Opinion: Newsom’s budget cuts threaten public health investment

The state’s public health emergency, in place for nearly three years, expired Tuesday. Californians know from experience that it won’t be time to let down our guard.

We know better. Experience taught us that threats rarely subside permanently. For instance, after a wildfire is contained, there remain a threat it can flare up again – all it could take is another spark. We also know that while heavy rains and snow can ease a drought, dry years typically come again.

California learned these lessons from experience. The COVID-19 public health emergency caught the state off guard and taught us many lessons that we can use to prevent being caught off guard again.

In California and elsewhere, public health defenses had been weakened by decades of disinvestment, which made responding to the pandemic difficult while longstanding barriers to health exacted an inequitable toll in the most vulnerable communities. Yet on the eve of the scheduled end to the state of emergency, Gov. Gavin Newsom proposed cutting $49.8 million dedicated to rebuilding California’s local public health workforce.

To cut public health funding is a shortsighted proposal that the Legislature should reject and the governor should reconsider.

While the state wisely decided last year to provide annual, ongoing funding to rebuild California’s weakened public health infrastructure, achieving that goal won’t be possible without providing the planned boost of one-time workforce development funds to bolster a pipeline of laboratory directors, epidemiologists, microbiologists and other skilled professionals.

Local public health departments are the frontline of defense against all public health threats. Even as the pandemic raged, and despite the fact that many were already understaffed, they carried on as best they could to protect Californians from an outbreak of Mpox, rising rates of sexually transmitted diseases, tuberculosis and other infectious diseases that will continue to devastate our communities long after this declared emergency has ended.

It takes a highly skilled and specialized workforce to carry out the task of protecting the public’s health. However, statewide, there is a severe shortage of public health laboratory directors who can carry out the testing necessary to identify and respond to contagious diseases. The funds promised last year were designed to train professionals to fill those jobs. Fellowships for epidemiologists and training positions for microbiologists would also be created.

The overwhelming stress of responding to COVID-19, often with harassment and threats fueled by misinformation, has worn down public health professionals, many of whom are being heavily recruited by employers in other sectors or choosing to take extended breaks or retire. We must try to keep as many public health workers as possible. The promised funds were designed to create educational opportunities that would enable existing employees to advance their careers while staying on the job.

Now these funds are at risk of being lost forever – and with them, the opportunity to build the kind of robust public health workforce that will enable California to be prepared for the health threats that remain and whatever comes in the years ahead.

When it was announced last fall that California’s COVID-19 emergency would end on Feb. 28, Health and Human Services Agency Secretary Dr. Mark Ghaly observed that responding to the pandemic “has prepared us for whatever comes next.”

It’s true that many lessons have been learned. We know what we would need to address what comes next, but we will not be truly prepared unless we have fully trained and staffed local public health departments ready to provide a vigorous response to all existing and emerging public health threats.

We must never be caught off guard again. In California, we should know better.

Kim Saruwatari is the president of the County Health Executives Association of California and public health director for Riverside County.