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Coronavirus Tests States' Under-Funded Public Health Systems


Tip of the iceberg - that is how one doctor working on the COVID-19 outbreak in Washington state describes new cases discovered over the weekend. COVID-19 is the disease caused by coronavirus, and public health agencies believe more cases will be found as testing picks up. All this, though, is straining an already underfunded public health system. Will Stone, from member station KNKX, reports from Seattle.

WILL STONE, BYLINE: A lot goes into chasing a virus, much of it out of sight. At the downtown headquarters of Public Health Seattle & King County, staffers huddle over their laptops, fielding phone calls and directing a massive public health mobilization. COVID-19 cases are emerging here without any clear link to travel. And it's raising concern that Washington state may be on the cusp of a widespread outbreak. The health officer for Seattle & King County is Dr. Jeff Duchin.

JEFF DUCHIN: We've got an amazingly large challenge in front of us with these new cases coming very close together.

STONE: A few schools linked to cases are temporarily closed. The Centers for Disease Control and Prevention has sent a team to investigate a deadly outbreak at a nursing home in Kirkland just east of Seattle. Duchin says it's now clear the virus has been circulating locally, but only recently did state labs begin to do the test themselves and on more types of patients. That's led to more cases being discovered.

DUCHIN: So our team is working pretty much around the clock to follow up on all of these cases, all the potential interactions that they've had recently.

STONE: More than 100 people at his department are part of the COVID-19 response and they're hiring. They need nurses, disease investigators and public health workers.

CARINA ELSENBOSS: And it's costing a lot of money.

STONE: Carina Elsenboss is preparedness director for Seattle & King County. She says the coronavirus response is costing as much as $200,000 a week.

ELSENBOSS: We are now entering a new phase of looking at what does this look like when we have widespread transmission in the community?

STONE: Elsenboss was here in 2009 and 2010 during the outbreak of the H1N1 flu. One big difference between now and then...

ELSENBOSS: Unfortunately, we have less staff than we did during H1N1, and we have not had sustained investments in public health preparedness.

STONE: Budgets are tight for many public health departments throughout Washington. Congress is working on emergency funding that could free up billions of dollars for COVID-19. Ingrid Ulrey is the policy director for Public Health Seattle & King County. She went to D.C. last week to press for more money.

INGRID ULREY: If you look at past outbreaks and pandemics, it often takes the federal government a long time to take action.

STONE: She says it's also critical that that money goes straight to local departments and fast.

ULREY: The work at the local level is what really makes the difference to ensure that we stop the spread. And then we mitigate the crisis here on the ground.

STONE: Across Puget Sound from Seattle is Kitsap County, with a population one-eighth the size of King County.

KEITH GRELLNER: We're in desperate need for more funding.

STONE: Keith Grellner heads the Kitsap Public Health District.

GRELLNER: We just feel this incredible pressure and stress that we can't meet the needs of the community right now because we do not have the resources to do it.

STONE: His agency is busy revamping its pandemic plan and even updating the computer system to track illnesses. They're already overstretched.

GRELLNER: When people get really tired, when they're - they've got too much to do, that's when mistakes can happen. And we don't want to make mistakes.

STONE: Just how much money does he need from Congress? Grellner says he could come up with a number, only that would take more time and manpower, both already in short supply.

For NPR News, I'm Will Stone in Seattle.

(SOUNDBITE OF AMBINATE'S "SIGHT 02") Transcript provided by NPR, Copyright NPR.

Will Stone is a former reporter at KUNR Public Radio.