As the shock of the federal government shutdown has given way to cold, hard statistics, health and medical organizations - such as the NIH and CDC - are taking stock of what the shutdown means for the health of the American people.
It is now a common sight on any government website: "Due to a lapse in funding, the US federal government has shut down."
But one look at what is affected by the shutdown on the US government's official web portal reveals that many services vital for the wellbeing of the population are furloughed, along with the employees who monitor them.
Dr. Michael A. LeNoir, president of the National Medical Association, passionately observes:
"If we ran our medical practices the way the US Congress has handled the operation of the federal government, we'd be accused of malpractice."
Passions aside, here is a rundown of the important health and medical services that are - or are not - currently on hold.
NIH clinical trials on hold
The National Institutes of Health (NIH) is not able to accept any new patients into the hospital it runs in Maryland, and any research on cancer, heart disease and stroke is stopping immediately.
This means that any clinical trials that were set to begin are on hold, and no new patients will be accepted into these clinical trials.
According to NIH spokesman John Burklow, around 200 people register for clinical trials each week, but these patients are being told they must wait until the government resumes to begin their trials.
However, a memo from the Department of Health and Human Services (HHS) that lays out a contingency staffing plan in the event "annual appropriations" are not enacted, states that while the NIH will not accept new patients or initiate new clinical protocols, "the continued provision of care to existing patients (both inpatients and outpatients) means the hospital would be operating at roughly 90% of normal patient load during the initial weeks of a funding hiatus."
CDC flu shot program, disease outbreaks impaired
The Centers for Disease Control and Prevention (CDC) will be unable to support the seasonal flu program and outbreak detection, as well as technical assistance, analysis and support to state and local organizations for infectious disease surveillance (for example, HIV and TB).
The HHS memo identifies certain operations that will continue, albeit with minimal support and in a "significantly reduced capacity." Some of these continued operations include:
- Processing of laboratory samples
- Maintaining the agency's 24/7 emergency operations center
- World Trade Center health program
- Vaccines for Children (VFC) program
- President's Emergency Plan for AIDS Relief (PEPFAR)
- CDC's Global AIDS program.
Barbara Reynolds from the CDC told Medical News Today:
"The vast majority of CDC's activities have shut down completely. Of about 13,000 staff at CDC, with the lapse of appropriations for FY 2014 and no continuing resolution to fund HHS, about 4,000 CDC staff will continue to work. However, 3,000 of the 4,000 who will be working are either commissioned corps (uniformed services) or are working the programs funded outside annual appropriations."
She added that this shutdown has had a "significant impact to CDC."
FDA food and drug safety impaired
According to the HHS, the Food and Drug Administration (FDA) will be unable to support the majority of activities involving food safety, nutrition and cosmetics.
Safety activities, such as routine inspections, compliance and enforcement, monitoring of imports and lab research necessary to inform public health decisions will cease.
The US government web portal adds:
"Work to protect consumers, ranging from child product safety to financial security to the safety of hazardous waste facilities, will cease. The EPA (Environmental Protection Agency) will halt non-essential inspections of chemical facilities and drinking water systems."
Further implications of the shutdown
The Department of Health and Human Services says that contingency plans for its own operations in the event the federal government cannot appropriate funds involves furloughing 40,512 staff and retaining 37,686 staff.
"Put another way," the organization says, "52% of HHS employees would be on furlough, and 48% would be retained."
In addition, vital services that give seniors and young children access to healthy food and meals may not have enough federal funds to cater to everyone in an extended lapse.
The American Academy of Pediatrics released a statement about the shutdown's impact on children, pointing to these impaired programs that are essential for the health and wellbeing of American children and families.
The organization states:
"With nearly one in five children living in poverty, today's inaction by Congress significantly harms the most vulnerable families. Our children deserve better than this. Pediatricians are dedicated to doing everything we can to urge Congress to prioritize children's needs in the budget."
Though many of these health and safety organizations are worried about the future of vital programs, some are optimistic in the wake of the health insurance marketplace opening.
Dr. LeNoir, of the National Medical Association, refers to it as "a silver lining to this dark cloud," and urges Americans to visit www.healthcare.gov.
"We would also urge Congressional Republicans to abandon their crusade to repeal or delay the Affordable Care Act, so that government operations can resume this week," he adds.