COVID-19 shows desperate need for Gov. Newsom to invest in California’s public health

As California reckons with the darkest moment of the toughest public health challenge in generations, the new year brings a glimmer of hope. Our local public health departments are gearing up to be a crucial part of a massive mobilization to deliver vaccines against COVID-19, first to those whose jobs, age or underlying health conditions put them at greatest risk, and then to every Californian.

It’s a monumental challenge, and one made harder than necessary because California has for too long neglected our public health infrastructure. This is why we make an urgent plea to Gov. Gavin Newsom as he finalizes his budget proposals for California: Invest in public health.

Californians should have no doubt that we will get the job of delivering vaccines done, but they should also be clear-eyed about the urgent need for investments to effectively fight COVID-19 and future pandemics.

Fifteen years ago, California created a standalone state department to oversee public health programs, including lab services, chronic disease prevention and infectious disease control. Over the last ten years, however, the budget for the California Department of Public Health has declined from $3.4 billion to $3.1 billion while state spending has grown from $125 billion to $202 billion.

Simultaneously, the federal government has neglected public health. Nearly 75% of the budget for the United States Centers for Disease Control and Prevention (CDC) goes to states and local communities, and its budget has remained flat. Temporary funding through the Coronavirus Aid, Relief, and Economic Security Act last year, and recently extended, provided a short-term lifeline.

With local health departments on the frontlines of administering public health programs, we need to chart a new course. It is critical that California heavily invests funding from the new federal coronavirus relief package in local health departments and continues to assess and fund ongoing coronavirus response needs and public health infrastructure.

Without adequate funding, local health departments will have to close testing facilities, resulting in delays. Local health departments will have to let go of contact investigators and tracers, impeding the ability to intervene and control the spread of the virus and limiting our ability to target the areas of greatest need. Local health departments will also have to eliminate temporary housing used to quarantine or self-isolate, jeopardizing recovery efforts and placing the hardest-hit communities at greater risk.

Finally, with the vaccine rollout already underway, local health departments are buckling under the pressure to quickly vaccinate with limited available funding to hire additional staff to do mass vaccination clinics.

Through the years, tough cuts have already been made. Over the past decade, the public health workforce has drastically shrunk and never recovered. That really shows at a time like today.

In Riverside County, for example, a 40% funding decline over the last decade has left just 30 disease investigators, contact tracers and public health nurses to serve the sprawling region of 2.5 million people. In Yuba and Sutter counties, nearly a third of the contact investigators and contact tracers are extra hires with no clear funding past this month.

In the past decade, California has seen a steady hollowing out of our local public health staff. We need aggressive action to reverse this course. By including new investments in public health within his budget proposals, Gov. Newsom can expand our state’s capacity to prevent, track and recover from COVID-19. These same investments will help California confront other dangerous diseases when this pandemic is over.

This story was originally published January 7, 2021 at 12:53 PM.