Saving lives, restoring the economy — county governments try to keep up with COVID-19

Saving lives, restoring the economy — county governments try to keep up with COVID-19
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Saving lives while restoring the economy is our mantra of the day. 

As Congress assembles a massive supplemental aid package, we as a nation must balance the dueling objectives of being laser-focused on our public health fight against COVID-19, while confronting the unprecedented shock to our national economy and the daily lives of all Americans.

On the frontlines of this pandemic, America’s 40,000 county elected officials, nearly 1,000 county-supported hospitals and 1,900 local public health authorities are addressing the very real issues of COVID-19 preparedness, mitigation and response. We are grappling with test kit access, workforce capacity and safety, data reliability and real-time information sharing for critical decision making. As W. Edwards Deming famously stated, “You can’t manage what you can’t measure.” 


Even as federal policymakers turn their full attention to the real, complex web of economic challenges, we must also ensure that state and local officials have the essential, life-saving tools and capacity — equipment, experts, funding and policies — needed to protect the American public. As a nation, we are already far behind the eight ball, and every day and every dollar counts in our fight against the COVID-19 pandemic.

In recent years, I’ve made two main observations from several public speeches: smart nations, corporations, communities, families and individuals impose self-discipline — especially financially — during the best of times to prepare for the worst of times; and, underneath the glowing national economic indicators of strong GDP growth, modest wage increases and record-low unemployment, America’s counties were oddly enough confronting record high, crushing demands on our safety net services

While there will be plenty of time for Monday morning quarterbacking and investigations of our national decision-making and preparedness, we must ensure — right now — that our state and local public health providers have the resources, flexibility and cooperation to mitigate the COVID-19 pandemic. We’re already short staffed and under-resourced. Our local public health workforce has been gutted since the last economic recession in 2008; there are nearly one-fourth, or 60,000, fewer public health professionals at the local level, according to the National Association of City-County Health Officials

Each year, we kick and scream at federal policymakers about the need for a stronger federal, state and local partnership, and broader community collaboration on public health preparedness, mitigation and response. Unfortunately, local officials have been forced to play more defense, rather than offense, in this space. Rather than support the broader capacity of public health services, the nature of federal and state policy, and budget fights, has forced us into narrow, siloed responses, typically crisis by crisis — H.I.V./AIDS, Ebola, Zika, H1N1, the opioid crisis, and now, COVID-19. We’re now living with the consequences.

With 3.6 million public servants, county governments are working overtime to protect, prepare, inform and comfort the American public. But it isn’t easy. Even before this pandemic, our budgets and staffing were already stretched to the max. Child welfare caseloads were skyrocketing, especially demands on foster care, due to the opioid crisis. Substance abuse, also led by the opioid crisis, emerged as the number one cause of accidental death nationwide, with nearly 70,000 deaths each year. Mental illnesses, with the persistent lack of attention, funding and treatment facilities, accounted for nearly 70 percent of our 750,000 local jail inmates. Additionally, the number of incarcerated females, including many mothers, spiked in the past two years, again, related to the plight of our dueling “have-have not” societies.  

The slow nature of the American response is unacceptable. People will die unnecessarily. Families and individuals will suffer financially and emotionally. Companies and industries will be destroyed or set back years. Taxpayer dollars will be wasted. But we can still mitigate the damage if we stay focused on our core objective: stopping the spread of COVID-19.

San Diego County, California was among the first counties to declare a public health emergency for COVID-19, back on Feb. 14 – Valentine’s Day. Far from the national media spotlight, the county Board of Supervisors and county public health officials worked together with federal and state partners to prepare and respond quickly. 

Now, we as a nation must learn and adapt from our current emergency. We need to stay focused on curbing the spread of COVID-19, as it crushes our global and national economies.

We must take action together as we prepare for a potentially powerful coronavirus resurgence this fall.

Matthew D. Chase is the executive director of the National Association of Counties, the national organization representing America’s 3,069 county governments including 40,000 county elected officials and 3.6 million county employees.