Health services are applying lessons learned from Covid to other public health issues
The manager listened to Piccolo’s instructions on how to use Narcan, the brand name of the drug naloxone, and added four boxes of nasal spray to the hotel’s first aid kit.
The transaction took less than 10 minutes. It was the third hotel Piccolo visited on this hot July day in Livingston, a mountain town of about 8,000 people, where, like much of the country, health officials are worried about a recent increase in the use of the synthetic opioid fentanyl.
It was the first time the local health department had offered door-to-door training and supplies to prevent overdose deaths. The underlying strategy was forged during the pandemic when public health officials distributed rapid tests and vaccines to high-risk settings.
“We learned this from covid,” said county public health officer Dr. Laurel Desnick. “We go to people who may not have time to come to us.
The pandemic has laid bare gaps and disparities in the US public health system and often brought backlash against local officials trying to slow the spread of the coronavirus. But one positive result, fueled in part by an increase in federal dollars, is that health workers have begun to adapt the lessons they have learned from their response to covid-19 to other aspects of their work.
Some of these adaptations should cost little and be relatively simple to incorporate into departments’ post-pandemic work, such as the use of vans purchased with covid relief money for vaccine delivery and disease screening. Other tools cost more money and time, including updating covid data and monitoring systems to use in other ways.
Some public health workers worry that the lessons learned from their operations will disappear once the pandemic passes.
“When we have public health crises in this country, we tend to have a bumpy funding cycle,” said Adriane Casalotti, of the National Association of County and City Health Officials.
Some federal pandemic relief funds are expected to last for years, but other allocations have already run out. Local health workers will need to prioritize what to fund with what remains.
“You’re not just starting from where you were 2 and a half years ago, there’s actually a higher mountain to climb,” Casalotti said. “But places that have been able to build some of their systems can adapt them to allow for a more real-time understanding of public health challenges.”
“This program has the power to demonstrate the scalable effects of equitable access to historically underserved communities,” said Joshua O’Neal, director of sexual health programs for the county, in a press release announcing the kits.
Dr. Allison Arwady, commissioner of the Chicago Department of Public Health, said his team is expanding the covid data-driven approach to tracking and reporting neighborhood-level data on opioid overdoses. Nonprofits and city agencies that have worked together during the pandemic are now meeting monthly to review the numbers to shape their response.
Arwady said the city is trying to use the increased money and attention brought on by the pandemic for programs that can last beyond the covid emergency.
“Every day we have these debates about ‘How much do we go on? How far do we go?'” Arwady said. “I feel like this is such a moment. We’ve shown what we can do during covid, we’ve shown what we can do when we have additional funding.”
Additionally, neighborhood organizations created to manage covid contact tracing and education are focusing on food safety, violence prevention and diabetes education. Arwady said she hopes to continue grassroots public health efforts in areas with longstanding health disparities by using a patchwork of grants to retain 150 of the 600 people initially hired with pandemic relief dollars.
“The message that I’ve really given to my team is, ‘This is our opportunity to do things that we’ve wanted to do for a long time,'” Arwady said. “We built some of this up and I’m just gonna, I’m gonna kick and scream before I let it all come apart.”
Back in Montana, Desnick said not all changes depend on funding.
When flooding destroyed buildings and infrastructure in and around Yellowstone National Park in June, the Park County Health Department used a list of contacts collected during the pandemic to send updates to schools, churches and businesses.
Desnick posts regular public health video updates that began with covid case counts and expanded to include information on flood levels, federal cleanup assistance and ice cream socials. for people to meet first responders.
Piccolo, the county health director, spent about an hour that day in July visiting hotels in central Livingston to provide opioid overdose response training and supplies. Three hotel managers accepted the offer, two asked him to come back later and one scheduled a training for all staff later in the week. Piccolo plans to expand the program to restaurants and music venues.
It’s that kind of adaptation to his job that doesn’t require the continuous stream of covid help. The state provided the Narcan boxes. Otherwise, she says, “it’s just about taking the time to do it.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of the three main operating programs of KFF (Kaiser Family Foundation). KFF is an endowed non-profit organization providing information on health issues to the nation.
Correction: Kaiser Health News updated a caption to correct Dr. Laurel Desnick’s title.