FEATURE
These added responsibilities reinforce the importance of both new and traditional collaborations to be ready for the inevitable next public health crisis .”
Leslie Wolf , PhD , HCLD ( ABB )
methods and next generation sequencing . The larger menu of potential testing options can enable rapid turnaround and higher throughput workflows , but can also constrain laboratories to chosen testing platforms and supply chains . What ’ s more , federal and state funding for public health laboratories has not kept pace with increasing demands , even as it becomes more imperative to try to prepare for whatever might be just around the corner .
Fairfax County ( VA ) staff work in a clean room to test COVID-19 samples . Photo : Fairfax County PHL
A New Century
The anthrax attacks in 2001 helped usher in a new era of responsiveness and emergency preparedness for public health laboratories . Suddenly , laboratories were faced with demanding levels of roundthe-clock , high-stakes testing . “ Everybody needed to know the answer ASAP ,” said Andrew Cannons , PhD , HCLD ( ABB ), director of the
Bureau of Public Health Laboratories in Tampa , Florida . “ If that powder contained anthrax , you knew somebody was exposed and had to be treated , so you basically needed a 24 / 7 operation .”
From this involvement has emerged a new model in which public health laboratories must be prepared to respond to large-scale incidents alongside new partners , such as law enforcement and first responders . For the
Louisville Metro Health Department Laboratory in Kentucky , director Leslie Wolf , PhD , HCLD ( ABB ), said , “ that was our foray into learning about incident command structure and the National Incident Management System .” These added responsibilities reinforce the importance of both new and traditional collaborations to be ready for the inevitable next public health crisis . “ The job is becoming too big for a public health [ laboratory ] to carry on its back ,” Wolf said . “ We keep our core services , but we add on these layers of partnerships and collaborations .”
Parts of the COVID-19 pandemic carry echoes of the anthrax response , Cannons said , especially in some of the early fears and uncertainty and the need to ramp up high-volume testing capacity very quickly . But COVID-19 has reached a scope and duration that today ’ s public health leaders have never before confronted . “ Public health laboratories were not structured well [ then ] to meet those high throughput testing demands . Twenty years later , we ’ re facing the same demand with COVID-19 ,” said Mike Pentella , PhD , MS , D ( ABMM ), director of the
State Hygienic Laboratory at the University of Iowa . “ How do you maintain high throughput capacity when you only need it every 20 years ?”
That challenge is further complicated by the huge changes in testing technology seen in the past two decades , notably a massive expansion of molecular detection
At the Helm
One key role of the laboratory director is to balance the multitude of external pressures — from federal officials , state government , and state and local health departments , sometimes simultaneously — with getting the job done . Laboratories are facing unusually heavy political pressure right now , making it extra challenging to buffer those outside pressures and meet demand without overwhelming the laboratory staff .
“ I feel like my role as lab director is first to make sure my people are okay , because they ’ ve been asked to do a lot , and make sure they have what they need ,” said Wolf . “ Then , trying to take care of other things that come along so they can focus on what we ’ ve asked them to do in the laboratory and aren ’ t overburdened .”
The current COVID-shaped spotlight on public health means that it is more important than ever for directors to advocate for the importance of public health laboratories and showcase their value and expertise , Pentella argues . “ We are now recognized for what we ’ re doing to support our states . And we have to use that platform well , to make others in our state recognize the importance of a public health laboratory . We can ’ t squander this opportunity ,” he said .
6 LAB MATTERS Fall 2020