Dr. Betsy Schroeder, a public health veterinarian for the state of Pennsylvania, feels like sprinting a marathon.
She and the members of her public health teams are trying to find a sustainable pace in their work to protect people from COVID-19.
“We’ve all spent at least a year on regular working hours in just over six months,” said Dr. Schroeder.
Iowa State University Health Services tested returning students for SARS-CoV-2 infection before class in August. (Photos by Matt Van Winkle / ISU Alumni Association)
She is the chief of operations for pandemic response in Pennsylvania, overseeing the epidemiology, laboratory, and community nurse teams. You interact with health care providers and people who are or may be exposed to the COVID-19 virus.
Dr. Schroeder said Pennsylvania has a smart, dedicated corps of health officials, but not the deep bank of the federal workforce. Friends at the Centers for Disease Control and Prevention told her about times when pandemic-related tasks are changing.
However, she is working on adding staff using funds from the CDC.
Public health veterinarians describe this year’s shift from protecting against known local threats to managing full health and education efforts during a pandemic that killed approximately 1,000 Americans every day at press time. Some members of the state government have been supporting the national control efforts since the beginning of the year.
For example, veterinarians in the Department of Veterinary Medicine at the California Department of Health started their work in January to screen and monitor people coming to their state from other countries. This comes out from a weekly CDC report on morbidity and mortality released May 15, analyzing demographics of those infected, working with other agencies on animal testing and educating people who work with animals, CDPH officials said.
In February, CDC officials formed the One Health Federal Interagency’s COVID-19 Coordination Group with 17 agencies to share information and coordinate messages to the public. The agency also runs weekly federal and state One-Health calls to around 165 partners, including public health veterinarians, wildlife officials, animal health officials, and local partners.
Other outbreaks continue
Dr. Joann Lindenmayer is an elected volunteer in the health department of Uxbridge, Massachusetts, a town of 14,000 on the southern edge of the state. At the start of the pandemic, she, another board member and the city health director worked 60-hour weeks for two months.
She is a public health expert, epidemiologist, and former professor who has worked for a variety of institutions including the CDC, Tufts University, Brown University, and health departments in three states.
Dr. Lindenmayer led a coalition of non-profit organizations that bought food, cleaning supplies, baby diapers and masks and delivered them to the unemployed, and offered to call people who had to check-in daily, take trips to and from health care providers. and walking dogs. She and her colleagues also posted signs promoting practices such as hand washing and safety clearing, and distributed information about COVID-19 through the city’s website, city cable TV station, newsletters, and educational materials left or left on door handles of homes for the elderly who have disabilities. And she oversaw nine masters-level students from Harvard University School of Public Health participating in the COVID-19 Academic Public Health Volunteer Corps.
Pennsylvania and Massachusetts both suffered an increase in COVID-19-related deaths in April and a decrease in the summer, although confirmed infections in Pennsylvania increased in mid-to-late July, according to both states. As of August 3, Pennsylvania had more than 7,000 deaths from 114,000 infections and Massachusetts had nearly 9,000 deaths from 118,000 infections, according to the CDC.
Dr. Schroeder said her office is still investigating animal bites and her enteric disease experts divide their time between diseases.
At one time, they could be working on salmonella outbreaks and trying to coordinate an investigation into COVID-19 exposure at a restaurant, she said.
Dr. Schroeder is familiar with rabies consultations. She is good at them and can give final answers to people. Salmonella have a playbook, and the work is routine but important, she said.
However, health officials are still learning about COVID-19, including whether people can be re-infected.
Dr. Catherine Brown is a Massachusetts veterinarian and state epidemiologist. Much of their work involves collecting and analyzing data to find the people who are susceptible to SARS-CoV-2, the virus that causes COVID-19. Finding patterns among clinical outcomes; and use these results to shape policy.
“It’s fine for the Department of Health – at the state level – to collect information,” she said. “But if we don’t turn this around and turn it into actionable elements and then help people understand what those action elements should be involved in, what is it about?”
With COVID-19, Dr. Brown with the unusual job of analyzing tens of thousands of negative laboratory results every day and examining the emergency room’s data streams for COVID-19-like symptoms. She also works with other agencies to coordinate information about pet infections, whether pets should be tested, and how often human-to-pet transmission occurs.
An Iowa State employee checks a student’s temperature.
Demand community responsibility
That spring, Dr. Kristen Obbink planning how to test Iowa State University students for COVID-19 when they returned this fall. In July, she became the university’s public health coordinator for COVID-19.
She is ordinarily a veterinarian at the Center for Food Safety and Public Health in the state of Iowa. “In this new role, I will be a full-time public health coordinator for the COVID-19 response until the end of the fall semester,” said Dr. Obbink.
She coordinates efforts to reduce the risk of COVID-19 among 35,000 students and university employees. She is part of a university team that uses contact tracing, quarantine, isolation, and symptom tracking, and works with ISU statisticians and the university’s communications team. On campus and in the surrounding community, the university’s Cyclones Care campaign promotes physical distancing, masks, hand washing and – when people get sick – isolation in their homes or in dormitories reserved for them.
About 9,000 ISU students will be living on campus this fall. On August 3, Iowa state officials announced they had begun testing all students as they moved to dormitories and apartments on campus prior to class, which began on August 17.
The ISU processed these samples through the university’s veterinary diagnostic laboratory. Dr. Obbink said the lab intends to deliver test results within 24 hours – a goal it recognizes has been unmatched in much of the country.
The school planned to offer a mix of classes in person and at a distance. For those who need in-person attendance, the university has cut attendance in half and rearranged the seating.
“We all have the same goal, although we have a different role to play,” said Dr. Obbink. “We want our students, our faculty, and our staff to have the best experience possible. We would prefer it to be the way it used to be, and of course that is not possible now. “
Saving lives, often unnoticed
Dr. Lindenmayer said signs in her town thank first responders and key workers, but not public health workers. She said the public knows little historically about public health work and why it should be funded.
“The real dilemma with public health is that we don’t have a constituency,” she said. “If public health is successful, it means nothing is happening.”
Data released on March 23 by the Association of State and Territorial Health Officials shows that government health agency employment declined approximately 15% from 2010 to 2019, and spending by these agencies was nearly the same in fiscal years 2010 and 2018 – equal to a 13% budget cut after adjusting for inflation.
The ASTHO also warned in February of the Trump administration’s proposal for fiscal 2021 to cut funding for public health officials and consolidate public health programs.
“More than ever, Congress and the administration need to prioritize funding for the entire public health system,” the announcement said.
Public health veterinarians described boom-and-bust cycles associated with disease events, citing crises with West Nile virus, anthrax, Zika, and Ebola.
Dr. Schroeder said that public health officials go unnoticed when they are doing their job well and few people get into public health work for personal reasons. It’s hard to get credit for someone who doesn’t develop polio, she said.
Dr. Brown also said, “One of the things we say about public health is, ‘It is very difficult to measure the diseases that you prevent.'”
“I hope COVID teaches us all that there will always be the next,” she said. “So we don’t just have to invest in disease-specific public health measures. We need to invest in public health infrastructure. “
Dr. Lindenmayer also wants more veterinarians to apply their population health training in local government. They can improve the lives of people and animals, and many communities are desperate for volunteers, she said.
Dr. Brown also believes veterinarians can harm public health by, for example, building relationships with local health care providers and providing outbreak expertise.
Dr. Schroeder said anyone can help during this pandemic by wearing masks and washing their hands.
“These are really the best things we can do to collectively provide for all of us,” said Dr. Schroeder. “The only way we can get through this is to take care of each other.”