A coalition of religious groups, conservative think tanks, and Republican attorneys general have chipped away at local and state authority, altering how the nation can respond during health crises.

With bankruptcy looming in 2012, Detroit largely dismantled its public health department. Years later, that decision offers a cautionary tale to other U.S. cities as the painful rebuilding continues.

Access to testing is still uneven in the nation's largest state. Even as some urban counties offer tests to anyone who wants one, a rural county is testing raw sewage to track the virus.

Cities have tasked police and sanitation workers with dismantling homeless camps that they say pose a risk to health and safety. But that's meant some displaced people are losing needed medications.

October marks not only fire season in California, but also the peak of the grape harvest. In areas not imminently threatened, some workers labor through heat and smoke to save harvests and paychecks.

As recent arrivals to the U.S. are released from detention with health problems ranging from diarrhea to gaping wounds, doctors who are trying to help, with little federal support, feel the strain.