By Catherine Colquitt, MD, Tarrant County Public Health Medical Director
This article was originally published in the July/August 2022 issue of the Tarrant County Physician. You can read find the full magazine here.
In 1994, the Public Health National Center for Innovations and the de Beaumont Foundation collaborated with partners to establish the Essential Public Health Services (EPHS), and on September 9, 2020, the first updated version of the original EPHS was released.1,2 As we celebrate a much-needed decrease in COVID-19 cases and deaths, it seems timely to review the updated EPHS, take stock, and plan for the future.
First, here is the 2020 version of our EPHS:
Analysis of our public health response to COVID-19 reveals successes and shortcomings. The successes include scaling up to investigate COVID-19 cases, clusters, and contacts in real time, even when hundreds of cases were occurring daily, and ramping up, with our partners, to administer 2,995,204 doses of vaccines in Tarrant County since the first vaccine allocations became available in December 2020.3 As a result, 85.87 percent of Tarrant County residents 65 years or older and 61.37 percent of Tarrant County residents aged five years through 64 years are now fully vaccinated.4 We have also worked effectively with state and local agencies, municipalities and other partner entities to vaccinate staff and vulnerable people in congregate settings. Alongside all of this, we have expanded our communications apparatus to keep our county residents informed of changing COVID-19 guidance, vaccine and testing availability, and to bridge language, cultural, and other social and systemic barriers that have prevented some in our community from accessing COVID-19 related care.
But we have much to do. Many in our county still experience barriers to health care access and are confused by widely circulated myths about COVID-19 infection, control measures, and vaccination. While current COVID-19 infections, hospitalizations, deaths and outbreaks are falling, we and our partners are working to provide accurate and culturally sensitive messaging to residents in North Texas who may have felt excluded from access to COVID-19 related care and information thus far. Tarrant County Public Health is embedding mobile healthcare in communities in need; it is a move based on advice from community leaders and aided by precision mapping and real-time syndromic surveillance.
Challenges to COVID-19 response include differences in approach to the pandemic among local, state, and federal entities. There have also been disparities in not only healthcare access, but also public transportation services to facilitate travel to sites for COVID-19 vaccination, testing, and treatment. An addition, access disparities between rural and urban North Texas communities and language, cultural, and religious barriers to COVID-19 related care have further complicated the situation.
Building a more diverse public health workforce and collecting detailed community needs assessments with guidance from respected community leaders and partners are important steps toward improvement. Using innovative strategies for our outreach efforts will help tremendously in the development of verifiably successful measures to make our community safer during the next COVID-19 surge, and during the next public health challenge – like maybe monkeypox!
1. Harrell, JA, Baker, EL. The essential services of public health. Leadership Public Health. 1994; 3(3): 27-30
2. Revised 10 Essential Public Health Services, launched virtually by the de Beaumont Foundation and Public Health National Center for innovations on 9/9/2020. Available at http://www.cdc.gov. Background information of steps leading to the revision of guidance available at http://www.PHNCI.org
3. Texas COVID-19 Vaccine Tracker (by county)
4. Texas Department of State Health Services COVID-19 Dashboard