public health preparedness and response
2017 APHL All-Hazards Survey: A Year in Review
by Samuel Abrams, MPH, specialist, Public Health Preparedness and Response
In fall 2017, APHL issued its annual
All-Hazards Laboratory Preparedness
Survey to all 50 states, the District
of Columbia, Puerto Rico, New York
City and Los Angeles County public
health laboratories (PHLs) to gauge
the nation’s ability to prepare for and
respond to biological, chemical and
radiological threats. Fifty-three PHLs
responded to this survey for an overall
response rate of 98%. Here are some
key findings from this assessment.
PHLs Continue to Advance
The Zika response challenged the capacity
of the public health system greatly. As
a result, laboratories are evaluating
their surge capacity and exploring
options to partner with the private
sector, for example, commercial and
other large private clinical labs. Despite
these challenges, PHLs stepped up and
supported an almost two-year response to
Zika. With strong local partnerships and
federal support, they demonstrated that
they can quickly adopt new technologies
and respond to the next threat.
Partnerships are essential for an
effective response to chemical,
biological, radiological, nuclear and
emerging hazards. PHLs continued to
strengthen partnerships by working
with their sentinel clinical labs (e.g.,
hospitals); teaming up with their local
National Guard Bureau Civil Support
Team (CST); and collaborating with the
Federal Bureau of Investigation (FBI)
Weapons of Mass Destruction (WMD)
Coordinators as well as many other
local, state and national partners.
Since the public health system relies
heavily on sentinel clinical laboratories
for sample collection, rule-out and/
or referral of possible threats, outreach
and training for these laboratories is
critical. All 53 PHLs maintain a database
of active sentinel clinical labs in their
jurisdictions, capturing key contact and
capability information for nearly 4,000
sentinel clinical labs. Moreover, 45 PHLs
offered more than 400 training courses to
16
LAB MATTERS Winter 2018
Zika virus
over 1,300 clinical laboratories, reaching
3,000 laboratorians in one year. These
courses were delivered via a mix of
hands-on training workshops, interactive
webinars and large regional meetings.
Biosafety remained a key focus of training
courses with topics such as donning
and doffing procedures, performing
risk assessments and proper utilization
of personal protective equipment.
Challenges Still Remain
Despite these achievements, PHLs still
faced adversity in this past fiscal year.
Many cited barriers to exercising chemical
response plans, including challenges
tied to hiring freezes, lack of funding
and issues finding qualified applicants.
General preparedness activities also
lagged, with funding and hiring issues
as primary culprits. Some laboratories
struggled to maintain their laboratory
information management systems,
which are critical for relaying test
results to partner agencies. Additional
struggles included the inability to
purchase critical equipment such as
molecular assay instrumentation,
automated extractors and biosafety
cabinets, all of which are essential
for laboratories to operate effectively.
These issues, which have plagued PHLs
for years, can lead to vulnerabilities
in an already overtaxed system.
But in spite of these hardships,
laboratorians continued to perform
at the highest levels to protect the
nation from the next potential threat.
An in-depth summary of the findings
from the All-Hazards Laboratory
Preparedness Survey is forthcoming.
For more information on the survey,
please contact Samuel Abrams at
[email protected]. n
PublicHealthLabs
@APHL
APHL.org