From Policy to Practice: Teamwork in a Public Health Crisis

During its recent mid-year meeting, the American Public Health Association’s Medical Care Section was honored to hear from two physician leaders serving at the heart of the fight against COVID-19. Hailing from opposite ends of the country, Drs. Atul Nakhasi (California) and Ayne Amjad (West Virginia) shared their insight about teamwork in a public health crisis. Here we share their key messages and offer three takeaways for Section members and readers of this blog.

This Is Our Shot

We first heard from Atul Nakhasi, MD who is a primary care physician working at a community health center within the Los Angeles County Department of Health Services. He leads the COVID-19 campaign called This is Our Shot. He spoke about the important role healthcare providers play as “the number one trusted source of information [about the COVID-19 vaccine].”  

As the vaccine roll out picks up speed nationwide, more Americans are finding the COVID-19 vaccine available. In fact, in some areas of the country, including Los Angeles, there are now more vaccines available than people who want them.  

For some communities, there are questions of whether the vaccine can be trusted. And so many are turning to their healthcare providers for advice. As Dr. Nakhasi and the team at This is Our Shot know, the fight to build trust in the vaccine is critical. In his words: 

“The last mile is what we focus on. We battle for trust in that last mile because what we always say is: you can have a 100% effective vaccine but if you have 0% uptake in your community, you have 0% immunity in your community.”

Dr. Nakhasi explained that This is Our Shot is building a diverse coalition of healthcare providers. Their goal is to disseminate simple, evidence-based messaging to build vaccine trust and combat disinformation. His team knows they aren’t the only ones in this fight. In response, they have taken the fight to social media. He explained: 

“We focus on the digital space for two primary reasons. One, you can scale very quickly digitally. Two, we know anti-vaxxers and people who are intentionally spreading misinformation are proliferating on the digital space.”

Being First Isn’t As Important As Saving lives

We then heard from Ayne Amjad, MD, MPH, the Commissioner for the West Virginia Department of Health and Human Resources, Bureau for Public Health and West Virginia’s State Health Officer. Dr. Amjad and her team were early leaders in the drive to vaccinate vulnerable persons. But as she was quick to point out: “Being first isn’t so much important as it is saving lives.” She explained that from the early days of the pandemic, the state’s goals have been consistent: 

“We want to protect our most vulnerable in the state, reduce deaths, reduce hospitalizations, and maintain our critical services and acute care.” 

Dr. Amjad’s team had the challenge of establishing statewide networks throughout rural West Virginia to expand testing in areas with high rates of COVID-19. She stressed the importance of teamwork and communication in order to be successful with such widespread endeavors – and not necessarily with just healthcare professionals. A large portion of her work was collaborating with other government officials to relay the need for more resources to combat the virus in her state. 

Different Circumstances, Shared Lessons

From an urban community health center to a rural state capitol, in some ways Drs. Nakhasi and Amjad face dramatically different circumstances in their respective fights against coronavirus. Initially, urban areas saw a drastic rise in COVID-19 cases accompanied with overwhelmed hospitals and healthcare providers. In contrast, many small-town communities were hoping to reap the protective factors of rural life during the pandemic. Eventually, however, rural areas began to feel the effects of the pandemic. These areas faced difficulties of their own, as many rural hospitals didn’t have adequate resources and large proportions of their populations had to travel long distances for both medical care or vaccinationDespite these differences, there are shared lessons about teamwork in a public health crisis to be drawn from their presentations:

First, take advantage of the vaccine that is available to you. Many people have delayed getting their COVID-19 vaccine in hopes of receiving their preferred vaccine. So consistent vaccination communications should be developed to emphasize the value of getting the first shot available. In the words of Dr. Nakhasi: “The best vaccine of them all? The shot in your arm!” 

Second, develop a trusting relationship with patients and community members. Medical misinformation is rampant in today’s technology-reliant world. But patients still trust their medical providers more than any other source of information. This allows for a unique opportunity to disseminate evidence-based and accurate information to those who may be hesitant or curious about receiving a COVID-19 vaccine – a point that both Drs. Nakhasi and Amjad agree on. 

Third, unify and collaborate as a team. A public health crisis of this nature necessitates a wide variety of professionals, ranging from those providing medical care to those developing public health policies.  In the words of Dr. Nakhasi, “If we do that–unify with trusted messengers at scale–we can reach the public and bring them on this journey of trust in a way no one else can.”

The Medical Care Section is grateful to Drs. Nakhasi and Amjad for sharing their perspectives and advice on teamwork in a public health crisis to combat the threat of COVID-19. For those who were unable to attend the mid-year meeting, Dr. Nakhasi and Dr. Amjad’s sessions were recorded and available for viewing online.

Tiffany Johnson

Tiffany Johnson

Tiffany Johnson is currently a medical student at the University of South Dakota Sanford School of Medicine and holds a Master's degree in Public Health from the University of South Dakota. She is a member of the Medical Care and Epidemiology sections of the American Public Health Association. Some of her interests include healthcare optimization, health policy, and health equity.
Tiffany Johnson
Tiffany Johnson

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Cole Ettingoff

Cole Ettingoff

Cole Ettingoff is currently a medical student at Tel Aviv University and the student liaison to the Medical Care Section of APHA. Cole previously worked for the San Francisco Department of Public Health focusing on improving delivery of socially conscious healthcare and the Montgomery County Maryland Department of Health and Human Services as part of the COVID response Task Force. Cole also has a background in emergency management in a wide range of roles with a passion for comprehensive pre-hospital and out of hospital care as an integrated piece of the larger healthcare system.
Cole Ettingoff

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