Although I was following the outbreak of novel carona virus in China back in January. Activities began in earnest at the local level as we moved into March. Our early preparations included the provision of consultation to localities, healthcare institutions, and private sector businesses. Most of that had to focus on estimates of personnel loss as the result of the disease. As a novel virus, we did not know, so the framework was based on all of the pandemic influenza planning from 2009.
We wrestled with information sharing. The privacy protections of individuals and the desire to know from first responders potentially going in harm’s way and the localitiy leadership’s desire to “get in front” of messaging to the public. Rumors were rampant. Simple observation of social media platforms were filled with misinformation which was not helped by a variety of misstatements by leadership at many levels. I will say that the localities we serve are great; asking questions, listening to the science even when the answer was, “we don’t know yet…”.
As of this writing, we have hit our battle rhythm, to use a term from a previous life. The Population Health workcenter has a smooth call center for answering questions and referrals. The expanded Communicable Disease workcenter continues the normal workload of other outbreaks and supports the Covid-19 contact investigations; many, many contacts. We have conducted Point Prevalence Testing (all staff and all clients at a specific point in time) at nursing homes and corrections facilities to support epidemiological science. We have conducted Community Based Testing (diverse groups and businesses) to increase the understanding of conditions in the ~600,000 people on the Peninsula.
As we move into the Phase One decreased restrictions in public. We expect to see a rise in the number of cases, not just because of the interactions of people, but the new information reporting that a large number of people are without symptoms. Ongoing messaging regarding hand-washing, masks where interactions occur, and decreased congregations of people are important to mitigate the spread of the disease.
As the planner, I hope that all our citizens will not become complacent; weddings, church services, funerals, and other gatherings put the most susceptible of our families at risk for the disease. Even as we understand that many cases of Covid-19 are mild, we must protect the folks with chronic illnesses (comorbidities) and a higher likelihood of severe illness. National level data is confirming that about half of the current deaths are in the over-65 age group.
As we all move through an altered way of living, I am reminded of the historical lines for smallpox vaccination. The population, all of us, knew the dangers of smallpox (or polio, whooping cough, tetanus…) and readily accepted the availability of vaccine and the mission to eradicate the disease. As Covid-19 runs through our society, at some point, we will all know someone who had the disease, the adverse impacts to families, and so on.
Our work in Public Health has always been the bedrock of wherever you live; water you drink, the food at a restaurant, rabies control, or tracking and tracing tuberculosis and other diseases. With the decrease in movement restrictions there will be cases and we will be there doing that testing, tracing, and closely watching the hospitals, quarantines, and isolation. Our work does not end there. When the vaccine comes, we will provide the initial clinics and transfer of vaccines to hospitals and doctor’s offices. There will be a great deal of “vaccine hesitancy” and misinformation, but we will provide the vaccine nonetheless.
The work continues. To my Public Health colleagues, not just here, but around the world, salute.