20 Public Health Organizations Condemn Herd Immunity Scheme for Controlling Spread of SARS-CoV-2

Great Barrington Declaration is not grounded in science and is dangerous

(Washington, DC – October 14, 2020) – SARS-CoV-2, the virus that causes COVID-19 has infected at least 7.8 million people in the United States and 38 million worldwide. It has led to over 215,000 deaths domestically, and more than 1 million globally – with deaths continuing to climb.

If followed, the recommendations in the Great Barrington Declaration would haphazardly and unnecessarily sacrifice lives. The declaration is not a strategy, it is a political statement. It ignores sound public health expertise. It preys on a frustrated populace. Instead of selling false hope that will predictably backfire, we must focus on how to manage this pandemic in a safe, responsible, and equitable way.

The suggestions put forth by the Great Barrington Declaration are NOT based in science.

  • There is no evidence that we are even remotely close to herd immunity. To the contrary, experts believe that 85 to 90 percent of the U.S. population is still at risk of contracting SARS-CoV-2. Herd immunity is achieved when the virus stops circulating because a large segment of the population has already been infected. Letting Americans get sick, rather than focusing on proven methods to prevent infections, could lead to hundreds of thousands of preventable illnesses and deaths.[i] It would also add greater risk in communities of color which have already experienced disproportionate impacts of the pandemic.
  • The declaration ignores what are our best tools to fight the virus, i.e. wearing masks, physical distancing, hand-washing, avoiding large crowds, strategic testing, rapid isolation of infected people and supportive quarantine for people who need to isolate.
  • We have seen the failure of the herd immunity experiment in nations such as Sweden, which has the highest mortality rate among Nordic countries.[ii] COVID-19 carries a much higher risk of severe disease and death than other infections where herd immunity was attempted before a vaccine was available.[iii] It is illogical to ignore public health and scientific evidence when so many lives are at stake.

Combatting the pandemic with lockdowns or full reopening is not a binary, either/or choice. We need to embrace common sense public health practices that allow for a safe reopening of the economy and a return to in-person work and learning while also using proven strategies to reduce the spread of the virus.

The declaration suggests a so-called focused protection approach. It suggests allowing the virus to spread unchecked among young people to create herd immunity in the entire population. This notion is dangerous because it puts the entire population, particularly the most vulnerable, at risk. Young people are not all healthy and they don’t live in vacuums.[iv] They interact with family members, co-workers and neighbors. Inviting increased rates of COVID-19 in young people will lead to increased infections rates among all Americans.

Public health guidance and requirements related to masking and physical distancing are not an impediment to normalcy – they are the path to a new normal. The goal is both public health safety and economic security; the two are not in conflict with one another, they are dependent on each other. We need to focus our efforts on the development and implementation of a national, science-based and ethical pandemic disease-control strategy.

The pandemic has created serious hardships on families’ economic security and on American’s mental health and well-being. What we need is a coordinated and robust national response including mask use, hand hygiene and physical distancing, while also ensuring social supports for those most vulnerable, including physical and mental health, and social factors.  What we do not need is wrong-headed proposals masquerading as science.


This statement was authored by:

American Public Health Association

Big Cities Health Coalition

Trust for America’s Health

American Academy of Social Work and Social Welfare

Association for Professionals in Infection Control and Epidemiology

Association of Public Health Laboratories

Association of Schools and Programs of Public Health

de Beaumont Foundation

Johns Hopkins Center for Health Security at the Bloomberg School of Public Health

Los Angeles County Department of Public Health

National Association of County Behavioral Health and Developmental Disabilities Directors

National Association of County and City Health Officials

National Association for Rural Mental Health

National Network of Public Health Institutes

New York City Department of Health and Mental Hygiene

Nurses Who Vaccinate

Prevention Institute

Public Health Institute

Resolve to Save Lives, an initiative of Vital Strategies

Well Being Trust

 

[i] https://www.medpagetoday.com/infectiousdisease/covid19/88401

[ii] https://www.medpagetoday.com/infectiousdisease/covid19/88401

[iii] https://coronavirus.jhu.edu/from-our-experts/early-herd-immunity-against-covid-19-a-dangerous-misconception

[iv] https://www.cdc.gov/mmwr/volumes/69/wr/mm6941e1.htm?s_cid=mm6941e1_w

New Report Recommends Policies to Protect and Improve Americans’ Health by Transforming the Public Health System

Nation’s Public Health System Needs Sustained Attention and Investment; The Report Provides Action Plan for the Administration and Congress Taking Office in 2021

(Washington, DC – October 6, 2020) — The COVID-19 pandemic sharply illuminated weaknesses in the nation’s public health system and ways in which structural racism put communities of color at disproportionate risk of negative health outcomes, according to a new report, The Promise of Good Health for All: Transforming Public Health in America. The report was released today by Trust for America’s Health.  Among its findings is that the nation’s public health system is dangerously inadequate. The report offers a blueprint for policymakers taking office next year on how to strengthen the system, protect against health security threats, address the social determinants of health, and combat racism and other forms of discrimination that negatively affect community and individual health and resilience.

Americans are facing increasing environmental and weather-related threats from wildfires to hurricanes. Infectious disease outbreaks are a constant and complex risk as world travel allows small outbreaks to become worldwide threats in a matter of hours. Additionally, Americans have higher levels of chronic disease and mental health and substance misuse issues than ever before.  As a nation, we spend over $3 trillion annually on healthcare but lag behind other developed countries in practically every health metric. A key to addressing these threats to the nation’s health is a significant investment in the public health system, including programs rooted in prevention and working at the population health level. The report calls for an annual $4.5 billion investment in the nation’s public health infrastructure including in 21st century data systems and a robust public health workforce.

“Even before COVID-19, numerous health emergencies, including infectious disease outbreaks like measles, Zika and Ebola, the opioid epidemic, weather-related events and lung injuries due to vaping demonstrated the urgency of a strong public health system,” says John Auerbach, President and CEO of Trust for America’s Health.

“Each of these emergencies brought short-term attention to the importance of the public health system, but short-term attention is not enough.  Without sustained investment the nation’s public health system we will not be ready to protect Americans’ lives and livelihoods during the next health emergency,” Auerbach said.

The conditions in which people live and work are key drivers of their health. Therefore, solutions to health risks and inequities largely exist outside the healthcare sector and reinforce the importance of investing in population health and the social determinants of health. Increasing the nation’s investment in health promotion and disease prevention will not only improve the quality of life for millions of Americans, it will help decrease the nation’s exploding healthcare spending.

The report focuses on five key priority areas:

PRIORITY 1: Make substantial and sustained investments in a more effective public health system including a highly-skilled public health workforce.

PRIORITY 2: Mobilize an all-out effort to combat racism and other forms of discrimination and to advance health equity by providing the conditions that optimize health.

PRIORITY 3: Address the social determinants of health including economic, social, and environmental factors that result in preventable illness, injuries and death.

PRIORITY 4: Proactively address threats to the nation’s health security.

PRIORITY 5: Improve health, safety, and well-being for all people by providing pathways to optimal health across the life span.


Among the report’s recommendations for federal policymakers are:

  • Strengthen and modernize the public health system by creating a $4.5 billion per year Public Health Infrastructure Fund to support foundational public health capabilities at the state, local, territorial and tribal levels.
  • Build 21st century public health surveillance systems at the federal, state and local levels to enable rapid detection and response to disease threats.
  • Create a Health Defense Operations budget designation to build sustainable funding for public health programs that prevent, detect and respond to outbreaks.
  • Make advancing health equity and eliminating health disparities a national priority with a senior-level, federal interdepartmental task force charged with adopting policies and programs in housing, employment, health, environmental justice and education that reduce health inequities and address the social determinants of health.
  • Expand grants to address health inequities and ensure funding is reaching under-resourced, marginalized, and disproportionately affected communities.
  • Prioritize increased funding for state, local, tribal and territorial public health emergency preparedness and response programs, such as CDC’s Public Health Emergency Preparedness program and HHS’s Hospital Preparedness Program.
  • Build surge capacity across the healthcare system and develop standards for healthcare facility readiness. Policymakers should provide payment incentives and reward facilities that maintain specialized disaster care capabilities.
  • Grow the CDC’s Climate and Health Program so it can support every state, large cities, territories and tribes to be climate-ready. Clean air and water regulations should be restored and strengthened, including the Clean Air Act and Clean Water Act.
  • Increase research and effective messaging to build vaccine confidence and ensure that no person faces barriers to receiving all necessary vaccinations.
  • Promote optimal health across the lifespan through access to health insurance, job-protected paid leave for workers, and significant investments in programs proven to support families and improve health – from babies to older adults.

The report is endorsed by the American Public Health Association, the Asian & Pacific Islander American Health Forum, the Big Cities Health Coalition, the Public Health Institute, and the National Network of Public Health Institutes.

 

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. On Twitter at @HealthyAmerica1

TFAH and Other Leaders Launch Public Health Communications Collaborative to Support and Advance Public Health During COVID-19 Pandemic

(Washington, DC, September 2, 2020) – The Public Health Communications Collaborative (PHCC), launched today, will promote the value of public health to protect Americans’ health and safety as well as the nation’s economy. The collaborative will coordinate and amplify public health messaging on COVID-19 issues to increase Americans’ confidence in health guidance by communicating the best available science, by positioning public health leaders as expert spokespersons, and by quickly correcting misinformation.

“Unfortunately, misinformation and conflicting messages about COVID-19 have confused the American public at a time when clear guidance about how to protect their health is critical,” said John Auerbach, President, and CEO of Trust for America’s Health. “This collaborative will share information that will advance science-based decision making during the pandemic and in doing so will help save lives.”

Founding members of the PHCC are Trust for America’s Health, the CDC Foundation, and the de Beaumont Foundation. Partner organizations are the American Public Health Association, the Association of State and Territorial Health Officials, the Big Cities Health Coalition, the National Association of County and City Health Officials, PATH, and Resolve to Save Lives.

The Public Health Communications Collaborative website will be a hub repository of information and messaging products designed to help state and local public health officials share information with their constituents and navigate the current media landscape. The site will be updated regularly with real-time messaging and resources.

To sign up for email updates from PHCC, visit the website.

TFAH Applauds the Introduction of the Improving Social Determinants of Health Act of 2020 by Senator Smith (MN) and Senator Murphy (CT)

(Washington, DC – August 5, 2020) – Trust for America’s Health (TFAH), a non-partisan, independent public health policy, research and advocacy organization, applauds Senators Tina Smith (MN) and Chris Murphy (CT) for introducing the Improving Social Determinants of Health Act of 2020. This critical bill would address the social, economic and environmental conditions that affect the health and wellbeing of millions of Americans.

If enacted, the bill would create a Social Determinants of Health (SDOH) Program at the   Centers for Disease Control and Prevention (CDC). Through grants, this program would improve the capacity of public health departments and community organizations to address social determinants of health and reduce health care costs by building multi-sector collaborations and addressing policies that currently inhibit good health. Grants would also be issued to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices, provide technical, training and evaluation assistance and/or disseminate those best practices. Lastly, the program would coordinate, support and align SDOH activities at CDC.

The President and CEO of Trust for America’s Health, John Auerbach, congratulates Sen. Smith and Sen. Murphy on the introduction of the bill:

The COVID-19 pandemic, as well as the continued conversations our country is having about racism and racial justice, continue to put a spotlight on the social and economic conditions that contribute to an individual’s health outcomes during their life.

We know that a community’s resources directly impact the health outcomes of its residents. Now is the time to work to address these disparities, including those in housing, employment, food security and education.

This legislation would empower public health departments and community organizations to act as chief health strategists in their communities and lead efforts to convene partners across sectors to build integrated systems and programs that improve health and health equity.

The Improving Social Determinants of Health Act of 2020 is an important next step in improving health outcomes, would reduce overall healthcare spending and help address health inequities; TFAH is proud to support this bill and urges Congressional support.”

This bill is the Senate companion bill to Improving Social Determinants of Health Act of 2020 (H.R. 6561), which was introduced by Representative Nanette Diaz Barragán (CA-44) in April 2020.

TFAH’s summary of the bill can be found here.  For more information on The Improving Social Determinants of Health Act of 2020, please contact Daphne Delgado at [email protected].

In addition to TFAH, original endorsing organizations include:

1,000 Days

A Vision of Change Inc.

Addiction Professionals of North Carolina

Addiction Connections Resource

All Youth Access, LLC

Aligning for Health

America’s Essential Hospitals

American Art Therapy Association

American Association for Psychoanalysis in Clinical Social Work

American Association of Birth Centers

American Association on Health and Disability

American Cancer Society Cancer Action Network

American College of Nurse-Midwives

American College of Preventative Medicine

American Federation of Teachers

American Heart Association

American Lung Association

American Institute for Cancer Research

American Kidney Fund

American Medical Student Association

American Public Health Association

Anders & Associates

Anxiety and Depression Association of America

APLA Health

Asian & Pacific Islander American Health Forum

Association of Maternal & Child Health Programs

Association of Minority Health Professions Schools

Association of Public Health Laboratories

Association of Schools and Programs of Public Health

Association of State and Territorial Health Officials

Association of State Public Health Nutritionists

Autism Family Services of New Jersey

Autistic Self Advocacy Network

Behavioral Health Association of Providers

Berean Wellness & Community Support Center

Better Health Partnership

Bike Cleveland

Blue Shield of California

Bridges Into the Future

Brighter Beginnings

Brooklyn Perinatal Network Inc

Build Healthy Places Network

Buffalo Niagara Medical Campus

California Consortium of Addiction Programs and Professionals

California Pan-Ethnic Health Network

CARE ADVISORS

Caregivers of New Jersey

Center for Civil Justice

Center for Law and Social Policy (CLASP)

Ceres Community Project

ChangeLab Solutions

Chicago Youth Programs, Inc.

Childhood Obesity Prevention Coalition

Cleveland Public Library

Coalition for Disability Health Equity

Commission on the Public’s Health System

Common Threads

Community Based Organization Partners (CBOP)- Brooklyn Chapter

Community Catalyst

Community Cup Classic Foundation

Community Engagement Studio of Flint

Community Health Councils

Community Resilience Initiative

Congregation of Our Lady of the Good Shepherd, U.S. Provinces

Consortium to Lower Obesity in Chicago Children (CLOCC)

Cook County Department of Public Health

Counter Tools

Cuyahoga County Board of Health

Deborah’s Place

Disability Rights Education and Defense Fund (DREDF)

Epilepsy Alliance America

Epilepsy Information Service of Wake Forest

Epilepsy Services of NJ

Epilepsy Services of New Jersey

Equality California

Equality North Carolina

Families USA

Farmworker Justice

Flint Association of Black Social Workers

flint rising

Flint Women’s Study Community Action Network

Florida Institute for Health Innovation

George Washington University Center for Health Policy and Media Engagement

Global Alliance for Behavioral Health and Social Justice

Greater Chicago Food Depository

Greater Flint Health Coalition

GSK Consumer Healthcare

Health by Design

Health Leadership Legacy Project

Health Outreach Partners

Health Resources in Action

Health Care Improvement Foundation

Healthy Chesapeake

Healthy Kinder International

Hispanic Federation

Human Impact Partners

Human Rights Campaign

Illinois Association of Behavioral Health

Indiana Public Health Association

Impetus –  Let’s Get Started LLC

Japanese American Citizens League

Jump IN for Healthy Kids

Justice in Aging

Lakeshore Foundation

Lanai Community Health Center

Latino Coalition for a Health CA

Lutheran Services in America

Maine Public Health Association

March of Dimes

MaryCatherine Jones Consulting, LLC

Metropolitan Area Planning Council

Mid-City CAN (Community Advocacy Network)

Midwest Asian Health Association

MomsRising

MountainCare

Move United

NAACP

NASTAD

National Advocacy Center of the Sisters of the Good Shepherd

National Association for Rural Mental Health

National Association of Certified Professional Midwives

National Association of Chronic Disease Directors

National Association of Community Health Workers

National Association of Counties

National Association of County Behavioral Health & Development Disability Directors

National Association of County and City Health Officials

National Association of Social Workers

National Association of School Nurses

National Center for Transgender Equality

National Collaborative for Education to Address the Social Determinants of Health

National Council of Jewish Women

National Health Care for the Homeless Council

National Hispanic Medical Association

National Medical Association (NMA)

National Network of Public Health Institutes

National Nurse-Led Care Consortium

National Partnership for Women & Families

National Recreation and Park Association

National Register of Health Service Psychologists

National WIC Association

National Working Positive Coalition

Nemours Children’s Health System

NERDS RULE INC

Network for Environmental & Economic Responsibility

NETWORK Lobby for Catholic Social Justice

New Jersey Association of County and City Health Officials (NJACCHO)

New Jersey Public Health Association

NOELA Community Health Center

North Carolina Alliance for Health

North Central Public Health District

North Dakota Rural Health Association

Northern Michigan Community Health Innovation Region

NOVA ScriptsCentral

One Joplin

Oregon Vision Coalition

PacificSource

PFLAG National

Physicians for Social Responsibility, AZ Chapter

Physicians for Social Responsibility-Los Angeles

Piedmont Access To Health Services, Inc.

Presbyterian Healthcare Services

Prevent Blindness

Prevent Cancer Foundation

Prevention Institute

Project for Whole Health Learning in K-12

Population Health Alliance

Public Health Alliance of Southern California

Public Health Foundation

Public Health Institute

Redstone Center for Prevention and Wellness

Respiratory Health Association

RESULTS

RESULTS DC

Silver State Equality-Nevada

SLM Consulting, LLC

Society for Community Research & Action (SCRA)

Society for Maternal-Fetal Medicine

Society for Public Health Education

Southeast Asia Resource Action Center (SEARAC)

tahoe forest Hospital Care coordination

Tennessee Justice Center

The AIDS Institute

The Center for Community Resilience

The Gerontological Society of America

The Health Trust

The Fairfield Group

The Family Resource Network

The Los Angeles Trust for Children’s Health

The National REACH Coalition

The Participatory Budgeting Project

The Praxis Project

The Pride Center at Equality Park

The Wall Las Memorias Project

Training Resources Network, Inc.

Treatment Action Group

Trust for America’s Health

United Way of Treasure Valley

Valley AIDS Council

Vita Health and Wellness Partnership

Washington State Department of Health

Wayne State University Center for Health and Community Impact

WE in the World

Well Being Trust

West Valley Neighborhoods Coalition

Western Idaho Community Health Collaborative

Wholesome Wave

Wisconsin Division of Public Health

Wright County Public Health

COVID-19 School Closures Put 30 Million Children at Risk of Hunger

Many States with High COVID-19 Infection Rates Also Have Highest School-Meal Programs Participation Rates

(Washington, DC – July 16, 2020) – As COVID-19 infection rates continue to increase in states across the country, many of those jurisdictions are facing the complex dilemma of high infections rates complicating school re-openings and thereby limiting students’ access to school-based meal programs. Among the states with spiking infection rates and a high percentage of students participating in school-based meal programs are Arizona, Florida, Louisiana, Mississippi and South Carolina.

In March schools across the country began closing to stop the spread of the COVID-19 virus. In response, and recognizing the important source of nutrition school-based meals were to millions of American children, the U.S. Department of Agriculture’s Food and Nutrition Service began approving nationwide waivers to provide school systems flexibility in how meals were provided to students.  For example, these waivers enable schools to serve meals in non-congregate settings and outside of standard mealtimes, serve afterschool snacks and meals outside of structured environments, and waive requirements that students be present when meals are picked up.

Over half of all students in elementary and secondary schools across the country depend on the National School Lunch Program, and 12.5 million of those students also participate in the School Breakfast Program. As the COVID-19 pandemic closed schools this spring, these students were placed at risk of not having enough to eat.

A new policy brief, Beyond School Walls: How Federal, State and Local Entities are Adapting Policies to Ensure Student Access to Healthy Meals During the COVID-19 Pandemic, released today by Trust for America’s Health, reviews steps the federal and state governments have taken to ensure students’ access to healthy meals when schools are closed and what needs to be done to ensure continued meal access as all school systems face uncertainties about how to safely reopen for the 2020-2021 school year.

“School meal programs are the most important source of nutritious food for millions of American children. To the degree possible, school systems, with financial and regulatory relief from the federal government,  should continue to be innovative about how to deliver meals to students and should strive to meet or exceed federal nutrition standards for these meals despite product shortages created by the pandemic,” said Adam Lustig, Project Manager at Trust for America’s Health and the brief’s author.

Due to the economic impact the pandemic has had on millions of American families and the numerous uncertainties about how to safely re-open schools, the currently in place program waivers should be extended through the summer and may need to be kept in place during the 2020–2021 school year, the brief says.

Many of the states hardest hit by COVID also have highest school meal programs participation rates

States with some of the highest rates of COVID-19 infections also have high percentages of students who depend on school meals for much of their nutrition. States in which both COVID-19 infection rates are above national medians and school meals program enrollment is high include Arizona, Florida, Georgia, Louisiana, Mississippi, and South Carolina.

States in which more than half of students are enrolled in school-meals programs are:

Percentage of students enrolled in school meal programs

D.C.                                        76.4%

Mississippi                           75.0%

New Mexico                         71.4%

South Carolina                    67.0%

Arkansas                              63.6%

Louisiana                             63.0%

Oklahoma                            62.5%

Georgia                                62.0%

Nevada                                60.8%

Kentucky                             58.7%

California                            58.1%

Florida                                 58.1%

Arizona                                57.0%

Missouri                              52.7%

New York                            52.6%

Illinois                                 50.2%

Alabama                              51.6%

Oregon                                 50.5%

Hunger, poor nutrition and food insecurity can increase a child’s risk of developing a range of physical, mental, behavioral, emotional, and learning problems. Hungry children also get sick more often and are more likely to be hospitalized. Maintaining children’s access to nutritious meals despite school closures not only ensure they do not go hungry, but also promotes children’s health.

“State and federal guidelines waivers have allowed school systems to provide meals to students during the pandemic response, keeping them in place this summer and into the 2020-2021 school year will be the difference between kids who have enough to eat and kids who go hungry,” Lustig said.

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 Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter:@HealthyAmerica1

Newly Announced Order for Hospitals to Bypass CDC and Send Coronavirus Patient Information Directly to Washington Database Likely to Worsen Pandemic Response Rather than Improve It

(Washington, DC – July 15, 2020) — The U.S. Centers for Disease Control and Prevention (CDC), as the nation’s lead public health agency, is uniquely qualified to collect, analyze and disseminate information regarding infectious diseases. It has been serving in that role since its creation and, in close collaboration with U.S. healthcare facilities nationwide, has developed a health statistics infrastructure that is the gold standard worldwide.

The problems with regard to the COVID-19 data collection have largely been a result of the decentralized and fragmented nature of both healthcare and public health in the United States. Furthermore, hospital data is only one aspect of what we need to know to fight the pandemic. A key role of health departments at all levels of government is to aggregate data to produce a detailed picture of a health problem at the national, state and local levels. Inadequate funding for data infrastructure, at CDC and at the local, state, tribal and territorial levels, is also a contributing factor.  That underfunding should be corrected rather than bypassed.

In the midst of the worst public health crisis in a century, it is counter-productive to create a new mechanism which will be extremely complicated to build and implement.  Another area of concern is that the planning for this new approach did not substantively involve officials at the local, state, tribal and/or territorial levels.  This is a time to support the public health system not take actions which may undermine its authority and critical role.

Americans must have confidence in the integrity of health data and its insulation from even the suggestion of political interference.  Sending these sensitive data to a newly created entity overseen directly by the White House will not eliminate such concerns, it will increase them.

John Auerbach, President and CEO, Trust for America’s Health

Dr. Tom Frieden, President and CEO, Resolve to Save Lives

Lori T. Freeman, Chief Executive Officer, National Association of County and City Health Officials

Dr. Georges C. Benjamin, Executive Director, American Public Health Association

Thomas M. File, Jr., M.D., MSc, FIDSA; President, Infectious Disease Society of America

Chrissie Juliano, MPP, Executive Director, Big Cities Health Coalition

William H. Dietz, MD, PhD, Chair, Redstone Center for Prevention and Wellness, George Washington University

Nearly 350 Public Health Organizations Implore HHS Secretary Azar to Support CDC’s Critical Role in the COVID-19 Pandemic Response

Letter calls on Secretary Azar to “speak up” and be an advocate for CDC and public health

(Washington, DC – July 7, 2020) – The expertise of the U.S. Centers for Disease Control and Prevention (CDC) and all public health agencies is critical to protecting Americans’ health during the COVID-19 crisis, said a letter to Health and Human Services Secretary Alex Azar from 347 health and public health organizations released today.

The authoring organizations, including the American Public Health Association, Association of State and Territorial Health Officials, Big Cities Health Coalition, National Association of County and City Health Officials and Trust for America’s Health,  expressed “deep concern” about increasing reports of resistance to evidence-based public health messages and threats to public health leaders and agencies, and called on the Secretary to be an advocate for public health.

At this sentinel moment, during the worst public health emergency in over a century, all of the nation’s leaders must resist any efforts that would undermine the critical role of the CDC to respond to the pandemic and must be an advocate for increased investment in public health, said the letter signatories.

“Secretary Azar, we urge you to speak up and amplify the critical role of CDC and that of all public health agencies during this monumental crisis,” the letter said.

The public health community’s work to respond to the pandemic, via the federal government, including within the CDC, and at the state, local, territorial and tribal levels, has been tireless but has been hamstrung by shrunken programs and inadequate technology; the result of decades of underfunding.

Public health leaders are calling attention to the need for CDC to play a central role as the nation’s navigates the COVID-19 pandemic, including:

“CDC is the world’s premier public health institution and should be treated as such during this pandemic. It must be appropriately funded and allowed to speak based on the best available science and with an unfettered voice,” said John Auerbach, President and CEO of Trust for America’s Health.

“When you look at the global response to the COVID-19 pandemic, countries that listen to and prioritize public health fare best,” said Dr. Tom Frieden, former director of the CDC, President and CEO of Resolve to Save Lives, an initiative of Vital Strategies. “Trying to fight this pandemic without daily, public guidance from the CDC is like fighting with one hand tied behind your back.”

“There’s no federal agency better suited to lead the response to this unprecedented pandemic. CDC has experts who have studied and helped control coronaviruses and other viral threats for decades, and can help our country emerge from this crisis,” said Dr. Julie Gerberding, former director of the CDC, Co-Chair CSIS Commission on Strengthening America’s Health Security.

The COVID-19 crisis has also illuminated the ways in which racial inequities impact health. Higher rates of COVID-19 deaths within communities of color illustrate the importance of all of CDC’s work, including its focus on chronic disease prevention. It is not possible to effectively meet the needs of the American people if that scope is narrowed.

The letter furthermore calls on Secretary Azar to be an advocate for increased funding for CDC’s core budget. While emergency supplemental funding has been critical to begin to address the immediate COVID-19 response needs, robust, sustained, and predictable funding for its full public health mission is essential to sustain its public health activities and to prevent the next emergency.  Increasing the federal investment in public health will be particularly important, as state and local government budgets are likely to be severely hampered in the coming fiscal year due to tax revenue losses during the COVID-19 related economic shutdown.

Today’s laser focus should be on preventing further deaths and disruptions due to the pandemic and the CDC, as the world’s premier public health institution, should be at the helm of that effort, the letter said. Once the pandemic is controlled, the CDC, other federal agencies, state and local leaders and the public health community should collaboratively evaluate their performance and must acknowledge and address shortcomings of the response in order to be better prepared for the next public health emergency.

Signing the letter were:

1,000 Days

Academic Health Resource

Academy for Eating Disorders

Action on Smoking and Health

Advocates for Better Children’s Diets

AES Consulting

AFSCME

AIDS Alliance for Women, Infants, Children, Youth & Families

AIDS United

AlohaCare

Alzheimer’s and Dementia Alliance of WI

Alzheimer’s Association

Alzheimer’s Impact Movement (AIM)

Alzheimer’s of Central Alabama

Alzheimer’s Orange County

American Academy of Family Physicians

American Academy of Pediatrics

American Academy of Pediatrics, California

American Association for Clinical Chemistry

American Association for Dental Research

American Association for the Study of Liver Diseases

American Association of Colleges of Pharmacy

American Association on Health and Disability

American Cancer Society Cancer Action Network (ACS CAN)

American College Health Association

American College of Clinical Pharmacy

American College of Clinical Pharmacy (ACCP)

American College of Obstetricians and Gynecologists

American College of Physicians

American College of Preventive Medicine

American Council on Exercise

American Dental Association

American Foundation for Suicide Prevention

American Geriatrics Society

American Heart Association

American Kidney Fund

American Lung Association

American Medical Women’s Association

American Organization for Nursing Leadership

American Public Health Association

American School Health Association

American Sexual Health Association

American Society for Clinical Pathology

American Society for Microbiology

American Society of Hematology

American Society of Pediatric Nephrology

American Society of Tropical Medicine & Hygiene

American Thoracic Society

American University Department of Health Studies

APLA Health

Arizona Community Health Workers Association

Arizona Public Health Association

Art & Science of Health Promotion Institute

Asian Health Coalition

Asian Health Services

Association for Prevention Teaching and Research

Association for Professionals in Infection Control and Epidemiology

Association of American Cancer Institutes

Association of American Medical Colleges

Association of Asian Pacific Community Health Organizations (AAPCHO)

Association of Departments of Family Medicine

Association of Family Medicine Residency Directors

Association of Food and Drug Officials

Association of Immunization Managers

Association of Maternal & Child Health Programs

Association of Minority Health Professions Schools

Association of Ohio Health Commissioners

Association of Population Centers

Association of Public Health Laboratories

Association of Schools and Programs of Public Health

Association of SNAP Nutrition Education Administrators

Association of State and Territorial Health Officials

Association of State Public Health Nutritionists

Autistic Self Advocacy Network

Big Cities Health Coalition

Bipartisan Policy Center

Black AIDS Institute

Black Men’s Health Initiative

Boston Public Health Commission

Bristol Health Equity Zone

Bronx Health REACH

California Coalition for Children’s Safety and Health

California Immunization Coalition

California Pan-Ethnic Health Network

California School Nurses Organization

Cambridge Public Health Department

Campaign for Tobacco-Free Kids

Cancer Council of the Pacific Islands

Caring Ambassadors Program

Cascade AIDS Project

Center for Community Resilience

Center for Health and Learning

Center for Law and Social Policy (CLASP)

CenterLink: The Community of LGBT Centers

Ceres Community Project

ChangeLab Solutions

Child Welfare League of America

Children’s Environmental Health Network

Children’s Mental Health Network

Christian Council of Delmarva

City of Houston Health Department

City of Milwaukee of Health Department

Climate for Health, ecoAmerica

Coalition for a Tobacco Free Arkansas

Coalition of National Health Education Organizations

Cohen Veterans Bioscience

Colorado Association of Local Public Health Officials

Colorado Public Health Association

Colorado Public Health Nursing Leaders

Community Access National Network

Community Education Group

Connecticut Public Health Association

Cooley’s Anemia Foundation

Council of State and Territorial Epidemiologists

Counter Tools

County Health Executives Association of California

Cuyahoga County Board of Health

Cystic Fibrosis Foundation

Delaware Academy of Medicine

Delaware Academy of Medicine / Delaware Public Health Association

Delaware Academy of Medicine and the Delaware Public Health Association

East Shore District Health Dept.

Eating Disorders Coalition for Research, Policy & Action

Education Development Center

Element Health, Inc.

Endocrine Society

Enlace Chicago

Epilepsy Alliance America

Epilepsy Foundation

Equality California

Eta Sigma Gamma

Families USA

Family Voices

Fetal Alcohol Syndrome Information Network

FHI 360

FIRST Family Service Center

Fletcher Group, Inc.

Florida Institute for Health Innovation

Florida Public Health Association

Foundation for Healthy Generations

Galaxy Aviation Corp

Gateway Region YMCA

George Mason University Center for Climate Change Communication

GLMA: Health Professionals Advancing LGBTQ Equality

Global Alliance for Behavioral Health and Social Justice

Global Health Council

Global Health Technologies Coalition (GHTC)

Global Healthy Living Foundation

Global Liver Institute

Grand Traverse County Health Department

Green & Healthy Homes Initiative

Harm Reduction Michigan

Hawaii Public Health Association

Hawaii State Dept of Health, Office of Primary Care and Rural Health

Health by Design

Health Care Improvement Foundation

Health Enhancement Research Organization (HERO)

Health Resources in Action

Healthcare Foundation Northern Sonoma County

Healthcare Ready

HealthHIV

HealthPartners Institute

Healthy Schools Campaign

Healthy Weight Partnership Inc.

Heartland Alliance

Hep B United

Hepatitis B Foundation

HIV Medicine Association

Hogg Foundation for Mental Health

Hope and Help Center of Central Florida, Inc.

Idaho Public Health Association

Immunization Action Coalition

Immunize Nevada

Impetus – Let’s Get Started LLC

Indiana Public Health Association

Infectious Diseases Society of America

Institute for Family Health

Interdisciplinary Association for Population Health Science (IAPHS)

International Association of Emergency Managers

International Association of Fire Chiefs

IWC Resources, LP

Jeffrey Modell Foundation

Journal of Public Health Management and Practice

Jump IN for Healthy Kids

Kaplan Health Innovations

Kentucky Health Departments Association

KidsAndCars.org

L.A. Care Health Plan

Lakeshore Foundation

League of American Bicyclists

Linn County Public Health

Louisiana Community Health Worker Outreach Network

Louisiana Public Health Association

Lupus and Allied Diseases Association, Inc.

Macoupin County Public Health Department

Maine Public Health Association

March of Dimes

MaryCatherine Jones Consulting, LLC

Maryland Association of County Health Officers (MACHO)

Maryland Office of Minority Health

Massachusetts Public Health Association

Medicago

MEND Foundation

Metropolitan Group

Michigan Association for Local Public Health

MindWise Innovations

Minneapolis Health Department

Mississippi Public Health Institute

Montana Public Health Association

Monterey County Health Department

Morehouse School of Medicine

MountainCare

Multnomah County Health Department

NAACP

NAPHSIS

NASTAD

National Adult Day Services Association

National Association of Chronic Disease Directors

National Association of Community Health Workers

National Association of County and City Health Officials

National Association of Pediatric Nurse Practitioners

National Association of School Nurses

National Athletic Trainers’ Association

National Birth Equity Collaborative

National Center for Disaster Preparedness, Columbia University

National Center for Healthy Housing

National Coalition for LGBT Health

National Coalition for the Homeless

National Coalition of STD Directors

National Environmental Health Association (NEHA)

National Forum for Heart Disease & Stroke Prevention

National Hemophilia Foundation

National Kidney Foundation

National Lipid Association

National Medical Association (NMA)

National Network of Public Health Institutes

National Nurse-Led Care Consortium

National Prevention Science Coalition to Improve Lives

National REACH Coalition

National Safety Council

National Viral Hepatitis Roundtable

National WIC Association

Nebraska Association of Local Health Directors

Network for Environmental & Economic Responsibility of United Church of Christ

Nevada Public Health Organization

Nevada Rural Hospital Partners

New Jersey Association of County and City Health Officials

New Jersey Public Health Association

New York State Public Health Association

North American Primary Care Research Group

North Carolina Healthcare Foundation

Northwest Center for Public Health Practice

NYU Grossman School of Medicine

NYU School of Global Public Health

Ohio Public Health Association

Onyx Strategic Consulting LLC

Pacific Island Health Officers Association

Partnering for Community Transformation Inc

Partnership to Fight Chronic Disease

Partnership to Fight Infectious Disease

PATH

Patrick Risha CTE Awareness Foundation

Pawtucket Central Falls Health Equity Zone

Peggy Lillis Foundation

Pennsylvania Public Health Association

PFLAG National

Population Association of America

Population Health Alliance

Prevent Blindness

Prevent Child Abuse America

Prevention Institute

Preventive Cardiovascular Nurses Association

Public Health Advocates

Public Health Alliance of Southern California

Public Health Foundation

Public Health Institute

Public Health Law Center

Public Health Solutions

Puerto Rico Public Health Association

Pulmonary Hypertension Association

Redstone Global Center for Prevention and Wellness GWU

Research!America

Residential Eating Disorders Consortium

RESOLVE

Resolve to Save Lives, an initiative of Vital Strategies

Respiratory Health Association

Rhode Island Department of Health

RiverStone Health

Rural Health Association of Tennessee

Rural Health Association of Utah

Safe Routes Partnership

Safe States Alliance

Samueli Integrative Health Programs

SANIPLAN

School-Based Health Alliance

SF Hep B Free – Bay Area

SHAPE America – Society of Health and Physical Educators

Shoals Community Clinic

Silver State Equality-Nevada

Smoke Free St. Joe

Society for Advancement of Violence and Injury Research

Society for Maternal-Fetal Medicine

Society for Public Health Education

Society of State Leaders of Health and Physical Education

Society of Teachers of Family Medicine

Southern California Public Health Association

Southwick BOH

Stanislaus County Medical Society

Susan G. Komen

Tennessee Justice Center

Tennessee Public Health Association

Texas Public Health Association

The AIDS Institute

The Broussard Company

The Center for Community Resilience, George Washington University

The Consortium

The Foundation for Sustainable Communities

The George Washington University (GW) Cancer Center

The Gerontological Society of America

The Immunization Partnership

The John A. Hartford Foundation

The Kennedy Forum

The Los Angeles Trust for Children’s Health

The National Commission for Health Education Credentialing, Inc

The Nourished Principles, LLC

The Permanente Medical Group

Thomas Jefferson University

Training Resources Network, Inc.

Treatment Action Group

Trillium Health

Trust for America’s Health

Truth Initiative

U.S. Breastfeeding Committee

UCLA Fielding School of Public Health

UNC Gillings School of Global Public Health

United Ostomy Associations of America

United Way of Greenwood and Abbeville Counties

University of Washington Department of Global Health

University of Washington School of Nursing

University of Washington School of Public Health

University of Wisconsin Population Health Institute

USAgainstAlzheimer’s

Vaccinate Your Family

Washington State Association of Local Health Officials

Washington State Department of Health

Washington State Public Health Association

WelCore Health, LLC

West Valley Neighborhoods Coalition

Whitefoord

Winer Family Foundation

Wisconsin Public Health Association

Women Of A Certain Age

WomenHeart: The National Coalition for Women with Heart Disease

Women’s Resource Center

Woodhull Freedom Foundation

Xavier University for Population Health

YMCA of the USA

Zell Community Health Strategies