State and local public health departments across the country are facing an uncertain future. A New York Times report found that many health departments have endured not only resistance and anger from the public during the ongoing COVID-19 pandemic, but also staff defections, burnout, firings, and unpredictable and unstable funding.
These same departments over the past two years also have faced a significant erosion in their authority to impose the health orders that were critical to America’s early response to the pandemic – and Kansas is not immune, the Times study found.
“The duration and scale of this pandemic is unprecedented and has brought challenges that were not anticipated and accounted for in our emergency response plans,” Sedgwick County Health Director Adrienne Byrne said.
The Times used Wilson County, Kansas, and Fredonia City public health officer Dr. Jennifer Bacani McKenney as an example. When the pandemic unfolded in 2020, McKenney, a family medicine physician who attended KUSM-W and did her residency in Wichita, began doing Facebook Live presentations about coronavirus and safety and coordinated with hospitals, schools and churches. She helped implement a state lockdown, but when it came time to reopen businesses, she didn’t do it as quickly as her county commissioners desired.
The Kansas Legislature, alarmed by the persistence and power of public health orders around the state, passed a series of laws that gutted the authority of the governor and health officials like McKenney, the Times reported. The new laws limited COVID-19 contact tracing, gave authority for health decisions to elected leaders and allowed anyone “aggrieved” by a mask mandate, business closure or limit on public gatherings the ability to sue the agencies that imposed the order.
That effectively shut down COVID-19-related mandates around much of Kansas, limiting public health leaders such as Sedgwick County public health officer Dr. Garold Minns to voicing “strong recommendations” to county commissioners.
These restrictive laws pose a serious risk to public health and undermine effective government response to public health issues, according to a report by the National Association of County and City Health Officials and the Network for Public Health Law.
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health officials, as their decisions about lockdowns or mask orders became political fodder, according to Route Fifty, an online government news clearinghouse. Burnout became common and some public health officials faced threats of violence, leading to a wave of resignations, retirements and firings among public health leaders over the past year, Route Fifty reported.
In the end, local public health departments across the country are less equipped to confront a pandemic now than they were at the beginning – largely due to new state restrictions, rampant understaffing and an uncertain future. But Sedgwick County public health officials say they’ve worked tirelessly to serve and protect residents despite the challenges.
Sedgwick County hired more than 200 temporary staff through the county’s hiring process and through temporary employment agencies to help with the COVID-19 response. Byrne said some staff have left to take permanent positions elsewhere. The department has had to create new positions as more and different work was needed throughout the pandemic. For some positions, Byrne said they have had difficulty finding qualified applicants.
“The pandemic length and work required has been exhausting for staff,” Byrne said. “There has been burnout. We have tried to ensure our organizational structure can support the work, but it has been difficult to keep up with the urgent needs and surges.”
Still, she said staff has been resilient and adaptable, quick to change directions and implement new processes based on federal, state, and county guidance that can change rapidly.
It’s the lack of support at the state level and future funding that worry Byrnes and Minns. “Many worry that once this pandemic quiets down (and we all want that as soon as possible), that public funding to enhance public health will shrink and public health will not be a priority,” Minns said. “That has happened in the past.”
Byrne agrees. She said a lack of public health funding has created minimal staffing in many areas including disease investigators, data analysts, public health emergency preparedness, outreach staff and health educators.
“Unless this changes, this could be a vicious cycle,” Byrne said. “We will have learned many things during this pandemic, but we will need adequate staffing to make a difference for the next pandemic.”