By Eric Boerwinkle PhD, Dean of UTHealth School of Public Health
The onset of the COVID-19 pandemic was a wake-up call — for all of us. The initial damage to our collective health, our health systems and the economy is well documented, but its long-term effects are still not fully understood. As we settle into new safety routines and become more confident in how we manage and deploy vital resources to mitigate the spread of COVID-19, the inevitable question looms:
Where do we go from here?
As dean of one of the nation’s largest schools of public health, the future of pandemic response has been on my mind in recent months. COVID-19 has taught us so much about how systems, government organizations and community groups cooperate and collaborate during a major health crisis. We have all worked incredibly hard to compile data, analyze risks and responses and take calculated steps toward stabilizing the economies so many Texans depend on to provide for their families. This knowledge must be leveraged, refined, and maintained. The National Guard, which serves our communities and country in times of sudden and immediate danger, provides a compelling model for a public health response from which we can work.
A Texas public health reserve would rely on partnerships between the state’s key public health responders, such as the Texas Department of State Health Services, the Texas Department of Emergency Management, city and county public health departments, and organizations like research centers, health care groups and academic institutions. It would also place a strong emphasis on comprehensive, accurate, timely and accessible data to help this network, along with the larger Texas population, to make informed decisions.
Much like muscle memory, when the next health crisis strikes, a network springs into action, and shared data are used to develop quick, accurate interventions at the appropriate scale. Our response would be faster and more strategic, allowing us to more efficiently contain and defeat the next novel virus, bacterial strain or biological agent that threatens the safety of our communities.
Similar to their military counterparts, members of the public health reserve would hold full-time jobs while engaging part time in training; reserve laboratories and other supporting infrastructure would have important applications during non-threatening times. All those affiliated with the public health reserve would participate in regular drills.
Standing up a full-time rapid response team would be unnecessarily expensive, and wouldn’t preserve the network of relationships or localization essential to an effective response. With a reserve force, however, the state would have the flexibility to quickly ramp up or down reserve members’ activity in support of chief public health emergency responders at the Department of State Health Services and local public health authorities. It is a nimble and cost-effective solution.
Work on this conceptual Texas public health reserve is already underway in the Texas Medical Center. As a platform to support the state’s response to the current COVID-19 pandemic and future health crises, The University of Texas Health Science Center at Houston (UTHealth) is developing the Texas Epidemic Public Health Institute (TEPHI). TEPHI’s mission is to enable a virtuous cycle of research and real-world application, so that the most recent evidence-based practices can be deployed quickly in times of need. Anchored in our school, UTHealth School of Public Health, TEPHI will design, pilot and collaboratively launch statewide response plans that are strategic, effective, efficient and balanced.
UTHealth School of Public Health is uniquely positioned to lead TEPHI. With campuses in Austin, Brownsville, Dallas, El Paso, Houston and San Antonio, we have a statewide network in place to gather, analyze and maintain data — all readily available and within Texas. With this distinct reach and access, our students, faculty and staff have proven expertise in capturing and interpreting data to create actionable public health safety measures at a population scale. Simply put, our work naturally aligns with TEPHI’s emphasis on multidisciplinary collaboration. In establishing TEPHI, we will:
develop and validate comprehensive training courses for the public health reserve and workforce
model and prepare for future pandemics
provide enhanced privacy and security by keeping Texas data in Texas
establish best practices, evidenced-based guidelines and prevention strategies
coordinate a network of equipped pre-certified testing sites
activate innovative contact tracing and communication strategies
create plans and ensure access to protect vulnerable populations
provide data and analytical support for clinical trials related to prevention and therapeutics
continue to foster relationships with the state’s top public health responders
Furthermore, as we learn more about the long-term health effects of COVID-19, TEPHI will catalyze research solutions for understanding and treating post-acute patients with resulting chronic conditions.
Pandemics are episodic, but their impact is long lasting. Working in partnership with others, TEPHI will help Texans live and work safely with an endemic COVID-19 and proactively identify and respond to emerging epidemic threats. For more information about TEPHI, visit sph.uth.edu/tephi.