PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Key Findings from the APHL 2023 All-Hazards Laboratory Preparedness Survey
By Jill Sutton Hanratty , specialist , Emergency Preparedness and Response
In fall 2023 , APHL fielded the 15th annual All-Hazards Laboratory Preparedness Survey to assess the capability and capacity of state and large local public health laboratories to prepare for and respond to all-hazards threats , including biological , chemical and radiological events as well as other emerging public health threats . Distributed to the 50 state , District of Columbia ( DC ), Puerto Rico , Los Angeles County and New York City public health laboratories , the survey covered the 12-month period from July 1 , 2022 to June 30 , 2023 , representing fiscal year ( FY ) 2022 of the US Centers for Disease Control and Prevention ( CDC ) Public Health Emergency Preparedness ( PHEP ) Cooperative Agreement . APHL received responses from 53 public health laboratories for a 98 % response rate . Here are some of the key findings from the assessment :
Funding and Workforce
• In FY2022 , 53 public health laboratories reported receiving more than $ 160.5 million in total funding to support preparedness activities . Of these funds , $ 16.6 million came from the state and other sources of funding and $ 143.8 million came from federal agencies , with $ 86.4 million attributed to the CDC PHEP Cooperative Agreement .
• Seventeen public health laboratories ( 32 %) experienced funding cuts and / or level funding that impacted preparedness activities . The top five preparedness activities impacted by level or funding cuts were increased staff turnover ( 70.6 %), unable to expand capabilities for new assays / tests / methods ( 52.9 %), unable to provide or reduced number of training courses and outreach activities ( 47.1 %), consolidated staff positions ( 41.1 %) and unable to purchase critical equipment ( 35.3 %).
• Other than funding , 52 public health laboratories ( 98.1 %) experienced barriers to carrying out preparedness activities . The top five barriers were non-competitive salaries ( 79.2 %), recruitment and / or retention of qualified personnel ( 73.6 %), response activities such as COVID-19 , mpox , flooding , fires , etc . ( 39.6 %), lack of training opportunities ( 34 %) and supply chain shortages ( 26.4 %).
• Twenty-eight public health laboratories ( 52.8 %) reported having a position dedicated to clinical laboratory outreach in addition to their laboratory ’ s Biological Threats ( BT ) Coordinator , Chemical Threats ( CT ) Coordinator and / or Biological Safety Officer who may also have duties related to outreach .
Preparedness Planning and Response
• Forty-nine public health laboratories ( 92.5 %) reported having a continuity of operations plan ( COOP ) consistent with National Incident Management System ( NIMS ) guidelines . Twenty-five laboratories ( 47.2 %) reported having a laboratory-specific COOP and 24 ( 45.3 ) reported their state agency / department-wide COOP includes the laboratory . Four public health laboratories ( 7.5 %) reported not having a COOP in place for FY2022 , however three ( 5.7 %) reported that the laboratory or state is developing a COOP .
• Public health laboratories conducted or participated in a total of 319 preparedness exercises in FY2022 . 23.5 % were discussion-based tabletop exercises and 76.5 % were operations-based drills , full-scale or functional exercises . Full-scale exercises for BT or CT were the most common , making up 31.7 % of preparedness exercises that public health laboratories conducted or participated in .
Biological Threats Preparedness
• All 53 public health laboratories maintain a database of active sentinel clinical laboratories for their state or jurisdiction , capturing key contact information and capabilities for 3,481 active laboratories across the country . Thirty-six ( 67.9 %) sponsored sentinel clinical laboratory trainings for biological threats , offering 564 training classes to 999 clinical laboratory facilities , reaching 4,054 laboratorians in one year .
Chemical Threats Preparedness
• Forty-nine public health laboratories ( 92.5 %) have either maintained ( 39 ) or increased ( 10 ) their Laboratory Response Network for Chemical Threats Preparedness ( LRN-C ) capabilities .
Radiological Threats Preparedness
• Twenty-two public health laboratories ( 41.5 %) reported having the responsibility for radiological surveillance and response testing within their jurisdiction . Thirty-one ( 58.5 %) reported not being responsible and if known , specified which agency is responsibility for their jurisdictions ’ radiological surveillance and response testing .
APHL would like to acknowledge and thank the 53 public health laboratories that provided data for last year ’ s survey . An in-depth summary of the findings from the 2023 All-Hazards Laboratory Preparedness Survey is forthcoming . For more information about the survey , please contact Jill Sutton Hanratty at jill . sutton @ aphl . org . g
30 LAB MATTERS Summer 2024
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