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Building trust in COVID-19 vaccination and other public health interventions is fundamental to the work of public health and efforts to end the COVID-19 pandemic. We can build trust by combating misinformation, supporting trusted messengers and networks, improving our trustworthiness, and deepening relationships that engender trust over time. Building trust between public health and communities facilitates acceptance of public health interventions and can cultivate an equitable COVID-19 response now and conditions for well-being in the future.

Community assessment is a systematic process by which a community’s health status and related factors are examined; it is used to identify problems and assets in a community. Through community engagement, stakeholders work together to address health-related issues and promote well-being with the goal of improving health outcomes. These two processes work hand-in-hand to facilitate health improvements. COVID-19 has changed the assessment landscape in many ways–introducing new challenges for engagement, upending pre-pandemic implementation plans, and necessitating new and updated data to understand emerging health impacts and needs.

Disease surveillance helps us detect disease cases, understand burden of disease and risk factors, provide the basis for timely and informed decision-making, guide control measures, and monitor impacts. Since the onset of COVID-19, surveillance efforts have worked to provide real-time tracking and forecast data, despite challenges with diagnostic capacity, case reporting, insufficient contact tracing, and fragmented data systems. COVID-19 has highlighted the need to invest in modern data systems, expand and skill up the workforce, and ensure data reporting and interpretation retain high ethical and epidemiological standards.

The authority to act to protect and promote the public's health has emerged over the course of our Nation’s history, and has enabled many of modern public health’s greatest achievements. Today, public health agencies use their authority to promote health, prevent the spread of infectious disease, protect against environmental hazards, advance equity and assure local public health infrastructure and health services. During declared emergencies, state and federal authorities have broader powers to act to assist governments, suspend or modify legal requirements, pass and enforce law and expend funds for the health, safety and welfare of society. Recently, some states have moved to limit public health powers. Such efforts pose a mounting challenge for public health’s response to COVID-19 and future threats.

The public health workforce plays an essential role in securing the vital conditions for health and well-being for all to thrive. A skilled, resourced, and robust public health workforce is needed to meet the demands of public health today and prepare for the needs of tomorrow. A diverse public health workforce is better equipped to address the needs of the most impacted and marginalized, and implement population health strategies. COVID-19 has shed light on challenges facing the public health workforce, while also exacerbating them. The COVID-19 pandemic has emphasized the need to skill up the workforce; support workers’ needs; center equity in workforce development efforts; and plan for the future.

The COVID-19 pandemic has put immense pressure on frontline and public health workers, exacerbating myriad mental health concerns, including stress, depression, and burnout. As with COVID-19 itself, impacts have disproportionately affected certain populations more likely to hold frontline positions, including women, LatinX people, and people of color. These challenges, compounded with broader issues affecting the workforce, undermine the capacities of frontline and public health workers to provide essential services. Key strategies for supporting frontline and public health workers include building a culture of caring across leadership and organizations, improving employment practices and working conditions, and fostering social support among workers.

Vaccination is one of public health’s most successful tools for preventing and controlling the spread of infectious diseases and, increasingly, cancers and chronic diseases too. Immunization is an effective and cost-efficient strategy that prevents sickness and death in all age groups and saves billions of dollars each year. The COVID-19 epidemic and recent outbreaks of measles and other preventable infectious diseases underscore the importance of vaccines and sustaining high vaccination rates. Work is needed to ensure that people of all ages receive a complete series of the vaccines they need.