When we were in the middle of the hepatitis A outbreak, The Courier Journal covered our response, and a CJ reporter and photographer even spent time with us to see exactly how we were dealing with the outbreak. So I was disappointed that the recent series of articles about “How Kentucky’s hep A outbreak became the nation’s largest,” barely mentioned the work here, including the fact that the Centers for Disease Control (CDC) described our response to the outbreak as the “gold standard.”
Louisville’s health department is a modern, collaborative operation at the forefront of public health innovation and transformation. That’s why we were able to tackle the hep A epidemic in half the time and with 1/20th the resources as other cities across the nation. When the outbreak first hit Louisville, we reached out to cities and states that experienced hepatitis A outbreaks before us to learn best practices and lessons learned. We relied on our partnerships in the city to quickly vaccinate the highest risk populations and effectively halted the spread of hep A before it impacted the wider community.
Having a robust Syringe Exchange Program – which allowed us to build trust with people who use drugs – enabled us to vaccinate them quickly when the need arose. Dr. Jeff Howard, Kentucky’s Commissioner for Public Health, a supporter of harm reduction practices, has recommended that every county have a syringe exchange program, which would eliminate the difficulty some rural counties have in finding and vaccinating people who use drugs when it’s needed to stop the spread of disease.
Having built an extensive network of community partners, we were able to quickly activate many trained individuals who helped administer the huge number of vaccinations necessary to contain the outbreak. Dr. Howard is leading the effort to move every local health department to this modern, collaborative model, which would eliminate the bottleneck many rural health departments experience, only having a small number of staff available to respond to an outbreak.
Rather than looking to other states for answers, as The Courier-Journal suggested, Kentucky should use Louisville as a model to modernize all our local health departments, and the state should properly fund public health. Even during a hepatitis A outbreak, Kentucky continued to battle other challenges that have much higher death rates – flu, the opioid crisis and suicide. Public health officials are always trying to decide best use of funds to save the most lives. Given proper funding, we wouldn’t have to choose which challenges to focus on, and instead we could provide the “gold standard” response to all of them.
Despite the many challenges, including lack of resources, faced by local health departments in Kentucky, the hep A outbreak is turning around, thanks to the diligence of local public health workers, whose commitment to their communities should be commended. Many local health departments are facing bankruptcy or devastating cuts due to the state pension crisis. Let the hep A outbreak be a reminder of the value of timely, effective, modern public health as discussions about budget cuts continue.
Dr. Sarah Moyer
Director, Louisville Metro Department of Public Health and Wellness
Louisville, KY 40202