Public Health Does What?!

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To say that it has been a weird time to work in public health would be an understatement. COVID-19 has completely shifted the day-to-day realities and priorities of health departments around the globe. And while everything has seemingly changed, the foundation of public health—what makes public health so vitally important—has remained the same despite it all.

Staff attending the Latino Health Forum (Oct 2019), pre-COVID.

As I sit here and reflect on my past three years with Skagit County Public Health, I’ve got to tell you, it has been one heck of a ride! I remember during those first few weeks learning (in astonishment!) all the things that public health is responsible for. After all, I had never worked for a government agency before. I knew that people visited their health department to pick up birth and death records or to get information about community resources, but I couldn’t have imagined the depth and breadth of the work that is done here at 700 S 2nd Street in Mount Vernon.

As I walked around the halls and met my new co-workers, I discovered the many divisions that make up our team: child and family health, communicable diseases and epidemiology, behavioral health and housing services, environmental health and food safety, senior services, and community health and assessment.

Of these, emergency preparedness and response was only one small (though critical) part of the puzzle. During a staff training one day, I learned a bit more about this division and was surprised to learn that all public health staff could be activated during times of public health crisis. At the time, I couldn’t fathom what this would look like. Now, a year into Public Health’s COVID-19 response, I can tell you exactly what this response is like!

When COVID-19 first appeared in Washington State last year, County leadership was the first to respond: Unified Command was established and plans were quickly put into place to mitigate risks associated with disease transmission.

Public Health staff working the COVID-19 Testing Site at Skagit Valley College on a foggy spring morning.

Our Public Health staff was activated—slowly at first, then almost entirely by the summer of 2020. On any given day in June or July at Skagit County’s COVID-19 testing site, you might have seen a hand-full of Public Health staff working to register people or help to administer tests—at times even jumping car batteries—whatever they had to do to get the job done.

Back at the office, a whole team of staff were called to conduct case investigation and contact tracing, conducting investigations seven days a week. Big plans for 2020 that had been on our work calendars were adjusted or put on hold to accommodate the ever-increasing demands of our COVID response.

More recently, with our vaccination initiative in full gear, we are in a much better (and sustainable) place. Our Vaccine Site at the Fairgrounds and Vaccine Hotline have been blessed by hundreds of hard-working and dedicated volunteers who show up every day to help get our community vaccinated. Our staff has also grown and changed, with an influx of new temporary and part-time staff that have been hired to conduct case investigations and to provide vaccine services at our clinic.

Case investigators staying cozy in their PJs on Thanksgiving Day.

As the numbers of vaccinated individuals in the state continues to increase, it begs the question: What will life look like after COVID? And even: What will Public Health look like if/when the demands of COVID begin to subside?

This week is National Public Health Week and is the perfect time to highlight the role of Public Health. Although our work has primarily been centered around COVID-19 this year, it is in no way all that we do.

Here is a quick look at some of the other things your local public health department does:

Behavioral Health Services

Public Health works with community organizations and coalitions, school districts, and regional partners to ensure that help is available to those in need, including access to mental health and substance use disorder treatment and recovery services. For more: https://www.skagitcounty.net/Departments/HumanServices/mh.htm.

Child & Family Services

The Child & Family Health Division works with individuals, families, and the community to assure that all Skagit County children have the healthiest possible start in life, with particular emphasis on pregnant women, infants, and toddlers. Programs include the Nurse-Family Partnership, ABCD Dental, Parent Cafes, and Skagit Bright Beginnings. For more information: https://www.skagitcounty.net/Departments/HealthFamily/main.htm.

Senior Services

Our Senior Services staff at the office are only the tip of the iceberg; this is a huge team! We have five senior centers in Skagit County and a robust Meals on Wheels and Senior Nutrition program. While many senior services have been put on hold due to COVID, the nutrition program has been instrumental to our crisis response. For more information: https://www.skagitcounty.net/Departments/HumanServices/SeniorCenters/Home/Main.htm.  

Developmental Disabilities Services

The Developmental Disabilities Program manages a variety of programs related to providing services to individuals with developmental disabilities, while also providing support for individuals and families and hosting community events and trainings to improve community awareness of developmental disabilities and inclusion. https://www.skagitcounty.net/Departments/HumanServices/DD/main.htm

Housing Services

Skagit County Public Health partners with local cities and nonprofits to provide humanitarian response, emergency shelters, rental assistance and supportive services with the goal of improving access to housing and reducing homelessness. Most recently, Public Health has made emergency funding available to those who have been impacted by COVID-19, and this funding can be used toward rental or utility bill assistance. For more: https://www.skagitcounty.net/Departments/HumanServices/HousingMain.htm.

Environmental Health Services

Environmental Health is easily the most diverse division that we have here at Public Health. From drinking water and food safety to the on-site sewage program and hazardous waste, our EH team is always super busy ensuring our residents are safe and healthy. For more: https://www.skagitcounty.net/Departments/HealthEnvironmental/main.htm.

Communicable Disease & Epidemiology

The shining star of 2020!  The Communicable Disease Program works closely with our healthcare provider partners to investigate notifiable conditions reported by health professionals, identify risk factors for disease, and provide education on how to prevent future infections. And we’re not just talking COVID-19! For more info: https://www.skagitcounty.net/Departments/HealthDiseases/main.htm.

Community Health and Assessment

Lastly, it is Public Health’s responsibility to think BIG: to analyze the data, identify the gaps, and propose new and innovative solutions. Public Health brings together a group of community leaders—called the Population Health Trust (PHT) —to solve Skagit County’s health issues that our community identifies. To learn more about the PHT, go to: https://www.skagitcounty.net/Departments/PHTAC.

If you run into a Public Health employee this week, give them a big air-five! And next time you’re wondering what the heck Public Health does, please remember—we’re so much more than COVID!

For information about Skagit County Public Health’s divisions, please visit: https://www.skagitcounty.net/Departments/Health/main.htm.

Gratitude: 2020 Reflections from Testing Site Staff & Volunteers

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Guest post by Rosemary Alpert, Skagit Valley Family YMCA

For many, the first step in their COVID-19 experience is driving to the testing site, now located at the Skagit County Fairgrounds. You are greeted by a staff member or volunteer, asked a few questions, then directed to the queue, like waiting for a ferry. Upon entering the barn, with your car window cracked, you are greeting by another staff member or volunteer to register you for the test. After, a nurse greets you with important information and directions for taking the test. The journey has begun, with hopes to receive a text in a few days with the singular word, “Negative.”  

As this unprecedented and challenging year comes to a welcome close, I never would have imagined my job as Volunteer and Community Engagement Coordinator for Skagit Valley Family YMCA would evolve into one of the most important experiences of my life: registering community members to get tested for COVID-19. 

Early on during the pandemic, Skagit County Public Health collaborated with the Y to support two full-time employees from the Y to work at the testing site. Over these past nine months, community collaborations have been created. A team of dedicated staff and volunteers have been working on the frontlines tirelessly through summer heat, high winds, bitter cold, sideways rain and ongoing challenges, day after day. These are the faces you see through your car windows: community members wholeheartedly supporting Skagit County.  

In early June, I started splitting my time between the Y and the COVID-19 testing site, registering community members at Skagit Valley College. Then, mid-September, I became full time at the testing site, putting my job at the Y on hold for the time. So many stories, reasons why people come through to get tested, are heartful and sometimes heartbreaking. Eyes to eyes, deeply listening, with respect and compassion. Dedicated coworkers and impeccable leadership keep our team fluid and flexible each day. They’re a privilege to work alongside.  

Last week, this group photograph was taken of our COVID-19 Testing Site team of staff and volunteers. In addition to registration, I was asked to contribute to the Skagit Health Connection weekly blog. This first blog is dedicated to the incredible group of testing site workers. I asked a few to share their thoughts about working at the testing site, what are they grateful for, an experience, or possibly an unexpected gift because of this time. Here are a few of the responses… 

Skagit testing site
Photograph taken inside the Skagit County COVID-19 Testing Site facility at the Skagit County Fairgrounds.

“I am grateful for getting the opportunity to work at the site and help our community get through this pandemic. And meeting all the amazing people who I work with.” 

“I’m grateful for being part of such an amazing team and being able to give back to our community. It’s honestly a rewarding job. You definitely learn how to communicate with so many different people. And being able to provide service for all, even those with a language barrier.” 

“I am grateful to be working at the site because seeing the relief on the faces of the people that go to get tested once they have been helped honestly lights up my day. Being able to provide the reassurance to the people. And unexpected gift I have got from working at the testing site is the ability to interact more with the people in my community and the opportunity I have been given to help better the community.” 

“Working here reminds me that people are kind. Folks wait an hour or more, often in bad weather, sometimes with kids and dogs in the car. All this stuff is scary and frustrating; but people are unfailingly kind, mostly patient, and always ready to share a (masked) smile. This is my best medicine for these times. (And staff and volunteers are wonderful!)” 

“I think I’m most amazed by the 200 volunteers who provided an estimated 12,000 hours of their time. In the rain, snow, smoke, wind and blistering heat, they are there!” 

“Each car is an opportunity to connect with our community, offering a little comfort, reassurance and hope. We keep our community moving forward during these challenging times. I’m grateful for the tiny moments of connection, whether it be the little girl who noticed the twinkling lights or the great-grandma wanting to visit her 16th great-grandchild. I didn’t expect to become a part of an elite team of community rock stars! Grateful for the opportunity to share a little light and serve our community.” 

As we wrap up 2020, let’s keep moving forward, find the moments of gratitude. Be vigilant, wear your masks, wash your hands, practice social distancing, keep your connections safe, and know you are not alone.

Please remember: If you or someone you know needs any support with the mental and emotional challenges of these days, PLEASE reach out! It’s OK to ask for help. The Disaster Distress Helpline 24/7 crisis counseling and support is always available. Call 800-985-5990 or text TalkWithUs to 66749. Skagit County also has a new website—SkagitHelps—that can assist people in getting connected to local and state resources.

Thanksgiving Planning for Safer Gatherings

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Reading Time: 4 minutes

Thanksgiving has always been a holiday full of planning: When should you start thawing the turkey? How many seats will you need at the table? And who—WHO?!—is bringing the pumpkin pie? While this year’s festivities will obviously be different, there will still be some planning involved.

If you have been watching the news, you know that there is a surge in COVID-19 cases right now—not only in Washington State, but throughout the United States. With the colder weather drawing people indoors, and the greater likelihood of transmission in enclosed spaces, it isn’t a surprise that cases have gone up. We also know that COVID-19 cases typically spike in the weeks following holidays when a lot of gatherings of non-household members take place.

With these factors in play, we must ask the uncomfortable question: Should Thanksgiving be canceled or postponed this year? It is a question, at least, to think critically on. After all, the Public Health recommendation continues to be that gatherings should be limited to reduce the risk of transmission.

However, if your family chooses to gather despite these recommendations, there are harm reduction practices that should be put into place. If you decide to gather, there’s always a risk of spreading COVID-19 infection. You can help lessen this risk through pre-planning, conversations, and some trade-offs.

The Washington Department of Health has a great safety checklist for those planning to gather this holiday season. It comes down to three steps: 1) planning before; 2) planning during; and 3) planning after.

Before You Gather

  • Have “the conversation.” Get really clear with friends and family about how you will make safety a priority when spending time together. Set some ground rules that will help everyone know what to expect. View a sample conversation guide. 
  • Review your guest list. Are there people who may be in a high-risk category or children? Think about special needs and precautions as part of your planning.
  • Check your space and gather outside if possible. Is there room to spread out, at least 6 feet (2m) from people you don’t live with? If no, is there an outdoor space, like a park where you could meet? If outside, will there be restrooms people can use? If inside, be sure your space is well ventilated by opening windows. Remind guests to wear warm clothes!
  • Right-size your guest list. Limit the number of guests based on the number allowed in your county per the Safe Start Plan, and the outdoor or indoor space available that allows you to be 6-feet apart.
  • Do a health check. Ask if anyone has had symptoms such as cough, fever or shortness of breath, in the last 2 weeks. Ask guests to check their temperature before arriving. Anyone with a fever—or who has had other symptoms, or knows they have been exposed to someone with COVID-19 within the last two weeks—should stay home.
  • Consider the children. Kids have trouble playing 6 feet apart, so wearing masks and frequent hand-washing may be the safest plan of action. Remember: Kids under 2 should never wear masks! 
  • Make a food plan. Talk through details like how food will be shared. The safest option is to have everyone bring their own food. If sharing, separate food ahead of time into individual servings and forgo communal bowls and utensils. Find more tips about food prep in the FAQs.
  • Clean, clean, clean. If you’re hosting, frequently disinfect surfaces that people may encounter during their visit. 
  • Consider pre-event quarantine. Can all participants (including yourself) self-quarantine for 14 days before the gathering?
  • Get tested. If you have been around many other people or do not regularly wear a mask, get a COVID-19 test to make sure you’re negative. Take into account that it can take a few days to receive test results. If you test negative, you still need to wear a mask and keep your distance from others when you socialize. 

While You Gather

  • Wash early and often. Ask adults and kids to wash hands on arrival, before and after eating, and before they leave with soap for at least 20 seconds. If there is no access to a sink, provide hand sanitizer. 
  • Gather outdoors if at all possible. If indoors, open windows to increase ventilation.
  • Mask up. Wear a face covering at all times when not eating. Consider having extra masks on hand if people forget.
  • Separate servings. Avoid communal food and sharing utensils, even with babies and young children. Don’t share drinks.
  • Avoid close contact. Smiles and air hugs only, and prepare kids ahead of time to do the same.

After You Gather

  • Wash hands (again). Wash for 20 seconds with soap and water.
  • Sanitize. Clean all surfaces that may have been touched by guests such as tabletops, counters, doorknobs and bathroom fixtures, with soap and water first, and then a disinfecting agent. 
  • Watch for symptoms. Alert others at the gathering if there’s a positive test among anyone in attendance. Learn more about what to do if you’ve been exposed.

If you are reading the above steps and feeling absolutely overwhelmed, you aren’t alone! And if the idea of canceling or postponing your Thanksgiving plans feels heartbreaking, that is an entirely normal response. During normal times, the fall and winter months are wonderful times to gather. So, limiting and changing the way in which we gather with family and friends isn’t easy. It may cause feelings of stress, anxiety or depression.

In the end, it is up to you and your family to decide what your Thanksgiving holiday should look like. But it is also important for us all to think hard about what really matters most to us. So even though the holidays may look a bit different this year, we know that our actions—as well as some planning—can go a long way in keeping all of us safe and healthy this winter.

If you are experiencing stress due to COVID-19, call the Washington Listens line at 833-681-0211 for support and resources.