COVID-19 tracking efforts led by WVU highlight the need for public health investment | WVU today – Community News
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COVID-19 tracking efforts led by WVU highlight the need for public health investment | WVU today

While most people don’t need smoke detectors in their homes for years, they would never choose to ditch a device that saves lives and prevents injury in an emergency. But that’s often what happens to public health systems across the country.

dr. Christopher J. Martin, a professor at the West Virginia University School of Public Health, calls it the “public health paradox.”

“When all goes well, you get a false sense of complacency and security, and you dismantle public health systems,” Martin said. “’Why do we need contact tracers? Everything is fine here.’ … We need to think of our public health infrastructure like a smoke detector. We need to build it up and understand that we need to maintain it, perhaps for a longer period of time, even if it seems unnecessary. It really is our smoke alarm for the next outbreak.”

The School of Public Health’s efforts to help track the spread of COVID-19 through contact tracing, mapping, wastewater monitoring and more played a critical role in West Virginia’s response to the pandemic. However, the teachers’ work also emphasized the need for public and private investment in research, training and infrastructure to ensure better health care and save lives in the future.

‘Learn on the fly’

At the outbreak of the pandemic, Martin and others recognized the need to train volunteers in contact tracing — a basic public health surveillance tool that has been used over the past century to contain disease.

Martin teamed up with WVU faculty and administrators, an associate of Johns Hopkins University and the West Virginia National Guard, to develop one of the nation’s first online training courses in contact tracing. The course, which started in May 2020, was open to Guard members and others assisting health authorities with the pandemic, as well as community volunteers interested in making a difference. More than 200 people statewide completed the course, more than the anticipated need for contact tracers in West Virginia, before it closed last fall.

Martin said the lack of general training in contact tracing reflects a broader need for more formal public health training statewide. He noted that there are only a few board-certified public health specialists in West Virginia — including Dr. Jennifer Lultschik, who oversees the WVU public health program.

Martin said the residency program was launched after WVU received a $1.77 million Preventive Medicine Residency Award from the federal Health Resources and Services Administration in May 2018, one of 17 such awards in the country. As the only program of its kind in the Appalachian region, private investment is needed to grow the public health program. Meanwhile, higher salaries and resources — funded by state and local dollars — will help attract qualified candidates for public health jobs statewide.

“We don’t have doctors formally trained in public health at every level of our public health infrastructure, so everyone — all county medical directors, all statesmen — are learning on the fly,” Martin said. “Not that those people haven’t done a great job, but I think there’s a broader need to train people for those positions and invest more in them.”

dr. Jeffrey Coben, dean of the School of Public Health, said WVU is also working to establish a public health education center that would provide better references, continuing education and the latest information to professionals working in the field. However, additional support – from public and/or private sources – is needed to implement the program together with the university’s government-wide partners.

Respond in real time

Other COVID-19 tracking efforts within the School of Public Health have involved mapping, modeling and monitoring. As these efforts deliver important results and provide valuable insights, they create opportunities to improve healthcare by addressing areas for improvement and building on research discoveries.

“I’m trying to show people the hot spots for coronavirus, or where we need more testing, or where we need vaccines,” said Brian Hendricks, assistant professor for the School of Public Health. “To me, it’s all about delivering health care to meet the needs of the population, and I think that’s what public health is largely about.”

As a spatial epidemiologist, Hendricks uses geographic data to identify health disparities related to risk and access to care. For example, space analysis conducted early in the pandemic revealed a shortage of COVID-19 testing among communities of color and increased testing rates and positivity in food insecure areas of West Virginia.

Hendricks also helped develop statewide maps to track the spread of disease, based on infection rates and positive test results. He is now working with a team of researchers — in collaboration with the West Virginia Clinical and Translational Science Institute, headquartered at WVU — to model how people go from susceptibility to infection to recovery from COVID-19. He also uses mapping tools to study the overlap between people vaccinated against COVID-19 and hospitalization among those infected, to determine the extent to which vaccination can explain the variation in hospitalizations.

Hendricks noted that methods used to study COVID-19 also apply to other areas of public health impacting West Virginia, such as substance abuse and the spread of HIV/Hepatitis C. The funding available is critical. importance to a timely response to public health threats such as these and others.

“You’re trying to respond quickly when you’re trying to prevent an outbreak or you’re trying to provide care to people who need it,” Hendricks said. “If you can’t roll out something quickly because there are too many hoops to jump through or you have to apply for funding and wait three months for it to come through, it has less of an impact.”

Hendricks is co-investigator of a wastewater sampling project that demonstrated the power of readily available funds. With financial support from WVU, an interdisciplinary team of researchers made efforts last year to identify trends in the spread of COVID-19 using wastewater samples. Their on-campus preparatory work provided the data necessary to secure a $2.9 million grant from the U.S. Centers for Disease Control and Prevention and the West Virginia Department of Health and Human Resources, making the project about could be expanded throughout the state.

Promotion of public health

The scientific achievements made at WVU and beyond during the pandemic have shown the impact of increased collaboration and investment in public health.

“This has been one of the most momentous times to be in science because of the pressure to solve the pandemic — because we don’t want the societal burden of care that this has caused,” Hendricks said. “So a stream of people has come together to achieve a common goal, which is to prevent illness, hospitalizations and deaths.”

Case in point: A team of WVU researchers — including Hendricks — earned a $1.5 million federal grant to lead a consortium of centralized COVID-19 treatment and outcome data from eight states, including West Virginia. The consortium feeds on the National COVID Cohort Collaborative, developed by the National Institutes for Health.

This level of enhanced cooperation is not possible without continued support, including public and private investment. Joanna DiStefano, program manager for the Health Sciences Center’s Global Engagement Office, assisted Martin in conducting the contact tracing course at WVU. She sees this moment in time as a critical turning point for public health.

“We need to do better in the future to strengthen our public health infrastructure and manage the peaks and troughs that we will inevitably experience in the future,” DiStefano said. “We know that now. I think it’s more of a policy choice to ignore it at this point. We can really embrace it and take public health in hand, or we can put it on the back burner. Either we’re going in a certain direction, or we’re not going to learn the lessons we’ve learned.”

Coben noted that the implications of that decision are far-reaching, as the impact of public health programs extends well beyond COVID-19.

“With COVID-19, we’ve seen the horrific impact of this disease on our population and we know prevention efforts can improve that,” Coben said. “But those kinds of efforts apply to many other areas of public health, whether it be smoking, substance use disorders, or safe driving. We benefit the entire state if we take a preventive approach and get ahead of them, instead of trying to treat people after they get sick or injured We have so much amazing talent in West Virginia, so many amazing people to build this state. For that we need to keep them healthy, and the best way to do it – from a public health point of view – is to prevent illness and injury.”

Contact Tiffany Walker-Samuels at [email protected] or 304-293-8604 to explore opportunities to support the School of Public Health. All donations are made through the WVU Foundation, the non-profit organization that receives and manages private donations on behalf of the university.

-WVU-

cr/11/22/21

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