88: Labs Prepared for Winter

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Monday, December 20th, 2021. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

The Omicron variant is taking hold in the U.S., infecting more people faster than expected. It's got public health officials worried about the next few months as people gather again for the holidays and cold weather forces them indoors.

Despite Omicron, ASTHO CEO Mike Fraser hopes the new year signals a shift in the pandemic.

MIKE FRASER:

Well, I think we've got a lot to look forward to in 2022. I think we'll know a lot more about COVID, for example. But, you know, I think it's premature to be able to say, like, "2022 is going to be the end of the pandemic."

I think we're just hoping for maybe a slower cadence, more developments in terms of treatments; but also, you know, more people getting vaccinated and just beginning to, in some ways, normalize this.

I think most health officials would say 2022 is going to be about the pandemic becoming more endemic and integrating it into the typical work of public health.

JOHNSON:

Public health labs have learned a lot from the pandemic. Kelly Wroblewski is the director of infectious diseases for the Association of Public Health Laboratories. She explores COVID lessons in today's morning conversation.

What have public health labs learned from the pandemic?

KELLY WROBLEWSKI:

I think—in particular when it comes to public health responses—previously everybody would plan for surges to last two weeks, four weeks, six weeks, not two years. So, I think that is probably the most important lesson that we have to take forward is that we really need to make our plans sustainable for a long response and need to pull in other laboratories, the entire laboratory system. The response can't just be based in public health and public health laboratories because if a response goes on a very long time, the testing is going to need to take place in all sectors, not just the public sector.

Beyond that, I think we've learned that laboratory workforce is—the bench is very, very narrow, we do not have a deep bench. There are not a lot of people that are qualified to step in when we do have to search for a long duration; so, building up those workforce pipelines in the next 5–10 years is going to be incredibly important and really critical to be able to respond effectively the next time.

JOHNSON:

Have labs run into any problems with technology or equipment during the pandemic?

WROBLEWSKI:

Yeah, I think that's another really important lesson learned—like I said, there's so many.

Previously, we had thought we were building a system and laboratory testing capacity that was diversified enough. Very early in the pandemic—March and April 2020—we ran into supply shortages and there just weren't supplies to be had, even though we thought we had diversified our testing platforms enough. So, I think going forward that diversification and making sure we are building testing capacity and capability on multiple testing platforms will be important.

And then, beyond that, I think of course, genomic sequencing and the importance that that's played over the last year in detecting new variants quickly. I think we knew that was important, we knew that that was coming; but the pandemic really accelerated the pace with which public health laboratories were able to implement that technology.

JOHNSON:

What approach should public health labs take to deal with or prepare for the future?

WROBLEWSKI:

Yeah, I think it has to be really flexible, right? And I think there are plenty of public health problems to tackle even when we're not dealing with a pandemic or to responding to a pandemic. There's always emerging pathogens—there are always problems in public health that we have to face in the infectious disease space like STIs, like foodborne disease, like influenza and other respiratory pathogens.

And so, I don't think we're ever short of things to do or things to test for. It's just about having sustainable funding and being able to sustain the funding levels with which we need to maintain that technology and those platforms and that capacity.

JOHNSON:

As we read predictions of another COVID surge coming, we see the case load going up already. Do labs have everything they need to get through the winter?

WROBLEWSKI:

I hate to say yes, right—I feel like I'm going to jinx it—but I do think we are in decent shape.

There are still supplies that are very, very tight—plastics, I've been talking about plastics for the last two years, but plastics is one of those supplies and one of those areas where the supply and the margin is really tight. So, if there is anything that happens in the supply chain to disrupt the supply of plastic materials that are used in testing, we feel it pretty quickly. So, that is an area that we're watching really closely.

But beyond that, I do think for laboratory-based testing, we're in very good shape. The availability of at-home tests or self tests, I think that's been widely discussed as being tight, and I know that there are lots of efforts to increase manufacturing in those areas. But for lab-based testing, I think we are okay.

JOHNSON:

ASTHO is thinking about lessons learned from the experiences of 20 disability and preparedness specialists who spent a year working to make sure people living with disabilities are included in pandemic and disaster response plans.

There's a webinar on the topic set for Tuesday, January 18th. During the meeting, seven of the specialists are scheduled to discuss their successes and challenges.

There's a link to register for the afternoon event in the show notes.

Finally today, ASTHO has a new blog article focused on rising cases of viral hepatitis. It includes several ideas jurisdictions might consider as they make plans to slow infections.

As always, you can read more using the link in the show notes.

That'll do it for today's report.

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Be sure to join us again tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.