Over the course of 2020, Shah and others will grapple with a new and bitter reality: due to the economic crisis triggered by the current pandemic, which has been exacerbated by a lack of investment in public health, public health authorities are likely to suffer further budget cuts in the coming years. "It's not like the environmental movement, or even the healthcare reform movement, where activists and lobbyists and advocates are struggling to change the status quo or secure their piece of the cake," Hearne said. "There are many isolated departments across the country that say," Oh, we're just going to keep doing God's work here, and if our budget is cut again, we'll somehow make it. "
To change this, the public health community, Shah, Hearne and others, must exercise more political will than in the past. In the years leading up to the onset of the coronavirus, the United States faced a variety of public health disasters: measles and syphilis resurgence; an increase in foodborne diseases; and an ongoing crisis with lead-contaminated water. None of these problems attracted a fraction of the attention that general health care provided. While the health care system was discussed tirelessly in 2019, since it is usually almost every parliamentary term, public health was hardly mentioned. "Nobody will vote for you or name a hospital wing for you because you prevented them from getting something they weren't prone to," says Frieden. "The people who cure diseases are glorified, not the people who prevent them."
end of June Abbott reversed the course and ordered the state bars to close and restaurants to reduce their capacity to 50 percent (they had been at 75 percent for several days). He also enacted an executive ordinance that required all Texans in counties with more than 20 active Covid-19 cases to wear a public mask. Scientists were concerned that it was too late, and in early July the numbers seemed to prove them right. On July 8, the state reached a record 9,952 new coronavirus cases reported in a single day. The state's positivity rate – the proportion of all tests performed that were positive – also rose from 7.9 percent three weeks ago to 15.6 percent.
The hospital beds filled, the hospital floors were reconfigured and the surge units were prepared. Doctors and nurses in Harris County and elsewhere have started a worrying and familiar census of respiratory equipment and personal protective equipment. And the same stories that happened in Wuhan and Lombardy as well as in Seattle and New York started again. And not just in Texas. In more than 35 countries, including some that had previously managed to control their outbreaks, daily case numbers, positivity rates, and new bleak records are rising – and then quickly surpassed. The people of Texas, Florida, California and New Jersey are preparing for a second wave of outbreaks in the fall, even if the first wave has not yet fully subsided. At the root of this disaster, doctors, scientists and health historians say, is our failure to fully involve public health in our understanding of what it means to be a functioning society. Until we do that, we will not be able to respond effectively to crises like these, let alone prevent them.
In Harris County, Hidalgo and her advisors have put in place a numeric and color-coded warning system so that residents know how bad the threat level is and how careful they have to be. "We needed something that was clear and concise because the back and forth with all the commands confused people and made them coordinate," she told me. "I chose colors and numbers because some people like one and some like the other, and I really just want it to stay that way." Harris County is currently at the highest threat level: one (or a red one), which means that the outbreak is serious and uncontrolled, and that people should only leave the house to meet essential needs. As with everything related to coronavirus, it will take a while for people to hear and notice the news.
In the meantime, political and cultural struggles to respond to the coronavirus crisis continued unabated. The Texas Education Agency announced it would hold back funding for schools that won't allow students to attend full-time in person in the fall. On July 8, the Mayor of Houston, Sylvester Turner, prevailed in the city's convention center to cancel the Republican state assembly scheduled for mid-July. The State party contested the move in court.