AILSA CHANG, HOST:
From mid-June to mid-July, millions of soccer fans from all around the world will gather here in the U.S. and Canada and Mexico for 104 matches across 16 cities because, yes, it is World Cup time. Millions of fans packing into more than a dozen stadiums, of course, means soccer for some, but public health officials have another perspective. They will be on high alert for disease spread. NPR's Pien Huang is here to tell us about the public health preparations here in the U.S. They come after a pretty bruising year for federal health agencies. Hi, Pien.
PIEN HUANG, BYLINE: Hey, Ailsa.
CHANG: OK, so public health officials, of course, are in the business of keeping people safe and healthy. So how is the CDC getting ready for this huge influx of human beings?
PIEN HUANG: Well, on a federal level, agencies that would usually be taking lead are a lot less visible. So for context, the CDC, the nation's public health agency, has taken some major hits in the Trump administration...
CHANG: Yeah.
PIEN HUANG: ...Which has pushed out thousands of workers, and you really just rarely hear from their scientists anymore. So this is the backdrop going into the World Cup. And Dr. Deb Houry was a top CDC official until she resigned last year.
DEB HOURY: Usually the CDC is a visible lead when we have international events in the United States, particularly across the country versus just in a single state.
PIEN HUANG: She also says that other groups that would typically be involved, like the National Security Council's biosecurity group, the Office of Pandemic Preparedness and Response Policy, the assistant secretary for preparedness and response, all of these high-level offices are disbanded or vacant or don't have permanent leaders.
CHANG: OK. Well, how then are individual cities preparing for the World Cup?
PIEN HUANG: Well, as Houry told me, the system has shifted to fill some of these perceived gaps. So outside of government, for instance, Georgetown University has set up what they're calling a health security operation center. They'll be monitoring for diseases, sending out daily situation reports. And in recent months, behind the scenes, groups that represent state and county health officials say the CDC has stepped up to hold some calls and give some guidance, but states and cities started long before that. Doctor Phil Huang is health director for Dallas County in Texas.
PHIL HUANG: To be able to begin preparations a year out is a luxury for us, compared to a lot of the situations that we deal with.
PIEN HUANG: He says that they've been focusing on preparing for all the things that you would expect to see with huge mass gatherings.
CHANG: OK, what are some of those things?
PIEN HUANG: OK, so let's take a tour. We're going to start in Atlanta, Georgia, which is hosting eight World Cup games and the team from Uzbekistan.
MARCUS PLESCIA: We call Atlanta Hotlanta (ph) for a reason. It's going to be hot and humid here. And so, heat related injuries are going to be an issue.
PIEN HUANG: That's Dr. Marcus Plescia, who's district health director for Fulton County, which includes Atlanta. Now, in addition to the World Cup games, Atlanta will also have a monthlong fan festival where they're expecting some 15,000 people a day. And he says they're setting up stations where people can sit in air conditioning and cool off. Then there's feeding the crowds.
PLESCIA: The biggest lift for us and for all local health departments is that our environmental health workers have to inspect all of the food vendors, and there will be a whole lot of food vendors.
PIEN HUANG: He also says that infectious diseases can spread when lots of people come together.
PLESCIA: We're worried about sexually transmitted infections 'cause there's going to be a lot of people here, and it's going to be a festive atmosphere. And then we're worried about things maybe we wouldn't have been as worried about, and particularly we are worried about measles.
CHANG: (Laughter) Well, I guess there's a lot of things to worry about when there's a festive atmosphere.
PIEN HUANG: Absolutely, absolutely, from a public health perspective.
CHANG: Sure.
PIEN HUANG: So heading over to Dallas, Texas, they're hosting nine World Cup matches, which is the most of any city. And Dr. Phil Huang, who we heard from earlier, he says they're stepping up disease surveillance, testing wastewater and also mosquitoes.
PHIL HUANG: One of the things we always test for is West Nile virus, but we're also testing - increasing our testing for dengue, chikungunya, Zika.
CHANG: Wow.
PIEN HUANG: And that's to be ready to alert hospitals and also the public immediately if any of these are found. Medical staff are also looking out for symptoms of Ebola or hantavirus due to outbreaks. Now, the World Cup finals will be just outside New York City where Dr. Alister Martin is the city's health commissioner. He says that they've been running simulations to prepare for outbreaks and mass casualty events, and they're also setting up what's called incident command.
ALISTER MARTIN: It just means that we're diverting resources from some other kind of normal stuff so that we can manage any potential emergencies that happen.
CHANG: OK. So it sounds like cities have been pretty busy preparing. But Pien, we started by talking about how federal public health has weakened, and I guess I'm just wondering, what's been the impact of that?
PIEN HUANG: Yeah, so federal funding for public health is strapped, for instance in Los Angeles, which is hosting the U.S. team's opening match versus Paraguay.
CHANG: Yeah.
PIEN HUANG: Dr. Barbara Ferrer, who's the county health director there, she says that they're counting on their existing staff to do all this extra work.
BARBARA FERRER: You know, most of our staff are not taking vacations during the month of the World Cup because they'll need to work. We'll be obviously accruing overtime costs.
PIEN HUANG: And a lot of their normal work like routine food inspections are going to get put aside.
CHANG: That is NPR's Pien Huang. Thank you so much, Pien.
PIEN HUANG: Thank you, Ailsa. Transcript provided by NPR, Copyright NPR.
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