Emily Lu, Biodefense MS Graduate
COVID-19 has had an enormous negative impact on healthcare systems. The 2022 Preparedness Summit, hosted by the National Association of County and City Health Officials (NACCHO) in Atlanta, Georgia, took place April 4-7 and aimed to cover the entire scope of issues and solutions discussed during these two years. The main purpose of this summit was to collaborate and share information as well as collaboration on what actions have been taken.
This conference covered a variety of topics, including biodefense, biosecurity, public health awareness, and biotechnologies and their role in the response to the COVID-19 pandemic. The conference’s slogan-“Reimagining Preparedness in the Era of COVID-19”- is evidence of that. The conference was organized into several sessions. Track 5, Strengthening Global Health Security, is one that I chose to focus on, specifically biosecurity and public health emergency preparedness and management. One of the key highlights of Track 5: Strengthening Global Health Security was Ryan Houser’s presentation, “The Security Threat of Infectious Disease: Applying a Public Health Emergency Management Approach to Biodefense”. Houser, an emergency preparedness professional and Biodefense PhD student, defines biodefense as “any actions designed to counter biological threats, reduce risks, and prepare for, respond to, and recover from bio incidents.” Houser’s definition of biosecurity is the “strategic and integrated approach to analyzing and managing relevant risks to human, animal, and plant life.” He explained that, in examining the COVID-19 pandemic from a biodefense and biosecurity viewpoint, shortcomings are most obvious in the inadequate amount of funding that the government gives out via routine congressional appropriations.
Funding
Houser highlighted that “public health emergency preparedness grants decreased from $939 million in 2003 to $675 million in 2020.” These grants, funded by the Federal Emergency Management Agency (FEMA), are designed to prevent and respond to terrorism and future natural disasters. This number is similar to the Public Health Emergency Preparedness budget in 2020, which totaled $622,850,000 and increased to $637,850,603 in 2021. Regarding the argument that $675 million may not be enough funding for the United States, it would be difficult to assess partially because the amount and how this money is distributed within each state can have an impact on their response.
During the COVID-19 pandemic, FEMA conducted a study in New Jersey that found the pandemic response was successful in providing support and coordination efforts, improving relationships between the urban area security initiative members, and enhancing communications with the public and other stakeholders. However, the success of this 2020 study may have to do with the total amount of funding available to New Jersey, which, in 2020, was $15,144,167. However, this is not the case for all states, which have different amounts of funding.
Funding for each state is calculated by adding a base amount to an amount relative to the state’s population, which is then added to that amount set aside by each state. Chemical laboratory funding is also included if there is a chemical laboratory available within the state. Therefore, money may impact response efforts, but there is not enough evidence to determine if it is the main factor in response success. However, what can be said is that the amount of financial support given towards hospital preparedness as well as public preparedness has increased slightly for each state. It’s more likely that how this money is spent and where it is being distributed within the state impacts the situation even more.
Healthcare Response
The lack of cohesion between government funding and healthcare was a recurring theme at the conference. Healthcare management during the COVID-19 pandemic has tended to fare better in some areas over others. For example, around 95% of hospitals passed a compliance check conducted by the Unified Hospital Data Surveillance System with scores between 90 and 100% that was conducted by the Unified Hospital Data Surveillance System (UHDSS) during its enforcement period in 2020.
However, the COVID-19 pandemic has also created many challenges for healthcare institutions. For example, hospitals can quickly near maximum capacity based on the circumstances in their state and local area. An example of this was when, due to Arizona re-opening early, ICU units in the state’s hospitals rapidly came close to 80% capacity as new cases were admitted in 2020. In some states, circumstances make it difficult for individuals to follow protocols. Again, using Arizona as an example, the state re-opened due to many different factors, including high temperatures motivating individuals to violate regulations and seek indoor shelter, and a general avoidance of hospital environments.
Other issues in the healthcare system include shortages of personal protective equipment (PPE), including the shortage of N95 respirators, surgical/procedure masks, eye protection (including face shields and goggles), single-use gowns, and exam gloves. This could be attributed to a lack of funding, though this may not necessarily be the case.
Lastly, there may have been difficulties regarding the coordination of staff within large hospital systems. In larger systems, changes can become difficult to execute during a short amount of time. Throughout the COVID-19 response, hospital staffing has been inconsistent and limited. For example, at the start of the pandemic, according to ECRI (formerly the Emergency Care Research Institute), a nonprofit patient safety organization, “staffing shortages are the nation’s top safety concern”, especially in 2022. Ways to compensate for this have come in the form of adding staff and bringing more interest to keep medical students within the field.
Highlights
Despite the issues discussed above, there are some examples of successes in the United States’ COVID-19 response. An example of this is the successes of fusion centers in assisting institutions and the public with accessing quality resources during this crisis. Fusion centers, according to the Department of Homeland Security, “are state-owned and operated centers that serve as focal points in states, and major urban areas for the receipt, analysis, gathering, and sharing of threat-related information…”. Individuals can report certain concerns, which then allows the fusion center to connect them to the right resources.
One example of this was offered by Jarad Modaber of the Maryland Coordination and Analysis Center, in which there was a case of counterfeit N95s being stored and distributed from a warehouse. These were seized by the Department of Homeland Security with this news reported on Feb 18, 2021. Later, it was revealed that China was the source of the fake masks with around 6,000 victims of the massive scam. This demonstrates that during the pandemic, attention towards biosecurity measures and reporting them was helpful in the long run. For biosecurity and biodefense, there is a sense of coordination between law enforcement and healthcare backers that exists within the fusion center. Individuals from different backgrounds are grouped to help with calls regarding healthcare and suspicious activity.
For the 2022 Preparedness Summit, biodefense representation and its impact on decisions was only a small part of the entire picture. Funding, hospital management and coordination within organizations also plays a part in response efforts for the COVID-19 pandemic. However, despite its small role, biodefense, and biosecurity play an important role in being part of the solution in improving healthcare funding and communication between organizations. As shown by this summary, every part plays a critical role in successful response.
The Pandora Report 