COVID-19: Preparing for Catastrophic Events

April 16, 2020

More than a decade ago, the Little Hoover Commission issued two reports offering recommendations to the Governor and Legislature on how California can better prepare for a catastrophic event and how the state’s public health system can operate more robustly. The COVID-19 pandemic has made it clear that the Commission’s recommendations on disaster preparedness are still vital to ensure that California’s government is prepared to serve its residents effectively during catastrophes.

In the weeks since Governor Newsom declared a statewide stay at home order on March 19, Californians have grown accustomed to seeing the State Operations Center of the Governor’s Office of Emergency Services (CalOES) in the background of the Governor’s daily coronavirus updates. As the emergency management authority for the state, CalOES coordinates California’s emergency coronavirus response across a multitude of government agencies and jurisdictions, carrying out the logistics of the Governor’s Executive Orders to procure and distribute protective equipment and ventilators throughout the state. CalOES’s operations have been bolstered by an infusion of $500 million in emergency funding passed by the Legislature and an additional $1.3 billion transferred from the state’s reserve account that can be used to cover any costs related to COVID-19. These funds have been used to expand hospital capacities, lease hotel space for individuals experiencing homelessness, and refurbish broken ventilators. Additionally, CalOES is currently in the process of securing enough protective equipment to provide for California’s need in this area, and perhaps other states’ as well.

This type of high-level emergency response and coordination was exactly what the Little Hoover Commission envisioned in its 2006 report, Safeguarding the Golden State: Preparing for Catastrophic Events, in which we recommended that the state restructure emergency management operations into a single, cabinet-level entity under the direction of an experienced leader and ensure that emergency preparedness funding is adequate, strategic, and creates incentives for improvement. Years of careful planning, strategic investments, and prudent financial decisions have now made it possible for CalOES to coordinate an efficient statewide response to COVID-19. Relative to many other states, California is now well-prepared to handle an expected surge of coronavirus patients at hospitals and temporary expansion facilities across the state and has even gone so far as to donate 500 ventilators to states struggling on the East Coast. “We feel confident in our capacity to meet our needs as we support the needs of others,” Governor Newsom said at a press conference, a confidence that is the result of several administrations’ work in preparing the state for a time such as this. Unfortunately, the same cannot be said for the state’s ability to test patients for COVID-19.

California’s public health infrastructure is suffering from a lack of sustained investment during a time when its services are desperately needed. Nowhere is this more apparent than in the current public health laboratory landscape. These labs, run by cities, counties, and the California Department of Public Health, provide essential expertise on disease outbreaks and surveillance to pinpoint where clusters will emerge ahead of time. According to the Sacramento Bee, California only has 30 public health labs in operation – the same number as in 1950. As a result, local jurisdictions have pooled their resources to regionalize public health labs. This may have increased efficiency, but these labs have struggled to keep up with the demand for disease testing. University and privately- owned laboratories are now being relied upon to fulfill California’s testing needs. On April 4, Governor Newsom announced the formation of a testing task force that will oversee state efforts to increase COVID-19 testing, particularly through partnerships with university labs at UC Davis and UC San Diego and private laboratories such as Abbott and Project Baseline by Verily, a subsidiary of Google. While this effort and these laboratories should be commended for helping California during this time of crisis, policymakers should consider the need for a more reliable and sustainable emergency response plan for its public health laboratories in the future.

In its 2009 report, First Year Checkup: Strategies for a Stronger Public Health System, the Little Hoover Commission recommended that California expand its public health workforce and increase the state’s laboratory capacity by:

  • Lifting barriers to workforce development
  • Increasing salaries at public health laboratories so they are competitive with private labs
  • Restoring training programs offered by public health labs to recruit and retain qualified staff members.

More recent work, such as a 2020 report by the Trust for America’s Health, has reaffirmed concerns about the state’s public health preparedness, ranking California in a middle tier of states for public health emergency readiness.

California, while no stranger to catastrophic events, is being put to the test by the COVID-19 pandemic. The Little Hoover Commission’s recommendations to restructure the state’s emergency management operations into a single, cabinet-level entity under the direction of an experienced leader has resulted in the efficient and effective CalOES that is combatting the spread of COVID-19. The same care, planning, and funding that made CalOES’s response possible now must be directed at the state’s public health laboratories. The essential services provided by these labs must be addressed for California to be further prepared for the next public health catastrophe.

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