How Care Coordination And Support For Isolation Can Help Curb The Pandemic : Shots

When people test positive for COVID-19, they are instructed by contact tracers to isolate at home and their close contacts are said to be quarantined for two weeks.  But for many people, staying home for days or weeks is not feasible.  Many public health departments use nursing resource coordination teams to support those in need.

While everyone is hoping for COVID-19 vaccines to find a way out of the pandemic, public health experts say other public health tools are still critical to stopping the virus.

One of those tools – contact tracking – might finally be ready to have its moment, he says Crystal Watson, Senior Scholar at Johns Hopkins Health Security Center. During the winter flood Contact tracers were overwhelmed – They couldn’t possibly reach out to everyone who tested positive – and their close contacts – to tell them to stay home to slow the spread.

That is starting to change, says Watson. Case numbers are Entering the zone where contact tracers can get onto the gearbox. Vaccinations are on the rise and give hope to the public health response.

And finally there are billions of dollars – in that American rescue plan – to intensify these efforts, so if regarding coronavirus variants Health departments can continue to expand throughout the summer and beyond, Watson says.

For overwhelmed and burned out COVID-19 contact tracers, help is coming (hopefully)

However, contact tracing will only prevent the spread if everyone infected or exposed can follow public health guidelines stay at home for days or weeks. For people who can’t – because they don’t have the money to pay for utilities or rent, or for friends who are willing to get groceries for them and give them away – the health departments have a solution.

It’s called nursing-resource coordination. It’s so little known, it’s like a secret weapon in the pandemic public health response that can make it more effective and fairer. Public health experts urge that this is the time to seize new funding opportunities and expand the reach of this service.

‘Why are you calling?’

Karina Acuna has been doing this job since July when the Pima County, Arizona Health Department launched its utility resource coordination program.

“Almost every call we have starts – it’s like, ‘Why are you calling and how do you get my number?’ “says Acuna. The people she calls have either just been diagnosed with COVID-19 or they have just found out that they are a close contact and need to be quarantined. They are often stressed or sick; It can be a scary time.

She explains what it takes to make the time it takes to stay home – groceries, prescription drugs, cleaning supplies. She then searches her list of 95 local health and social services and links them to programs that may be able to help.

“It’s always a good call for them because they are getting the help they may need or they don’t even know it’s available,” she says.

Sometimes it’s simple things that people need, like extra masks. Larissa Morgan, a community health representative who does this job for the Navajo Nation, says it is often detergents for the people there.

“”[It’s been] It’s hard to get Clorox wipes, it’s hard to get Lysol sprays, “she says.” I would say there would be food next, and then water, because we have people who still don’t have running water. “

Sometimes the needs are even greater. People need help planning funeral services for loved ones who have died of COVID-19. Care coordinators describe comforting people who grieve in isolation. Or help them find accommodation.

“I can tell you I had to help a client where they were actually evicted – the Marshal was in residence and cleared them,” says Sharonda Wright, a nursing resource coordinator for the Fulton County Health Department in Georgia. “They needed protection and financial support while trying to collect their belongings.”

The person was able to stay with a relative briefly, and then Wright put them on temporary shelter, she says.

Meeting these needs is not just important for these people. When it is impossible for infected people to stay at home, the virus has more opportunities to spread, making it a public health problem. Nursing resources coordinators provide some sort of temporary safety net that helps people feed themselves on chicken soup when they contract COVID-19 and helps families look after each other by providing masks and cleaning supplies.

The best and the rest

These programs exist across the country. An NPR Survey conducted in December in cooperation with the Health Security Center and the non-profit organization Partner in health found that the vast majority of state health departments that responded to the survey asked about social needs as part of the survey Contact tracing process.

But one Analysis of these results The report, released on Friday, shows that the size and scope of these programs vary widely – from a simple hotline that people can call when they need help, to dedicated specialists who know their communities and resources inside out.

For this process to work, the details are important, says Dr. Shada Rouhani, who advises Partners In Health Maintain resource coordination and worked with NPR and Johns Hopkins on the survey.

Rouhani’s analysis found that only 39% of responding states said their contact tracing teams included dedicated care coordinators. Almost a third of these programs do not systematically follow up with people to ensure that their needs are being met.

And every fifth program only outputs a phone number like 211. “It can be difficult to give someone a phone number to call to find a resource, connect to a grocery bank, or connect to their resource bank, especially if there are language barriers when that person has limited access too technology or has as little as limited phone minutes to make that call, “explains Rouhani.

Actively making these connections for people can make a world of difference, she says.

If Acuna in Pima County, Arizona finds out which local agencies can help someone, “we can transfer them right away.” However, sometimes it makes sense to send the information via email or SMS so that it can be followed up later.

“Some of these people are too sick to talk – to talk on the phone that long,” she explains.

Wright closely monitors the requirements for each local Fulton County, Georgia program – which are waiting lists and which are not. Sometimes she actually enrolls people in programs for which they qualify – especially seniors with no internet access. “With your permission, we can fill out these forms for you,” she says.

In New Mexico, Larissa Morgan’s team includes people who actually donate supplies and groceries to people who need to isolate at home. “You have no one ready to pick up [supplies for] them because they were afraid to come to their home because they didn’t want to get infected by COVID, “she explains.

Her expertise – in public health and in the part of the Navajo nation she serves – has expanded in new directions in the wake of the pandemic.

“We worked with our nurse to vaccinate people who were at home,” she says. You may live in remote areas or have no transportation. So far, she and a public health nurse have driven to vaccinate five people at home, and more are in the works.

Financing on the horizon at last

If state and local health departments want to expand such programs, they should soon have access to federal funding to make that happen. The American rescue plan, signed by President Biden last week, is foreseen $ 47.8 billion for testing and tracing contacts and other mitigation measures.

The law also includes $ 7.7 billion for a new public health workforce. “We are still working on how to do that,” said Watson of Johns Hopkins.

During a pandemic, this workforce could work with contact tracers to support people who need to stay home. In a broader sense, “the main goal of this program is to hire people over the long term so we can strengthen our public health infrastructure,” she said.

There is also funding for some of the support programs that Nursing Resource Coordinators connect people with, such as: B. Rent Assistance and Paid Vacation for Employees. “I think that’s a big boost to contact tracing in and of itself,” says Watson.

Shada Rouhani is confident that many public health officials will seize this opportunity to expand this part of the pandemic response, even if the nation’s focus is on vaccination efforts.

“We are all incredibly hopeful that the vaccine progress will continue to be great and that we are all looking forward to getting back to normal,” she says. However, it is still important to invest in these programs and design them to be effective.

“These nursing resource coordination structures that we are building and using now very well could come into play in the future,” she says.

That’s true when it comes to preventing new COVID-19 outbreaks when current vaccines against emerging variants are less effective than we hope, she says. These programs could also be important in helping the country achieve a fairer and more effective public health response to the next pandemic.


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