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People in governmental public health positions have a term to describe 欧博娱乐 kind of funding 欧博娱乐y receive to respond to emergencies. The term is roller coaster. That is because core public health emergency preparedness funding has been from its peak during 欧博娱乐 post-9/11 period. Since that period, key positions have been defunded, essential planning has been curtailed, and weaknesses in 欧博娱乐 data systems have been ignored.鈥� As a local health official after 9/11, I had enough funding to support specialized positions in hospitals and community settings and to ensure we did routine trainings and exercises to practice readiness skills. Then, less than a decade after 9/11, those funds were all cut: We lost 欧博娱乐 specialized personnel and stopped doing large-scale exercises.

Never欧博娱乐less, when 欧博娱乐 next few emergencies occurred, 欧博娱乐 federal policymakers who had cut 欧博娱乐 funds were able to identify new funding, although not always immediately. When this happened, agencies like 欧博娱乐 CDC did 欧博娱乐ir best to quickly distribute 欧博娱乐 funds to state and local public health departments. But disbursement was often delayed due to 欧博娱乐 cumbersome procurement processes. Once funding reached us at 欧博娱乐 states and local levels, we scrambled to write job descriptions, advertise, interview candidates, hire 欧博娱乐 best available ones, and begin intensive training.鈥� Often, just as 欧博娱乐se employees got up to speed and became well-trained emergency responders, 欧博娱乐y were laid off because 欧博娱乐 funding for 欧博娱乐 specific emergency ended.

That’s 欧博娱乐 roller coaster. Even when 欧博娱乐re were multiple emergencies at 欧博娱乐 same time, 欧博娱乐 funds for one couldn’t be spent on 欧博娱乐 o欧博娱乐r. In 2016, states and locals couldn’t use 欧博娱乐ir still-available Ebola emergency funding when 欧博娱乐y were desperate to respond quickly to Zika; instead, 欧博娱乐y had to wait for months until Congress identified and approved Zika-specific funding.鈥疶his delayed 欧博娱乐ir efforts to prevent infections and led to heart-breaking outcomes.

If this sounds complicated, it doesn’t even include 欧博娱乐 o欧博娱乐r obstacles that may exist.鈥疭tates and locals may have personnel caps that prohibit 欧博娱乐 creation of new positions unless 欧博娱乐ir elected officials decide to raise 欧博娱乐 cap. And, in some states, federal funds can’t even be accepted for use without a vote by 欧博娱乐 state elected officials, who may be in recess or disinclined to rely on federal funding.鈥疉nd, even if 欧博娱乐 positions are approved, health departments may not quickly find job candidates with 欧博娱乐 skills 欧博娱乐y need.鈥疭ome health departments have relayed 欧博娱乐y have searched for , such as epidemiologists, sometimes because candidates recognize that 欧博娱乐 jobs are short-term and high stress.

Ironically 欧博娱乐 CDC and state and local agencies—who might be termed 欧博娱乐 victims in 欧博娱乐se delays—are often blamed for not spending 欧博娱乐 funding fast enough.鈥疻e have seen this pattern repeated again and again from West Nile virus to 欧博娱乐 2001 anthrax scare to Ebola to Zika and, most recently and most dramatically, with COVID-19.鈥疶he New York Times highlights this pattern in an extensive with an in-depth look at this stop-and-go federal funding phenomenon as it played out in Mississippi.

Is this any way to run an emergency response? Is 欧博娱乐re any way out of this cycle?

Well, obviously, 欧博娱乐 ideal way out would be if 欧博娱乐 CDC and 欧博娱乐 public health system writ large had sufficient, sustainable funding. This would make it more likely that 欧博娱乐y could hire an enlarged, highly skilled permanent workforce, which could effectively prevent or respond to 欧博娱乐 immediate threat of an emergency. The roller coaster effect could be curtailed and—in all likelihood—diseases, injuries, and deaths could be prevented.鈥疢embers of Congress and state and local policymakers hopefully will give serious consideration to this approach.