The study released this month by the Robert Wood Johnson Foundation said the state’s rating for health security dropped 3.2% last year, while its ability to monitor threats that would require large-scale medical responses dropped 7%.
“It’s not the direction you want to move in,” said Glen Mays, the University of Kentucky-based head researcher who led a team that reviewed 129 measures that go into the study.
The 2019 Index showed the United States scored a 6.7 on a 10-point scale for preparedness. That’s a 3.1 percent improvement over the last year, and a 11.7 percent improvement since the Index began in 2013.
However, West Virginia did not see the advances other states experienced.
“West Virginia has lost some capacity of being table to protect health status in the advent of an emergency. It’s not the direction we hope to go in,” Mays said.
The study examined multiple facets of natural and manmade events ranging from flooding to wildfires to disease outbreaks to chemical spills. The study also looked at housing and transportation and how those issues play into health care security.
Mays said states can use the data in the Index to look at ways to make their health care delivery and emergency response systems better.
“We want to look at what specific kinds of capacities we have deficits in and look at shoring those up,” Mays said.
Mays also said West Virginia received a low score in the Index because the state does not have a uniform Electronic Laboratory Information System to share medical information quickly with other partners to fend off or respond to disasters.
“It’s 2019 now, electronic lab information systems allow the states to share information with other states, and the Centers for Disease Control,” Mays said.
Lack of a uniform electronic records system slows down how quickly disaster information is shared, Mays said.
“Slower is bad when you’re trying to contain an outbreak. You want to contain that first case rapidly and try and stop it from spreading. Being able to notify the neighboring state, if it takes you a day or two to transmit that data rather than within minutes, that gap in time allows that pathogen to spread quicker,” Mays said.
Donnie Haynes, director of the West Virginia Center for Threat Preparedness in Charleston, said while he would argue Mays’ point about sharing electronic records, there are some links in the state’s information-sharing chain that are not as strong as they should be to have optimum health security preparedness.
“Our state public health lab, the Office of Laboratory Services, they currently do use an electronic laboratory information system and we do have some capability to provide electronic laboratory reporting to our partners across the state. However, not all hospitals are currently set up or capable to receive those electronic records,” Haynes said.
“So, currently we use a fax mechanism to send those submitted results to make sure that we share with our partners, but we do have that capability to use an electronic lab reporting system because we are required by federal law to submit outbreak monitoring and surveillance records to the CDC for all required laboratory reporting,” Haynes said.
Not all of the West Virginia data in the study is negative, Mays said. West Virginia leads the nation in the countermeasure management domain — the measure of how quickly remedies, such as supplies and medications, can be deployed in the event of a contagion or outbreak.
Mays said the Mountain State scored high in this measure due to the large number of pharmacies in the state.
“Pharmacies are incurably important if we had an outbreak, relief is going to occur through pharmacies and the pharmacists are a big part of that,” Mays said.
“For example, if we have an outbreak that requires, say, Cipro, the pharmacies are going to be the ones on the front line distributing the medications needed to stop the spread of the outbreak.”
But being prepared for a large-scale disaster that could claim a large of number of lives goes far beyond pharmacies, according to Haynes.
Haynes cited the state’s current Hepatitis A outbreak as a good example of real-life health care threat preparedness. He said Hepatitis A, for the most part, is being handled directly at the source in West Virginia because of relationships, planning and coordination.
“We’re able to go into these non-traditional facilities, such as comprehensive treatment centers or homeless shelters or soup kitchens, and reach these at-risk populations directly without having to rely on them coming to physicians’ offices or pharmacies to get their vaccination,” Haynes said. “So, that outreach really is critical and substantial to the impact that we’re having here to reduce the spread of Hepatitis A.”
Haynes said health care threat preparedness involves coalition building on the state, regional and local levels.
He also said several factors could have contributed to the overall drop in West Virginia’s score. Lower salaries have created staffing shortages in health care and other fields. Despite those staffing issues, however, West Virginia scored well in the 2019 Index on the measure of EMS response times in rural areas.
“For rural areas, you’ve actually gotten a little faster in emergency response times and are better than the national average,” Mays said. “One of the recommendations we make, about response times, is to get more organizations collaborating in local coalitions.”
And that’s where Jamie Moore comes in.
As the coordinator of the Monongalia County Preparedness Action Coalition Team that covers Doddridge, Harrison, Monongalia, Marion, Taylor And Preston counties, it’s Moore’s job to serve as “the relationship guy.”
“In each county, there is also a coordinator and they also have a relationship guy. So you’ve got a bunch of people always working on the relationships,” Moore said.
One of the health care programs Moore is currently helping to coordinate is called “Stop the Bleed,” which involves training hundreds of citizens and health care professionals on how to provide aid to someone who is losing blood.
“Threat preparedness is all about evaluating what your risks are and having a plan to handle them,” Moore said. “It’s important to have conversations about how you're going to react in an emergency.”
Email Eric Cravey at ecravey@timeswv.com.
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