Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials (NACCHO), shared insights into the organization’s efforts to combat healthcare-associated infections (HAIs) and antimicrobial resistance (AR), particularly in light of the ongoing challenges posed by the COVID-19 pandemic. NACCHO has been providing capacity-building programs designed to address local health departments’ needs, focusing on improving infection prevention and control (IPC) practices across various healthcare settings.
Freeman discussed how NACCHO prioritizes specific pathogens or healthcare settings in its efforts, Freeman explained, “We provide opportunities for local health departments to adapt NACCHO’s capacity-building programs to their unique jurisdictional needs at those counties and cities and to serve their communities more broadly. While these programs can help build capacity in infection prevention and control, participating project sites can also target specific pathogens or healthcare settings based on the prevalence, severity, and potential for outbreaks.”
Freeman highlighted how local health departments specifically targeted long-term care facilities and skilled nursing facilities during the pandemic, “For example, during COVID-19, throughout the pandemic, local health departments worked to scale up IPC, which stands for infection prevention and control, in long-term care facilities and skilled nursing facilities, as patients in these settings were far more vulnerable to the COVID virus.”
Freeman went on to describe NACCHO’s strategies to ensure the expansion of local health departments’ capacity for diagnosing, testing, and outbreak response in the long term, “To sustain and expand outbreak response capabilities at local health departments, NACCHO advocates for relevant policy change. We also secure funding to support and improve public health infrastructure and promote opportunities for local health departments to build that capacity to do this work.”
Freeman shared specific examples of how these initiatives resulted in increased confidence in diagnostic testing and IPC practices, “For example, local health departments participated in the ‘Building Local Operational Capacity for COVID-19’ project, where they received funding and technical assistance. As a result, they reported a 12% increase in diagnostic testing confidence and a 16% increase in overall confidence in conducting and continuing their IPC activities. We also have examples from the ‘Building Local Operational Capacity for COVID-19 Healthcare-Associated Infections and Antimicrobial Resistance Project,’ where participants reported a 35% increase in confidence in their IPC practices overall. All of the sites that participated in this pilot reported a significant 2/3 increase in confidence in conducting diagnostic testing.”
She concluded by stressing the need for flexibility in outbreak response and diagnostic testing, given the dynamic nature of emerging and persistent infectious diseases, “Long-term sustainability of outbreak response and diagnostic testing efforts really calls for flexibility in that focus, as emerging and persistent infectious disease threats come our way every day, and the impacts they pose to jurisdictions can shift over time.”
