Thread by @LaurenWeberHP

The U.S. has starved state and local public health departments of funding for decades, leaving the country ill-equipped for #COVID19, our @KHNews @AP investigation found.

This is America's public health system in a pandemic.

#UnderfundedUnderThreat

khn.org/news/us-public…

Workers are paid so little, some qualify for Medicaid. They track the coronavirus on paper records shared via fax.

Working seven-day weeks for months on end, they fear pay freezes, public backlash and even losing their jobs amid a wave of budget cuts.

While interviewing 150+ public health experts, analyzing records from 100s of health departments and surveying statehouses, @laura_ungar @MRSmithAP @hannah_recht @annabarryjester and I heard story after story of what this weakened line of defense means amid #COVID19.

And so you meet Jennifer Gottschalk, whose job list is a mile long for Ohio’s Toledo-Lucas County Health Department after years of cuts.

When she came down with #COVID19, she still took phone calls for her job from a hospital bed. There was no one else to do it.

After all, at least 38,000 state and local public health jobs have disappeared since the 2008 recession.

Only 28% of local health departments have an epidemiologist on staff.

Then there’s Scott Lockard, a public health director in rural Ky. battling #covid19 with 3G cell service, paper records and 1/3 of the employees from 20 years ago.

Or Tim Struna in Alaska, where they were forced to eliminate well-child exams for kids over the age of 6.

These public health workers are living the reality of facing a pandemic in a public health system where 3/4 of Americans live in states that spend under $100 per person on public health annually.

83% live in counties that spend more on policing than on nonhospital health.

And our investigation shows spending is about to be slashed AGAIN as the boom-bust cycle of public health funding continues.

At least 14 states have already cut health department budgets or positions or were actively considering such cuts in June.

Former @CDCgov head @DrTomFrieden said it’s “stunning” that the U.S. is furloughing public health workers amid a pandemic.

The country should demand resources, he said, as it does for the military.

And the overstretched public health system isn’t able to juggle everything.

Childhood vaccination rates are plummeting and all of these cuts to programs like diabetes control and nutrition programs further hurt communities hard-hit by #covid19 : @NACCHOalerts @EOscarAlleyne

And now, cases across America are surging, and Lockard says he can’t get his rural Kentucky community to listen.

“They’re not wearing masks, and they’re throwing social distancing to the wind.”

“We’re paying for it.”

The people who spend their lives working in public health say the temporary coronavirus funds won’t fix the eroded foundation entrusted with protecting the nation’s health -- as thousands continue to die.

#UnderfundedUnderThreat

apnews.com/e28724a125a127…