Who will vaccinate people during the next pandemic? US public health sector lags behind

Arguably, one bright spot in the US’s overall checkered response to COVID-19 is Record-breaking development of an effective vaccine Largest vaccination campaign The country has taken on. All the communication about ‘travel bans’ or ‘lockdowns’ or conducting tests was a mess, but within a year of the outbreak in Wuhan you could have those shots in people’s arms. Did you? It was a glorious success.

But since then, warning signs have piled up that the country is not ready for its next big event. The decline of the very same public health workforce, including many individuals who have

Public health workers are no less important in surviving COVID-19 than the thousands of doctors, nurses, and other hospital staff who have seen their work environment turn into a contagious war zone overnight. bottom. If another disaster inevitably strikes, these workers will again assume responsibility for monitoring new disease threats, tracking existing ones, applying control measures, and organizing vaccination campaigns. increase. However, the pandemic has significantly reduced their ranks. Believe it or not, the public health sector may be less prepared for the pandemic than he was in late 2019. But they are actively stepping back when it comes to building a better public health system.

Organizations such as the de Beaumont Foundation and the Association of State and Territorial Health Officials (ASTHO) National survey To better understand how public health workers are holding up. Statistics are scary. About 46% of state and local public health workers will quit their jobs between her 2017 and he 2021. For staff under the age of 35 or with less than 5 years of experience, this he exceeds 70%. These figures mean that older public health workers continue to retire from the workforce while disproportionately losing junior entry-level staff.

If those numbers aren’t bad enough, a 2022 study by deBeaumont and ASTHO showed that: nearly a third of current public health workers are considering leaving their jobs next year.and number of public health workers About 200,000 people heading into the pandemic are already 50,000 fewer than in 2008. This means it is at risk of losing about 70,000 more workers from its already stretched workforce.

Despite its critical role in responding to biological threats (and beyond), public health continues to struggle with adequate investment.Each year, or each crisis, Congress pass Fund the CDC, and the CDC distributes resources to the states.apart from definitely a bigger need, the CDC has suffered an overall (inflation-adjusted) 2% budget cut over the past decade. Congress may point to temporary pandemic-era funding pots like the Epidemic Rapid Response Preparedness Fund, but these are largely limited to his COVID-19 response efforts. They are the opposite of the required sustained and stable funding.

In response to this dire situation, the United States is preparing for the next major biological threat. Of course, Washington officials understand that another pandemic is possible. They made a plan so that we can do better next time.For example, in 2022 the Biden administration will Updated National Biodefence Strategy, a 53-page document detailing how the U.S. government intends to prepare and respond to natural and deliberate biological threats. We are focused on continuing partnerships with governments and the private sector to ensure the ability to rapidly innovate, research, develop and mass-produce antivirals and other therapeutics. This goal definitely has merit. Not surprisingly, many public health leaders and researchers have their sights set on broad-spectrum antivirals that can target more broadly a family of pathogens rather than a single pathogen or single variant at a time. I am particularly excited about the great potential that has been created.

At the same time, frankly, who makes those innovations and great discoveries count? As the COVID-19 pandemic has made clear, there is a difference between vaccines and immunizations. One aspect of him that the National Biodefence Strategy doesn’t seem to adequately account for is the critical state of our public health workforce.

The words “workforce” or “recruitment” are explicitly mentioned only three times throughout the document. Moreover, even in such cases, the focus is on public health laboratories and technicians who understand the relationship between environment, animal and human health, and laboratory staff such as “One Health” professionals. is assigned. And absolutely, the strategy does a great job of recognizing the risks of zoonotic spread of animal pathogens, so recruiting this kind of expert will be key to moving forward. Yet even these references, in essence, vastly obscure the current state of the public health workforce.

There are two implicit assumptions about the public health workforce in this strategy. (1) By not mentioning the need to rebuild the public health workforce, this strategy means that the public health workforce will remain the same as it was pre-pandemic. (2) Lacking a clear action item for ensuring a strong public health workforce, this strategy relies on ensuring that the public health workforce is generally robust, well-resourced, and well-supported; is also assumed. Both of these assumptions are far from the truth.

The reality is that the public health workforce was already strained prior to the pandemic, and during the response to COVID-19, not only physical numbers but, importantly, the mental health of practitioners. But it has plummeted.

Gerrit Bakker, former director of the Colorado Department of Public Health, said public health workers have generally accepted that “burnout comes with communities.” But the pressure of the pandemic has proven too great. It wasn’t just a shortage of resources and a surge in demand. Employees faced relentless harassment, especially as public health officials became the target of protests against his COVID-19 policies. In contrast to the many health care providers that were celebrated, public health workers were not viewed with the same heroic lens. Mackenzie Laub, a former employee of Pennsylvania’s county public health department, spoke of the harassment public health officials faced in the form of phone calls, emails, protests, and direct public confrontations.

Strengthening and improving the public health sector will be critical to delivering on the promise of national biodefense strategies and other plans to increase national resilience to pandemics. Rebuilding this workforce as soon as possible is critical to stop further bleeding of both institutional knowledge and the organizations needed to carry out the response. Because while the world may be tired of hearing anything about outbreaks and viruses, the unfortunate reality is that COVID-19 will not be our last pandemic.

With climate change, there will be an increase in natural disasters such as hurricanes, which will lead to the loss of homes, displacement and other crises, creating conditions for disease outbreaks. With increasing globalization, population growth, overcrowding, and poor sanitation can lead to the spread of disease. With urbanization comes new interactions between humans and wildlife, increasing the likelihood of spillover events. But while humans cannot resist all forces in these scenarios, they can prepare and respond to prevent a single event from turning into a full-blown pandemic. , is the cornerstone of this larger strategy and should always be.

The threat of future pandemics will again require public health workers to plan immunization clinics and conduct community outreach. As public health departments and federal agencies try to improve data collection and upgrade their systems, public health workers remain unsuccessful in collecting and analyzing data on everything from race- and age-based disease prevalence to the presence of pathogens. should participate in the analysis. nearby wastewater. And while the Biden administration’s National Biodefense Strategy discusses the need to combat misinformation and disinformation, outreach efforts and building trust cannot be done with AI chatbots and web pages alone. We have the time and resources to take on these roles.

The 2022 National Biodefence Strategy represents a significant improvement from the 2018 edition. The 2018 edition lacked details such as specific action items on how to implement the ideas within. While the 2022 iteration is a more concrete roadmap for moving forward, Congress and public health leaders are digging a little deeper to see if, as a country, we fully recognize the devastation COVID-19 has wreaked on top of our previous state. You should consider if you are explaining. – Existing vulnerabilities. The public health workforce is just one potential example. After experiencing COVID-19, public health departments may think he’s ten steps ahead of 2019 and fully prepared for the next big thing. In reality, it only lags further behind. Staff are under-resourced and burnt out. Many of Bakker or Raub’s former colleagues have either retired early or have continued to leave for other career opportunities. General long-term investment in pandemic preparedness will most likely require formal federal recognition of the public health foundational role in our nation’s hitherto lacking biodefense capabilities. expensive.

The Biden administration will lift the COVID-19 public health emergency declaration on May 11. This is a sort of official end to the pandemic response in the United States. All critical components, including public health staff, to ensure that America’s biodefense capabilities are robust and ready, whether it’s the next variant tomorrow or a bioweapon attack ten years from now. But they can’t exist just hanging by a thread. Rather, they all need to be resourceful, diverse, and thriving.