Op-Ed: While U.S. Moves on from COVID-19, Local Leaders Left to Pick Up the Slack

The following op-ed was written by Katie Bollbach, executive director of Partners In Health United States. 

Despite a recent rise in COVID-19 cases, many communities across the country are grasping for a return to normal: vaccine mandates are being rolled back, masks are increasingly optional, and people are returning to their everyday social activities.

But local leaders and community-based organizations in Immokalee know the country––and their southwestern Florida town––are far from returning to normal. So, they continue scheduling testing fairs, prepping food packages for people in isolation, and conducting vaccine outreach and education. For them, adapting to shifting federal guidance is nothing new. And with COVID-19 likely to continue disrupting the lives of their community, local leaders are prepared to respond to COVID-19 long after the news cycle moves on.

Even as national cases increase and more subvariants emerge, federal funding is drying up. Medical care reimbursement funds for many millions of uninsured COVID-19 patients have already run out of cash. Claims for testing and treatment are being denied, leaving states scrambling to figure out their own short-term fixes. And lawmakers have not yet agreed to extend even a portion of the $22 billion in emergency funding requested by President Joseph Biden. Failure to pass this means fewer tests available to people living in the United States, less surveillance for future variants, and a risk of running out of vaccines and affordable treatments.

So, if nearly a million deaths since the start of the pandemic isn’t enough to generate political resolve and the federal dollars never appear, where does that leave us?

In the absence of a cohesive and comprehensive federal plan, local health departments, community-based organizations, and others across the country are stepping up to assume the responsibility of accompanying their communities through this new phase, just as they have throughout the entire pandemic.

At Partners In Health, we’ve seen the consequences of congressional inaction play out among individuals and families as we’ve worked with public health departments and local leaders to successfully navigate the impacts of COVID-19 on those most affected by this health crisis.

When elites – the predominantly white cadre of Americans with political and financial power – feel safe, the impetus and political will for protective measures evaporates, further exacerbating health inequities. But local leaders continue to forge ahead, adapting COVID-19 guidance, delivering resources, and providing critical support to ensure communities they deem most in need and at risk remain protected—and prepared.

In Immokalee, PIH and our partners have bridged gaps in response efforts by serving as community-based public health navigators to meet the needs of Immokalee’s residents. Through a group of health promotores, we worked alongside our partners at the Collier County Department of Health, the Coalition of Immokalee Workers, Healthcare Network, and Misión Peniel to provide individualized help to members of the community, from securing transportation to testing and vaccination sites, to delivering food and providing rental assistance, labor protections, and cash to help cover costs during quarantine and isolation.

Through this partnership, over $950,000 in direct transfers have been provided to over 800 households. This crucial support protected the livelihoods and well-being of local farm and packinghouse workers.

Departments of health in other parts of the country are applying a similar approach. Despite an uptick in cases across the state, the rate of COVID-19 infections in the port city of New Bedford, Mass., continues to decline. When Omicron threatened to reverse the progress New Bedford had made in controlling COVID-19, the local health department pivoted existing efforts, devising a strategy that doubled-down on access to testing and vaccination.

In December, even before the White House began distributing free, at-home tests to households across the country, the health department in New Bedford worked with community organizations to distribute 38,000 testing kits to local populations that were the least vaccinated and therefore most at risk for illness, as well as those that have seen disproportionately high case rates.

Across the country, local health departments and community leaders have developed and modified strategies, and built the human resources and infrastructure required to execute them. Federal funding must come through, full stop. If it doesn’t, we could be sending ourselves back to the darkest days of the pandemic, competing for limited tools to combat the spread of a debilitating disease. Such a scenario all but guarantees ongoing inequity in COVID-19 impact falling along familiar fault lines of historical and structural injustice.

In the meantime, while organizing for change, we can lift up and learn from the community preparedness and ingenuity exhibited in places like Immokalee and New Bedford as local response strategies that can both succeed on their own and inform the development of future interventions when federal funding does come through.