As Americans look beyond the pandemic, public officials from over 50 states and territories invest time in weekly calls hosted by Brown University to stay abreast of COVID-19 mutations, vaccines, mitigation strategies, and more. They aren’t logging on for a lecture—they are active participants in a learning and action network called the State and Territory Alliance for Testing (STAT).
The Brown School of Public Health received a two-year, $2 million grant from the Rockefeller Foundation in January 2022 to lead STAT. Originally launched by the foundation in 2020 to foster multistate purchasing power for coronavirus tests, STAT has since evolved into a national network of state officials exchanging notes about how to best address each new COVID-19 challenge, formulating COVID-19 policy and guidelines for response and recovery efforts broadly and for K-12 education specifically.
Scott Rivkees MD, who joined the Brown School of Public Health in February 2022 as professor of practice of health services, policy and practice, facilitates STAT’s 60-minute online sessions. Rivkees is a pediatric endocrinologist and physician-scientist who served as Florida’s state surgeon general and secretary of health from June 2019 to September 2021. This summer, we spoke to him about the unique peer-to peer network.
Tell us about STAT and your role in engaging with participants. What do you aim to create and provide?
Well, first of all, the pandemic that we’re in now is really dynamic and keeps changing in unpredictable ways. STAT provides a unique forum where individuals involved in the
COVID-19 response—whether it’s in departments of health or individuals involved with the school system—are able to share information and learn from others across the country about the COVID-19 response. We meet on a weekly basis, and it’s a situation where we can have good conversations and learn from each other.
Was there any aspect of your training that is particularly helpful in this current role?
In terms of past training, one of the things that has always been instilled in me is that as physicians, we are lifelong learners, and this virus really keeps changing, and we really have to keep learning about what’s happening in terms of the virus transmission, and how we’re going to respond to it, and then how do we work together as a collective to try to learn about what’s the best way to address these roles. One of the things that I’ve also learned is how humbling the field of medicine is, like the field of public health, and the more bright minds we can get together to address issues and share information, the better off we are.
The STAT Zoom sessions involve hundreds of participants from a variety of positions—from state epidemiologists, medical directors, and public health nurses to school team leads, testing directors, tribal liaison officers, and policy analysts—along with featured subject matter experts from federal agencies and academia. Given the diversity of the roles, and this dynamic coronavirus environment, how do you approach the task of keeping on top of all of the emerging issues to serve these participants?
Well, this is a network of the participants. A lot of the questions and topics that we focus on actually come from the network in our calls, where we say this is an area that really needs further conversation. So, it’s the network that drives the conversation, and it’s the network that drives the direction. We also have a phenomenal team that organizes the network, plans the sessions, and handles the logistics. And in terms of how I personally prepare for these calls and understand what to speak about, it’s the same strategy employed from the pandemic very early on: there’s lots of written information, and it’s about staying on top of the literature and having conversations with experts in the field.
So, is it a feedback loop then with the network? Questions and topics surface, and then there’s follow-up, and then participants ask more questions. It’s a weekly engagement, yes?
Exactly. As we like to say, it’s a network of the participants and for the participants.
Let’s talk about health communications more broadly. From your experience with STAT, what are the elements of helpful, timely health communications for these daily decision makers?
Communication is a huge part of this response: communicating to individuals in the public about mitigation measures, communication about the effectiveness of some of the tools that we have such as testing, treatments and vaccination, and communicating how we keep children safe in schools.
Every state, every community is a little different, and so one of the beautiful things about STAT is hearing how different states are reaching different groups within their state. Often we will hear about different types of communication toolkits that have been developed within different states, and we will actually share these with other members within the call. We also have a weekly newsletter that has links to many of these tools.
What are some examples of the impact this access to expert information has had in this fluid environment?
I’m thinking about some of the call topics: for example, vaccine was being rolled out for children between six months and five years of age, which now means that pretty much all Americans will be eligible for vaccine. Knowing that this was happening, we had a call where we had an expert from the American Academy of Pediatrics talking about their perspective related to vaccines.
We’re going to have a conversation about ventilation in schools. Ventilation, or air exchange, is a really important mitigation measure, so we’re going to hear from different states about some of the approaches that they’re taking.
There was a call related to how the response to the pandemic is shifting within states. It’s very clear now that the federal government, which has played a tremendous role and will continue to play a very important role in this response, is now involving more state and more local responses. So, what are some of the strategies that different states are employing going forward?
How would you characterize the range of differences in the state responses?
Public health responses are very much local, influenced by the local environment, local resources in terms of healthcare settings, local vulnerabilities of different populations, rural responses versus urban responses. So, there are core principles that we all go by, and these end up being tailored specifically to different states.
In terms of therapeutics, different states will have different approaches in terms of getting agents such as the Paxlovid antiviral therapy out to different individuals.
In some states there will be differences in test-and-treat programs. In terms of vaccination strategies, the communication approach related to that will vary.
I think the overlying message is that across the country, individuals in public health have the same core mission to try to keep the public safe. How do we best use the tools that we have now? How do we best see where the pandemic is going, and how do we best protect and serve the public?
What does this listening, learning, and sharing space mean to STAT participants?
I think the biggest telling factor about its impact is the continued participation and the engagement that we have in our calls.
The conversations that we have sometimes can be difficult conversations, where we’ll have more questions than answers that are raised. And one of the beautiful things about STAT is that I’m not aware of another venue that allows individuals involved in public health and individuals involved in education to be able to have these types of discussions.
What does this opportunity, this STAT network, mean for public health in the United States—now and for the next generation?
That’s a really important question. Right now, what have we learned from STAT? First, we’ve learned that there’s lots of information for different departments of health to share across the country. Second, people want to hear what is happening in other departments of health. And third, what are the strategies?
How can we use this network to be able to move forward? It’s one of these situations where the whole is greater than the sum of the parts. Right now, we’re largely focusing on COVID-19, but using the same methodology, there are so many other incredible challenges in public health where we could put more minds together and would be able to come up with different answers to pressing questions.
For example, how do we end the epidemic of HIV? How do we deal with the opioid crisis? What strategies can be taken to make sure that we address health equity issues? How do we improve maternal and infant mortality rates? What are the strategies that we can put in place to make sure that communities end up becoming healthier?
These are the kinds of things that we think about in public health, and these are the kinds of things that the STAT network could eventually become involved with—but that’s for the future to decide. Because it’s a network of the participants, this really is for the participants to decide the future of the network as well.
We already have really effective, broad engagement, and so certainly, we hope that STAT will be able to play a continued, further role in public health.
What does this STAT role mean for the Brown School of Public Health?
Even before STAT shifted to the Brown School of Public Health, the school had a very prominent voice in this pandemic, and Brown has a tremendous reputation as really one of the leading schools of public health when it came to responding to this pandemic.
We’re fortunate at Brown to be able to play a role within this network because it really provides a unique opportunity for different states to share information with each other. And coming out of that really makes us feel that we’re doing something that is important in terms of helping with the response, not in terms of what we necessarily bring to the table, but it’s what all the members on this call bring to the table. Their solutions and their challenges.
It’s really a privilege to play a role in this robust national conversation about public health.