Even before the coronavirus pandemic placed an unprecedented strain on medical resources, public health laboratories were facing signs of trouble. Budget cuts and inconsistent funding have plagued public health labs across the country for more than a decade.
According to a 2018 report prepared by Trust for America’s Health (TFAH), a non-profit, non-partisan organization dedicated to protecting community health, “persistent underfunding of the country’s public health system has left the nation vulnerable.”
These budget cuts and layoffs, which have occurred at all levels of the public health system in rural, suburban, and urban areas alike, created an enormous uphill battle for the experts responsible for confronting the emerging COVID-19 pandemic.
Public Health Labs Have Faced Budget Concerns For Years
Nearly 75% of the CDC’s budget is distributed to states, localities, and public and private programs. This means that any budget cuts to the CDC directly impact health labs run at the state and local level.
Even in the best case scenarios, many states only receive a portion of the money they’re approved or granted. The federal government often operates under a continuing resolution (CR) that offers short-term funding without any long-term guarantees.
According to the TFAH report, “This limiting funding can cripple state and local public health programs that serve the public. If there are staff vacancies… they are unlikely to be filled since new employees can only be guaranteed a few months of employment.”
Unfortunately, it’s not just federal funds that are difficult to obtain. TFAH found that 31 states made cuts to their public health budgets from 2016 to 2017, a trend that has continued in recent years. The results of such budget cuts are clear:
- California has closed 10 local public health labs since 2003
- Florida closed a public health lab in 2015
- Iowa’s lab furloughed 11 staff members in 2019 and reported a major issue with “continuity of funding”
- Georgia closed a regional public health lab and cut 23 lab employees, partly due to salary freezes and difficulty upgrading equipment
All of these staffing and facility reductions came amid warnings that the public health system wasn’t ready for a pandemic or biological attack.
State and Local Labs Are Critical During Early Stages of Disease Outbreak
Public health laboratories serve as our nation’s first line of defense against health emergencies. They’re expected to be prepared, at every hour of every day, to respond to new strains of disease, natural disasters, chemical spills, foodborne outbreaks, and countless other types of health crises.
When an infectious outbreak like COVID-19 occurs, it’s the state and local health labs that closely collaborate with federal agencies to prevent and control the spread. States rely on their health labs to perform the early diagnostic tests needed to locate and contain clusters of disease.
This is exactly why directors of public health laboratories in states across the country found themselves scrambling to find enough technicians and microbiologists to respond to the coronavirus in March 2020.
Labs Take Extraordinary Measures to Meet COVID-19 Demands
Bernard Jilly, director of the Alaska State Public Health Laboratories, is just one of the many public health leaders dealing with the repercussions of budget cuts, inconsistent federal funding, and layoffs. Jilly actually postponed his March retirement to lead his staff through the coronavirus crisis as they desperately searched for qualified scientists and lab technicians.
Though a portion of the federal governments $13.45 billion in aid to public health agencies will be directed to labs, the new funds won’t last forever. “We continue to go from crisis to crisis, instead of appreciating that this is a service that’s needed all the time,” said Frances Pouch Downes, a professor with the Biomedical Laboratory Diagnostics Program at Michigan State University. “Would we do that with a fire department?”