ST. LOUIS-Missouri have spent many hours finding treatment in rural villages - at least those with cars and time. Tens of thousands of volumes await distribution, gradually being phased out of the government's long-term care program. The waiting lists are hundreds of thousands of people tall. Black citizens are left behind.
Missouri vaccination rolls put you among the lowest regions in the country, with 23.7% of people being vaccinated at least one dose since Thursday, compared to the national average of 26.3%. If Missouri were the national average, that would be equivalent to the additional 162,000 vaccinated people, or almost the entire Spanish city population.
Part of the problem, health experts say, is that the state has skipped 115 local health departments in its initial immunization programs. Instead, government officials outsourced work in hospitals, counselors and government programs, mental hospitals and mass vaccinations had staff and resources to deliver the highest standards.
Meanwhile, local health departments and well-trained health facilities, which often reach high-risk populations unrelated to traditional health systems, each were initially left to allocate about 8% of state immunization coverage. That allocation has risen to 15%, but it was not enough to fill the remaining vacancies.
"You get what we pay for," said Spring Schmidt, a former co-manager of the St. Louis Department of Health. Louis County, noting that the public health departments in the state had been funded for decades. "This is infrastructure such as government services or other services that our citizens expect to be provided and often only see when they fall."
The local health departments knew what needed to be done. "We've got this in mind, we have plans on the dusty shelves for this," Schmidt said.
But that is the backbone of the long-running health department: Although all programs have been honored with flu and H1N1 vaccination campaigns, health departments will still need staff and institutions to contribute something to this scale, said Dr. Alex Garza, head of the Louis Metropolitan Pandemic Task Force, a major hospital. place. And national and regional governments do not provide the funding needed to do this work.
A 2020 study by Kaiser Health News and AP found that public health workers in Missouri at the state level had dropped by 8% from 2010 to 2019, losing 106 full-time employees. Public health spending per Missourian person was $ 50 per year - one of the ten poorest places in the nation.
At the time of the epidemic, local health departments had only 408 staff trained to be vaccinated, according to a report released Friday by #HealthierMO, a group that promotes better public health in government. That means that if those workers had provided the vaccine, each would have had to vaccinate about 15,000 people - in most cases, with two firearms. In the most efficient case, when each person takes five minutes to vaccinate, that can take more than seven months by shooting just one person.
At the same time, public health officials have been accused of setting standards for epidemic protection. State legislatures are debating the limits on public health power and local officials have withheld funding for their health departments, limiting their ability to work on the issue.