Stimulus Checks Cost $290 Billion. A Fraction of That Could Have Changed Response to Coronavirus Outbreak, Experts Say

Cases of a new coronavirus in the United States couldn't have been prevented, but experts say investing even $4.5 billion annually, 0.2 percent of the cost of the total stimulus package, would have put America in a far better position to respond to the outbreak.

"That's where we're paying a very high price in terms of dollars and lives," Jeffrey Levi, a professor of health policy and management at George Washington University, told Newsweek.

When a public health crisis is ongoing, experts told Newsweek funding pours in, but once the outbreak subsides, the investment dissipates. The out-of-sight, out-of-mind funding method has long been a point of frustration for experts and now that a pandemic is taking a massive toll on the economy, they're considering what might have been.

In an effort to boost the economy and help those who are carrying the financial burden of the outbreak, Congress passed a $2.2 trillion stimulus package. Part of that relief effort is stimulus checks, which will be awarded on an income-based scale starting at $1,200.

Stimulus checks will cost the government an estimated $290 billion.

An annual investment of $4.5 billion would have filled gaps in public health foundational capabilities at the state and local level, according to a study published in the American Journal of Public Health in September. Levi, who co-authored the study, said the shortfall impacted America's capacity to respond to the outbreak.

"Had we had that a greater capacity to respond, the economic impact would have been drastically lower," Levi said. There's a lot we could have done for way less."

It's hard to nail down a specific dollar amount that could have been saved had investments been made and no measure of preparedness could have fully prevented the outbreak. But, Levi said building up state and local health departments, even at a minimal level, would have put America "in a much better starting position to do traditional public health interventions."

coronavirus outbreak stimulus investment public health
Doctors and nurses confer in the intensive care unit of MedStar St. Mary's Hospital on Wednesday in Leonardtown, Maryland. Experts told Newsweek that if America invested in public health in between outbreaks, the country would have been better positioned to respond to the outbreak. Win McNamee/Getty

We could have had a better and larger trained workforce, a modernized, data-driven surveillance system, and more enhanced laboratories at state and local levels, according to Levi. This could have given us better knowledge of what was happening and more disease intervention specialists to do contact tracing, potentially interrupting transmissions.

Academy Health, a leading national organization serving the fields of health services and policy research, wrote in a 2018 report that evidence came to the nearly unanimous conclusion that higher total public health spending was tied to better health outcomes. A 2012 Public Health report that studied health department expenditures from 1993 to 2005 found a $10 per capita increase in local public health expenditures resulted in a 7.4 percent decrease in infectious disease morbidity.

A 2017 systemic review of international studies published in the Journal of Epidemiology and Community Health found a median return on investment of $14.30 per $1 that was invested in individual public health interventions, services or policies.

America has had 404,352 cases of a new coronavirus, making it the largest outbreak worldwide with an epicenter in New York City, the most densely populated city in the country. In California, where the first case of community transmission was reported, researchers found that every $1 invested in county departments of public health resulted in a return on investment ranged from $67 to $88.

"Had we invested from local all the way up to state and federal level, we wouldn't be here now," Ruth McDermott-Levy, the director for the Center for Global and Public Health at Villanova University, told Newsweek. "I strongly believe we would not be in this situation now. This is kind of the worst nightmare scenario that we've been talking about for many years."

The new coronavirus is highly transmissible and officials sounded the alarm about the U.S. being ill-equipped to handle the need for personal protective equipment. Experts have been calling for officials to take action to boost the National Strategic Stockpile for years, but significant steps haven't been taken to replenish its supplies.

Supplies from the stockpile, including N95 respirators, have been sent to states to aid their coronavirus response, but officials in New York, Oregon and Pennsylvania claimed the items they initially received were expired. McDermott-Levy and Levi said investments could have been made to keep the stockpile up to par, including monitoring the items that are in it, before the outbreak began.

"Would it have been in better shape if it was properly maintained? Absolutely," Levi said. "Would we have replaced expired equipment, absolutely?"

The lack of funding in between public health crises isn't a new trend and falling into complacency has enabled budget cuts to continue. Decades ago, clean water and antibiotics gave people a false sense of security and in 1967, Surgeon General William Stewart declared, "Because infectious diseases have been largely controlled in the United States, we can now close the book on infectious diseases."

That statement proved to be untrue a little more than a decade later when HIV ran rampant in the United States. More than 774,460 people in America contracted the virus between 1981 and 2001 and 450,000 died, according to the National Institutes of Health. This caused public health to get "a little more attention," according to McDermott-Levy, but it was short-lived.

The HIV outbreak and three subsequent pandemics haven't completely changed how people look at public health and it's still only seriously funded when there's a problem. But, experts are holding out hope that this pandemic will be the wake-up call America needs.

"I am hopeful—I can't say confident—that in a post COVID-19 world they won't forget this and health will be included in every policy and every discussion, although, who knows,"McDermott-Levy said.