Why Public Health Is in Crisis: Threats, Departures, New Laws

Many, particularly in conservative circles, have increasingly embraced individual rights over collective responsibilities, a trend that Dr. Rosner said is undercutting the notion of a social contract in which people work together to achieve a greater good.

“It’s a depressing moment,” he said. “What makes a society if you can’t even get together around keeping your people healthy?”

During the pandemic, the federal government made tens of billions of dollars available to bolster testing, contact tracing and vaccinations.

In May, the Biden administration announced that it would invest an additional $7.4 billion from the Covid-19 stimulus package to train and recruit public health workers.

But while health officials described the money as critical to helping them quickly build out teams after years of budget cuts, many of those new hires were temporary workers and much of the spending went to urgent needs such as testing and vaccinations. The new funding often came routed through states or grant programs with conditions, like a short time frame for spending money or time-consuming requirements for state or county approvals. Some departments said they had to lay off employees at inopportune times over the past year because grants had run out of money.

And the funding is not permanent. Many local health officials said they expected that the extra money would peter out over the next two to three years. They likened the Covid-19 funds to the money that flowed into health departments after the 9/11 attacks but then vanished when political priorities changed.

Dozens of departments said that, in order to be prepared for more surges or a future pandemic, what they truly needed was a higher baseline of qualified, permanent employees. Instead, they purchased equipment or, more frequently, hired temporary staff, knowing they would need to let them go when the money dried up.

A health official in Berrien County, Mich., said it was so time-consuming to get approval from the county to hire temporary staff members in the fall of 2020 that, when her department received more funding later, she focused instead on quicker purchases, like software. When the virus closed in, she had to pull existing employees off their regular duties.

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