As 2020 advances, Shah and others are grappling with a bitter new reality: due to the economic crisis, triggered by the current pandemic, compounded by the lack of investment in public health, public health agencies will suffer probably further budget cuts in the coming years. “It’s not like the environmental movement or even the health care reform movement, where you have activists and lobbyists and defenders fighting to change the status quo or to secure their share of the cake”, m ‘ said Hearne. “There are a lot of isolated departments across the country that say,” Oh, we’ll just keep doing God’s work here, and if our budget is cut again, we’ll just do something. “”
To change this, say Shah, Hearne and others, the public health community will need to mobilize more political will than it has in the past. In the years before the coronavirus epidemic, the United States has faced a multitude of public health disasters: a resurgence of measles and syphilis; a slight increase in foodborne illness; and a continuing crisis of lead-contaminated water. None of these problems captured even a fraction of the attention given to universal health care. In fact, while the healthcare system was discussed endlessly in 2019, as it tends to be almost every election season, public health was barely mentioned. “No one is going to vote for you or name a hospital wing after you because you prevented them from getting something they didn’t expect to receive in the first place,” said Frieden. “People who cure illnesses are glorified, not those who prevent them.”
End of June, Abbott turned the corner and ordered state bars to close and restaurants to reduce their capacity to 50% (they had been 75% for several days). He also issued an executive order demanding that all Texans in counties with more than 20 active Covid-19 cases wear a mask in public. Scientists feared it was too little too late, and by early July the numbers seemed to prove them right. On July 8, the state hit a record 9,952 new cases of coronavirus reported in a single day. The state’s positivity rate – the portion of all tests that tested positive – also rose to 15.6%, down from 7.9% three weeks earlier.
Hospital beds were filling, hospital floors were reconfigured, and rescue units were ready. Doctors and nurses in Harris County and elsewhere have started a disturbing and familiar census of ventilators and personal protective equipment. And the same stories that happened in Wuhan and Lombardy, Seattle and New York started again. And not just in Texas. In more than 35 states, including some that had previously mastered their epidemics, the number of daily cases is increasing, positivity rates are increasing and new claims records are set – and quickly broken. Residents of Texas, Florida, California and New Jersey are preparing for a second wave of epidemics in the fall, although the first wave has not yet fully subsided. Doctors, scientists and health historians say the root of this disaster is our failure to fully integrate public health into our understanding of what it means to be a functioning society. Until we do, we will not be able to respond effectively to crises like this one – much less prevent them.
In Harris County, Hidalgo and his advisers created a digital, color-coded warning system to let residents know how dire the threat level is and how careful they should be. “We needed something clear and concise, because going back and forth with all orders confused people and forced them to disagree,” she told me. “I went with colors and numbers because some people like one and some people like the other, and I really want it to stay.” Currently, Harris County is at the highest threat level: one (or red), which means that the epidemic is serious and uncontrolled, and people should only leave home to respond to basic needs. As with everything about the coronavirus, it will take some time to see if people hear the message and pay attention to it.
Meanwhile, political and cultural battles over how to respond to the coronavirus crisis have continued unabated. The Texas Education Agency has said it will refuse to fund schools that don’t allow students to attend full-time, in person, this fall. On July 8, Houston mayor Sylvester Turner ordered the city convention center to cancel the state republican convention scheduled for mid-July. The State party has challenged this decision before the courts.