Funding cuts and flu virus a deadly combination

A doctor stands inside a mobile emergency room set up outside Grady Memorial Hospital to help handle the ever-growing number of flu cases in Jan. 2018.
A doctor stands inside a mobile emergency room set up outside Grady Memorial Hospital to help handle the ever-growing number of flu cases in Jan. 2018. AP

Flu is causing almost 1 in 10 American deaths right now, and experts are predicting that it may well get worse before it gets better. Along with the pneumonia it spawns, this year’s epidemic may be killing 4,000 people every week. A government report out last week shows 1 of every 13 visits to the doctor was for fever, cough and other symptoms of the flu. That nearly ties the highest level seen in the U.S. during swine flu in 2009, and it surpasses every winter flu season since 2003, when the government changed the way it measures flu.

Given those grim statistics, it seems like a great time to slash public health funding, right? I know it seems crazy, but that is exactly what Congress voted to do last week when they passed the budget bill which included a $1.35 billion cut from the Prevention and Public Health Fund over the next 10 years.

When you add that to the $750 million cut from the PPHF in December by the GOP tax bill, the total cuts will be devastating. PPHF is responsible for more than 10 percent of the CDC budget, and most of that money is passed-though directly to the states for their local prevention and outbreak control efforts. For example, NC receives more than $17 million a year from the fund, specifically to counter public health crises such as this current influenza epidemic.

With the monetary shift, it is not clear which programs will be affected, or how much money North Carolina will get next year, but the shortfall will doubtlessly create holes in public health programs. The CDC will also suffer a blow in the coming year as funds from a five-year, $582-million supplemental package to combat the 2014 Ebola outbreak will run out, and there are no indications as of yet that it will be renewed.

The timing could scarcely be worse. The levels of influenza-like illnesses being reported now are as high as the peak of the swine flu epidemic in 2009, which swept the globe in 2009 and 2010, sickened 60.8 million Americans, hospitalized 274,304 and killed 12,469, according to CDC data. Deaths from the current outbreak will likely far outstrip those of the 2009-2010 season.

The PPHF is an indispensable part of our national public health programs. It was established in 2010 and financed by the Affordable Care Act (ACA), with the goal of improving health outcomes and enhancing the quality of health care. Initially, the ACA authorized $500 million for the fund in 2010, which was to grow to $2 billion per year by 2015. The funding was to be mandatory, and therefore protected during yearly appropriations allocations.

But almost immediately after it was created, Congress began dipping into the fund to pay for various health care-related expense shortfalls. It was the arbitrary cuts imposed by sequestration beginning in 2013, however, that really hobbled the ability of fund to perform as originally envisioned. By last year, the PPHF was left with only $931 million annually to support public health, wellness, and prevention activities. In the same fiscal year, the CDC received more than $891 million from PPHF to support vaccine coverage, respond to outbreaks of foodborne infections and waterborne diseases, develop programs to counter the leading causes of death and disability, such as cancer, heart disease, stroke, and diabetes, and eliminate childhood lead poisoning, among other initiatives.

Deaths from influenza and pneumonia, which are closely tied to each other in the winter months, were responsible for 1 of every 10 deaths last week, and that’s likely to rise. Of 40,414 deaths in the U.S. during the third week of this year, 4,064 were from pneumonia or influenza, according to the CDC. The number for that week is expected to rise as more recent reports come in.

With the flu-related death toll expected to grow even higher, it seems unthinkable that Congress and President Trump would agree to such drastic and unplanned cuts to public health funding. It again underscores how out of touch lawmakers are when it comes to the healthcare needs of the American people.

Kevin J. Rogers, JD, is the director of policy and public affairs for Action NC and a lecturer of government and political science at William Peace University in Raleigh.