In the decade before Michigan and its largest city became the latest hot spot for the deadly coronavirus, officials were steadily, and at times dramatically, cutting back on their first line of defense against pandemics and other public health emergencies. Approaching bankruptcy, Detroit disbanded most of its public health department and handed its responsibilities to a private nonprofit. In Ingham County, home to the capital city of Lansing, then-Public Health Director Renee Branch Canady sat down at budget time every year for seven straight years to figure out what more to cut.