In October, when doctors in Pasadena, California, reported that hospitalized patients were exhibiting typical symptoms of dengue fever, including vomiting, rash, and bone and joint pain, local disease investigators sprang into action. did.
The mosquito-borne virus is common in Southeast Asia, East Africa, Latin America and elsewhere, and Americans usually contract the disease while traveling. However, in this case, the patient had not left California.
Epidemiologists and public health nurses visited 175 households and took blood samples, and local exterminators began fumigating the areas where the patients lived. During the process, a second infected person with no travel history was discovered.
Both patients recovered, and nearly 65% of Aedes aegypti carrier mosquitoes in the area were eradicated within seven days, said Matthew Feaster, an epidemiologist with the Pasadena Department of Public Health.
Manuel Carmona, Pasadena's deputy director of public health, said the rapid and intensive response was funded primarily by new funding in the state budget for public health and preparedness across California.
Facing pleas from public health officials that there aren't enough resources to track and contain the disease amid the COVID-19 pandemic, California Governor Gavin Newsom has pledged $300 million annually to the state's chronic disease program. Agreed to allocate dollars. Underfunded public health systems.
Two years after the money started flowing, and facing a $45 billion deficit, the second-term Democratic governor is proposing cutting funding entirely.
“This is a huge setback,” said Kat DeBerg, executive director of the California Health Officials Association. “We can't go back to where we were before the pandemic. The future is very scary.”
Michelle Gibbons, executive director of the California Association of County Health Executives, said the new funding has already hired about 900 public health workers, including some disease researchers in Pasadena. and said his position would be at risk if Mr. Newsom prevailed.
The governor released his latest budget proposal for the 2024-25 fiscal year on May 10, saying that while it is painful to move forward with such deep cuts to health and human services, the state is making “difficult decisions” to balance the budget. He said it was necessary to make a decision. Unlike the federal government, it cannot operate at a deficit.
Tense budget negotiations are underway between Newsom and leaders of the state House and Senate, with an agreement needed to be reached by June 15 on an estimated $288 billion state budget.
“We have shortfalls, and we have to take a hard look at reality and take a hard look at what our priorities are,” Newsom said after unveiling the proposed layoffs. “This is a program that we hope to continue to absorb and be able to afford.”
Public health officials lobbied Newsom hard in 2020 and 2021 to get more resources, including $100 million a year for the state Department of Public Health and funding for the 61 local health departments that form the backbone of California's public health system. Secured $200 million in additional annual funding for the Bureau.
They are now fighting to keep the money, just as cities and counties began using it to shore up California's public health defenses.
Some of the workers hired with this money are fighting homelessness, combating climate change, and surveying farmworkers to identify health and social needs, but most are infectious disease experts such as epidemiologists and public health nurses who are responsible for investigating threats and outbreaks.
Measles infections are occurring in Davis, San Diego, and Humboldt counties. Earlier this month, the city of Long Beach declared a public health emergency due to a tuberculosis outbreak. Tuberculosis is spread through the air when an infected person coughs, talks, or sneezes. Los Angeles public health officials are investigating a spate of hepatitis A infections among homeless people.
And across the United States, the spread of bird flu from animals to humans is causing widespread concern.
“The longer this virus travels between cattle and birds, the more likely it is to evolve and be transmitted from person to person,” DeBerg said. She argues that public health agencies need to ensure they have enough funding to hire staff who can stop threats when they emerge, as they did in Pasadena.
“The dengue epidemic was stopped because of increased employment capacity. That was a huge public health success,” she said.
Pasadena public health officials worked with local mosquito control agencies to spray insecticides and sent 29 staff to test residents for dengue fever.
“We put the best and brightest people on this case,” Carmona said, adding that four of the disease researchers were funded with about $1 million in new state funding the department receives each year. “Without that, we wouldn't have been able to respond in a timely manner and probably have identified dengue as West Nile or some other type of virus.”
Interim Public Health Officer and Placer County Health and Human Services Director Rob Oldham said he is considering the “devastating” cuts that would be imposed if Newsom's proposal passes. He said the county used about $1.8 million in new state funding annually to hire 11 full-time and six part-time employees.
“This money was just starting to take hold,” he says. “To be honest, we're in a hectic situation, just like we're dealing with another measles case.”
Legislative leaders declined to say whether they would protect funding as nearly every area of state government faces deep cuts, including early childhood education, public safety, energy and transportation.
“We are at the last minute in budget negotiations, but we are working hard to preserve the progress we have made,” said State Senate Minority Leader Mike McGuire, a Northern California Democrat.
Public health officials have warned that losing hard-earned funding leaves the state vulnerable to health and economic disaster.
“It's tempting to go back to how things were before, because when you're working, you can't see it. Crisis is averted,” Gibbons said. “But the thought of returning to the boom-bust cycle of public health funding of neglect, panic, and repetition is devastating.”
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
This article is republished from khn.org. khn.org is a national newsroom that produces in-depth journalism on health issues and is one of KFF's core operating programs, providing independent information for health policy research, polling, and journalism. It is the source.
