Bug spray, swollen welts, citronella. It’s mosquito season.
And in a normal year, the health department serving Ohio’s Delaware County would be setting out more than 90 mosquito traps a week — tubs of stagnant water with nets designed to ensnare the little buggers.
But this year, because of COVID-19, the mosquitoes will fly free.
Staffers haven’t set a single trap this year, according to Dustin Kent, the program manager of the residential services unit. Even if they had the time, the state lab that typically would test the insects for viruses that infect humans, such as West Nile, isn’t able to take the samples because it's too busy with COVID-19.
“It’s frustrating knowing that we can do a more preventative approach,” Kent said. “But we’re stuck reacting.”
In Washtenaw County, Michigan, mosquito samples aren’t being collected because the health department couldn't hire the summer interns who typically perform the work. In COVID-19 hot spot Houston, Texas, a third of mosquito control staffers are working the COVID call center and preparing coronavirus testing materials. And across Florida, public health officials couldn’t test chicken blood for exposure to mosquito-borne viruses — chickens get bitten by the insects, too, so they can serve as a warning sign — at the overwhelmed state lab until mid-June, a task that typically begins in the spring.
Monitoring and killing mosquitoes is a key public health task used to curb the spread of deadly disease. In recent years, top mosquito-borne illnesses have killed some 200 people annually in the U.S. But that relatively low toll is due in part to the efforts of public health departments to keep the spread at bay, unlike in other countries where hundreds of thousands are sickened and die each year.
“Mosquitoes are the biggest nuisance and pest on this planet. Hands down,” said Ary Faraji, the president of the American Mosquito Control Association, which supports public agencies dedicated to mosquito control. “They are responsible for more deaths than any other organism on this planet, including humans.”
Around the U.S., more than half of public health departments combat mosquitoes. The goal is to find infected mosquito populations and kill them before they get to humans, or at least warn the community about their presence. Mosquito-borne epidemics are happening more frequently nationally as temperatures rise.
But a joint investigation published this month by KHN and The Associated Press detailed how state and local public health departments across the U.S. have been starved for decades, leaving them underfunded and without adequate resources to confront the coronavirus pandemic, let alone perform mosquito control at the same time. Over 38,000 public health worker jobs have been lost since 2008. Per capita spending on local health departments has been cut by 18% since 2010.
The short staffing is leaving many localities — especially smaller departments or those without separate, dedicated control districts — flying blind on potential mosquito threats.
The Centers for Disease Control and Prevention has stepped in to help and is now running mosquito testing for at least nine states, including Florida, Arizona and the Carolinas, said Roxanne Connelly, entomology and ecology team leader for the CDC’s National Center for Emerging and Zoonotic Infectious Diseases. It is also evaluating human blood samples for mosquito-borne disease for 40 states. Concerned about the disruptions, the CDC issued a policy brief with the Environmental Protection Agency on Thursday, stressing that mosquito prevention and spraying of insecticides was an essential service that needs to continue even in a national health emergency.
Fourteen people in the Florida Keys have come down with dengue, which can cause fever, severe body aches and vomiting. Massachusetts has found its first mosquito carrying Eastern Equine Encephalitis, which kills approximately a third of people infected, according to the CDC. West Nile virus has been found in mosquitoes, birds and other species in at least 18 states and has infected people in nine.
The flu-like symptoms of diseases like West Nile especially worry Nina Dacko, who supervises the mosquito control program for Tarrant County Public Health in Fort Worth, Texas.
“I wonder which cases are going to be missed as everyone is going to expect COVID and then move on when they test negative,” she said.
Budget cuts are coming in waves as tax shortfalls rock local health departments. Three municipalities in Texas, including Watauga, Saginaw and Lake Worth, haven’t sent any mosquitoes in for testing this year — they don’t have the time, staffing or money due to revenue shortfalls from COVID-19, Dacko said.
While public health officials say small outdoor gatherings are safest when it comes to avoiding exposure to the coronavirus, some worry that the risk of acquiring mosquito-borne diseases could rise.
“Everyone knows if you’re outdoors, that’s where you’re actually going to get exposed,” said Chelsea Gridley-Smith, environmental health director for the National Association of County and City Health Officials.
Labs swamped by COVID tests may be increasing that risk. Local governments often rely on the same public health labs to test whether mosquitoes are carrying diseases like West Nile, dengue or Eastern Equine Encephalitis that they do to test humans for infectious diseases, like COVID-19.
But any grand fix to the hole in the nation’s current mosquito netting is going to require some serious cash, Gridley-Smith said, to allow for dedicated staffing, instead of expecting public health workers to juggle it alongside multiple other programs.
Several bills to support mosquito control efforts have passed through Congress with bipartisan support in recent years, but they haven’t been funded.
For the CDC’s Connelly, the lack of dollars is just another part of the boom-bust nature of funding for health departments and mosquito control programs nationally. Cash infusions after bouts with mosquito-borne Zika aren’t enough to fully maintain robust programs, she said, and they often have to start over when the next crisis hits.
Weber and Barry-Jester are writers for KHN. AP journalists Mike Householder in Canton Township, Michigan, Juan A. Lozano in Houston and Jeannie Ohm in Arlington, Va. contributed to this report.
This story is a collaboration between The Associated Press and KHN. To reach the AP’s investigative team, email firstname.lastname@example.org.