COVID risk could rise again as federal funding drains, Chicago’s top doc warns


Declining federal public health funding and low participation in booster vaccinations threaten to once again increase the risk of COVID-19 in Chicago, according to Public Health Commissioner Dr. Allison Arwady.

“COVID hasn’t gone away,” he said at an event promoting vaccinations on the Southwest Side last week.

This news comes at a time when the city is the risk of infection is low, with fewer hospitalizations and a dramatic drop in deaths compared to a year ago. Then, a new variant of the virus, omicron, was catching on and a deadly wave of cases was looming. More than 10,000 city residents were diagnosed with COVID every day. More than 300 Chicagoans were hospitalized each day last December and January, on average, and dozens died each day. Today, on average, about 400 Chicagoans are diagnosed with COVID — and about 30 are hospitalized — each day, resulting in a death rate of less than one per day.

But two factors risk undoing some of this progress.

Chicagoans have become remiss in getting their latest booster shots: Only about 15 percent of eligible received the latest shot aimed at omicron variant strains, the culprit in mass hospitalizations and deaths this past winter.

And federal money is starting to dry up, leaving health departments locally and across the country — many of which have already been gutted over the past 20 years — again fending for themselves under-resourced.

In 2002, Chicago had a public health workforce of 1,600. That number fell to less than 600 by 2019, largely due to federal cuts, a city spokesman said, before climbing to just over 800 in response to the pandemic.

In recent interviews with the Sun-TimesArwady said the pandemic has exposed what he describes as a flaw in the funding of public health departments. Health departments are on a lifeline from Washington, and that funding tends to ramp up during crises and then fade away.

Chicago Department of Public Health Commissioner Dr. Allison Arwady receives her dual-purpose COVID-19 booster
Chicago Department of Public Health Commissioner Dr. Allison Arwady receives her bivalent COVID-19 booster during a news conference Tuesday at a CVS Pharmacy on West Lawn, where health officials encouraged people to get a COVID booster vaccine -19 and a flu shot ahead of the holidays. Pat Nabong/Chicago Sun Times

That’s a problem because other health crises happen, he said, whether it’s an unexpected outbreak, like monkeypox, or a particularly bad flu season. And for every crisis, local health officials must build programs knowing they will ultimately end them once the current health threat subsides.

Chicago has received an unprecedented amount of federal taxpayer funding since the pandemic hit in 2020. The city’s health department, which is funded almost entirely with federal tax dollars, has grown from about $220 million annually to about $1 billion for the current year.

That money went to staffing, community vaccination centers, home visits for COVID vaccines, education, outreach and marketing, testing, disease monitoring and contract tracing plus many other programs . Newer tracing efforts, such as wastewater surveillance to help detect community spread early, are a product of pandemic funding.

Now that money is destined to disappear. Almost everything — nearly 90 percent — will disappear within the next two years, Arwady said.

It’s a cycle that repeats itself after every crisis, he said, and it doesn’t have to be that way. Congress could commit to a more steady stream of public health funding rather than racking up a lot of money—much of it with restrictions—all at once to tackle a single event, like a once-a-century pandemic, she he has declared. he said she.

Of course, the current pandemic is historic and has required enormous resources. But with tens of millions of dollars of federal funding running out in the first half of next year alone, the city is losing dozens of employees funded by a nonprofit linked to the U.S. Centers for Disease Control and Prevention.

COVID funding restrictions are also straining efforts to get the word out about the need for booster shots, Arwady said. Without additional protection from new boosters, cases will likely increase.

“Our recall rates, not just here but across the country, are not where they should be,” Arwady said. “I need to do the kind of vaccine awareness that we were doing at the start of COVID, but I’m not able to do that.”

Arwady is alarmed at the low uptake of the new COVID booster, especially in communities — like the Southwest Side where she recently visited — that are still at high risk of infection, hospitalization and death.

Progress over the past three years has required continued education, often convincing people without adequate access to health care that they should suddenly trust a broken system. Many people are still not fully vaccinated, much less boosted.

Arwady gets a sympathetic hearing from the state’s two U.S. senators, though no quick fixes are forthcoming.

“As Congress has worked to fund our local response to COVID-19, our public health officials need more resources and flexible tools to meet evolving disease threats,” Senator Dick Durbin said in a statement. statement to the Sun-Times.

He said the money in a bill he is cosponsoring “will provide consistent and predictable funding increases” to health agencies.

Senator Tammy Duckworth “knows Congress should do more to ensure that we provide our public health departments with the support and flexibility they need to protect the overall health and well-being of our communities,” according to a statement.

A recent report published in Public Health Management and Practice last month highlights the need to strengthen local health agencies to protect public health on an ongoing basis.

“A robust public health infrastructure is essential to ensure communities are able to deliver key public health functions,” said the authors of the report, published in Public Health Management and Practice last month. “Even before the COVID-19 pandemic, many say local health agencies were operating with minimally sufficient staffing levels to meet health needs and protect and promote health in the communities they serve.”

Recognizing that funding cuts are to be expected, Arwady argues that a sudden and significant drop should be avoided.

“We have a problem emerge at least once a year,” Arwady adds. “Because all funding comes in the short term, you can’t keep preparing for whatever comes next.”

Brett Chase’s environmental and public health reporting is made possible by a grant from the Chicago Community Trust.


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Written by Natalia Chi

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