The writer is dean of the College of Public Health at the University of Nebraska Medical Center.
Our nation, once again, finds itself at the worst possible time to prepare for a public health threat: in the midst of a public health emergency of international concern.
Worries about the novel coronavirus have the public, and public servants, asking the predictable questions. They inquire about the nature and prevention of the disease, about the existence of an ample supply of face masks and protective gear, and about the outlook for the development and deployment of a drug or vaccine.
We have seen this before — and recently. Many will remember the swine flu, or H1N1, that in 2009 sent more than a quarter-million Americans to the hospital and claimed more than 12,000 lives in the U.S.
Regardless of whether the novel coronavirus will become a U.S. epidemic, the situation shines the light on barriers to preparedness across the country. This includes preparedness for outbreaks of the likes of this coronavirus as well as for a particularly dangerous new flu strain. It also includes preparedness for a heinous act of bioterrorism.
Make no mistake, much has been done to improve readiness. Over the past two decades, lessons learned from the 9/11 attacks, from Hurricane Katrina and from H1N1 have spurred remarkable public health upgrades at the national, state and local levels. International collaboration has improved, too. Our nation is dramatically better prepared to detect and address emergencies.
Still, in key areas, progress is insufficient. The discussion in this area inevitably turns to the funding of state, territorial, local and tribal health agencies, which all too often is the subject of political arguments rather than practical needs.
Local health agencies are operating with approximately 50,000 fewer personnel, compared with 2008. They also have seen steady declines in preparedness funding. However, health care preparedness is the critical gap in national preparedness.
Funding aside, not enough has been done to leverage the array of partners who extend the public face of public health. Retail clinics and community pharmacists come to mind quickly. Progress has been made in expanding pharmacists’ vaccination authority and allowing them to screen and even help to treat an array of illnesses. However, many states lag behind, despite strong public desire for increased access to pharmacist-provided services.
A study published in 2018 in the Journal of the American Pharmacists Association found that approximately 6 million Americans per year who did not previously get the flu shot now do as a result of public policy changes that have expanded pharmacists’ authority to vaccinate. A key public health message for this epidemic is for individuals to be vaccinated against flu and pneumonia.
Much upside potential exists if needless state barriers are eliminated. Overcoming these barriers includes expanding consumers’ access and coverage to recommended vaccines in community care settings, and establishing emergency standing orders that allow for needed medications to be furnished to a patient.
In any case, the optimum time to commit to public health preparedness is before a crisis is upon us. While time will tell if this coronavirus will be a serious threat in the United States, now is the right time to take action for this potential crisis, and for the next ones.
While the nation has come a long way, more strides are needed. Until then, public health partners such as pharmacists will do whatever they can to answer the call. Let us not take them for granted, nor leave them underutilized.