A Q&A with Erin Mrenak, director of the Erie County Department of Health

Erin Mrenak spoke with City & State to talk about the county’s ongoing public health initiatives, lessons learned from COVID-19 and how public health leaders can improve public trust in the aftermath of the pandemic.

This conversation has been edited and condensed for length and clarity. 

What is your department doing to protect public health?

We offer some core services here, as do all the local health departments in Pennsylvania. We do STI testing and education. We have a tuberculosis program. We monitor 74 communicable diseases every day. We have a team of disease investigators. We do a lot of work with our environmental division, with restaurant inspections, septic permitting, licensing and inspections. 

A lot of what we have is due to our location. We have a grant to monitor E. coli levels at local beaches. We have a program that focuses on harmful algal blooms, which is unique to our area because of our location. We've made a lot of improvements to our data capacity with epidemiology. We have a division that focuses on health promotion and preparedness. We've beefed up that work as well as a result of the pandemic, just to help maintain preparedness. Then, like most businesses, we have an administrative function that's handling all of our fiscal matters, our IT, stuff like that.

How did COVID affect the daily operations of the department?

Everything changed during COVID, and it was a very rapid response where pretty much everyone who worked here had to switch gears to help support what the community needed in response to COVID, because information was coming so quickly and the needs were changing so quickly. Then, as a result of that, as COVID evolved and services changed, we wanted to really make sure that we maintained preparedness activities so that in the event something like that happens again, we have more internal capacity to respond quickly and pivot as we would need to to meet those needs, but still maintain operational functioning in our other departments.

You mentioned preparedness activities. What does that include? Is that something our public health system at large should be doing in the aftermath of the pandemic?

I will say most local health departments and state health departments, at least in Pennsylvania – it's what we do. We have plans for many things. COVID was just such a massive event that it stressed the system, and we saw a lot of staffing changes and turnover. It was a difficult time in public health, but I think that maintaining our data systems has seen significant improvements since COVID. People have been focused on that, making sure that we're being transparent to the community. For us, we've done a lot of work on adding more real-time dashboards to our website, so that we have more information that's easier to access for our users.

One of the things we did in response was add a second full-time position. We had one public health preparedness coordinator. We added the second full-time position to help support those activities. We also heavily relied on our Medical Reserve Corps – the public health preparedness coordinators facilitate that. They're volunteers from the community, both medical and non-medical, who have helped tremendously when we were doing our mass testing program and when we were doing mass vaccination clinics.

Is that reserve corps something that other health departments have?

Other communities, I'm not sure, to be honest … but that is something that we've always done here. We cover a region in the northwest part of Pennsylvania – there are several counties where we work with volunteers. We help them get access to CPR and first aid training, and we also offer active-shooter training. We have them come in, and they've helped. We've recently had some measles cases, which we hadn't seen in Erie County since 1991. So we're making sure that they have education; we're doing a vaccination clinic next week in response to that.

Building on what we've discussed so far, how do you feel like we're positioned for future health crises? 

We've done a lot of work. We formed some partnerships solely due to the need during COVID, specifically with our larger healthcare systems. I can speak to Erie County: those relationships weren’t as developed before the pandemic. It's been a priority for us here to maintain those relationships so that if something happens, we know who to contact. We've got plans in place. There are times when there are tabletop exercises or trainings, where all those parties are at the table, so that we know how we can deploy resources back to the community. 

But, as always, a lot comes down to funding. Sure, a lot of funding is directed toward public health when there's a large crisis, such as COVID-19, and then when that funding dries up, it doesn't help maintain the public health infrastructure that was really vital and built during COVID. So, I think most local health departments are trying to switch gears to maintain what they need to continue operating.

Have you been affected at all by some of the federal funding cuts and pauses?

We've been fortunate to have some other funding streams that can support the staffing we've built up. But if things continue to change, we may be impacted by that.

COVID really exposed some divides around public health, with many expressing mistrust toward our public health system. How do we improve trust in public health moving forward?

That's the nice thing about having a local health department, because we live and work in the community. Getting out and meeting with people, doing outreach events or educational events, providing services to the community, where we're talking with people face-to-face, not just on social media … just knowing faces and who to contact at your health department when there are questions or concerns – I think is a priority of ours.