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The article by Ward et al. in this issue of AJPH (p. 736) aptly quantifies the harassment and devaluation experienced by many public health officials in the earliest and darkest days of the COVID-19 pandemic in the United States. Local and state public health officials, who before the pandemic mainly worked behind the scenes to protect the public's health, were quickly thrust into the spotlight alongside their governors, mayors, and county commissioners to explain public health mitigation efforts such as business and school closures, mandatory mask orders, and social distancing recommendations. This new visibility led some members of the public to celebrate and thank these public health heroes, and others to disparage and vilify them.The harassment of health officials has taken many forms. One of the most dramatic was the armed protest in the front yard of Ohio's then health officer, Amy Acton.1 Others reported receiving death threats, being physically assaulted, and being the targets of racial, religious, transphobic, and sexist hate speech by phone, mail, or social media.2-6 In some of these cases, the threats and harassment warranted state police protection with officers detailed to personal residences or police protection at public vaccination events, county council meetings, and school board meetings.7-9 These events were serious, led to the resignation of several local and state health officials, and resulted in many others ending their public participation in press briefings and news conferences and playing a less public role in their jurisdiction's COVID-19 response.Controversy and criticism in public health is not new, nor are isolated experiences of harassment of health officers. Before COVID-19, state and territorial health officials faced opposition from members of the public for supporting efforts to ban youth vaping and the sale of flavored e-cigarettes, for failing to support (and in some states for supporting) the use of cannabis for medical or recreational use, for enforcing vaccination requirements for school entry, or for supporting taxes on sugar-sweetened beverages. But these prior controversies and their discontents were few, local in nature, and less vehement. In their study, Ward et al. found that more than half of local health directors surveyed reported harassment of themselves, their staff, or their agencies in the study period (n 5 1499) between March 2020 and January 2021. As Ward et al. describe, COVID-19-related harassment has been far more widespread, far better organized, and much more violent than anything we have seen before.

Under Operation Warp Speed (OWS), the US government invested an unprecedented $10 billion to speed the development, manufacturing, and distribution of a COVID-19 vaccine, resulting in emergency use authorizations for two effective vaccine products in a record-breaking 11-month time frame. Although this is a remarkable scientific accomplishment, the United States now faces the urgent task of ensuring widespread acceptance and uptake of COVID-19 vaccines to contain the COVID-19 pandemic, and begin to resume normal economic, educational, and social activities. The operational responsibility for ensuring that COVID19 vaccines are safely and efficiently delivered in a jurisdiction falls largely on state, territorial, tribal, and local governmental public health systems that support jurisdiction-wide vaccination efforts for a variety of immunizations, including childhood diseases and seasonal influenza. Ultimately, state and territory governors are responsible for the \"last mile\" of COVID-19 vaccine distribution in their states and ensuring that vaccination is efficiently prioritized for those who need it most, as well as administered, tracked, and reported to the federal government. Although all states and territories have developed plans to increase capacity, enhance data systems, and develop partnerships to support this complex effort, the initial rollout of vaccine allocations did not match federal projections and public expectations; states reportedly distributed roughly one third of allocated doses in the first two weeks of the program.

The nation’s first broad-based, mandatory investment in public health and prevention, the Prevention and Public Health Fund (the Fund), has had a brief and controversial history. Advocates for the Fund have had to defend it from both Democratic and Republican threats, including being used as an offset for administration priorities, and from congressional efforts to repeal and replace the Patient Protection and Affordable Care Act. Lessons learned from efforts to sustain the Fund are instructive in addressing current and future challenges faced by advocates for public health programs and prevention policies.

Containing coronavirus disease 2019 (COVID-19) through case investigation and contact tracing is a crucial strategy for governmental public health agencies to control the spread of COVID-19 infection in the United States. Because of the recency of the pandemic, few examples of COVID-19 contact-tracing models have been shared among local, state, and federal public health officials to date. This case study of the Anne Arundel County Department of Health (Maryland) illustrates one model of contact-tracing activity developed early in the outbreak. We describe the contact-tracing effort’s place within the broader county health agency Incident Command System, as well as the capabilities needed, team composition, special considerations, and major lessons learned by county health officials. Other local, state, tribal, territorial, and federal health officials and policy makers can use this case study to innovate, iterate, and further refine contact-tracing efforts to prevent the spread of COVID-19 infection and support community members in isolation or quarantine.

Containing coronavirus disease 2019 (COVID-19) through case investigation and contact tracing is a crucial strategy for governmental public health agencies to control the spread of COVID-19 infection in the United States. Because of the recency of the pandemic, few examples of COVID-19 contact-tracing models have been shared among local, state, and federal public health officials to date. This case study of the Anne Arundel County Department of Health (Maryland) illustrates one model of contact-tracing activity developed early in the outbreak. We describe the contact-tracing effort’s place within the broader county health agency Incident Command System, as well as the capabilities needed, team composition, special considerations, and major lessons learned by county health officials. Other local, state, tribal, territorial, and federal health officials and policy makers can use this case study to innovate, iterate, and further refine contact-tracing efforts to prevent the spread of COVID-19 infection and support community members in isolation or quarantine.

September 1 1,2021 (9/1 1) will mark 20 years since the terrorist attacks on the World Trade Center and the Pentagon, the foiled attempt to hijack Flight 93, and the subsequent anthrax attacks in October. Significant strides in advancing local, state, and national public health preparedness through investments that build core preparedness and emergency response capabilities have been made since. Twenty years after 9/11, COVID19 demonstrated that our nation's public health readiness, despite the tireless efforts of committed and skilled public health professionals who have admirably responded, was compromised by disconnected local, state, and federal data systems and disease surveillance capacity; an inadequate medical supply chain to meet demand for personal protective equipment; insufficient surge capacity to meet the national demand for contact tracing and case investigation; and varied attention to building equity and community resilience activities into ongoing response and recovery efforts. So, do we have the preparedness we need? The answer is mixed.

Reproductive well-being and equity require systems working together to develop trust and authentic, powersharing relationships with communities, particularly those that have been historically marginalized. This includes addressing structural racism and healing from it; promoting equity, including equitable access to health care services; and engaging communities as decision makers in policy development, program design, and quality care.1,2 Appropriate contraception access that includes receiving the desired care and support that one needs is critical for promoting optimal and equitable reproductive health.3Public health leaders have demonstrated the unique role their agencies bring to cross-sector contraception access collaborations with clinical and community partners. Statewide and jurisdiction-wide contraception access initiatives are great opportunities for such collaborations. The Association of State and Territorial Health Officials Increasing Access to Contraception Learning Community project, conducted in collaboration with the Centers for Disease Control and Prevention's Division of Reproductive Health, implemented a series of learning communities with 27 multidisciplinary teams (from 26 states and one territory) between 2014 and 2018 to improve access to the full range of contraceptive methods. These communities required public health and clinical partnerships, with team memberships representing state and territorial public health agencies, state Medicaid agencies, clinical champions, and other essential partners including community organizations, to collaboratively implement policies, programs, and evaluations to increase access to contraception.