staffs of medical and administrative workers are trying to answer a sudden rush of demands — taking phone calls from frightened residents, quarantining people who may be infected, and tracing the known contacts and whereabouts of the ill — that accompany a public health crisis few have seen before.Now, these bare-bones staffs of medical and administrative workers are trying to answer a sudden rush of demands — taking phone calls from frightened residents, quarantining people who may be infected, and tracing the known contacts and whereabouts of the ill — that accompany a public health crisis few have seen before.
Nationwide, local and state health departments have lost nearly a quarter of their work force since 2008, according to the National Association of County and City Health Officials. As the nation’s local and state public health officials confront a pandemic that has paralyzed much of the world, many of them have made their situation plain: They are heading into a crisis without the resources they need.Nationwide, local and state health departments have lost nearly a quarter of their work force since 2008, according to the National Association of County and City Health Officials. As the nation’s local and state public health officials confront a pandemic that has paralyzed much of the world, many of them have made their situation plain: They are heading into a crisis without the resources they need.
“We’ve had to deal with budget cut after budget cut,” said A. Scott Lockard, director of the Kentucky River District Health Department, which serves seven counties in rural eastern Kentucky. “Our staffing level is much less now than what it was previously. People are wearing several different hats and sharing job responsibilities for things that they were not doing before, so we’re already operating at peak efficiency and we have no capacity when something like this happens.”“We’ve had to deal with budget cut after budget cut,” said A. Scott Lockard, director of the Kentucky River District Health Department, which serves seven counties in rural eastern Kentucky. “Our staffing level is much less now than what it was previously. People are wearing several different hats and sharing job responsibilities for things that they were not doing before, so we’re already operating at peak efficiency and we have no capacity when something like this happens.”
With the virus now consuming all attention, key functions have been put on hold. Some health departments are now making reductions in home health care and education on unwanted teenage pregnancy and other core issues. In Wayne County, Ohio, the health department called off upcoming seminars to vaccinate people in Amish communities, where parents are often reluctant to immunize their children.With the virus now consuming all attention, key functions have been put on hold. Some health departments are now making reductions in home health care and education on unwanted teenage pregnancy and other core issues. In Wayne County, Ohio, the health department called off upcoming seminars to vaccinate people in Amish communities, where parents are often reluctant to immunize their children.
“Local health departments in the state of Ohio are underfunded,” said Nicholas Cascarelli, the commissioner for the Wayne County Health Department in Ohio, near Akron. “We’re kind of quiet and we go about our business. But when stuff like this happens, people notice.”“Local health departments in the state of Ohio are underfunded,” said Nicholas Cascarelli, the commissioner for the Wayne County Health Department in Ohio, near Akron. “We’re kind of quiet and we go about our business. But when stuff like this happens, people notice.”
Since the coronavirus outbreak began, many of the nation’s thousands of health departments have coped by pulling their entire staffs into the effort. For smaller departments, there is little wiggle room.Since the coronavirus outbreak began, many of the nation’s thousands of health departments have coped by pulling their entire staffs into the effort. For smaller departments, there is little wiggle room.
Cindy Kinnard, the director of public health in Kewaunee County, a mostly rural Wisconsin community on the shore of Lake Michigan, said her 23 years at the department have usually felt short-staffed.Cindy Kinnard, the director of public health in Kewaunee County, a mostly rural Wisconsin community on the shore of Lake Michigan, said her 23 years at the department have usually felt short-staffed.
At its height, the department had eight employees. Now it is down to six, hardly enough to handle the flood of tasks in this moment, she said.At its height, the department had eight employees. Now it is down to six, hardly enough to handle the flood of tasks in this moment, she said.
“We’re getting a lot of telephone calls and a lot of questions,” she said. “We are definitely understaffed for it.”“We’re getting a lot of telephone calls and a lot of questions,” she said. “We are definitely understaffed for it.”
On Friday, President Trump declared a national emergency over the coronavirus pandemic, pledged up to $50 billion in aid and appeared to strike a deal with House Democrats to provide other assistance, offering some hope of an injection of resources that could provide temporary relief.On Friday, President Trump declared a national emergency over the coronavirus pandemic, pledged up to $50 billion in aid and appeared to strike a deal with House Democrats to provide other assistance, offering some hope of an injection of resources that could provide temporary relief.
He had previously authorized an $8.3 billion supplemental package for coronavirus issues; state and local health agencies will receive $950 million under the law.He had previously authorized an $8.3 billion supplemental package for coronavirus issues; state and local health agencies will receive $950 million under the law.
“It’s definitely going to help,” said John Auerbach, president and chief executive of Trust for America’s Health, who suggested that some states could use the funds to attempt to quickly hire more epidemiologists or increase laboratory capacity.“It’s definitely going to help,” said John Auerbach, president and chief executive of Trust for America’s Health, who suggested that some states could use the funds to attempt to quickly hire more epidemiologists or increase laboratory capacity.
Still, the money comes as local health workers already are fully engulfed in the immediate crisis. And Mr. Auerbach said that the money, which must be spent on coronavirus-related actions, will not solve long-term problems many agencies face. “The money will run out and the core budget will be what remains,” he said.Still, the money comes as local health workers already are fully engulfed in the immediate crisis. And Mr. Auerbach said that the money, which must be spent on coronavirus-related actions, will not solve long-term problems many agencies face. “The money will run out and the core budget will be what remains,” he said.
A panel of experts studying the public health system in the United States, convened by Resolve, a nonprofit public policy group, recently found that the country would need an additional $4.5 billion annual investment to protect national security and “create the conditions in which people can be as healthy as possible.”A panel of experts studying the public health system in the United States, convened by Resolve, a nonprofit public policy group, recently found that the country would need an additional $4.5 billion annual investment to protect national security and “create the conditions in which people can be as healthy as possible.”
And a study by the Trust for America’s Health, a nonprofit public health advocacy group in Washington, found in 2019 that “chronic underfunding has presented a consistent obstacle” to the nation’s public health systems.And a study by the Trust for America’s Health, a nonprofit public health advocacy group in Washington, found in 2019 that “chronic underfunding has presented a consistent obstacle” to the nation’s public health systems.
“Since 2008, they’ve really been hit hard, and the vast majority of them have not recovered,” said Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials. “That’s apparent in both budgets and also in their work force.”“Since 2008, they’ve really been hit hard, and the vast majority of them have not recovered,” said Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials. “That’s apparent in both budgets and also in their work force.”
Mr. Lockard, the director of the public health system in eastern Kentucky, said his department had roughly 300 employees in the early 2000s but was now down to 110 workers.Mr. Lockard, the director of the public health system in eastern Kentucky, said his department had roughly 300 employees in the early 2000s but was now down to 110 workers.
They were doing what they could, he said. But it was not going to be easy. “It shows that our public health infrastructure has been severely weakened over the years,” he said. “We have much fewer people to respond when we have a situation like this.”They were doing what they could, he said. But it was not going to be easy. “It shows that our public health infrastructure has been severely weakened over the years,” he said. “We have much fewer people to respond when we have a situation like this.”
A staff of 30 clinical nurses was now down to eight. His preparedness planner left 14 months ago, he said, because of budget cuts. His sole epidemiologist, he said, was “completely overwhelmed.” The area was still dealing with one of the most intense flu seasons seen in years.A staff of 30 clinical nurses was now down to eight. His preparedness planner left 14 months ago, he said, because of budget cuts. His sole epidemiologist, he said, was “completely overwhelmed.” The area was still dealing with one of the most intense flu seasons seen in years.
On the federal level, the Centers for Disease Control and Prevention, the nation’s main public health agency, has seen its budget fall 10 percent over the last decade, adjusting for inflation, according to the Trust for America’s Health report. The C.D.C. saw a 2 percent increase in its budget program funding between the 2018 and 2019 fiscal years, after accounting for interagency transfers and one-time funding, and as measured in inflation-adjusted dollars.On the federal level, the Centers for Disease Control and Prevention, the nation’s main public health agency, has seen its budget fall 10 percent over the last decade, adjusting for inflation, according to the Trust for America’s Health report. The C.D.C. saw a 2 percent increase in its budget program funding between the 2018 and 2019 fiscal years, after accounting for interagency transfers and one-time funding, and as measured in inflation-adjusted dollars.
And while the report found that total state spending on public health increased 2 percent in the 2018 fiscal year, 17 states and the District of Columbia cut public health funding that year, while 21 percent of local health departments reported reductions in budgets for the 2017 fiscal year.And while the report found that total state spending on public health increased 2 percent in the 2018 fiscal year, 17 states and the District of Columbia cut public health funding that year, while 21 percent of local health departments reported reductions in budgets for the 2017 fiscal year.
The federal Public Health Emergency Preparedness program, which helps state and local health departments prepare for and respond to emergencies, including outbreaks of infectious diseases, has also seen funding reductions, falling from $940 million in the 2002 fiscal year to $617 million in the 2019 fiscal year, according to statistics compiled by the Trust for America’s Health.The federal Public Health Emergency Preparedness program, which helps state and local health departments prepare for and respond to emergencies, including outbreaks of infectious diseases, has also seen funding reductions, falling from $940 million in the 2002 fiscal year to $617 million in the 2019 fiscal year, according to statistics compiled by the Trust for America’s Health.
Updated June 12, 2020 Updated June 16, 2020
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Some of the states hardest hit by the coronavirus run the gamut in terms of public health emergency preparedness, according to rankings by Trust for America’s Health, with Washington State in a top category of preparedness, California in the middle, and New York in the bottom.Some of the states hardest hit by the coronavirus run the gamut in terms of public health emergency preparedness, according to rankings by Trust for America’s Health, with Washington State in a top category of preparedness, California in the middle, and New York in the bottom.
Still, even Washington State’s system has been hampered by a lack of resources needed for upkeep, equipment and the flexibility to respond to emergencies. In recent weeks, state lawmakers there discussed adding $5 million to the budget to aid the state’s coronavirus response. That later rose to $100 million. Then, this week, just as lawmakers were finalizing the budget, they doubled the new funding to $200 million.Still, even Washington State’s system has been hampered by a lack of resources needed for upkeep, equipment and the flexibility to respond to emergencies. In recent weeks, state lawmakers there discussed adding $5 million to the budget to aid the state’s coronavirus response. That later rose to $100 million. Then, this week, just as lawmakers were finalizing the budget, they doubled the new funding to $200 million.
Around the country, some public health systems are actually in stronger shape than in years past. Amelia Clark, administrative officer of the Spokane Regional Health District in eastern Washington, said her agency had grown to 263 employees from 221 employees 10 years ago.Around the country, some public health systems are actually in stronger shape than in years past. Amelia Clark, administrative officer of the Spokane Regional Health District in eastern Washington, said her agency had grown to 263 employees from 221 employees 10 years ago.
“Washington’s done a pretty good job of funding public health,” she said.“Washington’s done a pretty good job of funding public health,” she said.
Still, the Spokane agency has been contracting with retired public health workers in recent days to help handle what is expected to be a wave of coronavirus cases. By the end of a week in which cases of the virus in the United States rose above 2,100 and schools and offices closed, the stress on local health care systems was already being felt.Still, the Spokane agency has been contracting with retired public health workers in recent days to help handle what is expected to be a wave of coronavirus cases. By the end of a week in which cases of the virus in the United States rose above 2,100 and schools and offices closed, the stress on local health care systems was already being felt.
A website for the Kentucky Cabinet for Health and Family Services suggests that residents call an 800 number if they are feeling ill “but would not have sought care if not for Covid-19.”A website for the Kentucky Cabinet for Health and Family Services suggests that residents call an 800 number if they are feeling ill “but would not have sought care if not for Covid-19.”
Numerous attempts to call the number on Thursday were met with a busy signal. On Friday, calls went through, and a recording was available offering details on the virus and tips for not contracting it. There was also an option to speak with a health care specialist. One of them picked up after a one-hour hold time.Numerous attempts to call the number on Thursday were met with a busy signal. On Friday, calls went through, and a recording was available offering details on the virus and tips for not contracting it. There was also an option to speak with a health care specialist. One of them picked up after a one-hour hold time.
“The biggest problem off the top is there’s sort of like a surge capacity,” said Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials. “This all-hands-on-deck metaphor, of people getting pulled off of all sorts of things to work on this, some of that’s OK. But the problem is you’re pulling across all of these programs, all of which have been cut and chopped away at over the last few years, so there’s not the same capacity as there once was.”“The biggest problem off the top is there’s sort of like a surge capacity,” said Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials. “This all-hands-on-deck metaphor, of people getting pulled off of all sorts of things to work on this, some of that’s OK. But the problem is you’re pulling across all of these programs, all of which have been cut and chopped away at over the last few years, so there’s not the same capacity as there once was.”
State public health departments, Dr. Plescia said, were staffed with some excellent workers. The issue is that there are not enough of them. Now the coronavirus was going to put the model to the ultimate test. “Everybody’s been saying that this is a problem, that we haven’t been investing in public health, and now we’re seeing how that might play out to be a bigger issue,” he said.State public health departments, Dr. Plescia said, were staffed with some excellent workers. The issue is that there are not enough of them. Now the coronavirus was going to put the model to the ultimate test. “Everybody’s been saying that this is a problem, that we haven’t been investing in public health, and now we’re seeing how that might play out to be a bigger issue,” he said.
Dr. Boris Lushniak, the dean of the School of Public Health at the University of Maryland, said he was concerned that in the coming weeks and months, the demands on local and state public health workers would become difficult to sustain.Dr. Boris Lushniak, the dean of the School of Public Health at the University of Maryland, said he was concerned that in the coming weeks and months, the demands on local and state public health workers would become difficult to sustain.
“We can project out what’s going to happen in the next few weeks,” he said. “We are going to get an influx of diagnostics. It’s here, there’s no stopping it, it is spreading person to person. And as the numbers surge up, that puts more pressure on the states and locals.”“We can project out what’s going to happen in the next few weeks,” he said. “We are going to get an influx of diagnostics. It’s here, there’s no stopping it, it is spreading person to person. And as the numbers surge up, that puts more pressure on the states and locals.”
On Thursday afternoon, Debra Nagel, a nurse who specializes in communicable disease and preparedness, answered the phone at the Jasper County Health Department in Rensselaer, Ind., and said she would be happy to briefly chat about her department’s response to the coronavirus outbreak.On Thursday afternoon, Debra Nagel, a nurse who specializes in communicable disease and preparedness, answered the phone at the Jasper County Health Department in Rensselaer, Ind., and said she would be happy to briefly chat about her department’s response to the coronavirus outbreak.
“I think the main challenge is —” she said, stopped short by another phone trilling in the background.“I think the main challenge is —” she said, stopped short by another phone trilling in the background.
“I guess I don’t really have the time to talk,” she said. “I’m the only one here.”“I guess I don’t really have the time to talk,” she said. “I’m the only one here.”
She apologized and hung up.She apologized and hung up.
Julie Bosman reported from Chicago, and Richard Fausset from Atlanta. Mike Baker contributed reporting from Seattle.Julie Bosman reported from Chicago, and Richard Fausset from Atlanta. Mike Baker contributed reporting from Seattle.