Public Health Preparedness During the COVID-19 Pandemic

As professionals with a combined 60-plus years of experience in public health preparedness, the authors have repeatedly witnessed the impact of sub-optimal education and training in this field. Public health professionals and practitioners urgently need competency in public health preparedness and response. Historically, most Departments of Public Health in the United States lack an Emergency Manager and an updated Emergency Response Plan.Reference Reid, Mba, Brown, Landis and Mph ⁸ The COVID-19 pandemic further highlighted that every discipline within public health plays a crucial role in disaster response. Environmental health scientists assess air and water quality, biostatisticians analyze outbreak data, epidemiologists track the spread of diseases, health policy and management professionals develop response strategies, and health promotion and behavior experts communicate public health messages. ⁹ Despite these vital roles, it is disheartening to know that the majority of public health graduates will enter the workforce lacking the essential knowledge, skills, and abilities (KSAs) needed to prepare for and respond to public health disasters.Reference Burns, Strickland and Horney ^{10 ,} Reference Czabanowska and Kuhlmann ¹¹ These KSAs include, but are not limited to, operating in Incident Command System-based settings, navigating resource limitations (i.e., personnel and supplies), adapting to challenging conditions (i.e., working outside in the elements or a facility with no bed capacity), addressing misinformation and disinformation, and navigating situations with limited access to accurate data. Moreover, numerous studies have demonstrated that this lack of knowledge and training resulted in high levels of stress, burnout, and other severe mental health consequences throughout the COVID-19 pandemic and other previous epidemics.Reference Stone, Kintziger and Jagger ^{12 –}Reference Maunder, Lancee and Balderson ¹⁴ Therefore, the gap in public health preparedness education leaves our future public health professionals unprepared to face the realities of a disaster, where interdisciplinary collaboration is essential. Public health preparedness should be woven into the fabric of every public health degree, with courses and practical experiences designed to foster an understanding of disaster response strategies, disaster communication, resource allocation, and the unique demands on public health in times of disaster.

Integrating public health preparedness into the curriculum cannot just include theoretical knowledge, however. Students must develop practical skills that will save lives. Students should have the opportunity to participate in drills, simulations, and real-world exercises that mimic the challenges of responding to a public health disaster. These experiences will equip them with the confidence and competencies necessary to excel in high-stress, high-stakes situations.

Furthermore, the COVID-19 pandemic highlighted that students may encounter the challenges of a disaster even before graduation. The reduction of over 50 000 full-time employees (FTEs) in the public health workforce from 2008 to 2016, coupled with the current demand for 80 000 FTEs to effectively implement Foundational Public Health Services at the state and local levels,Reference Leider, Coronado and Beck ¹⁵ underscores the crucial role public health students played in supplementing the strained workforce. During the pandemic, students were mobilized and provided with “Just-in-Time Training” for tasks such as contact tracing, training, and handling surge capacity.Reference Burns, Strickland and Horney ¹⁰ Although this real-world experience proved invaluable, it also emphasized the necessity for a formalized, experience-basedReference Magaña ¹⁶ education in public health preparedness to better equip students for their roles during such disasters. Without such education, students found themselves in need of just-in-time training for essential skills like using personal protective equipment,Reference Suwanbamrung and Kaewsawat ¹⁷ conducting contact tracing, ¹⁸ and employing coping mechanismsReference Suwanbamrung and Kaewsawat ¹⁷—skills currently only obtained as a professional.

Public Health Preparedness Beyond Pandemics

The need for public health preparedness education is not confined to pandemic preparedness. As natural, human-made, and technological disasters have been a part of human history since the beginning of human civilizations, the frequency, intensity, and scope of disasters are ever increasing. Each of these events carries significant public health consequences, and our public health workers are called upon to address these challenges.Reference Murray and Lopez ¹⁹ Whether it is providing medical care in austere environments, addressing mental health needs of survivors and responders, monitoring the spread of diseases during and following these events, or ensuring access to clean water and sanitation, public health professionals are at the forefront of population-level health. ²⁰

Students studying public health disciplines should be well versed in the complexities of working in challenging and even austere environments where their skills can (and will) make life-or-death differences. Incorporating education on public health preparedness and disaster response strategies within the public health curriculum is imperative for producing graduates who can navigate the realities of today’s world.