AUSTIN — To be ready for the next pandemic, Texas must find a dedicated source of tax revenue so it can hire enough scientists and update computer systems, a group of a dozen experts recommended in a report that will be released Wednesday.
Before the next crisis, Texas also needs to expand access to broadband to bring telemedicine to 1.8 million residents now shut out because they lack internet connections, the Texas Advisory on Public Health Infrastructure Improvement said in a report.
The state will need to fund training programs for — and then hire more — government epidemiologists, the experts said in the report, a copy of which was obtained by The Dallas Morning News.
Epidemiologists interpret data and help decide which populations are at risk and where to move vaccines first, and Texas currently has 240 on public-sector payrolls.
But half of them are in the Houston region, with only 40 in the Dallas-Fort Worth area, the report noted.
The Texas Department of State Health Services and some local health departments that haven’t obtained national accreditation should do so, the advisory group said.
The federal Centers for Disease Control and Prevention say that undergoing the accreditation process helps an entity identify weaknesses and improve management.
And the experts stressed that state and local public health departments, hospital systems, clinical laboratories, pharmacies and schools urgently need to update and integrate their information technology platforms.
“Texas experienced challenges during the current COVID-19 outbreak caused by incompatible systems, changes in reporting requirements and lags in reporting positive cases from labs, resulting in missed opportunities for contact tracing,” the report said.
During this year’s surges of coronavirus, the state had to gather some data from hospitals from paperwork submissions, said Jon Comola of the Washington, D.C.-based nonprofit Wye River Group, which convened the experts.
Referring to the state health commissioner, Dr. John Hellerstedt, Comola recounted:
“Hellerstedt will tell you that they had hospitals sending handwritten numbers that they then had to put into electronic formats so they could run the stats on where we stood with things like availability of beds. [They] still are.”
Public health officials also should look for ways to conduct more real-time data analysis, which would help them better manage crises, the experts said.
Various commercial datasets are available from insurers, providers and other entities that could help leaders “detect and respond proactively in a data-driven manner to the next public health crisis and be able to tailor responses to unique community needs,” the report said.
Poorly funded, underappreciated
Public health in the U.S. and Texas is poorly funded “and underappreciated until there’s a crisis,” it said.
Though Congress increased funding after the Sept. 2001 terrorist attacks, which were soon followed by the fatal mailing of anthrax spores to news outlets and some U.S. senators, the main federal stream of dollars supporting state and local health departments shrank by one-third between 2003 and last year, the report noted.
“Texas has a history of ignoring the importance of maintaining robust, reliable and sustainable funding for public health activities,” it said.
Without specifying a new state tax or fee, the group said Texas needs to find “sustainable funding” to hire more epidemiologists and improve IT systems.
It’s time to “appropriately invest in public health,” wrote former University of Texas System Chancellor Francisco Cigarroa, one of the report’s authors.
“To respond swiftly and accurately to a public health crisis, whether it be a pandemic or not … requires a public health surge capacity, innovative ways of educating more public health professionals and the appropriate information technology infrastructure,” said Cigarroa, now a transplant surgeon at UT Health San Antonio, UT’s health sciences center in Bexar County.
The report said the “public health response” to COVID-19 in Texas “has been exemplary.” However, it didn’t review the squabbling between county judges and Gov. Greg Abbott over stay-at-home orders that sent mixed messages to ordinary Texans.
Nor did it, while discussing telemedicine and the state’s growing shortage of primary care doctors, discuss how Texas leads the nation in both the share and actual number of residents who lack health insurance.
Other panel members included some leading hospital executives; health policy gurus; former state health commissioner Eduardo Sanchez of Dallas, who’s now with the American Heart Association; and top Abbott adviser John Zerwas, who’s the UT system’s vice chancellor for health affairs.
