CHIEF EXECUTIVE OFFICER’S MESSAGE
The Value of Public Health Infrastructure
It is no surprise that our time at
APHL is now devoted largely to novel
coronavirus (COVID-19) response. Yet,
amidst questions about case counts
(now topping over 10,000 globally), the
pathogen’s virulence (still unclear, but
some illnesses have resulted in death)
and implementation of the anticipated
COVID-19 assay, I am also fielding many
questions about funding.
Historically, the trajectory of public health
funding has been like a rollercoaster
ride, meaning that the down times are
tough. An outbreak occurs, funding
appears, and we make good use of that
funding because we’re expecting the next
drop into the trough. The ride is always
more harrowing than we’d like. And it’s
certainly not the best way to maintain or
enhance one of America’s principal health
security assets.
While I have no magic bullet to end the
ride, I do see some signs that members of
Congress understand the immense value
of America’s public health infrastructure. I
was, for example, happy and relieved that
in the last appropriations cycle Congress
provided funding to CDC for a data
modernization initiative—although not
as much as we hoped. Frankly, the public
health data infrastructure is not incredibly
sexy; it doesn’t capture the imagination
like SARS or Ebola or anthrax. Yet it is
of paramount importance for near-real
time transmission of public health data,
including electronic test ordering and
results reporting (ETOR), a key component
for disease surveillance.
Overall, there are five key aspects of the
public health laboratory infrastructure:
highly trained laboratory scientists,
state-of-the-art instrumentation, the data
infrastructure (especially the laboratory
information management system or
LIMS), safe and secure laboratory facilities,
and quality laboratory systems to ensure
we have accurate test results every time.
PublicHealthLabs
@APHL
What does concern me right now?
Funding for biosafety and biosecurity
initiatives for public health laboratories
ended when Ebola funding stopped
flowing. As we saw during that crisis,
biosafety was an issue in the lab
community. Yet that funding was dropped
as the rollercoaster went over the cliff.
As we respond to COVID-19, the issue
of biosafety surfaces yet again with
laboratories concerned about routine
testing and safely implementing new
assays. A critical position in laboratories
is a dedicated biosafety officer who works
across the laboratory and outwardly with
private clinical laboratories to strengthen
safety. Via Ebola funding, public health
laboratories had the resources for a
dedicated biosafety officer. As that
funding ended, public health laboratories
began to combine positions—that is, one
staff performing multiple roles—and
we are now seeing reduced outreach to
clinical laboratories. All laboratories—
private and public—need a dedicated
biosafety officer.
Let’s also not forget how important global
health security is to the United States and
to our partners around the world. After
all, the new coronavirus, SARS-CoV-2,
a sister to the severe acute respiratory
syndrome coronavirus (SARS-CoV)
originated thousands of miles from the
US. SARS-CoV hit Canada particularly
hard, killing 44 people and costing that
country an estimated $1.5 billion in
lost economic activity. Already, China’s
economy is stumbling under the weight
of COVID-19.
Let’s not forget the lessons we learned
during the 2009 H1N1 influenza
pandemic—documented in the APHL
publication, Lessons From a Virus. One
of the most important of these was to
be flexible as imperatives change along
with the changing, unfolding, evolving
outbreak. This can only happen with
access to flexible funding that can be
applied where needed.
APHL.org
Let’s not forget the lessons
we learned during the 2009 H1N1
influenza pandemic. One of the most
important of these was to be flexible
as imperatives change along with
the changing, unfolding, evolving
outbreak. This can only happen with
access to flexible funding that can be
applied where needed.”
Scott Becker, MS
In any case, as your laboratory deals with
COVID-19, please jot down any lessons
learned. I’d like to catalogue those lessons
and share them at APHL 2020 in Portland,
Oregon, in June.
Finally, this seems a good opportunity to
mention a new APHL event focused on
the laboratory science aspect of infectious
disease—ID Lab Con, a conference
intended for public health laboratory
professionals, clinical laboratorians,
epidemiologists, researchers and
diagnostics developers. The kick-off
conference—ID Lab Con 2020—will take
place in August in Atlanta, Georgia. I hope
to see you there. I’m pretty sure COVID-19
will be on the agenda. n
Winter 2020 LAB MATTERS
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