Perspectives of Enteric Disease Epidemiologists at State Public Health Agencies, United States, 2023.

OBJECTIVE

To describe how pandemic-era changes to enteric disease staff and resources impacted investigations and program needs post-COVID-19-emergency and to develop recommendations for maintaining capacity during future emergencies and periods of resource shortages.

CONTEXT: The federal COVID-19 public health emergency declaration ended in May 2023; however, pandemic-era changes continue to disrupt public health capacity and routine enteric disease activities. The Integrated Food Safety Centers of Excellence (Food Safety CoEs) assessed the ongoing impacts of the pandemic on enteric disease epidemiologists and developed recommendations for maintaining capacity during future emergencies and periods of resource shortages.

SETTING AND

PARTICIPANTS

The Food Safety CoEs conducted 53 interviews with 135 enteric disease epidemiologists at public health agencies in 48 states, 2 cities, and 3 territories. Interviews occurred using bidirectional video conferencing software between April and June 2023; one interview occurred in October 2023.

DESIGN

A structured data extraction was performed by assigning emergent descriptive codes to transcript excerpts. Comprehensive topic summaries were used to summarize participant perspectives and experiences.

MAIN OUTCOMES: Nine topic summaries emerged: work culture, remote work, innovation, competition for qualified epidemiologists, novice workforce, increasing workload and responsibilities, relationships, end of COVID-19 funding, and recommendations for future public health emergencies.

RESULTS

While many epidemiologists transitioned back to pre-pandemic roles, disparities in staffing, funding, and retention remained. Programs with strong leadership and team cohesion demonstrated greater resilience. Participants emphasized the need for sustainable funding, improved hiring mechanisms, and expanded surge capacity plans, including student interview teams and knowledge-transfer protocols.

CONCLUSION

The pandemic exacerbated preexisting workforce challenges and revealed ongoing public health vulnerabilities. Structural changes, such as flexible funding, remote work policies, and centralized interview teams, can enhance workforce sustainability. Addressing these issues proactively will strengthen public health capacity and preparedness for the future.