Lab Matters Spring 2020 | Page 29

PUBLIC HEALTH PREPAREDNESS AND RESPONSE Response and Restoration: Public Health Systems in Puerto Rico and the US Virgin Islands By Jill Sutton, associate specialist, Crisis Response In recent years, natural disasters have intensified and become increasingly more frequent, placing immense pressure on the public health systems that respond. The consecutive waves of destruction brought on by Hurricanes Irma and Maria in 2017 caused severe damage to facilities and key public health infrastructure in Houston, Texas, Puerto Rico and the US Virgin Islands (USVI). Following the 2017 hurricane season, APHL was awarded a $15.1 million cooperative agreement by the US Centers for Disease Control and Prevention (CDC) Center for State, Tribal, Local and Territorial Support (CSTLTS) to help restore essential public health services and strengthen recovery within those three jurisdictions. Though more than two years have passed since hurricanes Irma and Maria made landfall, the impact on the public health systems of Puerto Rico and USVI still lingers. APHL continues to work collaboratively with CDC and personnel at both territorial health departments to increase workforce capacity; support technical training and professional development for new and existing staff; and expedite the procurement of supplies, equipment and services needed to restore and maintain essential public health services. Since December 2018, APHL and the territorial health departments have been able to: Puerto Rico • Increase workforce capacity by hiring 49 new personnel • Travel 14 staff to attend trainings and conferences • Procure over $1.6M in equipment and over $1.7M in supplies, including 20 new laboratory instruments, 10 custom built back-up generators and more than 75 refrigerators and freezers. Chawnique Schrang operates Hologic’s Panther platform which is used for STD testing. Photo: USVI PHL • Execute four contracts, such as the implementation of video direct observation therapy for tuberculosis patients and the successful infrastructure repair of the PRDOH’s central laboratory. US Virgin Islands • Increase workforce capacity by hiring 13 new personnel • Procure over $190,000 in equipment and over $170,000 in supplies, including four new laboratory instruments and a 40 foot refrigerated container. • Execute five contracts, such as the implementation of a public health data repository to integrate healthcare data of public health significance and initiate a feasibility project to assess the use of drones for transporting specimens between St. Croix, St. Thomas and St. John. APHL is working with the jurisdictions to address sustainability after August 2020 and to build on the lessons learned from the past two years to improve their preparedness and response capabilities. Katia Matias loads the centrifuge with cistern water samples. Photo: USVI PHL The 2017 Atlantic hurricane season is a reminder that natural disasters and other public health emergencies escalate rapidly, have the potential to cross jurisdictional lines and can occur in quick succession or simultaneously. The inevitability of these events reinforces the importance of preparedness activities that can help mitigate the impact of future natural disasters and other public health threats. n PublicHealthLabs @APHL Spring 2020 LAB MATTERS 27