Next biothreat response? Lori Trahan listens to health leaders on lessons from COVID

By: Melanie Gilbert 

LOWELL — Are we ready for the next pandemic? What lessons were learned?

These questions were discussed during a pandemic preparedness roundtable hosted by U.S. Rep. Lori Trahan at UKG on Monday. She was joined by Massachusetts Health and Human Services Secretary Kate Walsh, and 15 area health care leaders, in a frank conversation about recovering from and preparing for the next COVID-style biothreat.

The congresswoman is a cofounder of the bipartisan Congressional Pandemic Preparedness Caucus, that is working to secure reauthorization of the Pandemics and All-Hazards Preparedness Act.

“I want to ensure that your perspectives help shape the way I approach this legislation, whether it’s testing, therapeutics, disease countermeasures or public health infrastructure,” Trahan said. “You were on the front lines; I will benefit from this discussion and your input.”

The act was first signed into law by President George W. Bush in 2006, and reauthorized in 2013. The purpose of the act is “to improve the Nation’s public health and medical preparedness and response capabilities for emergencies, whether deliberate, accidental, or natural.”

As is her style, Trahan opened the forum, before stepping back to allow the attendees to guide the conversation, which she called a “listening session to inform the legislative space.”

The participants hailed from organizations involved in direct patient health care, public health, biotech and medical manufacturing. They shared their best practices — or skin-of-the-teeth strategies — that guided their  response to an unprecedented public health emergency that has caused the deaths of more than 1 million Americans, and continues to reverberate throughout the health care field.

Walsh said that in her 40 years of public health service, nothing prepared her for COVID.

“I never spent so much time counting masks and trying to predict how many days they were going to last,” she said, as people in attendance nodded in agreement. The inequity of access to care was her biggest concern going forward.

“A colorblind virus wasn’t so colorblind,” she said. “Six days into vaccinations being available, of the people that were eligible to get the vaccine, 66% of the people who were white had it, and 6% of Black people got it. How we react, how we respond, really needs to be through an equity lens.”

Michael Curry, who is president and chief operating officer of the Massachusetts League of Community Health Centers, said his biggest takeaway from the pandemic was that community partnerships worked. He was one of four such nonprofits represented at the table.

That observation was endorsed by CEO Susan Levine of the Lowell Community Health Center.

“We reach over half the population in the city of Lowell,” Levine said. “We learned during the pandemic how critical community health centers are in being the trusted providers of care for our communities.”

Staffing up medical facilities was on the mind of other providers such as Lawrence General Hospital Executive Vice President/Chief Operating Offiver Robin Hynds and Lowell General Hospital CEO Jody White, both of whom noted the high staff burnout after an almost three-year, all-hands-on-deck event.

“We still had to run our day-to-day operations on top of managing this unexpected situation,” Hynds said. “COVID really hit Lawrence. We’re still today, the highest incidence of COVID in the commonwealth.”

She thanked Trahan and her staff for helping the hospital find resources, and “keep our heads above water,” including an extension of a National Guard contingent in early days to manage the patient load. National Guard members were also sent to Lowell General.

“At one point we had 115 COVID patients, today we have five,” Hynds said, but noted that workforce challenges remain, creating “a burden on top of a burden,” a situation she called unsustainable.

White put a hard number on that impact to operations telling Trahan and Walsh that Lowell General had a $50 million loss in 2022, and will have another bad year in 2023. The hospital had layoffs in January.

“We’re still in the middle of cleanup mode,” he said. “It’s impossible to get nurses now, they’ve been scared out of the business. The emergency stop is May 11, and the federal dollars are going to shrink, and the hospitals are still trying to recover.”

Themes from both public and private companies tracked along the same lines: loosen regulatory obstacles to increase response flexibility; eliminate bottlenecks in reimbursement for pandemic-related outlays; continue community partnerships, surveillance and testing strategies; invest in the workforce; prepare a stockpile according to the predicted biothreat; conduct a pandemic debrief to discover best practices; build in surge capacity so that organizations aren’t scrambling or competing for resources; and keep listening and talking to one another.

The conversation that got the attention of Trahan and Walsh came from consultant Steve Wolfe, who also serves on the steering committee of the Medical Countermeasure Coalition.

“The lack of resources for the level of the challenges (with COVID) were staggering,” he said. “There was no one person responsible at Health and Human Services.”

Walsh wondered if Wolfe was suggesting that preparedness be pulled from HHS, to which he sighed, and offered, “After 9-11, the decision was made that the government didn’t have a structure, so the Department of Homeland Security was created.”

Trahan’s engagement in the discussion extended well beyond the allocated one-hour timeframe. In closing, she thanked the participants for their candid input.

“We’re focused on the reauthorization of PAPHA,” she said. “This will be one of many opportunities for Congress to take the lessons learned from COVID and actually legislate to prepare our systems to be ready to respond to an unknown future public health threat.”