This brief dives into the impact of the COVID-19 pandemic on the ability of people with disabilities to access vital health care services during the public health emergency.
Each September marks National Preparedness Month. This year, public health emergency preparedness professionals look back on 20 years since the 9/11 attacks—the event that effectively launched the preparedness field—while actively responding to COVID-19.
Each September, the United States observes National Preparedness Month, a month dedicated to raising awareness of public health preparedness. Preparedness—a field that readies our nation to respond to a range of emergencies—is a newer public health discipline, advanced by lessons learned from each response to a public health threat. While significant progress has been made over the past 20 years, the COVID-19 pandemic has shed light on the need to strengthen state and local capabilities to address future emergencies. The history of public health preparedness is worth understanding, as each current and future response is impacted by lessons from the past.
As the Delta variant spreads across the country and increases the number of COVID-19 cases, the strain it is placing on the nation’s health system continues to grow. The surge of COVID-19 patients is contributing to a shortage of the medications and equipment used to treat the disease. As these limitations grow, decisions will need to be made as to which patients receive resources and care and which patients don’t. To guide these decisions, policies called crisis standards of care are often established to maximize resource benefit and ensure they are distributed equitably.
Pharmacies have long been instrumental partners in providing lifesaving vaccines nationwide. As state and territorial health officials evaluate their COVID-19 response, planners must include input from the pharmacy community when identifying areas for improvement, as well as best vaccination practices in advance of future public health emergencies.
The COVID-19 pandemic has impacted both the physical and mental health well-being of youth. Disruptions in both their home and school life have put youth at risk for poor mental health outcomes that include increased anxiety, depression, and risk of suicide. This Mental Health Month we examine state and territorial legislation that addresses youth mental health.
All too often, work in health, housing, and human services systems is siloed. However, when you move upstream and work together, these industries can address the root causes of health and social issues. If we continue to operate our systems in silos, responding with a crisis orientation, we will be unable to fundamentally improve the challenging conditions our communities face. We may be able to create the conditions for strong, thriving families and communities if we focus on strengthening community leadership and working across systems.
Learn how health agencies are prioritizing children’s health as they develop public health emergency preparedness planning in this blog.
Health providers have widely used telehealth to mitigate the spread of COVID-19 infection and to improve access to healthcare services thanks in large part to policy changes and regulations. This brief explores how state and territorial health agencies (S/THAs) are responding to COVID-19 through telehealth policy and operational changes, as well as how telehealth has quickly emerged as a tool to improve health equity.
People who use electricity-dependent durable medical equipment (DME) at home—such as ventilators and oxygen concentrators—can face life-threatening consequences during a power outage. HHS reports that 2.7 million Medicare beneficiaries rely on electricity-dependent DME to live independently. This ASTHOBrief details the significant challenges that individuals who rely on electricity-dependent DME face during power outages and discuss recent efforts to increase support for this population.
An ASTHO brief on the importance of understanding moral injury and burnout, with recommendations on areas of organizational focus.
This policy update emphasizes the importance of policymakers choosing to increase funding for public health infrastructure and important initiatives, such as health equity, in the wake of the COVID-19 pandemic.
As COVID spread through the country and infection rates rose in every state, many of the the U.S. Affiliated Pacific Islands (USAPI) received media attention for remaining relatively COVID-free. The USAPI’s unified response in the face of a global pandemic is a history-making tale of collaboration, communication, and partnership. The successes of public health leaders provide important lessons for preventing, preparing for, and responding to future public health emergencies.
In anticipation of the upcoming presidential election in November, the Republican and Democratic National Committees released their platforms. These platforms provide an overview of values, policies, positions, and principles on various domestic and foreign issues deemed most important to the two political parties. For the upcoming 2020 elections, delegates of the Republican National Committee approved a resolution that renewed support for the platform adopted in 2016 and the Democratic National Committee approved a 2020 platform. Although both platforms touch on a diverse list of issues, there are several that are of interest to health and public health.
Conditioning school attendance on student vaccinations is an evidence-based way of maintaining and increasing vaccine coverage. State law establishes school vaccination requirements which apply not only to public schools but often to private schools and childcare facilities as well. All states allow an exemption for those where a vaccine poses a medical risk. Several states also allow non-medical exemptions, often based on an asserted religious, philosophical, or personal belief of the parents or child opposing vaccinations. However, a few states have recently abolished all non-medical exemptions.
2020 has been a year of unprecedented events, and the past few months have already shown that they do not exist in a vacuum. While the country continues to respond and cope with the COVID-19 pandemic, many extreme weather events have already occurred, and are additional infectious disease challenges to consider. Responding to these events in the current conditions presents unique challenges to responders and communities.
A New Normal for Public Health Agencies Association of state and territorial health officials, astho, states and territories, covid-19, covid-19 pandemic, immunization, vaccination, influenza vaccination, chronic disease, opioid epidemic, behavioral health, public health, public health agency Marcus Plescia Public health agencies have had to face the challenge of managing the COVID-19 pandemic while also continuing to conduct their normal duties in maintaining the public’s well-being. As states and territories prepare to reopen many of the functions of their economies and communities, it is also time to pivot to a new normal at health departments nationwide. COVID-19 has been the most substantive threat facing public health in decades and required an urgent mobilization and redirection of resources for all public health programs. A crisis of this proportion would stress any agency, but following a steady decrease in workforce over the past decade, public health has been hit particularly hard. We cannot expect health departments to continue pre-COVID work and continue to sustain the COVID-19 response without adequately scaling up our resources. Many vital public health functions such as immunizations, chronic disease prevention, STI/HIV prevention, and the opioid overdose response have had to be scaled back in response to COVID-19. If this continues, it will soon have profound effects on the public’s health, even in areas where we have previously been successful, such as tobacco cessation and childhood immunizations. The new normal in public health must be an adaptation to the need to contain and control COVID-19 while simultaneously addressing the many other public health needs in a jurisdiction. We need to adapt to the new normal, but we cannot continue to do more with less. Scale Up Vaccination Campaigns The threat of other infectious disease outbreaks is an immediate concern for public health. As we desperately seek a vaccination for COVID-19, it should remind us of the important function of health departments in assuring access to existing vaccination schedules. Under current "stay at home" orders, many families have not participated in well-child visits. According to the Association of Immunization Managers, activities involving going out in the field have been suspended in most health departments. As a result, studies have estimated that the administration of the MMR vaccine has dropped substantially. The new normal means we must address this issue prior to the likely resumption of the school season this fall. Adult and child influenza vaccinations will also be far more important. If a predicted second wave of COVID-19 this fall is accompanied by a serious flu outbreak, the impact on the medical system could be catastrophic. Our vaccination efforts need to resume soon and go beyond traditional public health campaigns—like increased opportunities for large-scale immunization in non-clinical settings like parking lots, summer camps and workplaces. Prevent a Resurgence of Other Chronic Diseases It is never useful to pit one public health problem against another. But it is important to recognize that despite the substantial death toll of COVID-19 over a short period, heart disease and cancer continue to be the top killers in America. Last year there were 269,000 cancer deaths and 525,000 deaths from heart disease. State and local tobacco control programs have had a profound effect on reducing the incidence of these diseases, but tobacco-use trends that were concerning prior to the pandemic have worsened. COVID-19 has shifted public health’s attention from the concerning implications of the EVALI outbreak, and efforts to address e-cigarette use have been undermined in the last three months. The Food and Drug Administration (FDA) has now delayed the premarket review deadline for e-cigarettes because of COVID-19, and significant reductions in charitable giving have diminished the capacity of important tobacco control advocacy groups. Refocus on Diseases of Despair This pandemic came during an existing epidemic of addiction and opioid misuse that provided many indications of the strains on the fabric of our society that have now become so evident with COVID-19. Often referred to as "diseases of despair," the opioid epidemic, suicide, alcohol addiction, and domestic violence continue to rage across our society, and have worsened as a result of the stress and hardship of COVID-19. Some efforts to address behavioral health have been hampered by the challenges of continuing effective interventions and therapy during a pandemic. Recent reports of suicides among medical providers treating COVID-19 patients and soaring rates of calls to mental health crisis lines highlight the alarming national suicide trends we continue to experience, and addressing stigma and providing mental health first aid programs are important now more than ever. Protect the Most Vulnerable As we think about a new normal in public health, the core work of promoting and protecting the health of those at risk is particularly acute given the devastating toll of COVID-19 among the elderly and people of color. Social distancing rules have exacerbated social isolation among those who are physically debilitated or suffer cognitive impairment, a situation that will not improve as our plans to reopen America place significant emphasis on the need for continued mitigation strategies for groups at greatest risk. Mitigation strategies must shift from "social" isolation to physical isolation, and public health should help pursue policy and environmental interventions that provide resources and stimulation for those who have been "shut in" by the pandemic. In this new normal, public health needs to continue to look for ways to partner with clinical providers to encourage different forms of preventive services that address a wide range of both medical and social problems. Create a New Normal Public health plays an important role as a convener in addressing many population, medical and social issues. That role is critically important moving forward. The recently updated Healthy People 2030 objectives, which will launch in August are a way to reset our efforts and lead the new normal. They provide a shared vision for public health across sectors and regions, and the developmental and research objectives which are designed to address areas of substantial disparity between populations are particularly important to our experience with COVID-19. It is a challenging time in public health. COVID-19 has made it difficult to meet needs and still attend to longstanding issues. After decades of neglect, public health has little surge capacity. While public health practitioners are good at finding ways to do two things at once, this is not a sustainable model for health improvement. New funding streams are emerging for public health through testing and contact tracing that may provide resources for agency expansion. We must insist that this expansion of the public health workforce is long overdue and must be sustained. Once the pandemic is controlled, these contact tracers should stay in the workforce and expand public health capacity to control core infectious diseases like HIV and other STIs. Their focus should be expanded to engage creatively in other issues like violence prevention and better control of chronic disease risk factors like diabetes, hypertension, and tobacco use—all highly relevant to COVID-19 outcomes. Good leadership requires the ability to look ahead and get creative. That future will be with us before we know it, and if we are not attentive to it, the implications of the COVID-19 pandemic could ultimately be overshadowed by a resurgence of the public health issues that have plagued us in the past. The new normal means adjusting to the threat of COVID-19 while also sustaining the core work of public health. We can do two things at once, and always have, but sustained resources that will expand public health agency capacity have to be part of the high expectations of governmental public health to protect and promote the nation’s health. The new normal does not mean doing more with less. It means doing more with more. The success of our nation’s reopening depends on it. website yes
Several states and territories, as well as many local governments, are going beyond recommendations and requiring individuals to wear face coverings when they are in public settings and spaces (i.e. grocery stores, retail stores, restaurants, public and private transportation services, parks, etc.). Ongoing research and evidence suggests the relationship between mandatory face coverings and declines in daily COVID-19 growth rates is statistically significant.
Current Measles Outbreaks Should Alarm Every American and Highlight the Critical Importance of Vaccination Programs ARLINGTON, VA—John Wiesman, DrPH, MPH, secretary of health at the Washington State Department of Health and immediate past president of the Association of State and Territorial Health Officials (ASTHO) testified today before the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) on the growing number of infectious disease outbreaks impacting the country. The hearing, “Vaccines Save Lives: What Is Driving Preventable Disease Outbreaks?” provided members of Congress the opportunity to discuss the current measles outbreaks affecting several states, along with children’s health and vaccinations and significant gaps in public health funding for programs to address preventable outbreaks. “Every American should be alarmed by the current measles outbreaks occurring in many states. Measles is an entirely preventable disease and we must redouble our efforts as a nation to spread the truth that vaccines save lives and address parental concerns about vaccinating their children,” says Wiesman. “No one should live in fear of contracting this disease and it is part of my mission as a public health official to protect the lives of American people. I am deeply grateful to the Senate HELP Committee for bringing broader awareness to the importance of vaccinations and better understanding the current gaps that exist in the public health system. Addressing these outbreaks will require a strong and coordinated response from federal, state, and local governments.” Wiesman recently authored an op-ed citing concerns about the nation’s public health system, which has suffered as a result of chronic underfunding as the population continues to grow. We are constantly reacting to crises rather than working to prevent them, Wiesman says. ASTHO and 80 other organizations are requesting Congress to raise CDC’s budget 22 percent by 2022 to address growing public health threats, including support for state and territorial vaccination programs, in order to protect our nation’s health system. For more information and to read Wiesman’s testimony, visit the committee’s website. ASTHO Press Release Boilerplate website yes
ASTHO Statement on Public Notification of Legionella Outbreaks ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) issued the following statement today regarding the role of public health officials in notifying the public about complex infectious disease outbreaks, particularly as states continue to deal with Legionella outbreaks. “As leaders of state and territorial public health agencies charged with promoting and protecting the health of our jurisdictions, we are keenly aware that decisions on whether and when to notify the public of infectious disease outbreaks are complex. There is no national standard concerning the timing of public notification to prevent the spread of Legionella. Health officials must instead rely on the facts of the specific outbreak situation, assess the risks and benefits of notification, and consider other factors to determine the appropriate course of action to reduce harm, protect health, and save lives. The most urgent priorities in managing Legionella outbreaks are identifying those who have been potentially exposed and mitigating the environmental sources of infection. Both priorities require health authorities to provide immediate guidance to the facility where the outbreak is occurring. Public notification is, therefore, often not an urgent priority, particularly when there is no ongoing risk to the public and health agencies are actively working with facilities on how to (1) identify and notify anyone potentially exposed and at risk for illness and (2) implement potential remedial measures. The decision to issue public notification also involves carefully considering the potential ramifications of acting on preliminary or incomplete information, which could lead to unnecessary and burdensome protective actions being taken and result in erosion of trust in the public health authority. Decisions regarding public notification of Legionella outbreaks should be thoughtfully made by qualified, experienced public health professionals and should be informed by a solid understanding of the epidemiology of the disease and the particular characteristics of each individual outbreak setting. We strongly assert that public health officials should not be subjected to civil penalties or criminal charges for decisions made in good faith using available information and informed by sound public health science and practice.” ASTHO Press Release Boilerplate website yes