New study tracks public health laboratory challenges across COVID-19 pandemic

Planning, Government Support & Interference, Staffing, Funding, Supplies

Across the COVID-19 pandemic, public health laboratories (PHLs) have faced multiple evolving challenges hindering their ability to identify COVID-19 cases and slow the spread of the pandemic, according to a new research paper from the Johns Hopkins Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, the Brown University School of Public Health, and the Association of Public Health Laboratories. 

This study, based on interviews conducted in 2021 with 68 leaders and staff representing 28 local and state PHLs across 27 states, identifies specific challenges hampering the response of public health laboratories, including:

  • Lack of a clear mandate, as their role shifted from surveillance-based testing to large-scale clinical diagnostic testing;
  • Confusing or insufficient operational guidance from federal agencies, including the Centers for Disease Control and Prevention and the Food and Drug Administration;
  • Political interference at the state or local level;
  • Antiquated information systems limiting testing capacity;
  • Supply and material shortages reducing their pandemic response capacity and ability to continue normal operations;
  • Staffing shortages exacerbated by burnout and hiring complications.

The study also reports that lessons learned during the pandemic by public health laboratories and officials “can inform solutions to current challenges and future preparedness efforts.” The research and the report are the work of Christina Potter, MSPH, and Natasha Kaushal, MSPH of the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health; Kelly Wroblewski, MPH, and Scott Becker, MS, of the Association of Public Health Laboratories; and Jennifer B. Nuzzo, DrPH, SM, professor of epidemiology at the Brown University School of Public Health.  Their work was funded by the Open Philanthropy Project. 

“Our public health laboratories are the jewel of the US disease surveillance efforts, but they were not adequately supported during the pandemic. We must do better in future public health emergencies and ensure our nation’s labs have the resources they need to help us track and respond to deadly pathogens,” said Nuzzo, a study author and inaugural director of Brown's Pandemic Center.

“These findings underscore the need for continued investment in our nation’s public health laboratories,” said Scott Becker, MS, chief executive officer of the Association of Public Health Laboratories and study coauthor. “We need to use the lessons from the COVID-19 response to strengthen laboratory systems in advance of future health threats.”

“Some public health laboratories were able to conquer challenges through creative innovation and strong partnerships, but too many challenges were the result of longstanding issues or were exacerbated by excluding public health laboratories from response planning. We need to address these issues before the next emergency,” said Christina Potter, a coauthor from the Johns Hopkins Center for Health Security at the Johns Hopkins Bloomberg School of Public Health.