The Case for a COVID-19 Commission

While COVID-19 will be with us for a long time, recovery is underway, and it’s time to learn from the pandemic to improve our public health system and prepare for future emergencies.

In late February of last year, heading to DC for our National Association of Counties Legislative conference, we realized there was no resolution supporting action on COVID-19. We pulled together an emergency resolution that enabled us to advocate to our federal partners.

Everyone in our Health Policy Committee agreed, but there was plenty of discussion about the threat. That’s when a news alert popped up on my phone. Dozens of residents and staff at Life Care Center back home in Kirkland were suspected or confirmed for COVID-19. Our committee is a mixture of elected officials and staff. When I announced the outbreak, I watched the blood run out of the faces of the public health officials in the room. That’s the moment I first realized what was about to happen.

This year at our annual conference, we’re in recovery mode. It’s the first time we’ve been in a large group in over a year for most of us. County officials have worked hard to slow the spread and contain the economic damage.

The scale of the disaster and the number of policy questions it raised told me we need a comprehensive and coordinated analysis of our public health system and response to the pandemic. That’s why I introduced the resolution below.

RESOLUTION SUPPORTING A JOINT STATE, LOCAL, TRIBAL, TERRITORIAL, AND FEDERAL COVID-19 PANDEMIC AFTER-ACTION REPORT

Issue: The emergency caused by the COVID-19 pandemic demands a comprehensive analysis of our public health system and response to the crisis to recommend policy action.

Proposed Policy: NACo urges Congress and the President to charter a commission to prepare a complete account of the public health response to the COVID-19 pandemic, including but not limited to:

1. The condition of state, local, tribal, territorial, and federal public health agencies prior to the emergency.

2. A comprehensive and coordinated analysis on preparedness and response to the emergency by each level of the system.

3. Recommendations to legislative and executive policymakers and staff to improve response to future crises and effectiveness of the system overall.

Public health in the United States is state-planned, locally implemented, and federally supported. Rather than one public health system, we have thousands. The 10th Amendment reserves police powers like public health for the states, but the federal government plays a crucial role in providing research, coordination, guidance, and financial support.

Unfortunately, public health has also been a victim of its success. After decades of steady improvements in infectious diseases, environmental health, and social determinants, funding has dwindled over the last few decades. We’ve warned our state and federal partners for years that a serious public health emergency would strain the system.

Public health is about prevention. If you successfully stop the disaster from happening, nobody knows the threat existed. Counterfactuals are hard. We saw this throughout the pandemic. A sign of this problem is that few know the CDC’s name is the Centers for Disease Control and Prevention.

While most natural disasters would typically require coordination of multiple local agencies, states, and the federal government, COVID-19 touched everyone, everywhere. At the time of this writing, more than 600,000 Americans have lost their lives, and millions more suffered severe injuries. Those numbers will continue to rise. Economists expect the financial toll to exceed $16 trillion in the US alone. Given the terrible human and economic consequences, we must learn from the crisis and take time to improve.

To advocate for robust funding, improved coordination, and better response to future public health emergencies, we need accurate analysis backed by a trusted bipartisan commission.

After discussions in our National Association of Counties Health Policy Committee and Board of Directors, the General Assembly made up of nearly 2500 counties approved the resolution unanimously.