\n<\/p>\n
A series of health challenges \u2013 hantavirus, screwworm, Ebola, cyclospora, measles, whooping cough, bird flu \u2013 are exposing the widening gaps in America\u2019s ability to prevent, identify and halt infectious disease outbreaks.<\/p>\n
The rapid dismantling of the US public health system at all levels means the US is in worse shape than it was before the Covid pandemic, former top CDC officials say.<\/p>\n
The US Centers for Disease Control and Prevention (CDC) lost much of its funding for battling parasites, which are notable global killers, in the last year. Experts were tasked with monitoring potential outbreaks \u2013 such as a previously rare parasite called cyclospora \u2013 around the US and the world, lending expertise to help stop crises in their tracks.<\/p>\n
But their funding was decimated, and many people at the CDC were laid off or resigned without being replaced.<\/p>\n
\u201cAre we ready for the next big pandemic? My answer is no,\u201d said Dan Jernigan, the former director of the CDC\u2019s National Center for Emerging and Zoonotic Infectious Diseases.<\/p>\n
Debra Houry, the former chief medical officer of the CDC, told the Guardian: \u201cUnfortunately, we\u2019re really moving in the wrong direction.\u201d<\/p>\n
Some 80% of senior leadership positions at the CDC still have no permanent officials appointed, and between 25 and 30% of the CDC\u2019s entire staff are gone.<\/p>\n
\u201cThose are boots on the ground,\u201d Houry said. \u201cWhen you have Ebola, hantavirus, measles, and throw cyclospora in there \u2013 staffers were already spread thin, and now they\u2019re spread even more thin.\u201d<\/p>\n
When the Trump administration effectively dismantled the US Agency for International Development (USAID) last year, the CDC lost around $40m in funding to fight malaria and neglected tropical diseases, which means 35 employees \u2013 out of 73 \u2013 were laid off from those divisions. The program was able to claw back $4m, but faces an uncertain future as the administration dramatically reshapes foreign aid, even as more people die from malaria and other infectious diseases around the world.<\/p>\n
And the laid-off employees were some of the premier experts in the US on all parasites, not just malaria.<\/p>\n
\u201cWe\u2019re not where we would have been with parasitic diseases because of the changes that happened to USAID,\u201d Jernigan said. \u201cThe laboratory methods you use and the expertise and the microscopy and all of that stuff is the same \u2026 So the expertise in parasitic diseases has dropped.\u201d The CDC laboratory specializing in cyclospora, for instance, has fallen from 11 people to three.<\/p>\n
It\u2019s the same with other pathogens: there are very few mpox and Ebola experts left on staff.<\/p>\n
At the same time, millions in funding for mRNA vaccines, which would be \u201csignificant\u201d for battling the next pandemic, has been cut, Jernigan said. More than half of US states have passed laws limiting public health actions during emergencies. And outbreaks are intensifying: the US just surpassed last year\u2019s measles tally.<\/p>\n
\u201cThere\u2019s all these unintended, or intended, consequences that impact health in America and around the world,\u201d Houry said.<\/p>\n
Leaders\u2019 ideological approaches make the confusion worse, Jernigan said.<\/p>\n
\u201cWhen confronted with complex situations where decisions need to be made quickly, their gut response might be one driven by ideology rather than by what the data is actually showing. So in that sense, you might then get wildly different answers from different people that are having to make those decisions,\u201d he said. \u201cWithout that clarity and hierarchy within a big response, you\u2019re going to end up with uncoordinated activities and interventions.\u201d<\/p>\n
Take hantavirus. First, officials said passengers from the MV Hondius could quarantine at home, but then they required some to stay in a biocontainment facility. Even when a CDC medical officer said home quarantine would be sufficient, Robert F Kennedy Jr, secretary of the US Department of Health and Human Services, overruled the decision.<\/p>\n
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Sign up to Headlines US<\/span><\/p>\n Get the most important US headlines and highlights emailed direct to you every morning<\/p>\n after newsletter promotion<\/p>\n \u201cWhen you have conflicting messages, how do states then respond to things like CDC guidance?\u201d Jernigan said.<\/p>\n A similar story is playing out with Ebola. Between 100 and 150 people land in the US every day and need to be monitored for Ebola by public health departments. The US recently issued new guidance on travel that adds to the confusion: American travelers from the Democratic Republic of Congo are now required to quarantine in a third country for three weeks, but travelers from the region are also required to monitor for symptoms for three weeks after entering the US. It\u2019s not clear if both requirements will apply.<\/p>\n \u201cIt\u2019s difficult for states to implement this guidance that isn\u2019t based on science and often not on logic, coupled with the staffing and budget cuts,\u201d Houry said, calling this a \u201cprecarious\u201d time for public health.<\/p>\n Those who remain at the CDC are working hard, but their ability to manage complex crises \u2013 including a multi-state response such as the cyclosporiasis outbreak \u2013 has been compromised, and the US will continue seeing pathogens that could have been contained earlier or prevented altogether because of these cuts, Houry said.<\/p>\n \u201cWhen you\u2019ve got 30% less workforce, that\u2019s 30% less people able to respond, and when you\u2019re losing specific experts with backgrounds in some of these rare diseases, there\u2019s not the capacity then,\u201d Houry said. It will take time to rebuild that expertise even when the CDC is re-funded, she said.<\/p>\n There were the cuts made under the so-called \u201ddepartment of government efficiency\u201d (Doge), like the end of a program to bring in early-career laboratory and epidemiology staff, but some employees also decided to retire early, while others left and were not replaced, Houry said. \u201cWe lost a lot of our lab scientists, and some of our specialized experts on things like rabies \u2013 those you can\u2019t replace overnight.\u201d<\/p>\n While officials have focused on getting the CDC back to its size before Covid, the pandemic revealed the need for the opposite approach, Houry said. \u201cDuring the Covid pandemic, that\u2019s where we saw we didn\u2019t have enough staff to go around the nation to respond to outbreaks, and public health was already significantly understaffed in state and local health departments. It was a time to try to get right-sized, not oversized. And unfortunately, reverting back to more of the 2019 size leaves us woefully underprepared to respond to outbreaks, as we\u2019re seeing.\u201d<\/p>\n In the absence and confusion of federal leadership, other organizations are taking the lead. The Association of State and Territorial Health Officials coordinates regular calls for the state health officials, and regional organizations including the Northeast Public Health Collaborative and the West Coast Health Alliance \u2013 for which Houry is a consultant \u2013 have formed to collaborate on vaccination and crisis management.<\/p>\n \u201cNow you\u2019re starting to see more regional alliances forming to better track things,\u201d Houry said. \u201cLike with measles \u2013 we very much see that it doesn\u2019t stay within a city or state. So as a result of this moment, we\u2019re seeing others step in to fill the gap.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" A series of health challenges \u2013 hantavirus, screwworm, Ebola, cyclospora, measles, whooping cough, bird flu \u2013 are exposing the widening gaps in America\u2019s ability to prevent, identify and halt infectious disease outbreaks. The rapid dismantling of the US public health system at all levels means the US is in worse shape than it was before<\/p>\n","protected":false},"author":1,"featured_media":51336,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[51],"tags":[2132,562,4391,3194,2957,2969,4350,564,1952],"class_list":{"0":"post-51335","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-cdc","9":"tag-cuts","10":"tag-disease","11":"tag-healthcare","12":"tag-leave","13":"tag-officials","14":"tag-outbreaks","15":"tag-prepared","16":"tag-warn"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/51335","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=51335"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/51335\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/51336"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=51335"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=51335"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=51335"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}