Debra Bogen on leading a county health department through a pandemic

Debra Bogen, an MD, completed her training in pediatrics at Johns Hopkins in the ’90s and then joined the faculty at Pitt in 1998. Through the years, she’d grown interested in moving into health policy and community-level programming. She proved to be a quick study as she took the reins as Allegheny County’s top public health official just as the pandemic was taking shape.

Bogen assumed leadership of the Allegheny County Health Department two months ahead of schedule, shortly after the first cases of COVID-19 were reported in the United States, in mid-March 2020. She maintains ties to Pitt as adjunct professor of pediatrics with secondary appointments in psychiatry, in clinical and translational science and in health policy and management—and also as a community partner.  

How did the county health department approach the pandemic?

The pandemic was really a test in endurance and flexibility, because it never stopped changing.

We needed to continually respond and adapt—from information sharing, testing, case investigation, data analytics, to vaccinations. Usually, the department has a significant regulatory role and a smaller clinical role, but during the pandemic we ramped up clinical services and provided more than 100,000 vaccinations. We partnered with numerous organizations and agencies and also brought resources to partners. We adapted to meet the needs facing residents throughout the pandemic.

What surprised you about stepping into the role?

What really amazed me was how willing people were to step up.

I had been on a call with the Allegheny Conference, and the CEO of Argo AI said, “Anything you need, let me know.” A month or so later, I called him and said, “There are two things I need help with. One is logistics. If I give you a list of all these locations where the federally qualified health centers are doing testing, can you figure out how efficiently we could pick up those tests and get them to our county lab to be packaged and sent for analysis in California? The second is: Would your self-driving cars be willing to do the pickup?” And he said, “Yes and yes.” That was on a Friday at 4 p.m., and by early the next week, he and his team were ready with a plan. It was an incredible coalescing of resources and collaboration. The results were as we had hoped, to increase access to testing in higher risk, historically excluded communities.

Another example of collaboration was that the chief medical officers from the region’s health systems had weekly meetings to share protocols, strategies, ideas and challenges—and they always invited me to the table. That example of collaboration, I think, is just emblematic of the region, and one of the reasons I love living in Allegheny County. The CMO collaboration persists today, which is terrific.

How did your background in pediatrics influence you?

I was worried about the impact of the pandemic on children’s social and emotional growth and development—and on families, in general. I saw disparities every day as a pediatrician. For example, I often thought about a family I cared for and wondered how they were managing. The mother worked in health care. She had a long commute on a couple of buses—with a stop to bring her two young children to childcare early in the morning. What was she doing with many childcare programs closed and limitations on public transportation? These issues of health equity and access and who was at higher risk of COVID-19 were always on my mind. Community organizations stepped forward to try to address many of the issues in ways that I hope will endure. I hope we don’t backslide in our efforts to address these inequities. At the health department, we continue to keep this a major focus of our work.