Vacation is over, Congress. Fund the fight against Zika

Op-Ed by Katy Caldwell originally published in Stat on September 6, 2016

Unlike the suddenness of terrorism and natural disasters, public health emergencies tend to be slow burns. But at the end of the day, each dramatically affects our safety and security. With Congress back in session, it must get serious about providing funding to fight the Zika epidemic that is hitting Texas, Florida, and other states.

As one of the nation’s largest community health centers, Legacy Community Health in Houston sees thousands of low-income patients every week. That includes 300 pregnant women a day, and I can tell you that our OB/GYN doctorsare reporting that these women are anxious about Zika. Five of our pregnant moms have tested positive for the virus (all travel-related so far). In addition to issuing travel advisories regularly since January urging our pregnant patients not to visit areas where the virus is exploding, Legacy has handed out 2,000 free Zika prevention packs to pregnant moms, with another large shipment on the way.

We also announced last week a change in our screening protocols. In addition to checking pregnant women for the Zika virus, we are now screening men. That’s because the virus can be transmitted sexually through infected semen. Men at risk for transmission, meaning they’ve traveled to a region where Zika is flourishing or have symptoms of infection with the virus, ideally will abstain from sex with a pregnant partner or use condoms.

But a single health center like ours, even an entire city like Houston known for its world-class medicine, can’t manage Zika alone. Nor can the state of Texas, which has admirably stepped up to allow Medicaid to pay for insect repellant for low-income pregnant moms. Governor Greg Abbott has allocated state and federal funds to help prevention efforts. All of the public health players are doing their part.

Except the United States Congress.

After six months of deliberation on the Obama administration’s almost $2 billion emergency funding request for prevention and vaccines, and thousands of Zika-infected Americans later, both parties in Congress have chosen inaction. It’s likely that some members don’t believe there’s an emergency; others may be dragging their feet because of partisan politics. But the virus-carrying mosquitos that are biting pregnant women don’t care that it’s an election year.

The Obama administration has done what Republican leaders said they wanted it to do: go find the money elsewhere. The administration redirected more than $500 million from the Ebola fund to Zika prevention. Months later it infused another $80 million for vaccine research. Now, the ball is in Congress’s court. It will be far more expensive — at least $600,000 per Zika-infected family is one conservative estimate — not to mention morally reprehensible, if the federal government continues its political shenanigans.

There is ample evidence for Washington lawmakers to find a sense of urgency. There are now roughly 2,200 Zika cases in the continental US and Hawaii, up from about 120 in February. (More than 100 of these are in Texas.) The first infant death in the continental US from Zika-related complications was recently here in Harris County. The first cluster (a growing one) of locally transmitted casesappeared in South Florida, spurring the Centers for Disease Control and Prevention to urge pregnant women to postpone travel to Miami-Dade County. We saw the first infection across state lines, with a man from El Paso being infected in Miami and bringing the virus back to Texas.

A little here, a little there. That’s how infectious disease outbreaks begin. The FDA is now calling for Zika testing on all donated blood nationwide.

While panic is never productive and prevention is still the name of the game, health experts and political leaders agree that now, not later, is the time to deal with Zika. Dr. Thomas Frieden, the head of the CDC, called Zika “an unprecedented emergency.” US Senator John Cornyn, a Republican from Texas, declared Zika a “massive health threat heading our way,” one the country needs to address “now, not later.” This summer both presidential candidates called on Congress to come back early from recess to vote on Zika funding. That was likely never going to happen, but the message was clear: The clock is ticking.

The American public feels the same way. In a new Kaiser Family Foundation poll, three-quarters of respondents said that congressional funding for Zika management is “important” or a “top priority.”

A vote for Zika funding is a vote to help all women, their babies, and their families. It could also convey some badly needed reassurance to the public that Washington actually does work. At least some of the time.