It’s been nearly 500 days of responding to the pandemic for the Washington Department of Health, but the agency’s new leader, Secretary of Health Dr. Umair Shah, arrived on the scene about six months ago, joining the team just as vaccine distribution got underway.
Shah, an emergency room physician and former leader of the Harris County Health Department in the Houston area, spoke about what’s next in the pandemic and his vision for leading the Department of Health at a virtual Northwest Passages forum on Wednesday.
The vaccine campaign in Washington has entered its most difficult phase, with the department switching strategies from focusing on mass vaccination sites to mobile outreach. The more people are vaccinated, the less there are opportunities for a homegrown variant to develop, Shah said on Wednesday.
“At least so far the evidence is showing these vaccines are taking on those variants, but that’s not a forever thing,” Shah said .
The necessity of a booster shot is likely, he added. As clinical studies of the three emergency use vaccines continue, there will be forthcoming data on the longevity of the protection offered by vaccines. Shah, who was vaccinated in January, said he might need a booster shot this winter.
If booster shots become necessary, the department will have to start the vaccine campaign all over again, which Shah noted would be challenging.
The secretary has an ambitious and values-driven approach to how he wants to lead the Department of Health.
His top three values driving his strategy are equity, innovation and engagement.
The pandemic laid bare the inequities that persist in access to health care but also society in general. Nonwhite communities in Washington state were disproportionately affected by the virus.
Shah noted systemic and societal social determinants of health that affect Washington residents both before and during the pandemic from racism to access to housing or transportation.
“COVID-19 did not start these health inequities or disparities or outcomes, but it took it to a different level that’s been awful,” he said.
Shah, who responded to several emergencies in Houston ranging from hurricanes to other public health scares like the presence of Ebola in the United States, said historic underfunding of public health has led to a lack of resources necessary when something like a pandemic occurs.
“The reason we got into this hole with COVID-19 is because we never invested in public health,” he said.
He compares public health to the offensive line of a football team, while the more well-known quarterback is the health care system. Public health protects the rest of the system through disease prevention and other vital work.
“If the offensive line is not strong, Russell Wilson or the team will not be successful,” he said.
For the next two years foundational public health services in Washington will receive $147 million, and $296 million in future biennia, which represents a significant increase in funding compared to past budgets.
Shah said those funds will go toward foundational public health services, from workforce to technology as well as investments in mental health and substance use disorder treatment and programs. Some of the funding will support a new program the Department of Health launched this week called Care-a-Vans, which are mobile treatment vans that can go anywhere throughout the state. Currently they are being used to take COVID-19 vaccines to communities that need them.
Community organizations or groups can request a van come to their event or place of worship, Shah said, and the van and staff will come on-site to do vaccinations.
Even after the pandemic, the program will not disappear, he said, sharing his vision of these vans serving communities for other public health needs from routine vaccinations to preventative health care where it is needed in the state. The program and the state’s overall health care system can learn from the pandemic.
“Let’s leverage it so we can create healthy opportunities for the future,” he said.
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