PARTNER PROFILE
Now that opioids are being treated as
a public health issue, will this help
laboratories get funding to set up their
own opioid biosurveillance programs?
Yes, there’s been a lot of headway made.
It definitely is a public health issue with
opioid use pervasive across the public.
One of the issues across multiple types
of laboratories—forensics, public health,
private testing, pain testing—was the
need for consistent reference materials.
CDC and APHL recognized they could
assist all of them by providing the
correct reference materials for testing
targets. Together with APHL, DEA and
the US Department of Justice, we helped
create a set of traceable opioid material
(TOM) kits that enhanced the quality
of testing across the US to improve the
characterization of the opioid epidemic
and obtain better information to help
address it.
You’ve had a hand in developing the
Laboratory Response Network (LRN),
which recently celebrated its 20th
Anniversary. What has been the biggest
change you’ve seen in how the LRN
works?
I would say one of the biggest changes
that strikes me is the fact that the
network, when it first began, was geared
towards large emergencies or emergencies
involving weapons of mass destruction.
In public health, you really have to pay
attention to what’s right there in front
of you. So in the last five to 10 years, the
LRN has been retooled and re-tasked
to support local emergencies as well as
major events with a national impact.
It’s been very rewarding to see local
entities responding to their own needs
in everything from the water crisis in
Michigan to biomonitoring to different
natural disasters.
The way that federal, state and local
laboratories connect and share data
has radically changed over the past five
years. What are some lessons learned
from the EVALI response that public
health laboratories can put into practice
today?
State laboratories were able to take the
lead in this major response and then
share the burden across the LRN, working
collaboratively with CDC. To facilitate
that, there had to be very effective
communication first on what was the
nature of the emerging threat. Some of
the big things that happened across the
network were the use of “cutting-edge”
resources, the characterization of the
initial threat, and then the sharing of large
amounts of laboratory information on a
more consistent level so that we can get
our hands around the entire threat. The
LRN was able to provide a bridge for all of
those activities.
Even though we are consumed by the
coronavirus pandemic, there’s still work
being done, especially to characterize
some of the EVALI fluids that were used.
There are still publications coming out
on EVALI, and there’s information that
needs to be shared to characterize what
happened and to prevent a similar event
from occurring in the future. It’s fair to say
coordinating COVID-19 has put a strong
burden on the system. But one of the big
objectives in public health is to always
to make sure that you close out the last
epidemic, learn everything you can from it
and prepare for the next one.
APHL has worked continuously with
CDC to advance and build the LRN. How
can APHL continue to support the LRN’s
efforts?
APHL is one of the reasons that the LRN
has been transformed into a network that
can handle challenges at many levels
and represent many interests. The LRN
is no longer something which is newly
established—every year it grows in its
own way. It’s as though the LRN has its
own career and that career is moving
forward. It has its own pulse and you can
feel it when you go to a meeting. Through
the presence of the network we can take
care of problems in the present and we’re
preparing for the new and more difficult
challenges in the future. One of the best
parts of the partnership between APHL
and LRN is the ability to look forward.
Because the reality is by the time an
emergency shows up, it’s too late to
prepare for it. n
PublicHealthLabs
@APHL
APHL.org
Spring 2020 LAB MATTERS 11