Lab Matters Winter 2020 - Page 5

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 3