Self-directed regional networks: Connecting neighbors strengthens labs

The Pacific Rim Consortium met in person for the first time at the Hawaii Public Health Laboratory in March, 2019.

(Photo: The Pacific Rim Consortium met in person for the first time at the Hawaii Public Health Laboratory in March, 2019.)

How can a public health laboratory with limited resources sustain and expand its capabilities? One strategy is to leverage the resources and expertise of its neighbors.

With support from the US Centers for Disease Control and Prevention (CDC), APHL is assisting with development of self-directed regional laboratory networks (SDRN) to facilitate collaboration and resource management among neighboring public health and environmental laboratories. SDRNs operate independently, establishing their own governance and strategic priorities based on their unique needs. Soon these networks will be linked through a Coordination Council, which will bring together representatives from each of the SDRNs for joint planning and resource development.

A growing community of networks

Today, 48 states and one territory, Guam, are members of an SDRN. The original SDRN was founded over forty years ago when laboratory directors in New England came together in the mid-1970s to share common concerns around newborn screening legislation then pending in multiple states. This group evolved to become the New England Public Health Laboratory Directors Group (NEPHLD), and then became NEEPHLD when it expanded its constituency to include laboratories responsible for environmental testing.

However, the regional model did not pick up momentum until a review by APHL and CDC demonstrated its value in the early 2000s. This provided the impetus to form the Northern Plains Consortium in 2006, the Southeast Consortium in 2015, the Mid-Atlantic Consortium in 2017, and the Midwest, Pacific Rim, Four Corners and Central Plains networks in 2018 and 2019.

Members “have our back”

SDRN member laboratories report many benefits from participation. Members share technical expertise, technologies and capacity, and they forge relationships with colleagues at other laboratories, making it easier to collaborate when emergencies arise or a testing system goes down. Emily Travanty, PhD, scientific director of the Laboratory Services Division at the Colorado Department of Public Health and Environment reports: “Our fellow consortium members have our back when we need them. For example, the Utah Public Health Laboratory did TB testing for us when our laboratory was in the midst of renovations. Because of them, we were able to still meet our test turn-around times and keep our customers happy.”

Members also collaborate on fundraising, informatics systems, training and leadership development, as well as recruitment and retention. According to Denise Toney, PhD, director of the Virginia Division of Consolidated Laboratory Services:

“The Mid-Atlantic Consortium provides a venue to share ideas, resources and expertise across our region so we don’t have to reinvent the wheel. One project we worked on collectively was a compensation study, funded by CDC and APHL. Our members are using this data to educate their own state leaders about the salary levels needed to recruit and retain top-notch scientific staff in our region.”

SDRNs show strong prospects for the future, with planning in progress within and across networks. With sustainability a perennial challenge for state and local laboratories, that’s good news for public health.

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New Lab Matters: The promise and challenge of newborn screening in 2019

New Lab Matters cover depicts a newborn baby

Newborn screening is a public health success story, ongoing for 56 years. On the one hand, new treatment and laboratory testing options open up the possibility of expanded screening panels. On the other hand, testing laboratories and follow-up providers are generally under-resourced and straining to keep pace with growing workloads. But as our feature article shows, scientists are working diligently to improve the accuracy and precision of existing tests and to bring on new disorders, even as they continue the high-stakes work of screening tens of thousands of infants a year.

Here are just a few of this issue’s highlights:

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New Lab Matters: The ABCs of PFAS

New Lab Matters: The ABCs of PFAS | www.APHLblog.org

First discovered in the 1930s, per- and polyfluoroalkyl substances (PFAS) now pervade almost every aspect of modern life. In fact, PFAS compounds are found in everything from dental floss to cookware. But human exposure to PFAS comes at a cost, and as old compounds are removed from production, new compounds take their place. So how does a public health laboratory handle this challenge with limited resources? As our feature article shows, by establishing new public-private partnerships.

Here are just a few of this issue’s highlights:

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New Lab Matters: Time to welcome the next generation of public health laboratory scientists

New Lab Matters: Time to welcome the next generation of public health laboratory scientists | www.APHLblog.org

The Bureau of Labor Statistics estimates that 12,000 new laboratory professionals are needed each year to meet consumer demand. At the same time, while automation has eliminated some less-skilled laboratory jobs, the growing sophistication of public health laboratory analyses has generated demand for scientists with highly specialized training. As our feature article shows, laboratories are recruiting new talent for the “hidden profession” by taking a hard look into what they really want, and how they want to work.

Here are just a few of this issue’s highlights:

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5 most unexpected and unique partnerships forged through the Zika response

Top 5 most unexpected and unique partnerships forged through the Zika response | www.APHLblog.org

By Kelly Wroblewski, director, infectious disease, APHL

While the US public health system has been through a number of infectious disease responses in the last decade, the Zika response was unique in both its duration and complexity. For more than 20 months (January 22, 2016 – September 29, 2017), CDC’s Emergency Operations Center was activated to respond to the US’s largest Zika virus outbreak. State and local public health departments began their responses as early as November 2015 and continue to respond today. Through the uncertainty, public health built relationships with new partners and found opportunities for unique collaborations with old partners.

APHL explores the journey in detail in our new book, A Complex Virus, A Coordinated Response: Public Health Laboratories Battle Zika. For APHL and public health laboratories, five unique and unexpected partnerships forged during the Zika response proved critical to progress on this journey. Learn about them below:

1. Vector Control

Vector control is, of course, a time-honored, if underappreciated, public health partner; after all, CDC was established in the 1940s in response to malaria. The Zika response reinvigorated those relationships as public health laboratories and vector control programs worked together on the best methods and approaches for vector surveillance (i.e., testing vectors to see if the pathogen is present) and insecticide resistance testing (testing insects to determine which sprays will be most effective). Once local transmission occurred in Florida and Texas, vector control relied on public health laboratory test results to focus mosquito control efforts on the areas where transmission was most likely to occur.

2. Maternal and Child Health and OB/GYNs

While public health laboratories may connect with maternal and child health departments for other types of testing like newborn screening, it is unusual for these groups of public health professionals to work together in response to an emerging infectious disease. Many OB/GYNs treating patients concerned about their risk of Zika infection and exposure were used to working with clinical and commercial laboratories for prenatal testing, but had never ordered a test at a public health lab. Public health labs across the country worked with their maternal and child health counterparts to ensure they had the most up-to -date information on accessing testing, knew how to correctly complete test request forms and could interpret test results to pass along to appropriate healthcare providers.

3. Commercial Laboratories

At public health laboratories, Zika testing represented a massive increase in workload. Beyond demand from patients worried about their exposure, there were multiple new tests to validate, different tests required for different patient populations and often a single specimen from which multiple laboratories needed to conduct multiple tests. In April 2016, commercial laboratories began performing Zika testing, thus distributing some of the specimen volume, taking some of the load off public health labs and offering OB/GYNs access to testing from laboratories with whom they had established relationships.

4. The Zika Coalition (So. Many. Partners.)

This group, led by the March of Dimes, was comprised of more than 70 member organizations committed to the health and wellbeing of US children and families. It was established in response to Congress’ delay in approving the Obama Administration’s emergency request for funding to respond to the Zika crisis in the US. The request was made in in February of 2016 and was not approved by Congress until that September. The Zika Coalition visited congressional offices, wrote letters and testified before the Senate Appropriations Committee advocating for and applying pressure to ensure public health got the funding necessary to respond.

5. CDC, FDA and CMS – Tri-agency Taskforce for Emergency Diagnostics

Although partnerships with the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the Centers for Medicare and Medicaid Services (CMS) are neither unique nor unexpected during an infectious disease emergency response, the Zika response did change their nature with the establishment of the Tri-agency Taskforce for Emergency Diagnostics. Throughout the 20 month response, as we learned more about how the Zika virus behaved, APHL worked with these agencies to ensure that laboratories had access to the best possible tests through the emergency use authorization (EUA) process (FDA’s role), guidance on how to use those tests (CDC’s role) and assurance that the tests were being implemented in compliance with quality testing standards (CMS’s role). This taskforce remains intact for future responses.

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What a Day! Day 3 of the APHL Annual Meeting

What a Day! Day 3 of the APHL Annual Meeting | www.APHLblog.org

Day 3 of the APHL Annual Meeting was a big one! We had several captivating sessions including this year’s Katherine Kelley Distinguished Lecturer, Maryn McKenna, renowned journalist and author. Listen to today’s episode to hear a few attendees share what they took away from the day.

You can listen to our show via the player embedded below or on iTunes, Stitcher or wherever you get your podcasts. Please be sure to subscribe to Lab Culture so you never miss an episode.

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Hello, Pasadena! Day 1 of the APHL Annual Meeting

Hello, Pasadena! Day 1 of the APHL Annual Meeting | www.APHLblog.org

We are in sunny Pasadena, California for the 2018 APHL Annual Meeting! Here is a little look at what we did on the first day. Stay tuned for updates every day through June 5.

You can listen to our show via the player embedded below or on iTunes, Stitcher or wherever you get your podcasts. Please be sure to subscribe to Lab Culture so you never miss an episode.

Join the conversation using #APHL on:

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New Lab Matters: When the water comes, be prepared

New Lab Matters: When the water comes, be prepared | www.APHLblog.org

According to a study by the National Center for Atmospheric Research, the volume of rainfall from storms will rise by as much as 80% in North America by the end of the century. Not only do storms and floods threaten public health laboratory facilities, but receding floodwaters pose serious public health risks. As our feature article shows, the best weapon in a public health laboratory’s arsenal is preparation for inundation…from any source.

Here are just a few of this issue’s highlights:

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Lab Culture Ep. 9: What is the APHL Emerging Leader Program?

Lab Culture Ep. 9: What is the APHL Emerging Leader Program? | www.APHLblog.org

What is the Emerging Leader Program (ELP)? APHL staff, Pandora Ray and Kajari Shah, share how the ELP got its start and how it has progressed. This year’s ELP cohort is producing three episodes for Lab Culture that will be released over the coming weeks. Stay tuned!

APHL Emerging Leader Program

(Cohort 9 is pictured above. Pan and Kajari are kneeling in the center.)

You can listen to our show via the player embedded below or on iTunes, Stitcher or wherever you get your podcasts. Please be sure to subscribe to Lab Culture so you never miss an episode.

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Everything you need for Lab Week 2018

Everything you need for Lab Week 2018

Get ready for Lab Week! April 22-28 we will join our members and partners to celebrate the vital contributions laboratory professionals make to protect public health and safety in the US and around the globe. APHL will be particularly focused on the laboratory professionals who make up our community – the dedicated individuals working at local, state, environmental and agricultural laboratories which comprise the public health laboratory system.

We have lots of fun things planned this year! Scroll down for printable posters, downloadable graphics and more.

Follow APHL for our special Lab Week content (there might even be a contest on Facebook… hint hint…)!

While we celebrate our members, we also use Lab Week to increase awareness and demonstrate the importance of public health and environmental laboratories in our communities. We encourage you to do the same!

Below are some resources to help launch your own Lab Week celebration. These resources are for local, state, public health, environmental and agricultural laboratories alike!

Printable posters to display in your lab:

Everything you need for Lab Week 2018Graphics:

Sample social media posts (include a graphic or photo for added visibility):

Videos

Here are two animated videos to share with your public audiences. Feel free to share the link or embed on your website.

What exactly do public health laboratories do? Share these stories that highlight their work:

Encourage others to consider laboratory careers! Share these stories:

Celebration ideas:

  • Celebrate Lab Week internally with a social event, banners or other decorations.
  • Hold an open house for media, elected officials, school groups, staff families and other members of the public. Check out the Milwaukee Health Department Laboratory’s story about their health fair for students.
  • Visit local elementary, middle and high schools to talk with students interested in STEM disciplines.
  • Write an op-ed piece for local newspapers and/or magazines to highlight the valuable contributions your public health laboratory staff are making in your community, city and/or state.
  • Are you the lab director or section manager? Think of fun and meaningful ways to thank your staff for their dedication to public health.

Kick off Lab Week with an Earth Day celebration and carry it through the week!

  • Host a Green and Blue Day and ask staff to wear colors representing earth and water.
  • Hold a grounds-keeping afternoon: Invite staff and their families to help with weeding, mulch, planting, etc.
  • Ask if your regional EPA office plans to do something for Earth Day and join them as a partner.
  • Encourage employees to do Meatless Monday or purchase items at a local farmer’s market instead of the supermarket.
  • Encourage employees to Travel Differently on Tuesday carpooling, taking the bus, walking or riding their bike to work.

Check out the WEF-APHL environmental lab webcast: Introduction to the 2017 Method Update Rule

On April 26, 2018 1:00-3:00 pm ET, join Water Environment Federation (WEF) and the Association of Public Health Laboratories (APHL) for a free webcast that will introduce certified laboratory personnel to the changes found in the 2017 Method Update Rule (MUR). Updates include EPA-promulgated changes to Clean Water Act analytical test procedures for analyzing chemical, physical and biological components of wastewater and other environmental samples. If you work at a state or local public health or environmental laboratory and/or are an APHL member, please email Sarah Wright before registering to receive a code to waive the $40 fee.

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