I was working with the Texas Department of State Health Services (DSHS) when West Nile Virus arrived on our shores, and eventually in Texas (that’s me, the middle “conehead” during a rapid response team response to a hantavirus death in the photo). We had so many specimens to test that we had to adopt a 2nd shift which is RARE in a state agency. Shortly after that, the anthrax scares of 2001 arrived, then SARS, then “bird flu,” then…well, you know the story.

Now, as I continue my career in academia, I know we will continue to see deadly new foes from the microbial realm (chikungunya, zika, etc.), as well as ongoing visits from old foes (like influenza, tuberculosis, measles, healthcare associated infections such as MRSA), regardless of what we do in our world. This is about as close to certainty as death and taxes. You see, that’s what our microbial enemies do. They emerge, disappear, mutate and reemerge.  They join forces and recombine when we least expect it. They just don’t like to behave! Bad microbes!

So, we should just give up I suppose since we can’t control nature.

The end is near. Give up…Run for your very lives!

Oh, wait, there are two very important things that we actually can control – Public health support and media perspective! And, they may actually help us to minimize the deadly force that these microbes rain down on us, not to mention the growing number of acute and chronic non-microbial diseases like obesity, diabetes, and cancer.

First, we as a nation and world must begin to understand the critical and necessary support for public health. When I was working with DSHS and assisting CDC, I would look around and see  teams of highly trained professionals – public health and medical laboratorians, epidemiologists, physicians, nurses, veterinarians, Emerging Infectious Disease Fellows, and so many others. Now, when I walk in to a medical laboratory in the hospital or in a public health agency, I see that the practice of “doing more with less” has taken on a whole new meaning.

It’s ridiculous how we expect our public health agencies and medical laboratories to handle large-scale outbreaks, much less the daily work load, on a shoestring budget and a skeleton crew.  

In Investing in America’s Health: A State-by-State Look at Public Health Funding and Key Health Facts (April 2016), the Trust for America’s Health (TFAH) and Robert Wood Johnson Foundation (RWJF) examined public health funding and key health facts in states around the country, finding:

  • Inadequate Federal FundingPublic Health Emergency Preparedness (PHEP)Cooperative Agreement Funding – which provides support for states and localities to prepare for and respond to all types of disasters – has dropped from a high of $940 million in FY 2002 to $651 million in FY 2016. The Hospital Preparedness Program (HPP) has been cut from a high of $515 million in FY 2004 to $255 million in FY 2016, a cut of more than 50%.
  • National Public Health Funding: Public health spending is still below pre-recession levels.
  • Flat Federal Funding: Federal funding for public health has remained relatively level for years. The budget for CDC has decreased from a high of $7.07 billion in FY 2005 to $6.34 billion in FY 2016, approximately $600 million less than FY 2015 (adjusted for inflation). The amount of federal funding spent to prevent disease and improve health ranged significantly from state to state, with a per capita low of $15.99 in Indiana to a high of $53.06 in Alaska.  For my Texas colleagues, we rank #29 in the U.S. by rank.
  • Cuts in State and Local Funding: 16 states decreased their public health budgets from FY 2013-14 to FY 2014-15. Budgets in six states – Alabama, Indiana, Kansas, North Carolina, Ohio and Oklahoma –decreased for three or more years in a row. In FY 2014-15, the median state funding for public health was $33.50 per person – ranging from a low of $4.10 in Nevada to a high of $220.80 in West Virginia. The median per capita state spending in FY 2015 is around the same rate as in FY 2008 ($33.71), however adjusting for inflation, this represents a cut of $1.2 billion.

Do you know that today’s children are in danger of becoming the first generation in American history to live shorter, less healthy lives than their parents?

Proactive, prevention of disease is so much more cost effective and logical versus reactive, treatment of disease. Both are needed, certainly. Simply stated, the nation’s (and world) public health system has been way underfunded for decades. We can and must do better. Until we get serious about prioritizing public health in an ongoing, logical, purposeful way we will continue to fight these deadly foes with fewer soldiers in the public health and medical laboratory trenches. And, these soldiers will be overworked and perhaps rushed on to the battlefields too soon because we are not properly sustaining the pipeline of highly trained professionals in the wake of massive retirements of boomers in these fields. Cutting funding for new research on vaccines and creative ways of attacking disease will suffer. Cutting educational scholarships and programs for ushering in a new generation of these professionals is short-sighted. Utilizing simulations and modeling to try and prepare better for the next outbreak is critical.

We can and must do better!

Now…what was that 2nd item I mentioned that would help in this war. Oh yeah, how about a bit of media perspective, please? I do not mean we should hide from good, solid, cautionary journalism that details and discusses the ongoing threats, as well as the new and scary outbreaks. No, we need that dissemination of information. In fact, social media and the new order of instant information exchange are very powerful weapons in our war on disease.

However, we need to ask and demand perspective. We need for the media outlets to stand on the science and data that has been vetted by the experts in the field. By the way, this usually means you might want to check the credentials of those experts as well as the scientific rigor and reporting of the sources of information. Yep, you guessed it. Your local (insert non-scientific, non-medical) lay person may not be the best source to start with on this topic. Now, I am not bashing anyone that has the good sense to do the research on any given disease topic and vet it with the proper background. I am just saying that a blog from a post-apocalyptic, OCD zombie specialist might not be the way to go. At least not yet….

For example, I’ve written articles about having #perspective in regards to the last two public health threats – ebola and zika.  Indeed, both are very concerning and scary in many ways. But, did you know that ebola has killed one person in the U.S.? Meanwhile, ongoing healthcare associated infections (#HAIs) like MRSA kill roughly 270 people per day?  EVERYDAY?  Basically, this means that an airplane goes down every day in this country and we turn the channel to worry about ebola. Again, ebola is dangerous and kills thousands abroad, but the media needs to use proper perspective in regards to these “latest, greatest, threats” to all humanity. In reality, you and I stand a greater chance of dying from a nasty, antibiotic resistant infection like MRSA, or the flu, or diabetes than from ebola or zika.

Let’s all try to keep our perspective and find ways to work cooperatively and constructively across this country and with others around the globe to strengthen our public health system and support our healthcare professionals. These public health andmedical laboratory professionals are often “out of sight / out of mind” and many of us all too often take them for granted until it’s easy to criticize an “event” like the recent Ebola or Zika cases in the US. Remember, they/we are doing the very best we can with shoestring budgets, shortages of staff, and a retiring workforce that is taking their institutional memory and knowledge of best practices with them. Sounds like a perfect storm is brewing, or has already arrived!

Perhaps, we should all keep that in perspective.

I hope you will help me share this information with as many colleagues, friends, and strangers as possible. And, please follow me on Twitter @RodneyRohde and Linkedin to read more about my concerns on these issues and others, as well as visit my webpage for other background!

#Lab4Life  #Perspective  #IamASCLS  #WeSaveLivesEveryday

About The Author

Dr. Rodney E. Rohde (@RodneyRohde) is Professor, Research Dean and Chair of the Clinical Laboratory Science Program (CLS) in the College of Health Professions of Texas State University, where he spends a great deal of time mentoring and coaching students in this sometimes mysterious and vague path. He has been recognized with teaching excellence at both Texas State and Austin Community College. Dr. Rohde’s background is in public health and clinical microbiology, and his PhD dissertation at Texas State was aligned with his clinical background: MRSA knowledge, learning and adaptation. His research focuses on adult education and public health microbiology with respect to rabies virology, oral rabies wildlife vaccination, antibiotic resistant bacteria, and molecular diagnostics/biotechnology. He has published a book on MRSA stories, over 50 research articles, book chapters and abstracts and presented at more than 100 international, national and state conferences. In 2015, Dr. Rohde received the Cardinal Health #urEssential Award as Champion of the CLS Profession, named a Top 20 Professor of CLS and received the Texas State Mariel M. Muir Mentoring Award. Likewise, he was awarded the 2015 and the 2012 Distinguished Author Award and the 2014 and 2007 ASCLS Scientific Research Award for his work with rabies and MRSA, respectively. Learn more about his work here. Dr. Rohde is the current Texas Association for Clinical Laboratory Science (TACLS) President and has been involved in licensure efforts in Texas since 2007.

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