If Newsom invested in public health agencies before COVID, how many could have been saved?
Sacramento County’s Department of Health Services lost roughly one-third of its staff to budget cuts after the Great Recession. The field nursing unit, which tackled issues like infant mortality and disease prevention, was hit hardest. The persistent uncertainty caused high turnover, said County Public Health Officer Dr. Olivia Kasirye.
The unit was a large source of the department’s COVID-19 surge capacity when local hospitals became overwhelmed. The county also lacked three deputy physicians — important, localized roles — and had to rely on the state to fill those gaps, Kasirye said. Even after millions of dollars of federal aid poured in, valuable time was lost preparing enough people who could adequately respond to the escalating crisis in Sacramento.
“Ramping up took some time,” Kasirye said. “We had to get people hired or trained in order to be able to deploy them. There was a delay because of that.”
No arm of the government has been more essential to our daily lives during the pandemic than public health departments. Their orders closed schools and businesses and forced us to stay home. They set local mask rules, investigated infections, guided reopenings and administered life-saving vaccines. Many play a crucial role in addressing homelessness.
Yet prior to the pandemic, public health departments were on the brink of obscurity after more than a decade of austerity measures. Budgets declined at least 20% over the last decade, according to Michelle Gibbons, executive director of the County Health Executives Association of California. Without broader investment now and in the future, she said, public health leaders worry they may lose the staff and resources they’ve gained when emergency funding dries up. That could leave communities vulnerable, and overwhelm public health departments when the next crisis hits.
“The one thing I have heard repeatedly, time and time again, is if they had more staff early on — that knew the community, were trained and could be used flexibly — they could’ve started to address COVID much earlier,” Gibbons said.
A statewide group of public health officials and frontline workers, called the California Can’t Wait coalition, is asking for a $200 million annual commitment in Gov. Gavin Newsom’s 2021-22 budget. Gibbons said the funding would help departments sustain their workforce, expand disease monitoring and improve their abilities to confront the health disparities that led to more COVID infections and deaths in communities of color.
Newsom endorsed a smaller piece of their proposal in his revised budget, allocating $3 million to study public health needs for future budgets. He also proposed $300 million for public hospitals and behavioral health programs. But for the third year in a row, Newsom decided not to support a major funding request from public health leaders.
“This gives us an incredible opportunity over the weeks and months that isn’t knee jerk to the obvious gaps, but really build up investments at the county and state level to make sure we’ll be poised to respond to not just emergencies … but public health issues of need,” California Health and Human Services Secretary Dr. Mark Ghaly said about the administration’s proposal.
Newsom’s reluctance to support public health departments after a deadly and economically catastrophic global health crisis is disturbing. Democratic majorities in the state Senate and Assembly both identified public health investment as a priority this term, and Newsom signaled he was open to negotiating. But if nothing changes, it’ll take months before the budget is adopted and even longer before a study launches. It’s anyone’s guess how long it’ll take to finish the study, let alone present it and then act on the findings.
Recent reporting from Kaiser Health News detailed the governor’s cozy relationship with major tech companies and health care giants who donated to his campaigns and benefited from massive no-bid contracts to perform critical tasks like COVID testing and vaccine management.
Some partnerships, like the $50 million vaccine scheduling site MyTurn, was a total failure and accounted for less than one-third of appointments. The $72 million deal with Verily Life Sciences for testing was abandoned months later over privacy concerns and equity barriers. When it came time to distribute vaccines, some counties rejected California’s $15 million partnership with Blue Shield when they were asked to give up local oversight.
Each of these emergency contracts, all using public dollars, came at the expense of local health departments who know their communities better than profit-driven companies. If Newsom would rather prioritize his campaign supporters, California’s legislators in the senate and assembly must be the voice of reason and fight for public health departments in this year’s budget.
It’s taxpayers who are largely responsible for the $76 billion budget surplus, and it’s taxpayers who should benefit from the upcoming spending. Nearly 63,000 Californians have died from COVID. We shudder to think how many could have been spared if public health was properly funded.
This story was originally published May 21, 2021 at 5:00 AM.