Berry was a popular family physician and local health officer, trained in biostatistics and epidemiology at Johns Hopkins University.

State and local public health departments across the country have endured not only the public’s fury, but widespread staff defections, burnout, firings, unpredictable funding and a significant erosion in their authority to impose the health orders that were critical to America’s early response to the pandemic.

A New York Times review of hundreds of health departments in all 50 states indicates that local public health across the country is less equipped to confront a pandemic now than it was at the beginning of 2020.

“We have learned all the wrong lessons from the pandemic,” said Adriane Casalotti, chief of public and government affairs for the National Association of County and City Health Officials, an organization representing the nearly 3,000 local health departments across the nation.

The Times interviewed more than 140 local health officials, public health experts and lawmakers, reviewed new state laws, analyzed local government documents and sent a survey to every county health department in the country.

Almost 300 departments responded, discussing their concerns over long-term funding, staffing, authority and community support.

That overhaul of public health gives governors, lawmakers and county commissioners more power to undo health decisions and undermines everything from flu vaccination campaigns to quarantine protocols for measles.

Large segments of the public have also turned against agencies, voting in new local government leaders who ran on pledges to rein in public health departments.

Most of the departments that responded to The Times’s survey said they were worried about their funding levels, which in most cases had been decreasing or flat before the pandemic.

About three dozen departments said their budgets were the same or smaller than they were at the beginning of the pandemic.

At least 32 states have enacted legislation restricting state or local authority over health and emergency decisions.

More than 220 departments told The Times they had to temporarily or permanently abandon other public health functions to respond to the pandemic, leading to a spike in drug overdoses and a disturbing drop in reports of child abuse.

Several health officials pointed to runaway infections of sexually transmitted diseases, with gonorrhea cases doubling and syphilis on pace to triple in one county in Pennsylvania.

Public health departments later delivered vaccines to halt diseases such as smallpox and polio, upgraded water systems to limit typhoid and cholera, curbed sexually transmitted diseases and helped guarantee the safety of food in restaurants.

As scientists helped overcome many infectious diseases, the focus on keeping Americans healthy turned more to individualized treatment for ailments such as heart disease and cancers, said David Rosner, a historian at Columbia University who specializes in the history of public health.

Some departments said they had to lay off employees at inopportune times over the past year because grants had run out of money.

Many local health officials said they expected that the extra money would peter out over the next two to three years.

Dozens of departments said that, in order to be prepared for more surges or a future pandemic, what they truly needed was a higher baseline of qualified, permanent employees.

A health official in Berrien County, Mich., said it was so time-consuming to get approval from the county to hire temporary staff members in the fall of 2020 that, when her department received more funding later, she focused instead on quicker purchases, like software.

“If a ship is sinking, throwing treasure chests of gold at the ship is not going to help it float,” said Melissa Lyon, public health director for Erie County, Pa.

Jennifer Bacani McKenney, the top public health officer for Wilson County, Kan., began doing Facebook Live presentations and coordinated with hospitals, schools and churches.

The Kansas State Legislature, alarmed by the persistence and power of public health orders around the state, passed a series of laws that gutted the authority of health officials like Dr.

The new laws limited Covid-19 contact tracing, gave authority for health decisions to elected leaders and allowed anyone “aggrieved” by a mask mandate, business closure or limit on public gatherings the ability to sue the agencies that imposed the order.

McKenney, saying she focused too much on health and not enough on businesses, she said.

New laws passed in at least 32 states similarly restrict the ability of health officials to impose mask and vaccine mandates, close churches, schools and businesses, conduct contact tracing or apply penalties for violating health restrictions.

Many require a legislative body to approve health orders.

The Times spoke with dozens of lawmakers who have introduced such legislation, most of whom shared a concern that health officials had overstepped their authority and required a check on that power.

He drafted a bill, whose main provisions were incorporated into a law that took effect this summer, allowing the governor to squelch local health orders deemed too restrictive.

Ron DeSantis’s government, which has been aggressive in slapping down local restrictions, fined Leon County $3.5 million this month for mandating Covid-19 vaccinations for its employees — $5,000 for each person required to get a shot.

In Bismarck, N.D., the state capital, the health director Renae Moch credited a state mask mandate last year with curbing a devastating outbreak.

Jim Murphy, an epidemiologist who worked in leadership roles at Montana’s Department of Public Health and Human Services for three decades before retiring this summer, said the department had enjoyed the support of governors from both parties — until Gov.

Health department officials, Mr.

Murphy said, were left out of conversations over changes to public health laws.

In Gallatin County, Ron Marshall, a state representative who owns a vape store, said he had been battling the local health board’s ban on indoor vaping.

But after passage of a new law restricting local public health authority, he said, the board relented and told him that it would no longer enforce the ban.

Marshall said other local boards were also easing off on health orders.

Vernon Miller, the health officer for Hot Springs County, Wyo., found his staff huddled around the phone, listening to a voice mail.

In California, a health officer resigned after a resident announced her home address at one meeting.

In Nevada, a woman warned ominously that those protesting health orders made the meals, changed the tires and filled the prescriptions of local officials

Several health officials said they had installed security cameras, were getting police patrols at their houses or were now carrying pepper spray

In Klickitat County, Wash., the sheriff announced over the summer that his office would “arrest, detain and recommend prosecution” of any government official enforcing health restrictions that he deemed unconstitutional

Erinn Quinn, the county’s public health director, said she suspended some outreach work and thought seriously about resigning

In the past, health departments could lure workers with better hours and less heartache

Kathy Emmons, the executive director of the Cheyenne-Laramie County Health Department in Wyoming, said her department had a turnover approaching 80 percent during the pandemic

In January, hundreds of people gathered at the State Capitol to protest health orders and burn masks

A few days later, red paint was spattered across almost every entrance to the county health department

Sue Rhodes, the health department administrator in Marshall County, Kan., was one of many officials who said finding people to do contact tracing had become a challenge with the public sometimes threatening or verbally abusing tracers

“Everybody looks at public health now and says, ‘Who wants to work there?’” she said