Lancaster County's lack of a public health department makes rolling out the coronavirus vaccine and winning community acceptance more difficult, according to two doctors featured in an online Covid-19 town hall put on this week by the Lancaster branch of the NAACP.
The rollout is a complex coordination problem, explained Dr. Jeffrey Martin, chair of the Department of Community and Family Medicine at Penn Medicine Lancaster General Health. It involves matching providers — health systems, independent practitioners, local governments, pharmacies — with recipients who have widely varying access to health care and are being prioritized much differently depending on their age, health and employment.
"Without having the public health authority ... it's a little more challenging and difficult," Martin said.
Earlier in the conversation, Dr. Cherise Hamblin, who practices obstetrics and gynecology at LG Health, made a similar comment in response to a question about building confidence in the vaccine among people of color, many of whom distrust the medical establishment due to past abuses.
"It's very challenging not having a public health department," Hamblin said.
She and Martin both stressed that Lancaster County enjoys a level collaboration among community stakeholders that offsets that challenge to a large degree.
Raising the question anew
The pandemic has reawakened consideration of a public health department for Lancaster County, a conversation that had been largely dormant since a push about a dozen years came to naught.
The county's Democratic commissioner, Craig Lehman, has said he supports the idea. Republicans Josh Parsons and Ray D'Agostino haven't ruled it out, but are more skeptical. Parsons has said he has seen no evidence of differing performance or outcomes during the pandemic between counties that had health departments and those that didn't.
During the NAACP town hall, Marin said there is some benefit in not having a health department: It eliminates a level of bureaucracy, potentially allowing a more nimble, flexible response.
In a November board meeting, outgoing LG Health CEO Jan Bergen said, "There is no question that in our community a formalized community response is difficult without a public health department."
In a subsequent statement to LNP, LG Health spokesman John Lines said Bergen was endorsing the idea of building county capacity to deal with public health emergencies. Apart from that, he said, LG Health has "no opinion" regarding a public health department.