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Rebuilding a National Public Health Capability — Not so Easy!

There are many answers to why it is not easy to do.

Throwing money at an issue will not fix anything quickly. It is never that easy. Sure, if you want to just buy equipment or test kits — money helps. However, expertise and experience cannot be replaced by dollars. There are no quick fixes when the solution involves people and staffing.

See this article, Trump says he can bring in coronavirus experts quickly. The experts say it is not that simple.

Public health at the state and local levels began to be beefed up when federal grant funding for health became ramped up following the terrorist attacks of 9/11. This lasted for around 10 years and then ... as is normal ... the threat was not seen as great from a terrorist bio attack, and as we put more time between us and 9/11, the funding slowly began to diminish.

As the money decreased, capability at the state and local levels decreased with it.  

Now with a new influx of money being contemplated, and I'm sure it will be appropriated by Congress and a bill signed into law — the impact of the money will take years to really come to fruition. For instance, there is an administrative time lag from appropriation to the time it is actually in the hands of practitioners. There has to be funding guidance, contracts drawn up, signed and then projects developed that meet the guidance. In government — for a normal process, from the time you have authorization to hire, it can take six months easily before you have someone on board. A job description has to be developed, the job advertised, hiring panels assembled and interviews conducted. Finally a selection is made and someone has to give notice to the place where they work now.

Then the new person shows up on the job and they have to get oriented to the new workplace. Pay, computers, the copier, policies and procedures and if they are totally new to the region/organization — they likely don't know anyone. Relationships and trust are key ingredients in disaster responses of all types. 

So, no, Mr. President, you can't bring on "experts" quickly who are effective in the work that they need to do. If you want expertise in place, it requires a sustained effort over many years. Lastly, if you are hiring at the federal level, there are many who don't want to work in the current environment where "the deep state" is considered the enemy, when in fact, they are just people trying to do their job, and in this case a scientific job, where science not been respected so far within this administration. 

Eric Holdeman is a contributing writer for Emergency Management magazine and is the former director of the King County, Wash., Office of Emergency Management.