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In January 1995, seven men in the Wanamingo area of Goodhue County suddenly became critically ill. Three men developed necrotizing fasciitis, the so-called “flesh-eating” disease, and four died from toxic shock syndrome. The Minnesota Department of Health (MDH) kicked into high gear, mobilizing resources, rapidly identifying the source of the outbreak and implementing strategies to protect the community. This outbreak was just one of many public health crises that year, including major outbreaks of meningitis, Legionnaires’ disease, hemolytic uremic syndrome and one of the largest salmonella outbreaks in recorded history.
In my 19 years working in infectious diseases at MDH, I participated in hundreds of investigations like these. Since that time, a new generation of public servants has made breathtaking advances in controlling a staggering array of conditions such as drug overdoses, tick-borne diseases, influenza, viral respiratory disease, foodborne illnesses and invasive group A streptococcus, the bacteria responsible for the illnesses that devastated the town of Wanamingo in 1995. I suspect that most Minnesotans have no idea that their much-admired quality of life is due in no small part to wide-ranging activities at MDH, which quietly touch the lives of every citizen.
I was able to view MDH through a different lens when I took a job at the Centers for Disease Control and Prevention (CDC) in Atlanta. At the CDC, the MDH is viewed with an admiration that could almost be called reverence. MDH programs are held up as national models for other states to follow, and its experts are in high demand to sit on CDC advisory boards and workgroups. If you know where to look, you can find evidence of MDH in every state. MDH draws the best and brightest disease detectives in the U.S., even those who are not fans of Minnesota winters. When the CDC investigates multi-state outbreaks, we know that if there are cases in Minnesota, the outbreak is more likely to be solved because of its world-class epidemiologists and laboratorians. MDH’s reputation extends beyond the United States. Public health officials in other parts of the world may have no idea where Minnesota is, but they likely have heard of MDH. It is truly a national treasure.
It is for these reasons I find the recent massive cuts of federal funding to MDH particularly disturbing (“Health Department cuts hit hard in Minnesota,” April 2). The $220 million in cuts were made on March 25 with no notice. These funds were granted to MDH during the COVID-19 pandemic for much-needed upgrades to the infrastructure it uses to monitor COVID and other diseases. This infrastructure had become antiquated due to many years of flat-line funding by Congress without cost-of-living adjustments, which were further reduced by sky-high inflation, especially for high-tech scientific supplies and equipment. Grants to the states for COVID and related respiratory infections were most welcome, and hopes were high that costly inefficiencies would be fixed.
MDH was on track to meet its goals in the 14 remaining months in the grant period. Then the federal budget cleaver struck. It’s not a simple case of cutting emergency funds when the emergency is over. Withdrawing funds 14 months before they were scheduled to expire put MDH in a terrible position. It effectively ended efforts to modernize not only COVID tracking systems, but also tracking of all the other diseases that use the same systems. MDH had no opportunity to identify alternate sources of funding, to phase out activities and to reduce personnel through attrition. Instead, MDH had to immediately and brutally lay off approximately 170 employees who represented the next generation of experts, leaving MDH much worse off than before COVID.
I hope that the Minnesota Legislature can find somewhere in its budget a way to restore these job cuts, and that Minnesota’s U.S. senators and representatives work to stop and reverse this cutting madness. More than 90% of MDH’s budget for infectious diseases comes from the federal government. If the federal administration continues slashing funds to the states and the state doesn’t come to the rescue, could this be the beginning of the end for the Minnesota Miracle? Let’s hope not.
