As Congress stalls on releasing emergency funds to fight the Zika virus and new cases of it crop up around the United States almost daily, public health officials are getting more than a little nervous.
“I’m worried," said Georges Benjamin, executive director of the American Public Health Association. “I think there’s going to be more cases than we think. And since Congress hasn’t acted on funding, clearly there’s a lack of understanding of how fragile our public health system can be."
The Obama administration allocated nearly $2 billion in emergency spending for the Zika virus in February. But Congress has yet to approve the funds, arguing that money for other diseases, such as Ebola, should take priority instead.
That's left local governments with fewer options to respond to the crisis. For his part, Benjamin suggests governments do some old-fashioned housekeeping.
“Public health labs need to make sure they have the appropriate diagnostics in place," he said. "This is the time to make sure all logistical systems are in order. Additionally, there needs to be clear communication lines with the health-care delivery system. These are the people who will see the virus on the front lines, and they need to know where to refer people.”
There are two breeds of mosquitoes that carry the Zika virus. According to the Centers for Disease Control and Prevention (CDC), they lay eggs in and around standing water -- think flower pots, tarps and puddles. They are aggressive daytime biters and live close to homes, making it tougher for mosquito control departments to target them.
In Houston, where public officials are still cleaning up from the recent flooding, Zika prevention has become an all-hands-on-deck operation. The health department is coordinating efforts with the fire, housing and solid waste departments to educate the public. They’ve also started clearing out empty lots that often contain heavy trash, such as old tires -- the perfect breeding ground for the Zika-carrying mosquitoes.
“We’re still in pre-season mode, so we’re focused on planning and education efforts right now. This is going to be a marathon, not a sprint, ” said David Persse, medical director for the city of Houston.
If Congress issues emergency funding for local governments, Persse says he'll use the money for community outreach efforts like dispersing DEET in low-income neighborhoods and launching a door repair program.
Like Houston, Charleston County, S.C., is no stranger to the impact mosquitoes can have during the summer months. The county already boasts a well-staffed and active mosquito control department. Every year in late winter, the mosquito control team goes door-to-door in about a dozen neighborhoods to educate residents about protecting themselves and their properties. They give out pamphlets on how to curb breeding and, with permission, survey the property and offer personalized advice. Those efforts will be ramped up as the weather warms, with a fleet of interns going out and knocking on even more doors.
There are a few things every household can do, though, including keeping water from building up in places like tarps, making sure screendoors don't have holes and not leaving out heavy trash where water can collect.
The American Public Health Association's Benjamin wants local governments to stay vigilant but flexible as new information from the CDC and World Health Organization flows in.
“There’s an art form to properly informing people without scaring them,” he said. “Local governments need to know when to say ‘I don’t know' and also be willing to contradict yourself when new information comes in. We’re going to learn a lot over the summer."