How the pandemic has revolutionized one state's public health response

The Biden administration plans to send 500 million free at-home COVID-19 test kits to Americans via the U.S. Postal Service in early January 2022, but it's a historic effort that has, perhaps predictably, run into some snags.

At the height of the Omicron variant outbreak, logistical obstacles put testing out of reach for many people, and after receiving numerous negative reports from residents who said they never received their results or received delayed results for weeks, Washington state health officials decided to act: They bought their own test kits and worked with Amazon to provide next-day delivery.

Elizabeth Perez, communications and equity director for the Washington State Department of Health, said the effort shows what's possible when government leaders are innovative in finding solutions.

Currently, state residents want all of their packages delivered the next day in Amazon boxes, Perez said during a panel discussion at the Amazon Web Services Summit in Washington, D.C., last week. The initiative, known as “Say Yes to the Test,” has successfully delivered more than 13 million COVID-19 test kits to state residents.

But it can be hard for governments to innovate if they can't overcome the fear of failure. Les Becker, head of innovation at the Department of Health, said changing the culture within the department was key so new ideas would flow freely and be supported, even if they ultimately didn't work out.

Removing Fear [of failure] “From an innovation standpoint, getting people to be open with their ideas is probably one of the hardest things we have to do,” Becker says. “For us, it's really important to create an environment where people feel open and supported in that area.”

Health department officials are already toying with some ideas as part of a broader transformation process that Becker points to as a new approach to public health after the pandemic ends. The department is experimenting with expanding the use of pollen sensors, for example, to provide more accurate information about air quality.

Community engagement has also been revamped as health officials try to overcome the misinformation and distrust that has spread during the pandemic. Previously, when health officials wanted to share information with hundreds of community groups, Pérez and his colleagues would convene Zoom meetings, but it was hard to keep the meetings orderly, keep the conversation flowing and take notes, he said.

The department is using AWS to create online community groups to help people connect with each other, share resources and information, and get questions answered by the state without having to attend lengthy meetings. Perez said Washington doesn't have to be the organizer of the meetings; instead, state officials can let residents and community groups lead the discussions.

Eventually, public health may be able to use generative artificial intelligence to provide more predictive capabilities, such as informing people about benefits they may be eligible for when they reach a certain age, or sending their health data to hospitals for more seamless treatment if they are hospitalized after a road accident.

Having data available for these predictive tasks is crucial, but not always easy given the obstacles that still exist within government.

Kim Majerus, AWS' U.S. education, state and local government practice leader, said in an interview at the summit that it comes down to a fundamental challenge for government and education: Where is the data, and what do we do with it? The good news is, we know the data is there. The bad news is that the data sits in different departments.

One less tech-heavy but more innovative initiative born out of the pandemic is the department's partnership with Amazon Fresh to offer free grocery delivery to Supplemental Nutrition Assistance Program recipients in the state. Users can access a first-of-its-kind portal to order groceries and have them delivered. Perez said the initiative has been a big success, with plans to expand.

Becker, Washington's innovation chief, said the portal shows that innovation can take many forms in state government and doesn't have to rely solely on technological advances.

“There is innovation without technology, there is innovation supported by technology, and there is innovation caused by technology,” Becker said.

As public health officials still consider the long-term impacts of the pandemic and seek to learn lessons to prepare for future emergencies, Becker said the once-in-a-lifetime experience of COVID-19 should force leaders to rethink how their departments operate.

“Everybody has a tendency to want to forget about COVID, about public health, about all of these things,” he said. “But if we do that, regardless of what happens in the next 10 years, five years, two years, we're going to go through the same problems again that we went through as a system. And then, as our bosses like to say, shame on us.”

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