A Blast from the Past: CDC Funding

Looking back to a story from 2018.

Via WaPo from February 2018: CDC to cut by 80 percent efforts to prevent global disease outbreak.

Two weeks ago, the CDC began notifying staffers and officials abroad about its plan to downsize these activities, because officials assume there will be “no new resources,” said a senior government officialspeaking on the condition of anonymity to discuss budget matters. Notice is being given now to CDC country directors “as the very first phase of a transition,” the official said. There is a need for “forward planning,” the official said, to accommodate longer advance notice for staffers and for leases and property agreements. The downsizing decision was first reported by the Wall Street Journal.

The CDC plans to narrow its focus to 10 “priority countries,” starting in October 2019, the official said. They are India, Thailand and Vietnam in Asia; Jordan in the Middle East; Kenya, Uganda, Liberia, Nigeria and Senegal in Africa; and Guatemala in Central America.

Countries where the CDC is planning to scale back include some of the world’s hot spots for emerging infectious disease, such as China, Pakistan, Haiti, Rwanda and Congo. Last year, when Congo experienced a potentially deadly Ebola outbreak in a remote, forested area, CDC-trained disease detectives and rapid responders helped contain it quickly.

Emphasis mine.

Now, in fairness, the monies in question were initially the result of emergency spending linked to Ebola.

However, the Ebola outbreak (among other threats from disease) should have led the US government (i.e., the Trump administration) to consider finding a means to continue said funding.

On Monday, a coalition of global health organizations representing more than 200 groups and companies sent a letter to U.S. Health and Human Services Secretary Alex Azar asking the administration to reconsider the planned reductions to programs they described as essential to health and national security.

“Not only will CDC be forced to narrow its countries of operations, but the U.S. also stands to lose vital information about epidemic threats garnered on the ground through trusted relationships, real-time surveillance, and research,” wrote the coalition, which included the Global Health Security Agenda Consortium and the Global Health Council.

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Steven L. Taylor
About Steven L. Taylor
Steven L. Taylor is a Professor of Political Science and a College of Arts and Sciences Dean. His main areas of expertise include parties, elections, and the institutional design of democracies. His most recent book is the co-authored A Different Democracy: American Government in a 31-Country Perspective. He earned his Ph.D. from the University of Texas and his BA from the University of California, Irvine. He has been blogging since 2003 (originally at the now defunct Poliblog). Follow Steven on Twitter

Comments

  1. James Knauer says:

    Lessee….. incubation observed as high as 27 days, but they are letting folks go after 14… transmission among the people with no symptoms…. 20% require long-term expensive treatment… immune system hijacking puts vaccines beyond realistic reach as well a providing a mechanism to spread even further upon subsequent infection…a dog in Hong Kong tested positive next to her infected owner…

    Then the U.S. appoints an anti-science vice president, a non-medical treasury secretary, and a senile T.V. commentator who has never been right about anything to lead a “task force.”

    End well this will not. Pray it doesn’t turn more deadly. Everything is about to slow way down.

    12
  2. Andy says:

    The numbers for FY2020 are here.

    Looking back to 2018, funding increased in almost every area including global public health protection, but the exception is Public Health Preparedness and Response which decreased from ~$1.5 billion in 2018 to $850 million in 2020. That’s a significant decrease.

    4
  3. Teve says:

    @Andy: got to save money for all those wealthy people tax cuts. Google “Bezos yacht”. That thing’s not cheap! Who cares about mamaw?

    7
  4. Teve says:

    (just to preëmpt: I know it might not actually be his boat, that’s not the point.)

    1
  5. wr says:

    @James Knauer: “immune system hijacking”

    I have never heard of this, but it doesn’t sound happy. A few words of explanation, perhaps?

    1
  6. James Knauer says:

    @wr: The mechanism is antibody-dependent enhancement. In the first infection, the body mounts a defense, creating waves of antibodies. They are generally effective, as given by the low death rate. When the infection retreats, the antibodies also drop in number. Upon a second infection, however, the virus is able to use these depleted antibodies as part of the mechanism to open the necessary receptors on the membranes of cells. What once protected you is turned into an agency of infection.

    There are already cases of secondary infections in China and Hong Kong. Quarantines other than staying home are not going to be effective.

    2
  7. Liberal Capitalist says:

    So the expected kill rate is 2%: if you know 3000 people, 60 will die.

    Compared to the flu, which has a kill rate of 0.1% : If you know 3000 people, 3 would die.

    Greater metro Denver has 2.8 million… 56,000 will die.

    Globally, that means a pandemic likely death rate of 195 Million. Out of 7.8 billion.

    The global number is lost to me… The Denver number makes it real.

    The usual group will drop: The infirm, the elderly, those with already compromised respiratory systems, likely very young children as well. The virus doesn’t kill you… the resultant pneumonia does.

    Many will get it, and recover. Life will go on. Bad things will happen, but not to all.

    Math. Not so hard as it seems. Life, however, is a different matter.

    7
  8. just nutha ignint cracker says:

    @Teve: Of course it’s not. The real point is twofold:

    1) Rich nations like China should not be sponging off the efforts of the CDC. They should be building their own systems to fight their own battles so that diseases from there don’t get here in the first place.

    2) We’re not as rich as everyone would like to believe and simply cannot afford to be go to nation for every sh!thole country with health issues. Those sh!tsholes need some tough love so that they will start pulling themselves up by their own boot straps (or sandal straps or sky hooks or whatever). We need to take better care of our neglected rural people cruelly hooked on opioids by careless doctors in an out of control public health system as a higher priority anyway.

    (And no, I don’t really care about that problem either, but if I was going to, I would put America First! MAWA! KAW! They shall not replace us!)

    1
  9. Liberal Capitalist says:
  10. James Joyner says:

    @Liberal Capitalist:

    The usual group will drop: The infirm, the elderly, those with already compromised respiratory systems, likely very young children as well. The virus doesn’t kill you… the resultant pneumonia does.

    The NYT podcast the Daily had an informative episode on the topic this morning. Children, as it turns out, tend to fare quite well because they have had so much more recent exposure to various coronaviruses and therefore have more immunity built up.

    3
  11. Jen says:

    @wr: I believe another term for this is cytokine storms. The immune system response goes way into overdrive, and the body starts attacking itself. An individual’s immune response is key.

  12. Teve says:

    @Liberal Capitalist: i think it’s 2% of the people who get the disease condition, not 2% of everybody infected. I think 80% of the infected don’t get the condition. So if half the people get infected, the back of the envelope calculation is .5*.2*.02*100=.2% of the population would die. 640k people in the US.

    (I am not an epidemiologist. Somebody correct this if it’s wrong.)

    2
  13. Gustopher says:

    @James Knauer:

    End well this will not.

    All’s well that ends.

  14. Stormy Dragon says:

    Peak GOP: Whitehouse just announced plans to combat COVID19 with…..

    Tax cuts and interest rate cuts!

    7
  15. Teve says:

    @Teve: what percentage of people who get infected get the COVID-19 disease is what I want to know.

    1
  16. Teve says:

    @Teve:

    I think 80% of the infected don’t get the condition.

    OK now I think the statement was incorrect. 80% get a mild form of the condition, is my understanding.

  17. Teve says:

    Well drat. My epidemiologist friend just replied and said “all we know right now are numerators, not denominators.” We don’t know how many people who get infected don’t develop the illness.

    2
  18. Jen says:

    @Teve: The existence of asymptomatic carriers has always fascinated me. The fact that people can be teeming with virus and not show any symptoms has to be one of the most effective ways of spreading a disease. How would you even know? And this applies to all kinds of viral illnesses.

    @Guarneri: Do you have a citation for that death rate? That seems a lot lower than anything else I’ve read.

    4
  19. Mister Bluster says:

    outright fabrication going on

    You mean like this:

    Brian Kilmeade: And so now we’re getting to sprint towards November for — to — to see if your dad can get four more years. Are you surprised the way they’ve been handling the coronavirus situation, meaning Democrats?

    Donald Trump Jr.: Not at all. I mean, we’ve seen — like you said, we’ve seen this play out for four years. Anything that they can use to try to hurt Trump, they will. Anything he does in a positive sense, like you heard from the reporter that was just suspended from ABC, they will not give him credit for. The playbook is old at this point.
    But for them to try to take a pandemic and seemingly hope that it comes here, and kills millions of people so that they could end Donald Trump’s streak of winning, is a new level of sickness. You know, I don’t know if this is coronavirus or Trump derangement syndrome, but these people are infected badly.
    CNN

    3
  20. Stormy Dragon says:

    @Jen:

    The existence of asymptomatic carriers has always fascinated me. The fact that people can be teeming with virus and not show any symptoms has to be one of the most effective ways of spreading a disease. How would you even know? And this applies to all kinds of viral illnesses.

    From an evolutionary standpoint, this is the optimal state for both the host organism and the virus, which is why viruses tend to become less virulent as time passes. And indeed, SAR-Cov-2 probably was this way in whatever host animal it came from, and is only wreaking havoc in humans because it’s a new environment it hasn’t adapted to yet.

    Disturbing bit of trivia: most of the live cells (and yes, I know viruses aren’t cells so don’t count in this) currently in your body do not have your DNA.

    1
  21. wr says:

    @James Knauer: It’s like the virus equivalent of blowing up a bomb and then setting another one for the firsts responders. Oy! Can’t they pass a law against this or something?

    2
  22. wr says:

    @Teve: “what percentage of people who get infected get the COVID-19 disease is what I want to know.”

    I think there are a lot of scientists around the world desperately trying to figure that out…

  23. Just nutha ignint cracker says:

    @Jen: Even if Guarneri has a citation for his statistic, it’s going to be from someplace like ZeroHedge.com, so caveat your emptor.

    4
  24. Teve says:
  25. Jen says:

    @Just nutha ignint cracker: Pretty much exactly why I asked. If it’s ZeroHedge (my first thought too), I know to discount it.

    2
  26. Teve says:

    Social media this afternoon:

    Friend 1: if I get coronavirus I’m gonna start going to trump rallies.
    Friend 2: if I get coronavirus I’m going to start going to anti-vaxxer rallies.
    Friend 3 posts “why not both?” meme.

    5
  27. Liberal Capitalist says:

    @Teve:

    @Liberal Capitalist: i think it’s 2% of the people who get the disease condition, not 2% of everybody infected. I think 80% of the infected don’t get the condition. So if half the people get infected, the back of the envelope calculation is .5*.2*.02*100=.2% of the population would die. 640k people in the US.

    (I am not an epidemiologist. Somebody correct this if it’s wrong.)

    The proportion of infected people who die from Covid-19 appears to be between 1% and 2%

    The number I stated is the pandemic death rate, IF it becomes a pandemic.

    That is the thing about a pandemic. The numbers are huge. the 2% is the number applied broadly as a pandemic assumes broad potentials of infections. This is the worst case scenario, with an broad community infections

    If you wish to consider differing groups, the death rate in the elderly in a pandemic would likely hit 15%. It is just how these things work.

    Look, I’m not trying to rile anyone up, but the CDC is saying that 2 to 3 weeks of provisions is a good thing to have.

    And, if it does not become a pandemic, that just means less shopping in the future for some canned and powered staples

    As an optimist, I hope for the best. And educated as a sociologist fascinated by statistics I expect the worst from large numbers of people… it is just proven history.

    2
  28. rachel says:

    @Liberal Capitalist:

    Look, I’m not trying to rile anyone up, but the CDC is saying that 2 to 3 weeks of provisions is a good thing to have.

    Even if we weren’t looking at a global health emergency, it’s still good to have a your pantry stocked up for so many reasons. If I had space, I’d ideally keep 6 months to a year’s supply of food, medicines and other staples so I don’t have to worry about feeding my family if I lose my job or whatever.

    2
  29. Teve says:

    There’s now another community case in California, a case in Utah, maybe one in Oregon, and possibly one in Washington State.

  30. Bob@Youngstown says:

    @Teve:
    CDC’s official report Feb 25 2020:
    2,462 deaths associated to COVID-19
    as of Feb 23, reported 78,811 cases

    Therefore calculated death rate is 3.1%, based on reported.

    It is entirely possible that the number of reported cases is greater, perhaps more so*.

    * reported cases are those who have tested positive for COVID-19, not all persons who “are sick” have been tested. “As of February 23, [2020] 479 persons from 43 [US] states and territories had been or are being tested for COVID-19″

  31. wr says:

    @Liberal Capitalist: “Look, I’m not trying to rile anyone up, but the CDC is saying that 2 to 3 weeks of provisions is a good thing to have.”

    If I still lived in a 4,000 square foot house with a massive basement in California that would be a good idea. Unfortunately it’s just not practical in a small New York City apartment…

  32. mattbernius says:

    @Jen:

    Do you have a citation for that death rate? That seems a lot lower than anything else I’ve read.

    I suspect that the number he shared trace back to comments made my the WHO:

    Aylward said that across China, about 80% of cases are mild, about 14% are severe, and about 6% become critically ill. The case fatality rate — the percentage of known infected people who die — is between 2% and 4% in Hubei province, and 0.7% in other parts of China, he said.

    The lower rate outside of Hubei is likely due to the draconian social distancing measures China has put in place to try to slow spread of the virus. Other parts of China have not had the huge explosion of cases seen in Hubei, Aylward said.

    source: https://www.statnews.com/2020/02/25/new-data-from-china-buttress-fears-about-high-coronavirus-fatality-rate-who-expert-says/

    Saying the death rate is actually .7% isn’t accurate. However, it gets to the issue that figuring out a death rate at this point in the process is exceedingly difficult and we cannot assume that even transmission rates will be the same in urban areas in the US, which have no where near the same population concentration as cities elsewhere in the world.

  33. Just nutha ignint cracker says:

    @Jen: Ultimately, it’s easier (and probably wiser) to just discount what Guarneri says. It’s certainly quicker. 😉

  34. Just nutha ignint cracker says:

    @Teve: Two confirmed in Washington State. Also, just today, the first confirmed death. We’re #1! We’re #1!

    ETA: s/b first confirmed US death