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Health officials in many states now have less power to fight disease outbreaks than they did during the COVID-19 pandemic. NPR health correspondent Rob Stein reports on the changes.
ROB STEIN, BYLINE: All the COVID lockdowns, school closures, mass mandates and vaccine requirements left many Americans furious.
LAWRENCE GOSTIN: There's been such an enormous backlash from the COVID-19 pandemic right across America, particularly in red states.
STEIN: Lawrence Gostin studies public health law at Georgetown University.
GOSTIN: It's become, you know, part of our national lore of overreaching government.
STEIN: The Trump administration has reined in the Centers for Disease Control and Prevention in part because of that backlash. But most public health powers are local. And since the pandemic, more than half of the states made changes to their authorities to respond to public health emergencies, including many that watered down their powers.
GOSTIN: Taken all together, we're in a much weaker position post-COVID in handling a health emergency.
STEIN: At least 15 new laws in states such as Alabama, Virginia and Louisiana imposed restrictions on declaring official public health emergencies - declarations necessary to do things like muster disease fighters and clear away red tape. Dr. Georges Benjamin heads the American Public Health Association.
GEORGES BENJAMIN: They have said, well, if you want to do this, you now need to come to the legislature to get it, or the legislature has the authority now to reverse it. Moving these authorities from a government official who has a legal responsibility for the health and well-being of the community to a committee to make a decision, I'm worried that many of the public health officials now have their hands tied.
STEIN: Some states, including Kansas and Utah, have hamstrung key countermeasures, such as the authority to quarantine people who might have been infected with a dangerous pathogen or isolate people who are already sick. Some, like Florida, Texas and Oklahoma, pulled back authorities to impose mass mandates. Others have limited vaccination requirements or restrictions on gatherings.
BENJAMIN: If you think about what that really means, it's like telling the police department that you can't arrest people, that you can't protect people when you know there's extreme weather happening.
STEIN: At the same time, some state and local health departments have lost staff and funding, and some state and local health officials are more skittish about pulling the levers they have left. Some were harassed or threatened over COVID, and some who objected to the pandemic response are now in charge. Here's Lawrence Gostin again from Georgetown.
GOSTIN: There are a lot of public health commissioners now who are not traditional public health people and who are much more MAHA or MAGA. And so I think all in all, you've got weakened authority. You've got weakened political backing. And you don't have traditional public health scientists at the head-of-state public health agencies.
STEIN: Some people support some changes. James Hodge is a public health law professor at Arizona State University.
JAMES HODGE: Anytime you're building a level of accountability into how we utilize some of the most restrictive public health measures in the United States - like social distancing measures, closures, quarantine, isolation - OK, fine. You want to impose some new accountability? I'm fine with that.
STEIN: With a few hantavirus cases tied to the Dutch cruise ship still popping up, the Ebola crisis growing and millions of international visitors arriving for the World Cup, the next domestic outbreak may be just one plane ride away or already just around the corner.
Rob Stein, NPR News.
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