The week of April 6-12 is Public Health Week, an observance that is now in its 25th year. To be honest, I imagine it is an observance not much recognized outside of public health circles. Never has it been more crucial to highlight the importance of public health in maintaining healthy communities and to acknowledge the public health workforce.
The unseen enemy that is the novel coronavirus (COVID-19) has resulted in more than 1.3 million people diagnosed with the disease globally, and more than 73,900 around the world have died from the pandemic. The U.S. has by far the most cases, with more than 356,000 diagnosed with COVID-19, and more than 10,000 deaths. The actual numbers are believed to be much higher because of testing shortages and many unreported cases. This is a public health crisis the likes of which most people alive today have never seen.
From my vantage point as director of Communications at San Juan Basin Public Health, I have never felt more the need to sing the praises of public health practitioners, after witnessing the heroic and tireless efforts of my co-workers over the past month and a half. This column is more personally relevant than any I have written before.
The biggest challenge faced by any of us working on the front lines or behind the scenes to fight this unseen enemy is the novelty of COVID-19 – the fact that no one has ever seen it, and no one has a complete understanding of its behavior or how to fight it. As a result, as the lead organizations in responses to pandemics, local public health agencies have been forced to be nimble and responsive, adjusting to rapidly changing circumstances on a daily, even hourly, basis.
A month and a half ago, SJBPH activated its Operations Center – a step in the agency’s Pandemic Plan, with about 15 or so staff members. Using the Incident Command System, a structure used by many first-responder agencies for addressing a wide range of emergencies, we set our objectives for the incident. All SJBPH staff are trained on ICS and many have participated in exercises that mimic real-life emergencies.
With the topline objective to limit the number of illnesses and death from COVID-19, the SJBPH team has worked endless hours both on the front lines and behind the scenes to gain traction against this highly contagious and rapidly spreading disease.
I have seen my co-workers pull together two of the few locally run community testing sites in the state in a matter of days. I witnessed them out in the cold rain and snow for hours, as they helped run more than 100 people through the testing site at the La Plata County Fairgrounds. We greatly appreciate the collaboration with the La Plata County Sheriff’s Office, other first responders and many volunteers to make this community testing site the success that it was.
SJBPH followed this by implementing a community testing site in Archuleta County, in collaboration with Pagosa Springs Medical Center and other law enforcement and first responder agencies from the county. Altogether, SJBPH tested close to 150 people at both sites. The complexity in planning the logistics for these events is hard to comprehend. The efforts of SJBPH staff and other collaborative agencies resulted in the ability to gather snapshots of the spread of COVID-19 in our local communities.
Another herculean task being conducted by SJBPH staff is the communicable disease investigations of positive COVID-19 people led by our regional epidemiologist – a process known as contact tracing, which involves reaching out to anyone who had close contact with these people during their infectious period. The purpose of this is to control the spread of the disease by sharing quarantine and isolation information with anyone who may be at risk of spreading the disease further. From the 37 positive cases reported to SJBPH, more than 70 people have been contacted on a one-to-one basis, and more than a hundred additional contacts were made through letters and other forms of communication. The staffing time to accomplish this feat has amounted to more than 350 hours.
In the absence of widespread testing, and in order to get a better picture of the spread of COVID-19 in our communities, SJBPH recently launched a symptom tracker, which can be found on our website, sjbpublichealth.org/coronavirus. This will allow us to get a non-scientific understanding of how many residents believe they may have contracted the virus and whether the spread of the disease is accelerating, remaining steady or decreasing.
Another key aspect of SJBPH’s emergency response to COVID-19 is the highly complex coordination and collaboration with numerous multisector organizations. SJBPH identified early on that we needed a forum to communicate the actions we were taking to prepare for and respond to COVID-19 and identify and communicate what actions our partners were taking. The agency’s emergency manager convened a multi-agency call, meeting three times a week, and including agencies in both counties involved in the control of the disease as well as those working to reduce negative effects of the outbreak on all sectors of the community. Some of these partners include: law enforcement, medical providers, human service agencies, school districts, infrastructure partners, the business sector and many more. There are typically more than 100 people on this call, with report-outs from about 30 or so partner agencies.
Recent updates in the multi-agency call have focused on planning for a potential surge of patients in our local hospitals, managing medical volunteers for the surge and preparations to acquire adequate medical supplies.
In any emergency, communicating information to the public is crucially important as residents need to understand risks to their health and safety, as well as timely updates about the public health response. With the rapidly changing nature of the COVID-19 pandemic and the many unknowns associated with the virus, clear and timely communication becomes even more important. SJBPH has worked hard to keep all of our communication channels updated as best we can, however, we have been particularly challenged by how quickly guidance has changed, resulting in the need for numerous media releases and updates to our website and social media channels at all hours of day and night.
Additionally, we have done our best to respond the hundreds of inquiries that we receive by email, in social media comments and messaging, and to our call center, regarding every aspect of this unseen enemy. These inquiries include questions about the limited testing in our region, symptoms of the virus, complaints about violations of public health orders, and many more, some of which we are able to answer, some that require on-the-spot research, and some we can’t answer because we simply don’t know.
As the lead public information officer in SJBPH’s response, I convene a multi-agency call with other local pubic information officers to share information about the latest COVID-19 messaging and to coordinate with any and all organizations delivering information to their members or constituents. This group shares resources freely and widely, and materials recently created from this group were requested by state-level partners to use in their communications efforts.
I have coordinated countless interviews of our executive director, Liane Jollon, with a wide range of local, state and national media outlets including print, radio and TV. In all of our communications, we aim for frankness and transparency. SJBPH understands the intense need for information in such an unprecedented circumstance such as the COVID-19 outbreak and we have worked hard to meet this need.
None of the massive undertakings of SJBPH’s emergency response team would be possible if not for the commitment by nonemergency program staff continuing to deliver the crucially important services such as clinic services, Options for Long Term Care, Health Insurance Literacy, Nurse-Family Partnership, WIC and suicide prevention programming, to name a few. All of SJBPH’s programs quickly adapted their delivery to reflect the governor’s stay-at-home order and have gone above and beyond to provide their customary high level of service in new and unique ways. Other staff whose program work has been curtailed have jumped in to assist with the emergency response. More than 52 SJBPH employees have contributed time to this effort.
As I have mentioned in previous columns, public health impacts countless aspects of our lives and has resulted in the doubling of life expectancy over the past 200 years. This has been accomplished despite a serious lack of funding for these services and with little fanfare.
This year, I want to acknowledge my public health co-workers for the heroes and heroines that they are. Forced to respond with quick-thinking innovation and extreme problem-solving in response to the fast-moving crisis of COVID-19, I am honored to work under the leadership of our director Liane Jollon and with this incredible team of public health practitioners at every level of the organization. I have seen firsthand how each one is committed to the goal of protecting human health and safety.
I invite everyone to join me in honoring public health workers by making responsible decisions to abide by the public health stay-at-home orders; by practicing social distancing if you are required to go out; and following quarantine and isolation guidance if you believe you may have contracted or been exposed to the virus. Each of us are the only ones who can make a difference in fighting the spread of the disease, keeping each other safe and our communities resilient.
For more information, visit https://sjbpublichealth.org/coronavirus.
Claire Ninde is director of Communications at San Juan Basin Public Health.