Lab Matters Summer 2020 | Page 13

PARTNER PROFILE Cody, the Santa Clara County health commissioner, and the current New Orleans health commissioner Jen Avegno. Like others across the nation, they have been making a difference even in the face of limited resources and historic challenges. They and others have set a great example of what it means to show strategic leadership and use stature to encourage partnerships across sectors. Can you give us a thumbnail of Public Health 3.0, especially since COVID-19? Public Health 3.0 refers to a new era of enhanced and broadened public health practice that goes beyond traditional public department functions and programs. It was a signature project for me and my team and we released the vision paper in the fall of 2016 while I was serving in the Obama Administration. It grew from my own experiences as New Orleans health commissioner from listening sessions with hundreds of front line public health and community leaders across the country. There are five core areas identified that lead to a 21st century local health department: 1) Chief health strategiststyle leadership; 2) Cross-sectoral collaboration with strategic partners; 3) Performing essential functions as part of accreditation; 4) Modern data infrastructure and digital approaches; and 5) Flexible funding. It is precisely the foundation that would have been helpful for public health in this time of crisis. Though many states and localities have adopted the model, the weaknesses in the data and financing models have made response to COVID-19 a challenge. Increasingly, public health leadership across the country is calling for modernization and use of this vision as the framework, including the funding model of the Public Health Infrastructure Fund. Technology has traditionally been a stumbling block for public health. What can be done to remove the difficulties? It is widely accepted that the data infrastructure supporting public health is wildly outdated. It struggles to meet the needs of today, even pre-pandemic. To remove roadblocks, we need to see a lot of collaboration with the private sector, and recognition from healthcare leaders in the US that there is a need to modernize public health infrastructure. APHL has demonstrated that it is possible to partner with big tech companies like Apple, Microsoft and Google, and leverage their data and technology to augment the work of public health. Technology companies shouldn’t be the ones proposing recommendations, but rather sharing information with our public health partners to empower them to do so. As public health data becomes more available, how can public health address long-standing disparities in treatment and care for underserved and unserved populations? You can’t manage what you can’t measure. The data available to public health for routine surveillance of communities is often stale by the time they obtain it, making it difficult to act on. For instance, the Secretary of Health might be working with, and making decisions, based on 2-3 year old data. Emerging partnerships, including ones coming to head during COVID-19 between public health and sectors like medicine and technology, make for better data sharing and more access to information in real time. This better addresses the needs of marginalized populations, whose members may have more trust in public health than the medical system. This is one of the reasons we are partnering with Morehouse through the Satcher Institute, to develop a better equity surveillance system. APHL has partnered with Google and other tech companies to provide exposure notification technology. How will this help public health agencies support their communities? Our partnership with Apple and APHL on exposure notifications is a perfect example of how tech companies can partner to augment the important work of public health. As public health agencies have rolled out traditional forms of contact tracing in response to the pandemic, we’ve seen modern-day challenges that we needed to adapt to. For example, people often don’t answer unknown calls which might be a notification from public health. Through our partnership, mobile devices can be used in an automated and scalable way to help determine who has been exposed to a person that later reports a positive diagnosis of COVID-19. For example, they can be used to send a rapid notification to the exposed person with instructions on next steps. These notifications can be beneficial by alerting an exposed individual faster than they would be notified via conventional contact tracing. They’ll enable public health authorities to contact and provide guidance to the individual and, where appropriate, include them in conventional contact tracing efforts. Without the national server from APHL, each state implementing the technology would be responsible for its own datasets. APHL’s involvement makes it possible for this program to support every state public health agency. We’re so thankful APHL is a partner to Google and Apple on our exposure notification effort by building and hosting a national key server in partnership with Microsoft. This will help to ensure our exposure notifications are effective as users travel across state lines. APHL staff and the board have shown tremendous leadership in this and other ways during the pandemic. n Dr. DeSalvo will give the Dr. Katherine Kelly Distinguished Lecture, “Public Health 3.0: A 21st Century Model for 21st Century Challenges” on Wednesday, October 7 at 1:00 pm ET at the APHL 2020 Virtual Conference. Learn more and register. PublicHealthLabs @APHL APHL.org Summer 2020 LAB MATTERS 11