Lab Matters Winter 2018 - Page 18

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 n PublicHealthLabs @APHL