MEMBERSHIP
• Instituting an internal career ladder
and a merit pay system that boosts
salaries beyond the city’s periodic
cost-of-living increases and mandatory,
step-level increases based on years of
service. Said Tran, “Our salaries have
to be competitive with the federal
government and with area hospitals.”
Challenges
• The laboratory’s “rarely say no” ethos
and limited staff mean leaders must
“be innovative and think outside-
the-box” to meet their commitments.
At present, a major strategy is to “move
toward robotics and automation to
reduce the burden on staff” said Tran.
The LEED platinum certified facility at 401 E Street, SW. Photo: DC PHL
Success Stories
• Developing a “sequencing core” that
processes and tests biological samples
on behalf of other laboratory units and
provides the data back to them. Over
the course of 2018, DC PHL “went from
no PulseNet WGS and one sequencer
to PulseNet WGS certified and four
sequencers.” In addition, staff are
“taking the manual work out of next
generation sequencing (NGS)” and
applying NGS technologies to novel
areas; for example, using automated
nucleic extraction and library
preparation and developing CLIA-
approved field protocols to enable NGS
at point-of-care sites
• Achieving surveillance of nearly all
heroin and most other synthetic
opioids and cannabinoid drugs seized
by DC law enforcement personnel in
undercover buys or arrests—perhaps
the only US jurisdiction to do so.
Laboratory drug testing—supported by
a cooperative agreement from CDC—is
independent of any legal proceedings
and has so far identified roughly
half a dozen opioid analogues and
half a dozen synthetic cannabinoids
previously unseen in DC.
• Providing technical expertise to DC
government leaders. Despite its
national and global prominence, the
DC government is small enough that
“we’re able to interact intimately with
other agencies,” said Tran. A recent
collaboration with the DC Office of
the Attorney General led to the SAFE
PublicHealthLabs
@APHL
DC Act, which completely revamps
the city’s controlled substance’s list.
Said Luke Short, PhD, chief of the
PHL’s chemistry section, “As you find
new, opioid analogues and synthetic
cannabinoids on the street, if they’re
not in the law, you can’t arrest anyone
for possessing or selling them.” Instead
of enumerating such analogues drug-
by-drug, the SAFE DC Act creates a
taxonomy of controlled substances,
based on the class of chemical
compounds in the drugs. “DC is
pioneering a whole new approach to
dealing with controlled substances,”
said Short.
• Working with the DC medical examiner
on quick-turnaround “STAT” requests.
As Tran explained, “STAT requests
might seem unusual for someone
who is no longer living. But here, if the
medical examiner, upon autopsy, finds
signs of anything potentially highly
contagious, they will request a STAT
test to quickly identify the cause of
demise. A couple weeks ago, we had
such a request, and the cause of death
was identified as meningitis, which
is highly contagious and can pose a
severe public health threat, if that is
what killed the person.”
• Ramping up the city’s influenza
surveillance program, which increased
its scope by 700% between 2017 and
2018, in terms of specimens analyzed.
“In 2019, we will double that,” said Tran.
APHL.org
• Being part of a stand-alone, laboratory-
based department means the PHL
has to “work a little harder to assure
optimal coordination with the [city]
health department.” Tran said, “We
want folks to know we’re here and
available for them.”
• Although there are well over a million
people present in DC at any time, day
or night, the PHL is sometimes stymied
by funding algorithms based solely on
the size of its residential population
(about 700,000 people).
• The complex interplay between the DC
and federal governments sometimes
creates extra challenges. “If there is a
Legionnaires’ disease outbreak at the
NASA facility across the street,” said
Tran, “DC Health would be responsible
for responding to that outbreak, even
though it’s a federal property.”
Goals
• Provide city agencies with “the best
available laboratory expertise to
recognize and respond to emerging
health and safety threats.”
• Continue building the laboratory’s
next generation sequencing testing
capabilities.
• Re-establish the laboratory’s STD, HIV
and TB testing program.
• Employ the PHL’s state-of-the-art
facility as a demonstration laboratory
for other PHLs. n
Spring 2019 LAB MATTERS
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