CHARLOTTE, N.C. -- Americans are losing a vast array of people and programs dedicated to keeping them healthy. Gone are specialists who were confronting a measles outbreak in Ohio, workers who drove a van to schools in North Carolina to offer vaccinations and a program that provided free tests to sick people in Tennessee.

State and local health departments responsible for invisible but critical work such as inspecting restaurants, monitoring wastewater for new and harmful germs, and responding to outbreaks before they get too big -- along with a host of other tasks to protect individuals and communities -- are being hollowed out.

"Nobody wants to go swim in a community pool and come out of it with a rash or a disease from it. Nobody wants to walk out their door and take a fresh breath of air and start wheezing," said Lori Tremmel Freeman, executive director of the National Association of County and City Health Officials.

But local health officials say they now have no choice but to do a lot less of those tasks. The Trump administration is cutting health spending on an unprecedented scale, experts say, including pulling $11 billion of direct federal support because the pandemic is over and eliminating 20,000 jobs at national health agencies that support local public health work. It's proposing that billions more be slashed.