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Public health remains an integral part in the fight against COVID

Image of Infographic featuring health personnel wearing face shields and mask with "National Public Health Week" across the top of the picture. Click to open a larger version of the image. National Public Health Week 2021 runs from April 5-11.

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Although they may not be the ones putting needles in arms, public health personnel continue to play a crucial role in the ongoing battle against COVID-19. Often, this means keeping track of virus-related data, as well as facilitating the flow of information to both internal and external audiences.

"Public health's role in combatting COVID is very similar to our role in anything else related to communicable disease, which is a large portion of what we do," said Air Force Public Health Career Field Manager Chief Master Sgt. Sheryl Green. "We do a lot of risk communication — working with commanders and making sure we're messaging appropriately to our communities and vice versa, making sure those communities have access to those commanders."

This means ensuring information gets to its intended receivers. It also includes forming partnerships and coordinating with local health departments to make sure that efforts on installations better reflect what is happening in nearby communities.

"Communication is huge, not just on base but also within our civilian communities and civilian agencies," said Green.

The information that is being disseminated needs to be easily understood and easily acted on.

"Through outcomes from products such as surveillance, data modeling, and business analytics, we've been able to inform and assist the operational community with planning, logistics, tracking, forecasting and medical intelligence," said United States Public Health Service Capt. Kimberly Elenberg, chief of the Defense Health Agency's Total Force Fitness Division. "Further, a key role for public health professionals has been the interpretation of complex data into easily understood, actionable information."

Additionally, DHA's Immunization Healthcare Division has played a key role in providing critical information to beneficiaries through publishing articles explaining the vaccines, participating in social media events, conducting stakeholder briefings, and leading question-and-answer sessions at local events.

Since the beginning of the pandemic, Green said much of the focus has been on stopping the spread.

"Breaking the chain of infection" is a term that is near and dear to us, and that's where contact tracing comes into play," said Green. "A large focus of the COVID response has been contact tracing and trying to figure out who has been exposed and what that picture looks like for each community."

Within the Air Force, she said, public health is closely involved in tracking the number of positive cases, as well as the number of vaccinations being administered by its clinicians.

"In regard to surveillance and testing, our responsibility is to maintain close communication with the laboratory community and making sure we have visibility of all positive tests," said Green.

Public health's function is mirrored throughout the services.

"Our staff have worked tirelessly to make sure policies were synthesized and updated based on the latest research and Centers for Disease Control and Prevention guidance, interpreted in the unique context of Naval operations, and shared with operational decision-makers," said Navy Capt. (Dr.) Jesse Geibe, executive officer of operations at Navy and Marine Corps Public Health Center in Portsmouth, Virginia. "Whether we are advising on masking, testing and surveillance strategies, the impact of vaccination, or myriad other COVID-19 issues, we keep the health of our sailors and Marines and completion of the mission first and foremost."

Green said that, while public health professionals have become much more flexible and agile over the past year, the traditional role of public health hasn't necessarily changed.

"The scope has obviously gotten much larger, which has caused them to have to rework how they approach disease tracking and tracing from an overall perspective, and they've done an amazing job doing that," said Green.

Military health personnel setting up a trap for mosquitos
U.S. Air Force Senior Airman Brandi Spriggs, 97th Medical Operations Squadron health technician, sets up a dry ice trap to catch mosquitoes during the Zika virus outbreak in August 2016 (Photo by: Air Force Arman 1st Class Cody Dowell, 97th Air Wing Mobility Public Affairs). 

Green said one of the biggest lessons learned over the course of the pandemic has been in training.

"We train on disease surveillance and epidemiology and outbreak investigation, but not necessarily something of this scale," said Green. "That's definitely something we need to look at as we move forward - our training, how we have that established, and the different types of training that we provide."

Specifically, the pandemic has highlighted a need to provide more advanced training on infection prevention and control.

"We have to make sure our individuals are prepared, with the knowledge and capability to effectively support pandemic response in the field," said Green.

An additional lesson learned, and one not confined to public health, is the need to prevent or reduce fatigue in front-line health care workers.

Green reiterated the appreciation she has for what the public health community has had to endure, but also what they've been able to accomplish over the past year.

"The American Public Health Association has called this the most challenging public health crisis of our lifetimes," Green said. "I think our personnel have done a tremendous job while being on the front lines since the beginning and they continue to do wonderful work under extremely stressful, prolonged conditions."

A positive takeaway from the pandemic response is that it has prepared the public health community, and the military medical community at large, for what may come next.

"We don't know how long this is going to go on or what the next crisis will be. We've certainly dealt with outbreaks before - Ebola, Zika, H1N1 - but what is the next big pandemic-type disease going to be?" asked Green. "Based on the experience that all of our public health professionals have gained over the past year, they will absolutely be ready for anything that comes their way in the future."

Within the DHA, the inter-service pandemic response has shown the potential for greater interoperability between the services going forward.

"The coordination among the service public health entities has been invaluable in combating the COVID pandemic, which does not care what color uniform a service member is wearing. While health surveillance within the DOD has always been conducted to the highest scientific standards, it is now done through the lens of improving the medical readiness of the individual service member," said Army Col. Douglas Badzik, Armed Forces Health Surveillance division chief.

Geibe echoed this point.

"Public health work with other medical professionals in the fleet, Marine Corps and Military Health System has been significantly enhanced to include sharing information on outbreaks to slow the spread, investigating sources through contact tracing, and providing collaborative support for testing and immunization," he said.

During the first full week of April each year, the APHA brings together communities across the United States to observe National Public Health Week as a time to recognize the contributions of public health and highlight issues that are important to improving our nation's health. This year, NPHW runs from April 5-11.

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