COVID risk could rise as federal funds drain, Chicago’s top Doc Arwady warns

according to dr Allison Arwady, the commissioner of public health, dwindling federal funding for public health and low uptake for booster shots threatens to raise Chicago’s COVID-19 risk yet again.

“COVID isn’t going away,” she said at an event promoting immunization on the Southwest Side last week.

This news comes at a time when the city’s risk of infection is low, with fewer hospital admissions and a dramatic drop in deaths from a year ago. Then a new variant of the virus, Omicron, gained momentum and a deadly spike in cases became apparent. More than 10,000 city dwellers have been diagnosed with COVID every day. More than 300 Chicagoans were hospitalized each day on average last December and January, and dozens died each day. Today, on average, around 400 Chicagoans are diagnosed with COVID each day — and around 30 are hospitalized — with a death rate of less than one a day.

But two factors could undo some of these advances.

Chicagoans have become lax about getting their latest booster shots — only about 15% of those eligible received the latest shot against strains of the Omicron variant responsible for mass hospitalizations and deaths last winter.

And federal money is starting to dry up, leaving public health departments locally and across the country – many already gutted in the last 20 years – left to fend for themselves with insufficient resources.

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

dr Chicago Department of Public Health Commissioner Allison Arwady receives her bivalent COVID-19 booster shot during a news conference Tuesday at a CVS pharmacy in West Lawn, where health officials were encouraging people to get a COVID-19 booster shot and the flu Vaccination before the holidays.

In recent interviews with The Sun-Times, Arwady said the pandemic has exposed what she describes as failures in public health funding. Health departments are on a lifeline from Washington, and that funding tends to spike during crises and then wane.

That’s a problem because other health crises crop up, she 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 that once the current health threat subsides, they will eventually end it.

Chicago has received an unprecedented amount of federal taxpayer money since the pandemic broke out in 2020. The city’s health department, which is funded almost entirely by federal tax dollars, grew from about $220 million annually to about $1 billion year-to-date.

This money has been used for staffing, community immunization centers, home visits for COVID vaccinations, education, public relations and marketing, testing, disease tracking, and contract tracking, among many other programs. More recent tracking efforts, such as sewage monitoring to detect early community spread, are a product of pandemic funding.

Now that money is going to go away. Almost all of it — nearly 90% — will be gone within the next two years, Arwady said.

It’s a cycle that repeats itself after every crisis, she said, and it doesn’t have to be that way. Congress could commit to a steadier stream of public health funding, rather than piling up big bucks — much of it with restrictions — all at once to address a single event like a once-in-a-century pandemic, she said.

Of course, the current pandemic is historic and requires massive resources. But with tens of millions of dollars of federal funding drying up in the first half of next year alone, the city is losing dozens of employees funded by a nonprofit organization affiliated with the US Centers for Disease Control and Prevention.

Restrictions on COVID funding are also weighing on efforts to publicize the need for booster shots, Arwady said. Without additional protection from the new boosters, cases are likely to increase.

“Our booster rates, not just here but across the country, are not where they should be,” Arwady said. “I have to do the kind of vaccine campaigns that we did in the early days of COVID, but I can’t do it.”

Gloria Roberts, 61, receives a Pfizer COVID-19 booster vaccine at Walgreens in Chatham on Tuesday.

Gloria Roberts, 61, receives a Pfizer COVID-19 booster vaccine at Walgreens in Chatham on Tuesday.

Arwady is alarmed by the low uptake of the new COVID booster, particularly in communities – like the Southwest Side, which she recently visited – that are still at high risk of infection, hospitalizations and death.

Advances over the past three years have required ongoing education, which often convinced people without adequate access to healthcare that they should suddenly trust a broken system. Many people are still not fully vaccinated, let alone jacked.

Arwady is getting a sympathetic ear from the state’s two US senators, although no quick fixes are in sight.

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

He said money in a bill he’s co-sponsoring would allow health officials “steady, predictable increases in funding.”

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

A recent report published in Public Health Management and Practice underscores the need to strengthen local health authorities to continuously protect public health.

“Strong public health infrastructure is essential to ensure communities are able to perform core 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 state and local health agencies were operating with minimally adequate staffing to meet health needs and protect and promote health in the communities they serve.”

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

“We have a new problem at least once a year,” adds Arwady. “Because all of the funding is short-term, you can’t be prepared for everything that comes next.”

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

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