Lessons Learned From COVID to Prepare for Future Outbreaks

Interviewer: So, Dr. Rohde, can we speak to what lessons can be learned from past pandemics, such as the COVID pandemic, and how can we better inform and better be prepared for future outbreaks? And can you speak to improving current testing methods that have significant margins of error, such as false positives and things like of that sort?

Dr. Rodney Rohde: Yeah, oh boy, let me get on my soapbox for this one. So many lessons, so many lessons, and I hope we've not only learned them, but I hope we remember them going forward. So let me give you just a few here that I think are really critical. I think one of the first lessons that slapped us in the face right off the bat was a national testing strategy. And whether you talk about that from the United States or elsewhere, I think it's important. Again, remember early on we were relying on the Centers for Disease Control. I've worked there. I have colleagues there. It's an amazing institution, but make no mistake about it. The Centers for Disease Control was built to identify and understand through surveillance and really problematic cases that were sent to them from hospitals and other places around the world. The Centers for Disease Control is not a corporate reference lab that can crank out hundreds and millions of tests in a week. That's just not their mission. And so I think people expected that to happen. And I think CDC and others were a little hesitant to release some of that power. You remember we finally started releasing some of the testing to Quest, LabCorp, public health departments, even at the level of hospitals once the technology was in place and things got better.

Dr. Rodney Rohde: And that's what I think we need to learn that lesson is we need to look at our strategies and set that up so that in the future we don't make that same mistake. I think an important reminder in a weird way was the Mpox national emergency. Remember Mpox was just a couple of years after COVID right as we were starting to kind of slide into are we done with it kind of mentality and we really weren't. And so Mpox was a nice reminder that oh my goodness here comes another agent from around the world, it's showing up again. We're tired. We're COVID-fatigued. And again, viruses do not care whether it's Alaskapox, Mpox, COVID-19 coming from SARS-CoV-2 or flu or anything else. So testing strategy I think is really important. The other lesson I think we learned, and I think it was a good one, is that we can move vaccine development and delivery quicker than ever before. Again with the technology I mentioned before. Now we need to explore how we get that more equitable across the world so that other countries can ramp up as quickly as possible. Testing, wow, point of care test. There has to be a focus on that and availability of that testing. You know we had a really an explosion of at home testing and how that kind of rolled out.

Dr. Rodney Rohde: And I would just say as a medical lab professional and public health professional that that was really important and I value it, but I still think we need to examine that and what happened and make sure that when we roll out point of care testing that the public understands just because it's negative or even just because it's positive may not be perfect, because an at-home test can be problematic, for example, if it's expired. Or let's say you live in Texas and you leave that box that point of...not point of care, you leave that at home test on your dashboard of your car in Texas where it's 120,000 degrees in my car in July. You might actually not have a test that's working properly, and so we still need to understand that if there's any suspicion with at-home testing that you want to have a confirmatory test run through an established laboratory proper professionals with the proper credentials like a medical lab scientist or other laboratory professional. And that's really critical, because our data is only as good as it is accurate. And so that's important for the public to understand as well, because that needs to be there.

Dr. Rodney Rohde: Point of care, another exploding area across our world with respect to can we get tests quick to turn around at the bedside, or in your home, in the nursing home, and the dialysis clinic wherever you're at. And that will help us do better jobs if you don't know where the virus is or the agent is through testing. How do you really develop a good solid public health plan. Right. How do you prepare? How do you set up vaccination post? How do you think about handling wildlife or vectors if you have to deal with that? There's so much that has to go into planning and thinking about it. And my kind of other commentary around this, I've already mentioned it a little bit, I think one of the huge lessons that we have to continue to bring to your audiences like we're doing through this opportunity here is how absolutely critical it is that we continue to recruit and retain the professionals that do this testing whether it's in the hospital labs whether it's in research labs and whether it's in public health laboratories, because these are absolutely life-saving college majors and professional career pathways for people to enter into. We have huge national shortages in public health and medical lab science career areas including hospitals.

Dr. Rodney Rohde: And that number has not changed a lot. It was there before the pandemic, and it only exacerbated the problem during the pandemic. So that type of recruitment and retention along with great opportunities for increasing pay and understanding and awareness and recognition is going to be really critical to prepare for future outbreaks.