For months, Dr. Jennifer Evagino, director of the New Orleans Health Department, has seen threats approaching: Louisiana Led by the United States As matters of seasonal flu increased At their high rate in 15 yearsAnd the bird flu was the first death of the nation. After that, a fatal spread of measles came to the neighboring country of Texas. Louisiana school children doubled with discounts from vaccine requirements In a year.
During the Covade Poetry Disease, Dr. Evagino worked with state officials to eliminate high infections and promote vaccine. But after taking office last year, Government Jefflandry began promising to re -establish public health after the state’s full response, which he believed was a catastrophe.
Mr Landri, a Republican, launched a post for a state surgeon general, who appointed former Congress expert Dr. Ralph Ibrahim. Grieving against the similar “cruel” response of the state And argued that the real danger was not a virus itself but a vaccine against it.
So it was not surprising when Dr. Ibrahim announced last month that Louisiana “would no longer promote mass vaccination,” Calling attempts to do so during Kovid “The crime against personal sovereignty that will take years to overcome.”
For Dr. Eugeno, it was a two -pronged reminder of how the political influence of pandemic diseases has developed its field in many ways to fight the next one.
“We are in a very different world right now,” he said. “Now we are ready to throw the baby out of the bath water and leave ourselves incredibly weak.”
Local health officials like Dr. Eugeno are frontline to respond to the outbreak of any disease. Five years after pandemic disease begins, many people say that the politics that are engulfed in the coal has left them with low tools and fresh challenges to respond to them.
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The doubts about the covide vaccine have caused hesitation around all the vaccines, and there are fewer needs. The number of children with discounts from school safety vaccine requirements 41 states increased, high recorded level. I At least 36 statesThe vaccination rate for measles has dropped to less than 95 % – the level required to maintain the flock immunity.
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New rules in multiple states Limit the authority of local officials Not only issuing a mask or vaccine mandate, but also taking more target steps, such as separating people from tuberculosis or extremely infectious viruses.
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Have the Trump administration Left hundreds of workers And vowed to reduce the budget in the disease control and prevention centers, which provides most of the funds for local departments, integrating data collection on outbreaks and providing expert guidance.
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Management Has also withdrawn from the World Health Organization to the United StatesWhich talks about spreading all over the world, and reduces communication with federal health agencies. Local officials say the efforts are important to fight the confusion and unknown information that was so angry during the epidemic. Some local health department says CDC employees whom they have been talking for for years now sit quietly in meetings.
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Health public confidence has decreased rapidly: a KFF Pool in January It has been found that 54 % of Americans and 46 % of Republicans have relied on local and state health officials to “make the right recommendations” to 10 % points in each case compared to two years ago. A new Axios/IPSOS Pool It is found that 62 % of US CDs trust health information from C, which is less than 88 % in March 2020.
Janet Hamilton, Executive Director of the Council of State and Territorial Pandemy Diseases, said that the public’s distrust has made it difficult to respond quickly. He compared the outbreak of fighting with the Blaze, saying that the low rate of vaccination was providing a way to spread them.
“The gas line there can travel with fire, in these ways that it was not present in 2019,” he said.
Local health officials no longer need to protect police or sleep away from home, as some people rebelled against mask mandate and other projeed sanctions. In an interview with two dozen local and state health officials last month, many people admitted that health officials made mistakes when they tried to respond to a novel, changed the virus consistently. They say they have learned from these memories.
Many people rejected the strategies of reduction of future lockdowns, sanctions or other blankets.
“The ship has traveled completely,” said Dr. Ann Zinc, Chief Medical Officer of Alaska during the epidemic diseases. “And maybe for the best.”
Instead, he and others said, health agencies need to be “truly fruitful” and they need to respond to target interventions such as infectious disease tracking, identifying their contacts and reducing the risk of spread. It requires enough resources and detailed, latest information about the risk.
Nevertheless, Dr. Sanami Araola, director of the Metro Public Health Department in Nash Vill, fears that the laws passed in response to the Kovade 19 pandemic diseases are so widespread that they will restrict their ability to fight at a rapid risk. Tennessee, like many other states, is still a law that states that only governor can order patients to separate or expose people during pandemic diseases. This year, several states have proposed to ban MRNA vaccines, which are used against this type of covid, which is based on false claims that they change the recipient’s DNA.
“Once the public health officials had absent powers,” Dr Araola said, “Public impression, right or wrong, is a very important piece. We have to invest in creating messages and explaining the benefits.
Many health officials said the biggest lesson is clear communication.
Many people have invested in new outreach campaigns. Erin anda, a public health administrator in North Dakota, said that members of about 30 staff of their agency travel at least one community meeting every month to distribute fresh works about the work of the department.
In Kalakamas County, Ori, the Department of Health taped trusted community members to talk to specific groups, including Spanish and Eastern European immigrants. Since Oregon fought the spread of its biggest measles over the decades last year, he fans to remove doubts about the vaccine.
Nevertheless, County Health Officer, Dr. Sarah, is present on what he described as a moral injury in this field – angry public confrontation, threats, friends who ended. Like others, she has stopped telling strangers what she does, then when people met socially, she had the opportunity to discuss the vaccine.
“I think that burning people’s fatigue and burning in public health makes us a little less,” he said.
In Pima County, Area, which includes Tikson, Dr. Theresa Collin established the largest Free Coode 19 Testing Program in the state and established a mobile vaccination clinic to serve rural residents. But after Government Katie Hubs nominated her to guide the state’s health department, she quickly became the one who is called a “vodu doll” for the public health.
At the hearing of his confirmation in 2023, a state senator accused the students of depression and suicide during the school closure. One person testified that Dr. Colin’s agency had “terrorized” local businesses.
Dr. Colin said in an interview, “I was unconscious.” Because I know why I wanted to do this, and it was a service. “
The governor withdrew his nomination, and Dr. Colin Pima remained in the county. Others went away from stress. Had a lot of experience with them: Found a study In 2017, almost HALF half of all public health employees operating in state and local agencies were up to 2021.
Dr. Zinc said, “Those who have been there for 20 years, those who first saw measles or the measles spreading, many of those who worked through Ebola in the past, ended.”
At the same time, health challenges are increasing. Extreme heat and disasters such as hurricanes and forest fires are demanding the reaction of local departments that are also fighting the outbreak of measles, cough, saffose, HIV and TB.
The federal government sent billions of dollars of pandemic diseases to the state and local departments. But the emergency money is dry, leaving local departments with less resources to reduce staff, detect new viruses and increase vaccine campaigns.
“People do not raise questions about police and fire budgets – when you dial 911, you are coming to the police officer,” said Public Health Officer Raina Mach, Public Health Officer in North Dakota. “Health is the same, but we do not get the same respect. We are 24/7 here too. Why do we have to continue our price?
The spread of bird flu among humans from the fields is one of the top concerns, as Washington has more matters than most states, said Dr. Eric Chow, a interim health officer at the Seattle Health Department, said. Although a vaccine is available, it will be difficult to spread.
He said, “Being able to set access locations, get information to people,” he said, “We will need a lot of federal help.”
When pandemic disease began, the CDC was not sharing data on outbreaks. It was left to universities and private institutions to make public dashboards.
In 2023, the CDC set up a center for predictions and spreading analytics, a network of centers that collect and distribute data and information. But there are concerns that it will suffer from budget cuts.
“The difference between the CDC and the states, between the CDC and the states,” between the CDC and the states, “said Dr. Lauren Gardner, an infectious disease expert from John Hopkins,” said Dr. Lauren Gardner, an infectious disease in John Hopkins, “said Dr. Lauren Gardner. In January 2020, Dr. Gardner formed an interactive covied dashboard that came to rely quickly to members of public and health officials around the world.
He said that local departments “everyone has to network in something that is monitoring things at the highest level – this is the CDC.” And in view of the uncertainty of the agency, he added, “The CDC is still struggling to fulfill this role.”
Local officials say that without harmony with the federal government, it would be difficult to follow the lessons they have learned from Coid.
In North Dakota, Ms. Oda said, “The reputation of the public health has gone out of the window when people can see that we were never in the loop.” “It is such a thing where we are today, where we are no longer a member of society.”
