1197: Building Public Health Infrastructure for the Next Emergency

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Wednesday, September 2, 2026. I'm John Sheehan with news from the Association of State and Territorial Health Officials.

 

South Carolina is investing in public health infrastructure designed not just to meet today's needs, but to prepare for the next crisis. Today, Brannon Traxler, acting director for the South Carolina Department of Public Health and an ASTHO member discusses the state's new public health and environmental laboratory, built to replace an aging facility that struggled to handle the demands of COVID-19 testing and modern laboratory equipment.

 

BRANNON TRAXLER: 

The new lab is one of a small number of CDC laboratory response network level one facilities capable of high-volume surge testing for chemical threats and other emergencies, the need became urgently and just increasingly apparent during the COVID-19 pandemic. Our prior laboratory, the existing one, the Hane Laboratory, was, you know, 40 years old and very much showing its age in the sense that we had outgrown it. We had very little room to do any kind of surge capacity when we were trying to stand up COVID testing and mass testing of it. In addition, the electrical system and HVAC system for the lab, while state of the art in you know 40 years earlier, could not keep up with the equipment and the demands placed on the systems nowadays. With modern equipment, with as much equipment as we use, the heat generated by that equipment. I learned a lot about HVAC over the last you know six years, and it's about chillers and overloading them and them going down, and then the equipment being very sensitive to temperature and humidity, and also the electrical system again just not being able to handle all of it. Our lab's roof had its own roof, so we had two roofs on the building, which kind of is an example of just where it had been. We had really used it to its fullest extent. At some point along the way, they had punched so many different exhaust holes, you know, for exhaust tubes out there, out the initial roof that it was leaking. So, they just went up 10 feet, built up 10 feet, and put a new roof on top of that roof, and consolidated the vents and the number of holes. And so, you could literally go and stand on the roof, the initial one between the two roofs, and so you know just some of those practicalities, and so it was just a truly a physical space as well as just the practicalities and demands put on the different systems behind the scenes.

 

SHEEHAN: 

Yeah, and sort of showing how seriously it was taken. The new lab is only one of a few that is a CDC laboratory response network level one lab. Can you describe what that means and sort of why that's important?

 

TRAXLER: 

Sure. So the laboratory response network for chemical testing the LRNC system for the CDC is really looking at nationally setting into tiers or levels labs for an event of a of a large scale you know incident or emergency and so being level one puts us as one of the you know handful or 10 labs nationwide that can do the surge testing, can stand up in an emergency surge capacity testing, as well as being able to transmit the data in real time to CDC for these mass incidents, and being able to adapt and work with the new and novel protocols that may be handed down from CDC, you know, at a moment's notice, but so it really helps the system helps CDC be prepared nationally for a large scale, you know, chemical threat. It also has the ability to do testing for things your very high stakes or high threat chemicals like the mustard agents, nerve gas, and so that is also very critical again as we look at our emergency response, and so this just is part of that network to help protect the whole country.

 

SHEEHAN: 

Yeah, absolutely. That's quite an upgrade. So, in addition to being able to handle these surge events, is it going to help in sort of day-to-day surveillance?

 

TRAXLER: 

Absolutely. So, for one thing, we, it will allow just more continuity and consistency. We, in the summer months for several years now, have to hold our breath honestly each day when it gets super hot that the chillers aren't going to go down, and therefore equipment, which really plays a role when we're looking at newborn screening, that equipment often is the most sensitive to temperature and humidity, but yet also is very much the most time sensitive, needing to be processed quickly and resulted quickly. And so, we have had to ship specimens out to neighboring states before because the chillers are down and such. And so, this will ensure that it will also allow us to add. Equipment to not only now but going forward into the future to add on new tests, be able to bring on equipment that may speed up some tests. So, we have space in this new lab that will allow us as technology evolves and testing evolves to build out some of the remaining core you know, shell space.

 

SHEEHAN: 

Yeah, another benefit is that you can have environmental testing and public health testing in the same facility. Why is that important?

 

TRAXLER: 

So, we have a track record of working extremely closely with our environmental partners. We up until two years ago were a combined agency in South Carolina with our Environmental Protection Agency, and, so we still, and so our lab was combined. Then we still collaborate extremely closely with them. We still work with them behind the scenes, but also especially in the laboratory. You know, testing of things you know for food or water if we're concerned about outbreaks or whatnot, and so having that just literally one floor or one hallway away, you know, you can go quickly curbside your colleague who's an expert on that and get their involvement. I mean, is, just, is really beneficial.

 

SHEEHAN: 

And you sort of alluded to this that the facility was built out with future innovations, future technology in mind, what are some examples of what that could be?

 

TRAXLER: 

So, I think it could be things like again, even just the basics of adding more conditions for newborn screening that would require additional machines and equipment for testing, or even whole new processes. You know, we are participating in a pilot with NIH of doing some whole genome sequencing for newborn screening, and so could that be something more widespread in the future, possibly? And that would be all new equipment. You know, there's often new testing coming about to be able to both do confirmatory testing for various diseases that are detected. You know, whether it be an infectious disease or what? Also, being able to do faster or more large capacity testing at one time, that sort of thing. But you know, I think whole genome sequencing, as we look at you know using it for outbreaks, as we look at using it with wastewater, even doing more wastewater testing and then potentially sequencing, I think, is something that really has great potential. That's we're right on the cusp of.

 

SHEEHAN: 

Absolutely, you know, as you described your old facilities and you know having to hold your breath to make sure that the chillers stay online, it really speaks to the stakes of it and the importance of these new facilities. Can you talk about the importance of just having a functional lab at the ready?

 

TRAXLER: 

I mean, I think many, I think many people just don't appreciate it, right? I think most people don't realize it's there and working to protect them, literally 24/7, unless something goes wrong. But it is. I mean, from the moment you're born, when that newborn screening is done, and I know people whose lives have been saved by that newborn screening. I mean, from those all the way up to when we're doing outbreaks, you know, potentially in a in a nursing home, and working on that, and looking at doing testing, widespread testing of contacts. I mean, the lab is working your whole lifespan to help protect you, often behind the scenes. And you know, our environmental colleagues are testing the air and quality and water quality, ensuring those are safe. You know, we are helping with, of course, food, some of the food testing, and again, the outbreak detection and surveillance. Not to mention the emergencies, the true emergencies. I mean, our lab is you know tests for things as we were talking about like these chemical threats, you know, even biological threats. And so, we work very closely with law enforcement partners, both on the federal and state level, and get and test specimens for them at all hours of the day and night, you know, and on weekends, et cetera, to help get them quickly an answer to know what they're dealing with in a scenario. So it is, you know, both on the individual and the community level, helping to keep people safe across the state.

 

SHEEHAN: 

And lastly, for other states or jurisdictions who are thinking about you know their aging laboratory infrastructure. Any advice?

 

TRAXLER: 

I think that you have to tell the story to help people understand how important it is and how badly it's needed, probably. But you have to sell them first. They have to understand how important the lab is. And so for us, that was obvious during COVID. I mean, when we were being told, you know, it needed to scale up our testing considerably and very quickly, and I mean, we're limited by physical space, and so you know, getting the getting everyone to understand that, and I think having them understand how valuable. This work is in terms of helping protect folks. Like I said, that it's everything from babies to older folks to air and water quality for communities to emergency scary threat testing. You know that that is all being done there, and that just technology and you know is continuing to evolve, laboratory testings is continuing to evolve and advance, and it's great, but that all does take more space and more electrical demands, and of course, it puts off heat, the equipment, and so you know many of the aging infrastructure just cannot handle that, and so you know you have to really invest for the future for the for the future of the people of your state.

 

SHEEHAN: 

Dr. Brannon Traxler is acting director for the South Carolina Department of Public Health and an ASTHO member.

 

Hurricane preparedness, response, and recovery work continues to be a top priority for state and territorial health departments. Damaging winds, historic storm surge, and intense rainfall pose severe risks to those caught in the path of these formidable storms, and the impacts can be felt for far longer than the immediate hazards. To read about how Hurricane Ian led to South Carolina's new system for natural disaster response, head to the link in the show notes.

 

ASTHO immediate past-president and state health officer of the Alabama Department of Public Health, Dr. Scott Harris, and ASTHO board member and commissioner of the New York State Department of Public Health, Dr. James McDonald, were quoted in a CNN article on the upcoming respiratory virus season. Find the link in the show notes.

 

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.