Funding our strained public health systems must be a bipartisan priority

As the COVID-19 crisis worsens across the country, so too does the stress and fatigue being felt by public health workers. America’s public health system has been pushed to the brink by the pandemic, but the reality is COVID-19 is one of many emergencies public health departments are facing. Over the past weeks, for example, the New York City Health Department also dealt with a Legionella outbreak and two devastating tropical storms. 

Clearly America’s public health system is vital, and it should be funded as such. 

Now Congress has an opportunity to invest in public health — both for now and in the long-term — by passing President Biden’s budget reconciliation package.   

 The New York City Health Department has over 200 years of experience in public health, and the COVID-19 pandemic gives a sense of what resources health departments need. 

Our technology traces outbreaks, provides real-time, neighborhood-level data, and tracks records of vaccinations. This information has been the lifeblood of our public health response. We rely on strong partnerships with the health care system, built on years of coordination to prepare health care facilities and staff for emergencies. We communicate the latest information about the virus to over 8 million diverse New Yorkers. And our Public Health Laboratory is instrumental to understanding the virus and executing the City’s testing program. 

Data, surveillance reports, lab testing and genome sequencing may sound mundane, but when any of these components fail or are underfunded, the consequences are severe. 

Beyond the tragedy of lives lost, the impact of COVID-19 on the U.S. economy cannot be overstated. Leading economists estimate the cost of the pandemic in the United States is more than $16 trillion. 

Those dollars would have been better spent on public health investments well before COVID-19. A new analysis released by the Kaiser Family Foundation estimated that the federal government could have saved $5.7 billion in just June, July, and August of this year by avoiding over 340,000 hospitalizations through a more successful COVID-19 vaccination campaign. 

Public health has proven time and again that an ounce of prevention is worth a pound of cure. It should be a bipartisan priority, and we urge lawmakers on both sides of the aisle to come together to support funding.

To begin with, we must confront the fallout in the public health workforce. Over the past decade, local health departments across the country have had to eliminate more than 56,000 jobs, and COVID-19 is taking a toll on staff stretched too thin. That means each month, the nation loses over 450 public health workers, and the consequences compound. A recent Centers for Disease Control and Prevention survey found that over half (53 percent) of public health workers in the U.S. reported symptoms of depression, anxiety, PTSD or suicidal thoughts since the start of the pandemic. 

New Public Health Corps programs being launched in New York City and across the country as part of the Biden-Harris COVID-19 American Rescue plan are a step in the right direction. The Public Health Corps will be permanent community health workers who provide health and wellness services at the neighborhood level, including creating connections to care, delivering care management, and sharing public health education. Their focus will be tackling longstanding and systemic racial health injustices. These programs also ensure that people of the community will be an integral part of any emergency response.   

But it takes more than the Public Health Corps to prepare for emergencies. 

As we’ve learned from COVID-19, it takes lab technicians, epidemiologists, emergency managers, communication staff, public health nurses and doctors. They cannot just be brought on in times of crisis. Health departments need time to hire qualified staff who can build and sustain trusted relationships with the communities they serve.  

In addition, the technology that public health departments rely on are antiquated. In fact, most jurisdictions in the U.S. have data analysts maintaining technology systems established long before they were born.

Public health laboratories like New York City’s require up-to-the-minute, reliable, and secure systems to track data. With new funding, health departments will have the technology to prevent COVID-19’s resurgence and emergencies in the future.  

Our country has tragically lost more than 670,000 Americans to COVID-19, and the virus is still with us. Even as we continue responding to this “Code Blue,” we must prepare for the next one. 

We are calling on Congress to make a significant investment in public health for the long term. With the growth of commercial aviation, the federal government made sustained investments for the FAA to fund airplane safety, well-trained staff, and innovation. America’s public health system needs the same support, and it needs it now. Before the next crisis. 

Dr. Chokshi is New York City’s Health Commissioner. Sami Jarrah is the Chief Financial Officer and Deputy Commissioner of the NYC Health Department.