Monkeypox outbreak strains underskilled local health officials, officials say

Written by Colin Wood

Monkeypox virus has ‘overwhelmed’ outdated technological infrastructure in several Washington state health jurisdictions, with state health officials already burned out by the 2.5-year response to the COVID-19 pandemic. It puts an additional strain on the workforce, he said. .

When the Centers for Disease Control and Prevention made MPV reportable on August 1, the virus joined dozens of other diseases and conditions for which state and local health jurisdictions are responsible for monitoring. Elizabeth Perez, a spokeswoman for the Washington State Department of Health, said it created an additional burden for local health officials across the country, which are often understaffed and have little skill or technical training.

“Immigration is through the local health department, and the local health department can get very strained very quickly,” she told The State Scoop.

Before moving to Washington state, Perez said he worked for a local health agency in Harris County, Texas, which surrounds Houston during the coronavirus pandemic, and said that instead of relying on digital platforms, his office was able to move to a day. He said he sometimes handled 300 faxes.

new variable

MPV is more difficult to transmit than COVID-19 and, despite far fewer cases, places an administrative burden on local health departments, blaming the new data systems and modernization office of the Washington State Department of Health. CEO Michelle Campbell said.

“When the guidance from the CDC was released for the MPV interview questions, it included 150 new variables that didn’t exist in our core monitoring system,” she said. .

Washington State’s disease reporting system is now being upgraded to accommodate more languages ​​and ethnic information, Campbell said, so the state is turning to a web application called REDCap to collect MPV survey data. I turned it. But this also puts a strain on local governments who may not always have experience using their platforms or who are not at all prepared for digital data collection. .

“Information has not been obtained consistently in the various affected counties because we haven’t had time to build infrastructure,” Campbell said. “Based on research and obtaining electronic lab reports, there is a fair amount of manual work that needs to be reconciled where there is overlap. If you still have to do the same work that you’ve been doing for years, it’s just taking a lot of manpower and a lot of time.At this point, the workforce is really burnt out.”

Campbell said the CDC is aware of these issues. Also, federal agencies are now funding investments in local technology and training. CDC epidemiology and laboratory capacity grants funneled billions of dollars into local health officials during the pandemic. And in June, he said, the CDC announced a program to “Strengthen America’s Public Health Infrastructure, Workforce, and Data Systems.” It will provide about $4 billion in professional development and technology modernization, including $900 million in strengthening technology and data infrastructure.

financial gymnastics

But Campbell said funding for new technology was less of a necessity, citing the CDC’s restrictive funding model, in which institutions use awards according to narrowly defined program areas. , which naturally makes it difficult to develop multi-scope enterprise technology systems. program.

“We’ve had to do a lot of gymnastics to put the data to good use, but that funding model hasn’t really changed,” she said. Until we can raise the funding to support and do things in a sustainable way, both financially and staffing, it really is up to our federal partners to take a thoughtful approach from that perspective. Is required.”

However, the ELC grant will allow Washington State to design new training programs, hopefully to fill gaps in data science knowledge among epidemiologists who are often trained in other skills. Campbell says it can.

“Tools and different programming languages ​​that make it really easy to work with large amounts of data, do analysis on them, and gain insights is not what it is. [epidemiologists] They are trained when they are in college,” she said. “They are focused on analytical tools that were not designed for this large amount of data.”

Campbell said her office, created in June primarily to address the lack of advanced technology used by public health officials, is working with the University of Washington to teach public health officials basic data science. We design training programs that provide skills.

“We’re starting to lose staff through downsizing — a lot of burnout, and then we’re understaffed,” she said. “The lack of sophisticated technology is part of it, because it requires so much human intervention to get the job done.”

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