Inside the health department’s epidemiological response
The core of the health department’s work on the COVID-19 pandemic is the epidemiological response. This is the primary role of public health. During COVID-19, we have built out our epidemiology team and partnerships to best address the challenges presented by COVID-19. I want to introduce you to our team and our partners and share a behind the scenes look at our response.
Initially, our health department’s epidemiologist, Hope White, was a team of one, responsible for the investigation of all infectious diseases in the Roanoke City and Alleghany Health Districts. The first expansion was to bring on myself as retired former Virginia Department of Health (VDH) health director, VDH epidemiologist, Lex Gibson, and an infectious disease doctor, Dr. Thomas Kerkering, from Carilion Clinic to help lead the response. Additionally, Khristina Morgan, a southwest regional Hepatitis C epidemiologist, was able to shift to assist with the COVID-19 efforts. As the cases in the health district grew, it became clear that the important work of case investigation, contact tracing, and providing guidance to partners would require a more robust team.
Initially, much of the work was accomplished through a partnership with the Near Southwest Medical Reserve Corps (MRC). These individuals sign up to be public health volunteers. These volunteers assisted us in calling positive cases, case investigations, contact tracing, personal protective equipment distribution (PPE), and outreach. As funds became available from the state through the Centers for Disease Control and Prevention (CDC), several of these individuals were brought on as staff.
Today, the team consists of the director of communicable diseases, an infectious disease doctor, five epidemiologists, 17 case investigators, eight contact tracers, and one communicable disease nurse. Many other health department team members support our efforts. For example, our environmental health staff investigate positive cases in our restaurants, and our nurses support testing events, outbreaks, and work to distribute PPE to our healthcare partners. Additionally, we are able to train the staff of healthcare and long-term care facilities to ensure that their teams are properly fitted for their N95 masks.
The epidemiology team members review the “line list” of confirmed and probable positive cases each business day. Cases are assigned to case investigators, who connect with each positive case and identify their close contacts, as well as provide guidance. Next, contact tracers reach out to those who may have been exposed and advise about quarantine. The team is able to pull reports from the data system to analyze and identify trends. We can look at cases demographically to identify disparities, which we have seen locally in our Hispanic community. We can also identify clusters, which are several people with an illness but not yet linked by a known exposure. These cases are investigated in the hopes of preventing or promptly responding to an outbreak.
In future articles, we will take a deeper dive into the epidemiological response to COVID-19. For example, we will share more about how our team works to address a case, cluster, and outbreak.
For questions about COVID-19, call 540-204-9995. A public health professional is ready to answer the call.
