Dr. Rachel Bender Ignacio: Protecting rural Washington against the next pandemic
By Rachel Bender Ignacio, M.D., M.P.H.
It has been two years since the first U.S. case of COVID-19 was identified in Washington. The pandemic’s surges have pushed the health care systems beyond their capacity. Staff burnout and an exodus of front-line health care professionals have gained national attention.
Long before this pandemic, however, Washington’s health care system and those of other states faced a critical vulnerability: There are simply not enough people working in bio-preparedness and infectious diseases to manage public health emergencies.
It is alarming that 22 counties in Washington have no specialist trained to manage highly infectious diseases such as COVID-19, SARS, MRSA and Zika. In Spokane County, just five infectious diseases doctors do the job of many, supporting clinical services in much of Eastern Washington and neighboring states. Confluence Health, the main health care system serving north-central Washington’s population of about 263,000, has just two infectious diseases specialists. The lone specialist in Yakima has no routine back up for clinical care or supervision of hospital epidemiology and antibiotic stewardship, while they also serve as the county health officer.
Washington is not alone. Our neighbors Oregon, Idaho, Montana and Alaska are in similar perilous positions. Nationwide, 79.5% of counties, representing 208 million Americans, in predominately rural areas, have no infectious diseases specialist.
Fortunately, our state’s congressional delegation boasts leaders in health policy who can deliver the help we desperately need – in the form of the bipartisan BIO Preparedness Workforce Act. Washington – and other states – need Congress to pass this act this year. It happens to align perfectly with the aims of an important new pandemic preparedness initiative being led by Sen. Patty Murray: the PREVENT Pandemics Act, highlighted last week in The Spokesman-Review (“Lawmakers plan ahead for next pandemic,” Feb. 7).
The BIO Preparedness Workforce Act is designed to increase the number of health professionals pursuing careers in preparedness by helping them repay student loans if they commit to serve in communities that lack infectious diseases services. Much of the work done by these professionals stretches far beyond seeing patients; they also advise health systems and communities on safety precautions, run laboratories, and set up local systems to detect and respond to new infectious threats. This act strengthens a multidisciplinary workforce including infection preventionists, advance practice nurses and pharmacists, among others. The bill would also increase the diversity of the workforce in these roles, which could help improve health outcomes for underserved communities and communities of color.
The legislation represents a significant investment in health care in local communities and would strengthen the preparedness workforce, helping to protect against future threats. Without it, the dire situation illustrated by the statistics referenced above will only worsen.
The legislation would also help ensure that laboratories have resources to meet public needs. Testing demands have skyrocketed during the pandemic, with lab specialists needing to perform millions of COVID tests and analyze and deliver results while continuing to process all the non-COVID tests and screenings they performed pre-pandemic for HIV, hepatitis, and other conditions.
The bio-preparedness workforce desperately needs trained and skilled reinforcements for the health of the people it serves, and for the well-being of the people who provide the care. The BIO Preparedness Workforce Act would help create a stronger workforce that can provide better care to more people during a pandemic and beyond.
As leaders of health care committees in Congress, Sen. Murray and Rep. Cathy McMorris Rodgers deserve thanks for their tireless efforts to provide our state with resources for our ongoing COVID-19 response. As they look ahead to apply lessons learned from the current pandemic to improve our preparedness for the next one, the BIO Preparedness Workforce Act should be central to their efforts.
Lives depend on it.
Dr. Rachel Bender Ignacio is an assistant professor in the Division of Allergy and Infectious Diseases, Department of Medicine, at the University of Washington School of Medicine. She also is a physician-scientist and medical director of the COVID-19 Clinical Research Center at the Fred Hutchinson Cancer Research Center. She is proud to have been raised in Spokane and will always call Eastern Washington home.
This article has been updated to reflect that 22 counties in Washington (not Eastern Washington) don’t have specialists trained to manage highly infectious diseases such as COVID-19, SARS, MRSA and Zika.