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Illustration of a hundred dollar bill with Benjamin Franklin missing, in his stead is a sign that says, "Will return at" with a clock displayed without hands.  

Illustration: Aïda Amer/Axios

Most of the 4,000 specialized workers brought on by a national nonprofit to fortify public health departments during the pandemic are being let go, as time-limited funding needed to extend their contracts dries up.

Why it matters: The cuts are happening ahead of an expected winter surge in COVID, flu and RSV that could again tax health surveillance systems and a drained workforce of disease-trackers.

Details: COVID relief funding allowed the CDC Foundation — which supports but is independent of the federal agency — to supply epidemiologists and public health nurses to patch staffing shortages during the pandemic, KHN reported.

  • Roughly 80% now have to leave those jobs, with nearly all the contracts expected to expire by the end of the year, spokesperson Pierce Nelson told Axios.
  • The layoffs come ahead of a lame duck session of Congress during which the Biden administration will again try to lock in billions of additional dollars for COVID countermeasures. Republicans have rejected past requests.

What they’re saying: Without bipartisan consensus, which seems unlikely, “we won’t see it happen,” said Chris Jennings, president of Jennings Policy Strategies, during a Kaiser Family Foundation briefing on Tuesday.

  • “We may rue the day that we did not allocate resources for this, and I’m going to say that for the record now.”

The other side: Republicans have set their sights on ending remaining pandemic policies, adding that spending from past relief packages needs stricter oversight.

Catch up quick: The congressional gridlock has already threatened funding for testing, treatment and vaccines for the uninsured.

  • The end of government purchases means these preventive measures will shift to the private sector and likely result in high out-of-pocket costs.
  • Starting Nov. 30, an estimated $3 billion from the CDC over the next five years will be dedicated to recruiting and retaining the public health workforce. But that is one-time funding.
  • Even before COVID hit, researchers estimated an additional $4.5 billion per year would be needed to carry out basic disease surveillance and public health services.

By the numbers: Health departments nationwide will require an additional 80,000 full-time employees to meet the minimum needs of the public, according to Trust for America’s Health, which regularly releases reports on the impact of underfunding public health.

  • Nearly a third of the public health workforce is already considering leaving the profession within the next year, per a March report from the de Beaumont Foundation based on surveys of roughly 45,000 state and local health department employees.
  • Of those, almost 40% said the pandemic influenced their decision.
  • Nearly half of those who chose to leave said pay was a reason.

The bottom line: “A central message is that as a nation we have underinvested in public health — at all levels — for much too long,” Judy Monroe, physician and president of the CDC Foundation, said in a statement. “We must treat our public health departments as a key frontline of defense and fund them accordingly.”