“[It’s as though] you’re standing by and you see someone drowning, and you have the ability to stop them from drowning, but you can’t.”
Thomas Frieden, Director of the CDC, May 2016 when discussing congressional appropriations for Zika prevention.
The full PDF document, with citations and graphics, can be downloaded here.
Understanding the Zika Threat
The Zika virus has emerged as one of the greatest public health threats facing the U.S., particularly in Southeastern states. While Zika is rarely life-threatening for adults, when it infects pregnant women, the results can be catastrophic. Nearly one third of children infected in-utero will be born with birth defects, particularly microcephaly, where children are born with unusually small heads. With Zika, microcephaly is the result of severely underdeveloped brain tissue, posing a very real risk of permanent catastrophic brain damage to any child born to a mother infected with the virus.
On February 1st, the World Health Organization (WHO) declared the Zika Virus an international emergency. That should have been a call to action. Recent studies indicate 29% of babies born to women infected with the Zika virus suffer severe birth defects. NASA, as part of a national threat assessment for the spreading of the Zika virus, has evaluated the majority of South Carolina as at least a moderate threat for an outbreak. Specifically, Charleston has a severe risk, with Columbia and the Upstate identified as having a moderate risk.
Experts agree, the Zika virus is on track to put ten of thousands of South Carolinian mothers and their unborn children at risk. America’s scientific community leads the world; we are able to deal with these kinds of public health crises, but congressional inaction continues to undermine our citizens’ safety.
Despite the urgency of this threat, with more than 10,000 reported cases in the United States, Congress has failed the American people and South Carolinians through their repeated failure to act.
How We Got Here
In February, the Obama administration told Congress that $1.9 billion was needed to fight the Zika epidemic on a national scale. Months passed, and the Senate passed a bill allocating $1.1 billion dollars to the fight. The House responded with a funding bill of $616 million. The money congressional Republicans opted to give was wholly inadequate, but the caucus appeared determined to ensure that even a partial-fix was doomed to fail. Republicans attached legislative riders that made it impossible for any moderate representative to support the bill—amendments that would exempt the chemical companies from the Clean Water act, cancel contraceptive funding, and protect the Confederate flag. Adding insult to injury, the House GOP demanded that any funds allocated to Zika be matched with cuts to health research already in progress. Rather than leave the country defenseless in the face of an epidemic, President Obama has used his executive powers to repurpose funds intended to combat ebola and general health research. Secretary Sylvia Burwell has pointed out that at least $35 million of that money will come directly from vaccine research. Let’s be clear: This means that after successfully shortchanging Zika funding and causing America to fail to prevent the current health crisis, Republicans have made it much more likely that we will fail to prevent the next disease. The Ebola funding funneled into ZIka will run out on Sept 30th. The National Institutes of Health said in March that it could have a vaccine candidate in human trials by the end of this summer. At the moment, more than 10 thousand Americans have contracted the virus, with mosquito season reaching it’s peak. This outbreak was preventable, but the House GOP leadership chose to let happen anyway.
How We Fix It
It is important to stress that South Carolina is ready for this type of public health threat, with mechanisms in place at both the state and federal levels to effectively combat a virus such as Zika. SC DHEC has been extremely organized in their response, working to connect local authorities with the tools they need to protect their citizens. The CDC also has significant organizational resources ready for local health officials to deploy, beginning with simple preparedness plans that would allow localities to aggressively participate in mosquito abatement, transmission prevention, and birth control measures limiting both the spread and the potential impact of the virus.
However, with congressional appropriations in limbo, DHEC has only been able to mobilize limited funds throughout the state. The total emergency funding for the state has totaled less than $15 million; for reference, it would take roughly $550 thousand to fully fund mosquito control spraying in Horry county alone, and these methods only reduce mosquito prevalence by roughly 50%. Throughout much of South Carolina, we have failed to even execute simple standing water abatement.
The most troubling part of the current response is the fundamental lack of preparedness at the county level. Demonstrated in the graph below, 30 counties within SC lack mosquito control programs of any size or scale. In those 30 counties there is no vector control plan, no accounting of capacity for laboratory testing of specimens for the Zika virus, no blood safety protections, no outreach educational strategy to pregnant women and other vulnerable sections of the population, no basic preparedness plan, and no senior official to coordinate a response; these are all things the CDC recommends for state and local governments as part of Phase 0 of their Zika Action Plans (ZAP), which does not even cover basic precautions to be taken during a normal mosquito season.
Even if we escape the 2016 mosquito season largely unscathed, it is unlikely we would be so lucky in 2017. Our public health agencies must be able to initiate prompt and aggressive interventions when necessary. With current funding levels, our ability to mount even reactionary interventions is in question.
By helping to block the Zika appropriations bills in Congress, through outright “No” votes and poison pill riders on needed legislation, the Republicans of the SC congressional delegation have ensured that South Carolina will face a public health crisis largely of their making, when a Zika outbreak erupts throughout the South in earnest.
Federal agencies like the CDC are designed to provide this sort of surge funding in the face of public health crises. The $1.9 billion total proposed by the Obama administration is aimed largely at mobilizing the ground effort to prevent the spread of the vector mosquito and therefore slow the travel of the virus itself. This is crucial, for the obvious reason that it curtails the number of people infected, but it also buys time for NIH to develop a vaccine to the infection. The Zika virus belongs to a family of pathogens with well-defined vaccines, prompting the NIH to be confident in the development of a Zika-specific vaccine within 3 years if given the proper funding. In March, they even predicted they could be in human trials with a vaccine candidate by the end of the summer months. The efforts of local mosquito abatement and disaster response programs merely have to hold the line over the next several years, limiting infections until the vaccine is ready for widespread distribution.
Now is the Time to Act
Today, Chris Fedalei is calling upon Congress to take the responsible steps necessary to avert this highly-preventable health crisis. Particularly for members of the South Carolinian congressional delegation, failure to ignore the warnings of the WHO and CDC represents a total failure to put their constituents’ best interests first. The Fedalei for Congress campaign is proposing that Congress pass Zika relief aid without delay, including:
$828 million for the CDC to support prevention and emergency response.
Support Zika readiness and response capacity, specifically the implementation of Zika Action Plans (ZAPs) in states, counties and other localities.
Enhance mosquito control programs in all potential impact states, including the 30 South Carolina counties without them.
Fund the CDC’s Emergency Response Teams (CERTs)
Improve laboratory capacity for Zika testing and diagnostics
Enhance capacity for virus surveillance
$200 million for vaccine research to the NIH.
Would cover research into the rapid development and commercialization of vaccine candidates.
$250 million of expanded Medicare aid for Puerto Rico under the FMAP program.
Additional assistance for one year to provide health services to pregnant women at risk of infection.
More than 80% of American Zika infections currently are in Puerto Rico and the disease is actively being transmitted there.
Viruses that feature mosquitos as their main vectors are dangerous, but they are not new or unpredictable. The global public health community is very effective at combating the spread of these viruses. However, due to the obstruction of Republicans in Congress, the people of the United States and of South Carolina have become and will continue to be victims of a preventable public health crisis. Congress should have jumped at the chance to send Zika aid to the states and support vaccine research in February. It’s way past time, but not too late, for Congress to adequately fund Zika prevention and protect our South Carolina families. We need that help today.