State and local health officials are also pressing to use this moment to build back up public health capacities that they say have been insufficient for years.
“It’s so hard to get people and leaders to think about public health. That’s how we have found ourselves in the situation we are now in, with so little capacity,” said Michael Fraser, chief executive of the Association of State and Territorial Health Officials — which represents state health departments. “This is a chance to think about public health. We are never going to see this kind of interest again until the next pandemic, and then it will be too late again.”
Since the pandemic began earlier this year, Congress has appropriated at least $2.4 billion to state and local health departments. Of that, the CDC allocated $871 million to states, territories, tribes, and other jurisdictions for public health. That money has moved with historic speed to the states. But it pales in comparison to what disease experts say will be needed in the months ahead to keep the virus at bay while also reopening the economy and society to a functioning — if significantly altered — level.
For contact tracing alone, for example, a recent report by ASTHO and the Johns Hopkins Center for Health Security estimated 100,000 additional contact tracers are needed to keep the virus in check. That will cost $3.6 billion in national emergency funding as a starting point for that effort.
It is unclear how much money will be needed to ramp up testing, which remains woefully short across the country. Tests across the United States are running in the range of 130,000 to 160,000 tests a day, according to the COVID Tracking Project. A report by the Harvard Global Health Institute estimated that 500,000 tests would need to be conducted daily to reopen the economy. A different report by Harvard’s Edmond J. Safra Center for Ethics argues the country needs 5 million tests a day to identify hot spots, do contact tracing and isolate people to keep the virus under control.
“Yes, it’s a big investment, but it’s one we need because until that happens, our country is shut down,” said Adriane Casalotti, chief of government and public affairs at the National Association of County and City Health Officials.
Compared to other advanced nations, America’s state and local health departments come to the battle with the coronavirus at a severe disadvantage. Since 2008, local health agencies have lost almost a quarter of their overall workforce. Decades of budget cuts have left many of them unable to mount an aggressive response.
And recently, state health departments say they have had to lay off many more employees — an unintended consequence of federal officials delaying the tax filing deadline until July. Those tax filings generate state revenue.
The $631 million from the CDC is intended to help increase health departments’ abilities to perform labor-intensive activities such as contact tracing, testing for the coronavirus, and reporting information on morbidity and mortality.
“The ability to implement aggressive contact tracing, surveillance and testing will be fundamental to protecting vulnerable populations as the nation takes steps to reopen and Americans begin returning to their daily lives,” CDC Director Robert R. Redfield said in a statement.
Additional money may be on the way. On Thursday, the House passed a bipartisan $484 billion spending package, which includes $25 billion for a new coronavirus testing program, with some of that money possibly going to contact tracing as well.
The Trump administration had initially asked Congress to approve $250 billion to bolster the Paycheck Protection Program with no strings attached, but Democrats refused. They pushed for spending for hospitals and testing, as well as for changes to the small business program to make sure more money goes to lesser-served communities and through smaller lenders.
Lena H. Sun and Erica Werner contributed to this report.