Outbreaks of monkeypox burden poorly engineered local health agencies, officials say | Panda Anku

Written by Colin Wood

The monkeypox virus has “overwhelmed” the outdated technological infrastructure of some local health departments in Washington, further straining a workforce that state health officials said was feeling burned out after just two and a half years of responding to the COVID-19 pandemic.

When the Centers for Disease Control and Prevention made MPV a reportable condition on Aug. 1, the virus joined dozens of other diseases and conditions that state and local health departments are responsible for monitoring. It has created an additional burden on local health departments across the country, which are often understaffed and lack technology or technological training, said Elizabeth Perez, a spokeswoman for the Washington Department of Health.

“Entry is through local health departments and local health departments can get very tight very quickly,” she told StateScoop.

Perez said that prior to entering Washington state during the COVID pandemic, she worked for a local health agency in Harris County, Texas, which surrounds Houston, where she said offices were sometimes processing 300 faxes a day rather than relying on leave digital platforms.

New Variables

MPV, which is more difficult to transmit than COVID-19 and has generated far fewer cases, has nevertheless imposed an administrative burden on local health departments, said Michelle Campbell, director of the Washington Department of Health’s new Office of Data Systems and Modernization.

“When the CDC’s guidance for the interview questions for MPV came out, it included 150 new variables that weren’t present in our core surveillance system,” she said.

Campbell said the Washington Disease Reporting System is being updated to include more language and ethnicity information, so the state turned to a web application called REDCap to collect MPV survey data. However, this also puts a strain on the municipalities, which do not always have experience in using this platform or are not at all prepared for digital data collection. It has also led to inconsistencies in data collection.

“Because they haven’t had time to build the infrastructure, information isn’t being collected consistently across the different affected counties,” Campbell said. “There is a fair amount of manual work that needs to be put into reconciliation when there are duplicates based on an examination and an electronic lab report. That just takes a lot of manpower and a lot of time when the staff supporting MPV at the state and local levels are all still doing the same work that they’ve been doing for COVID for the past few years. It’s a really burned-out workforce at this point.”

Campbell said the CDC is aware of these issues. And the federal agency is currently funding investments in local technology and education. The CDC’s epidemiology and laboratory capacity grants have pumped billions of dollars into local public health agencies during the pandemic. And in June, CDC announced its Strengthening US Public Health Infrastructure, Workforce, and Data Systems program, which is expected to allocate nearly $4 billion for professional development and technology modernization, including $900 million for technology strengthening – and data infrastructure.

financial gymnastics

But Campbell said the new technology funding doesn’t do much to address needs, and that the CDC’s restrictive funding model — which only allows agencies to issue each award according to narrowly defined program areas — has made it difficult to develop business technology systems, which of course span multiple programs.

“We had to do a lot of gymnastics to get any meaningful use out of our data, and that funding model hasn’t really changed,” she said. “Until we get funding that will support the public health business and be able to do things in a way that is financially and also humanly sustainable, we really need an approach from our federal partners that looks at this from that perspective.” “

But the ELC grants allow Washington State to design a new training program that will hopefully fill a gap in data science knowledge among epidemiologists who are more commonly trained in other skills, Campbell said.

“The tools and different programming languages ​​that really make it easier to work with big data and do these analyzes and get insights, that’s just not the right thing [epidemiologists] get trained when they’re in college,” she said. “They’re more focused on analytics tools, which really aren’t designed for this big amount of data.”

Campbell said her office, established in June primarily to address the lack of sophisticated technology being used by health officials, is working with the University of Washington to develop a training program that will provide fundamental data science skills for public officials communicated to the public health system.

“We’re starting to lose employees through attrition — just a lot of burnout. Then you end up understaffed,” she said. “The lack of sophisticated technology is part of that because it requires so much human intervention to get the job done.”

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