The COVID-19 pandemic has strained Texas’ already limited public health resources and transformed what were once cracks in our public health system into deep chasms.
One focal point has been Texas’ lack of emergency preparedness for frontline health care workers. Throughout the pandemic, there has been a shortage of personal protective equipment (PPE), with up to 78% of Texas physicians having an insufficient supply in April 2020.
The shortage highlighted the inextricable link between Texas’ emergency response systems and essential medical services. Investments in PPE procurement, supply maintenance, and appropriate staffing are fundamental for physicians to safely care for their patients.
The pandemic exposed and overwhelmed Texas’ data reporting capacity with the sheer volume of cases, resulting in backlogs and coding errors, and impacting the state’s response rate. Texas needs to further implement, update, and streamline its statewide electronic case reporting (eCR) system for use across sectors and throughout all levels of public health systems. In addition, electronic lab reporting system vendors must prioritize the efficiency, functionality, and interoperability of their eCR systems. Texas needs a single portal for physicians and providers to transmit critical public health reportable conditions and data.
Racial and ethnic minority groups have been disproportionately affected by COVID-19 and have faced a higher risk of infection and death due to inherent inequities in social determinants of health like health care access and utilization, employment, education, income, and housing.
Black, Hispanic, and other communities of color are more likely to have underlying medical conditions, placing them at higher risk of severe COVID-19 illness and death.i In August 2020, Hispanic Texans accounted for almost 40% of confirmed COVID-19 cases and more than 55% of confirmed COVID-19 deaths, compared with their white counterparts, who accounted for 28.5% of confirmed COVID-19 cases and 30.4% of confirmed COVID-19 deaths.
Texas needs to strengthen its essential public health services by taking these three steps: (1) improve the state’s emergency preparedness, (2) streamline data reporting systems, and (3) address racial and ethnic health disparities.
TMA’s Legislative Recommendations
- Ensure state PPE stockpiles are adequately stocked, maintained, and replenished as necessary, and establish a plan for equitable distribution of PPE to private practice and hospital-based physicians.
- Expand Regional Advisory Council capabilities and personnel to manage local trauma systems, and include private local physicians in their focus.
- Retain epidemiologists, laboratory specialists, contact tracers, and other staff needed during a public health crisis.
- Support up-to-date statewide electronic case reporting systems for notifiable conditions to easily identify outbreaks of disease.
- Require electronic lab reporting system vendors to prioritize the efficiency, functionality, and interoperability of their eCR systems.
- Require laboratories to include race, ethnicity, gender, and other key demographic information in their reporting data to help guide state response.
- Ensure access to free, convenient testing for communities of color and other vulnerable populations, and provide culturally and language-appropriate informative resources for these groups, including the use of community health workers.
We’ve seen that our public health data systems are woefully ill-equipped to help with real response to disease outbreaks and surveillance against future threats. The Texas economy cannot afford the cost of not having a strong public health infrastructure.