New Study Reveals COVID’s Crushing Impact on Public Health

According to a new study from the University of Delaware, many public health workers have been transferred to COVID-related duties during the pandemic response, leaving other critical public health issues with reduced or suspended services. Credit: University of Delaware/Jeffrey C. Chase

New study shows the pandemic has engulfed the workforce and crippled other services.

The brutal impact of COVID-19, the virus that emerged in late 2019 and has claimed 5 million lives so far, is chronicled in the daily headlines. It has robbed us of loved ones, jobs, plans and much more.

The impact on those treating the sick and dying has been the subject of much research, and the depletion of health professionals turning over extra shifts and providing coverage for understaffed is well documented.

But the true extent of this plague is not yet known.

Now, a new study, published Oct. 14 by PLoS-One, shows another layer of impact: how the response to the virus has crushed the U.S. public health system, especially the workers and the critical services they provide to millions of people.

The study, led by Jennifer Horney, professor and founding director of the University of Delaware’s Epidemiology Program, sheds a chilling light on the state of the public health workforce and raises important questions about how public health services and programs will evolve in the future. can be supported.

Of particular note is the fact that many health professionals have been transferred to COVID-related tasks during the pandemic response, leaving other critical public health issues with reduced or suspended services.

That means research on other communicable diseases, food-related diseases, public health surveillance, chronic diseases and other critical services have suffered.

“That has implications for the overall health of the population,” Horney says. “Those things didn’t just go away. People still had high blood pressure, they were dying from substance abuse in increasing numbers, but those programs were suspended.”

She and her employees wanted to capture some of that data and also look on the road.

“What will the workforce look like in the future?” she said.

It’s a disturbing snapshot, based on survey responses from 298 people working in public health, including government agencies and academic departments. The surveys measured professional experience, mental and physical health, and career plans, reflecting some reflection of how their views and experiences had changed from pre-pandemic days to mid-pandemic days.

But how do you define the population of health professionals? It’s not easy, Horney said. It includes everyone from epidemiologists, lab workers and environmental health specialists to those who work in prevention programs and those who work to educate the public on a wide variety of health issues. Because state systems differ so much, it’s hard to get a clear picture of how many health workers there are in the US

What is known is that the system was severely understaffed and underfunded before the pandemic hit, Horney said. Now many of the most experienced leaders and workers have had enough.

“The people with experience — the people who have been through H1N1 or Zika or Ebola — are leaving public health or retiring,” she said. “Unfortunately, the health professionals with the most experience are also the most burned out.”

The Centers for Disease Control and Prevention released the results of a large-scale study in August examining the effect the pandemic has had on the mental health of health professionals.

Researchers say the situation is even more stressful because of pressure from outside forces, which have eroded public confidence and sometimes led to layoffs, layoffs and accelerated retirement.

“I’ve definitely had my moments on this thing,” Horney said. “But I love this job and so do most who choose a career in public health. This is the real deal. I so wish that people understood everything that includes public health.”

Studies like these can help explain the wide range of issues being addressed by public health professionals, especially when they don’t need to be diverted to pandemic response.

COVID-related relocations led to significant reductions in several areas, including chronic illness (39%), maternal and child health (42% reduction), substance abuse (28% reduction), environmental health (26% reduction) and injury (37% reduction). reduction), as well as 47% reductions in programs targeting HIV/sexually transmitted diseases, health inequalities, and others.

Program evaluation and health education also saw significant declines. In contrast, the number of infectious disease workers and preparedness remained constant from pre-pandemic to mid-pandemic periods, the study showed.

Most workers were also working many more hours. Pre-pandemic, about 21% of the 282 respondents who worked in public health in January 2020 said they worked more than 40 hours a week. That grew to more than two-thirds halfway through the pandemic (August to October 2020). About 7% said they worked more than five days a week before the pandemic. Halfway through the pandemic, two-thirds of them were working more than five days a week.

The study highlights the need for increased funding and better educational opportunities, both critical to addressing these issues and preparing for the future.

“What remains unknown, but critical to quantify, is the public health impacts that will result from these interruptions during the COVID-19 response,” the study says.

Horney’s collaborators on the study include Kristina W. Kintziger of the University of Tennessee at Knoxville, Kahler W. Stone of Middle Tennessee State University, and Meredith Jagger of Austin, Texas. Stone was a doctoral student at Horney’s and Kintziger was a mentee on a previous National Science Foundation grant.

Future studies are already underway to explore various issues more deeply and explore how attitudes and experiences have been changed by the challenges of 2021.

Researchers note several limitations in the study, including an overrepresentation of female, white respondents under the age of 40, and the inability to generalize findings due to the wide disparity in health departments across the country.

Reference: “The Impact of the COVID-19 Response on the Delivery of Other Public Health Services in the US: A Cross-sectional Study” by Kristina W. Kintziger, Kahler W. Stone, Meredith A. Jagger, and Jennifer A. Horney, October 14, 2021 , PLoS ONE.
DOI: 10.1371/journal.pone.0255844

Jennifer Horney is a professor and founding director of the University of Delaware’s program in epidemiology and a core faculty member of UD’s Disaster Research Center. She received her doctorate and master’s degree in public health from the University of North Carolina at Chapel Hill. Her research focuses on measuring the health impacts of disasters, as well as on disaster planning, preparedness, response and recovery.