As mentioned in part 1 of this two part series Trump tried to cut funding to the CDC and other public health programs. When Trump couldn't successfully get all the cuts he desired he used Bolton to go in and undermine the programs.
It's thus true that the Trump administration axed the executive branch team responsible for coordinating a response to a pandemic and did not replace it, eliminating Ziemer's position and reassigning others, although Bolton was the executive at the top of the National Security Council chain of command at the time.
Bolton may have been the one at the top of the National Security Council chain of command but it was Trump who initially tried to cut the funds. Short of being successful in his endeavor Trump got Bolton to reorganize by disbanding teams and firing individuals. This is what they call a work around congress because as we learned during the Trump administration over funding for his wall that without a specific compelling enough reason funds that congress appropriates can't just be taken and allocated somewhere else, at least not without the express approval of congressional members. This is an important point to make as this is how we know that not only the president(s) but members of congress are explicit in the approval of gain of function research that took place. Using the Zika virus as an example I'll show you how it works.
The National Institutes of Health and the Centers for Disease Control and Prevention said they had run out of fresh money to fight Zika. The administration had already pulled $589 million from other programs, including $500 million meant to help prevent another Ebola outbreak. The CDC and NIH had robbed emergency preparedness, cancer, vaccine and HIV programs for more cash.
This bill does not give back any of the borrowed money, said National Institute of Allergy and Infectious Diseases director Dr. Tony Fauci.
That includes $11 million from tuberculosis, malaria, flu; $47 million from reprogrammed Ebola funds and $34 million from the National Cancer Institute and other NIH institutes. "We may never get to officially pay that back," Fauci told NBC News.
Each listed item, tuberculosis, malaria, flu, Ebola, etc., have a specific amount appropriated by congress. Only congress or the expressed consent of congress can re-allocate those funds. This is why Fauci said "We may never get to "officially" pay that back", the house and senate authorizes funding under specific terms, only the house and senate can unauthorize funds for a specific item(s) and reallocate those funds, usually only done for a specific more compelling necessity, in this example it was because of a threat of an emerging disease. This is where you often times will see the phrase funding within a department(s) already allocated but not yet spent, or as we seen with the last banking crisis that the cost of the action taken by congress will not cost taxpayers money, the monies will be taken out of a reserve fund or found in monies allocated but not yet spent. Somewhere written in the accounting books is where those monies went and where they came from but they don't necessarily have to release a public notice to the press about it, usually what people hear about was the reason funds were reallocated.
This is why you see no house or congressional members interested in holding hearings on the reported detrimental effects of the vaccine, they helped fund the research over the last twenty years. In this video, in an article put out by Townhall, "Fauci Caught Saying the Quiet Part Out Loud About the COVID Vaccine During PBS Special", scroll down to the last tweet and listen to Fauci trying to convince a guy the vaccines are safe along with the mayor of Washington DC when they went out to engage the public together on the vaccines that they have been working on this vaccines for twenty years. The guy in the video tells Fauci nine months isn't enough to develop a vaccine and Fauci replies they have been working on this vaccine for twenty years to get it good enough. Going back to that Colonel Jessep statement in part one, Fauci, like Bolton is another “We live in a world that has walls,” and “deep down, in places you don’t talk about at parties, you want me on that wall" figure. Such individuals allows all those complicit in these actions to go home and sleep better at night. From presidents, congress, and the scientist involved they can all rest assured that Fauci will put himself out there as the point man. That's why nothing is ever going to happen to him, he is the fox that is guarding the hen house, he goes down they all go down. The president(s) and congress can get crafty in the way funds are allocated or reallocated, that's what happened when Trump changed funding of public health departments to grants. Despite the huge outcry from public health departments that monies allocated to specific diseases could be spent elsewhere within the public health department institutions. Despite the objections of public health officials congress went along with the change. What a change it ended up being.
Traditionally the bulk of funding for public health departments came from state and county monies, there wasn't much fiscal responsibility federally for public health department funding until a scathing report in the 1980's after the HIV outbreak occurred. The report highlighted the increasing number of uninsured American through employer based insurance and the increasing role of public health departments were playing. The amount the federal government was paying into the system was miniscule compared to local county and state governments. Though the report prompted more funding for education and prevention of diseases federal increases didn't take hold until after the completion of the humane genome project. They claimed it was due to the Anthrax scare but moving forward it's focus was on the health data collection and assessment of epidemiology capacities. That funding stayed pretty consistent up until the 2008 housing crash, the initial funding by congress was a commitment of one billion dollars a year though it was said it never reached the one billion promised, after 2008 it dropped slightly than raised back to over six hundred million a year. That funding level held consistent up until the pandemic of 2020. Funding for public health departments was so bad that a lot of epidemiologist held no academic degree (48%) and (28%) had no formal training or academic coursework in epidemiology.
The influx of approximately $1 billion in terrorism preparedness and emergency response funds substantially strengthened the epidemiologic capabilities of the public health structure in the United States. However, despite this increased funding, state and territorial health departments report that a 47% increase in the number of epidemiologists is needed to fully perform the nation's essential public health services most dependent on epidemiology. In 2003, CSTE recommended that 80% of the state and territorial epidemiology workforce should have formal training in epidemiology. However, in 2004, 48.0% of epidemiologists in state and territorial health departments had no academic degree in epidemiology, and 28.5% had no formal training or academic coursework in epidemiology. Further attention to recruitment and training are needed to increase the number of trained epidemiologists and improve the public health infrastructure in the United States.
That report was the second in Assessment of Epidemiology Capacity the government started in 2001 in five states. Prompted from the 2001 capacity assessment to assess in the 2004 assessment that local and state funding of health departments was so bad they didn't even have adequate people holding degrees.
Additional Assessment Information and Instructions:
Questions referred to the state or other jurisdictional health department. The 2006 assessment
included an example of who was considered a state health department epidemiologist.
Who should be counted as a STATE Health Department (HD) Epidemiologist?
Epidemiologists employed or contracted by the STATE HD. For example,
epidemiologists who work at the LOCAL or STATE level that are employed or
contracted by the state are considered STATE epidemiologists.
The definition of an epidemiologist (7) and who should be counted as an epidemiologist did not
change from the previous version.
What is an Epidemiologist?
According to Last (A Dictionary of Epidemiology, 4th Ed. , 2001), an Epidemiologist is
defined as “an investigator who studies the occurrence of disease or other health related
conditions or events in defined populations. The control of disease in populations is often
also considered to be a task for the epidemiologist. ” The discipline of Epidemiology is
defined as the “study of the distribution and determinants of health related states or
events in specified populations, and the application of this study to control of health
problems.” “Study” includes surveillance, observation, hypothesis testing, analytic
research, and experiments. “Distribution” refers to analysis by time, place, and classes of
persons affected. “Determinants” are all the physical, biological, social, cultural, and
behavioral factors that influence health. “Health related states and events” include
diseases, causes of death, behaviors such as use of tobacco, reactions to preventative
regimens, and provisions and use of health services. “Specified populations” are those
with identifiable characteristics such as precisely defined numbers. “Applications to
control…” makes explicit the aims of epidemilogy - to promote, protect and to restore health.
The Epidemiology Capacity Assessment done in 2004 spelled out the baseline of what the Institute of Medicine recommended public health departments should regularly and systematically collect, assemble, analyze, and make available information regarding the health of the community, including statistics on health status, community health needs, and epidemiologic and other studies of health problems.
In 1988, and again in 2002, the Institute of Medicine recommended that every public health department regularly and systematically collect, assemble, analyze, and make available information regarding the health of the community, including statistics on health status, community health needs, and epidemiologic and other studies of health problems (7,8). The threat of terrorism renewed calls for strengthening the public health infrastructure. The U.S. Department of Health and Human Services has emphasized the need for a closely linked, nationwide public health network of local, regional, and state health resources (4). Epidemiologists in state and territorial health departments are essential to the monitoring of chronic conditions and diseases and the rapid detection and reporting of infectious disease outbreaks, whether or not related to terrorism. New and better means for estimating the epidemiologic capacity needs and measuring the performance of state and territorial health departments should continue to be created. CDC and CSTE are in the process of defining core competencies for epidemiologists, which should facilitate staffing and development of training. In the meantime, the findings from the 2004 epidemiologic capacity survey, with the limitations noted, can serve as a useful baseline for future epidemiologic assessments.
That new and better means had already been created and it was called CASPER, created in 2001. Community Assessment For Public Health Emergency Response.
The Community Assessment for Public Health Emergency Response (CASPER) is designed to provide public health leaders and emergency managers information about a community so they can make informed decisions. CASPER is quick, relatively inexpensive, flexible, and uses a simple reporting format. It uses a valid sampling methodology to collect information at the household level and can be used in disaster or non-disaster settings.
You may be asking what is CASPER...
CASPER is a type of Rapid Needs Assessment (RNA) that provides household-level information to public health leaders and emergency managers. The information generated can be used to initiate public health action, identify information gaps; facilitate disaster planning, response, and recovery activities; allocate resources, and assess new or changing needs in the community. It is a cross-sectional epidemiologic design; it is not surveillance.
The CASPER methodology is an adaptation of epidemiologic techniques used by scientists in the World Health Organization’s (WHO’s) Expanded Program on Immunization (EPI) to estimate vaccine coverage in Africa.
The cluster sampling design used for CASPER involves two-stages (30 clusters selected probability proportional to size and seven households interviewed within each cluster) and provides estimates for the population.
It's not surveillance about as much as it's doesn't have to be terrorism related, terrorism being the original reason given for the incursion into public health departments to collect individuals health data. CASPER can be used in various methodologies. It can be used to send people out to collect data on the needs of a community after a disaster, it can be used to collect a sampling of vulnerable or compromised individuals within a community, it can be used to assess the incidence or rates of specific diseases within communities, and it's wholly possible it can be used like the World Health Organization uses it and assess the rates of vaccinations within a community.
How can CASPER be used?
There are many opportunities for CASPERs to influence public health. A CASPER can be used in both a disaster and non-disaster setting.
For example, CASPER methodology has been used to do the following:
Assess public health perceptions
Estimate needs of a community
Assist in planning for emergency response
As part of the public health accreditation process
Regardless of the setting and objectives, once the decision to conduct a CASPER has been made, it should be initiated as soon as possible. See the Interactive Map for examples of how CASPER has been used throughout the United States since 2001.
So regardless of the setting and objectives. So that would mean if they wanted to track the rate of heart disease, diabetes, cancers, or vaccinations rates in any given community they can just sit at their desk and plug in the data. Once downloaded it's as simple as plugging in give me the rates of covid vaccinated individuals living between 1000 to the 2000 block of Main Street Avenue in any city and state in America and it will pop up like this:
You could do like Trump and say "you have to ask yourself what's this all about", why the government felt a need to collect health data on Americans. You would assume it was used to determine the amount of funding designated into specific areas but come 2018 you find out that's not what it was all about. Realistically in the event of a terrorist attack they're not sending out a uber to pick you up because you are a vulnerable member of the community suffering from diabetes unable to keep pace or suffer a heart attack if you can't get a uber ride out. At best regardless of a terrorist attack or not a terrorist attack the best they can do looking at this data is determining a proper body bag count. It could allow them to send the number of vaccines or medicines needed to counter a biological attack if they have an antidote. Determine which population is most at risk first to administer but in a biological immediate death risk to the entire population health data is a non sequential, the data only would serve to locate individuals who refuse vaccination.
Now if you want to travel down the path of diabolical thoughts, or what some assume is a conspiratorial train of thought, knowing individuals health data can lead to targeting a area know for a high incidence of health related diseases. Like for instance, sending the J&J vaccine into area's know for high rates of heart disease, . I, if I wanted to go there, could go up one better though I am not convinced at this point they were that well established (yet), you could walk into a vaccine center, your name input into a computer and have a designated vaccine targeted toward what ails you. You can say that's nuts, you can say someone needs a tin foil hat, you can label someone a conspiracy theorist but what you can no longer do is deny that by Fauci's own admission in the video that they spent twenty years working on a cure for something that had yet to exist.
Now let us take a look at those Assessments of Epidemiologist Capacity in Public Health Departments over the years. Starting in 2001 they are rather blase'. The majority looking like they were written out on a standard typewriter. Most just list the number/percentage of epidemiologist in public health departments and in which fields and which fields are lacking a proper amount of epidemiologist for each field. Written or assessed in 2001 , 2004 , 2006 , 2013 , 2017 and a special supplementary workforce enumeration conducted in 2010 , which may have been prompted by the H1N1 flu outbreak. Outside of the 2006 assessment being formatted differently in a download format and the inclusion in 2009 questions were added to assess substance abuse epidemiology capacity and implementation of selected surveillance-related technology advancements, and in 2013, to assess mental health epidemiology capacity nothing quite stands out like the 2017 questionnaire and the subsequent report filed in 2018. It was written like there was an expected pandemic in the air.
Epidemiology Capacity Assessments were conducted in 2001, 2004, 2006, 2009, and 2013, with supplementary workforce enumeration conducted in 2010. Since 2004, 100% of the states and DC have responded to the assessment. The Epidemiology Capacity Assessment was updated in 2017 to reflect expansion of health department programs into genomics, informatics, and vital statistics. A core set of questions has remained essentially unchanged and permits the monitoring of trends in the epidemiology workforce employed by the 50 states, DC, and U.S. territories; current funding sources for epidemiology activities and personnel; capacity in the four EPHS relevant to epidemiology (1); and issues in hiring, training, and retaining skilled epidemiologists to meet current needs and changing priorities.
"The Epidemiology Capacity Assessment was updated in 2017 to reflect expansion of health department programs into genomics, informatics and vital statistics" and "issues in hiring, training, and retraining skilled epidemiologist to meet current needs and changing priorities".
Like I am often fond of saying if you dig deep enough you'll find where the beginning connects to an end means. I could have simply accepted that this was all about the Anthrax scare as told in the beginning but the end didn't meet that means. Since the Anthrax we've had several scares, Sars, Mers, Swine flu, Ebola, most scarier than what could have unfolded with the Anthrax scare yet not a single one of them prompted the massive response and changeover of the public health departments that was to come, they only served as a funding mechanism to assess epidemiology capacity and collect health data on Americans. Adding all those epidemiologist to collect specific data on rates of heart disease, cancers, diabetes, maternal and child health, oral care, etc., that really didn't matter in the end result because a vast majority of them were pulled from those fields and retrained to meet currents needs and changing priorities. Those current needs and changing priorities would be in the fields of genetics, vital statistic and the collecting of data therefore of something yet to come. The only way to fund such a vast changeover in public health was to change the funding mechanism in place for public health departments to grants. One of about the only thing you didn't see congressional members squash when Trump proposed it despite the huge outcry from public health officials that the money could be spent anywhere being delegated like that.
It literally goes from years of blase', mundane epidemiology capacity assessments into a robust scene of actions between the CDC and public health departments. There's so many to choose from I hardly know where to start. So I shall start with one of my favorites that I am sure you'll enjoy as how many of us have heard repeatedly from Tucker Carlson alone how they seem to all be speaking the same language.
Emergency Leaders: The Future of Incident Response
The Challenge
In a crisis every minute counts. CDC needs leaders who are prepared to step in and take immediate action.
Our Strategy
Trained emergency leaders bring together the best science with the most efficient systems for managing people and resources. Learning and using common framework like the CDC Incidental Management System (IMS) helps responders "speak the same language" during an event and work seamlessly together.
I know that after having gone through all of those blase' Epidemiology Capacity Assessments above you are going to be thrilled that this one doesn't just come with blaring headlines but comes complete with pictures of people in action! I don't really want to put out to many spoiler alerts on this but I wouldn't even have it anymore after having it sit on my computer for months it must have made such a mockery of the CDC considering their pandemic response they took it down. I was always meaning to get around to doing an op on it but you can clearly now understand how hard it was to struggle through all those mundane prior assessments and not want to fall asleep. So I really have to give a call out to a site called ReadKong for having the foresight to preserve the document in whole. I love the opener:
As stewards of public health we remain committed to a common defense of our country - from infectious disease outbreaks, natural disasters and man made threats we must stay true to the science that informs our evidence based practices and programs that protect communities from threats. We must be guided by surveillance, which helps identify new and immerging disease threats and predict when and where the next public health emergency might happen. And finally we must always return to the core value of our citizens here at home and people around the globe.
We must stay true to the science that informs "our" evidence, not science that forms the evidence. Got to love it, no wonder they took it down.
How does one go about forming their evidence? They implement a required two year training course to individuals wanting to become an Epidemic Intelligence Officer in the Epidemic Intelligence Service.
During this 2-year hands-on service fellowship, EIS officers serve our country while learning applied epidemiology and gaining practical skills to become future public health leaders.
Upon graduating from the course, as noted in the diagram, you move on to contribute to the public health workforce. In the videos displayed here on this site you can hear some of their personal stories. Like the guy on his first day on his job admits he had no idea what he was doing, or the guy who said he was sent out on a case of an outbreak about boy scouts in the wilderness and he wondered around for a week and it never came to thought he should make contact with someone at the CDC to talk about what he was finding, or how he says he now strikes fear in the hearts of snacks and turtles across the country but first without having made mistakes in the manuscripts and having to be corrected.
My most memorable moment was my first day on the job they put out an alert about lung injury and vaping in Wisconsin and my phone was flooded with call from state health departments and state epidemiologist wanting to know more details and I had no idea what I was doing I hadn't even figured out where to park yet.
I disappeared into the wilderness in Maine for a week investing a E.coli outbreak among boy scouts and didn't know I was suppose to keep in communication with my supervisor Dr Patty Griffin who forgave me. Teaching me mercy, but she later took out her emotions thorough twenty two drafts of the manuscript. In EIS I also investigated retile amphibian associated salmonella including swabbing for calici in pet stores throughout San Francisco Bay area. To this day my presence strikes fear into the hearts of snakes and turtles through out the country. When I made a mistake in the calculations in the manuscript it was picked up and corrected by Dr Rob Toast teaching me attention to detail.
This doesn't include the story of the team they assembled to fly off to Africa to investigate an Ebola outbreak who had to take a crash course on the way. What to breast feed in class? No problem. Have a child and want to take them along? No problem. Want to find a partner in life, fall in love and have two delightful children? No problem. Actually the later comes highly recommended by the reptile fearing man mentioned above. "Happily working at CC teaching me if you are interested in having an outstanding long term relationship and would like to have two delightful children I would highly recommend. Nepotism runs deep as it's not the only love story told.
Can you imagine getting off a plane having expertise requested to come help out to be told you just had a crash course on the way or you have no idea what you are doing. Can you imagine your expression if you went to a doctor who just came off a two year internship at a hospital if he said those same things to you. One would think they would send people with years of experience in those fields even if they had to request it from a university professor, but this isn't the movies evidently where they seek out the best professional they can find. But this is how they scope this into "our" science, this is how they can manage everyone to "speak" the same language. This is how we end up with someone like Walensky running an organization such as the CDC, a two year degree in biology isn't sufficient to meet the requirements needed to run domestic and global response to health emergencies. Since she has minimal experience she can be easily dictated what the science narrative will be lacking the credentials to have the knowledge to know any difference.
2017 Public Health Emergency Preparedness (PHEP) Provided 612 Million To Public Health Departments
The rate of what was given to public health departments in 2017 basically stays the same, what changes is that moving forward those funds can be spent anywhere and are not appropriated to any specific disease for the educations and prevention of due to the change over to funding public health departments with grants. This is where they start rock and rolling like they are expecting an epidemic.
Between 2017 and 2019 CDC and PHEP recipients will conduct nearly five hundred medical countermeasures Operational
Readiness Reviews (ORR) nationwide, including four hundred local jurisdictions in the seventy metropolitan areas where nearly sixty percent of the US population resides.
Over the next three years CDC will expand the ORR's to encompass measurement of hazardous for all fifteen public health preparedness capabilities. CDC will evaluate each PHEP recipients ability to effectively implement timely indentification and investigations of public health incidents, communications of public risk information, intervention and control measures. This includes identifying potentially exposed individuals and taking steps to prevent or minimize spread of disease and coordination and support of response activities with health care and other partners. CDC expects by 2022 all PHEP recipients public health emergency management and response programs to have achieved CDC expected levels of established readiness.
CDC has placed preparedness staff across the nation to support state and local health departments. In 2017, 90 Public Health an Preparedness (PHEP) cooperative agreements funded field staff were assigned to 58 different awardee locations, including 46 states, 4 localities and 8 US territories. CDC now has PHEP funded field staff in 14 more locations than in 2016.
PHEP Funded Field Staff Include
Here's an interesting thing to those stats. Career epidemiologist started out as two in 2002 under Bush, with 20 hired during Obama's term, so in a sixteen year span they had hired 22 altogether but in one single term (actual one year of his term) the Trump administration they hired 14 more professional epidemiologist. Coincidence? I think not. But you can clearly see how things started to get rolling in the complete take over of public health departments across the country during Trump's term, without having funding changed up to grants it couldn't have happened. Exactly what was so urgent that all of a sudden the hiring of fourteen more career epidemiologist and operational readiness practices had to be performed. What was so urgent that the traditional funding mechanism in place for public health departments had to be changed. Why the need to change the epidemiology capacity assessment to include how many were qualified in genome, genetics and informatics. The answer to those questions is because all of a sudden they had changing priorities. Priorities that evidently were so urgent they had to rob Peter to pay Paul to get it done. The pandemic would eventually hold sway to expand the CDC intervention in public health department funding to ascertain complete control and make sure everyone was on the same page moving forward. We've gone from 612 million give or take over the years prior to Trump to infusing billions into public health departments since the pandemic with no end in sight as they just infused three billion more claiming the health departments, who were given billions during covid are financially overwhelmed by the cost of covid....or is that really the reason as nothing seems to appear to be what it is. I'd be freezing eggs, stocking up on cold medications and definitely don't forget the fever reducers.