CT public health officials on managing COVID-19 relief

In February 2021, residents over 65 became eligible for the COVID vaccine. But for seniors with mobility issues, getting to appointments presented a challenge.

Officials in Vernon recognized the barrier and set out to address it. They struck a deal with Uber to give free rides to seniors who needed them. The program was the one of the first of its kind in the country, and a national campaign President Joe Biden rolled out months later closely mimicked the model.

“At the end of the day, all emergencies start and end at the local level,” said Michael Purcaro, Vernon town administrator and director of emergency and risk management.

The department also realized that many seniors needed help navigating the frustratingly clunky online appointment portal. They transformed the Rockville Public Library into a call center for technical support. Staff included a handful of full-time workers supported by roughly 100 volunteers, including senior center workers, librarians, teachers and police officers.

Vernon Town Administrator and Director of Emergency and Risk Management Mike Purcaro led major efforts to help residents access vaccination sites and proper protective equipment.

Vernon serves as just one example of the critical role that local public health departments played throughout the pandemic. Employees coordinated and managed broad efforts, like vaccine clinics and contact tracing. But they also found creative solutions to a seemingly infinite number of smaller-scale, but equally vital, issues that cropped up along the way.

The Connecticut Mirror spoke with five local public health leaders from around the state about their experiences coordinating relief efforts during a once-in-a-lifetime crisis and the lessons they hope will carry into the future.

Thousands of items left over from COVID-19 efforts line the shelves of a warehouse in Vernon.

‘The boots on the ground’

Over the course of the last three and a half years, local public health departments took charge of solving a constant onslaught of challenges that COVID presented to daily life.

“We were the boots on the ground,” said Aimee Krauss, director of health at the West Hartford-Bloomfield Health District.

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In March 2020, the health departments in New Haven and New Canaan launched contact tracing programs to track infections and connect COVID patients with resources like temporary shelter.

In New Haven, the health department partnered with Yale and used physicians’ assistants and students from the medical, nursing and public health schools as volunteer contact tracers.

“It was so effective that we were getting interview requests from people from all over the world,” said Maritza Bond, New Haven’s director of public health. “We did that for about six months, in setting up that infrastructure, until the [Department of Public Health] was ready to scale up their program.”

In New Canaan, the health department employees, along with school nurses, took on the task of calling patients and their families directly, often speaking to people who were hospitalized or family members losing a loved one to COVID.

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Jennifer Eielson, the town’s public health director, said it was one of the most challenging parts of the pandemic.

“We don’t normally, at the local health level, deal with people dying on us. We’re not first responders. So that whole process was very hard,” she said.

Local public health teams took on the monumental task of helping schools, businesses and people figure out how to stay healthy and make sense of the ever-changing guidelines coming from the federal and state governments.

“It was general guidance, and there were gaps,” explained Robert Miller, director of health at the Eastern Highlands Health District. “Nobody could fill those gaps except for local public health. And it wasn’t easy.”

One of the critical areas where several local public health departments offered support was to school systems.

In September 2020, schools reopened, and superintendents reached out with questions about how long students and staff should quarantine after an infection, how often to sanitize surfaces, and how to deal with pushback from parents on masking protocols.

The constantly changing guidance only made the task more difficult. Miller’s team kept a binder with a printed copy of each new executive order that the governor issued. Over time, it grew to nearly 3 inches thick (they’ve since thrown it out).

Later that year, the single thing the entire world had been hoping for finally arrived: a COVID vaccine. Local public health stepped in, playing a key role in distribution.

“It was Christmas Eve,” Krauss recalled the day the shots were delivered. “The UPS guy was bringing it in, and we were all cheering.”

The health district started off organizing small clinics but realized they weren’t meeting demand.

“People were looking for [the] vaccine, and local health departments were the ones that were receiving it. And so we started building larger clinics,” said Krauss.

Eventually, they ran three primary vaccine clinics, two in West Hartford and one in Bloomfield, as well as smaller pop-up clinics in their office and at churches. During the periods of peak demand, they vaccinated over 1,200 people a day across all the locations. If any doses were left unused at the end of a day, a clinic worker or volunteer would scour nearby streets and restaurants for someone who wanted it, in an effort not to waste a single shot.

In addition to these large-scale efforts, local public health also filled in gaps that popped up along the way. They distributed masks, hand sanitizer and testing kits. They guided restaurants and daycares through the process of reopening safely. They set up grocery deliveries and pickups for seniors.

But all that service came with a cost.

Eielson and the team at the New Canaan Public Health Department worked 18-hour days, six days a week for over two years.

“I was completely burnt out,” she said.

While many Americans want to move past the pandemic, Eielson said she’s still processing the experience. She currently sees a therapist for post-traumatic stress disorder and said she’s open about her experience in the hopes that others will seek out support as well.

“It’s OK to not be OK,” said Eielson. “Right now, a lot of public health officials are struggling from all the stress we’ve been put under the last three years.”

Lessons learned

The pandemic presented immense challenges, but it also united communities in unprecedented ways.

“At the state and national levels, there was a lot of politics involved,” said Purcaro, Vernon’s town administrator. “But I will tell you, locally, it brought people together.”

Local public health leaders recounted how physicians, school nurses, local government workers and everyday citizens volunteered their time to ensure as many people as possible got the support they needed.

Town governments also provided support with everything from funding to event space to hold vaccine clinics and testing sites. Leaders also emphasized the unwavering dedication from their teams during the most intense years of the pandemic.

“They never told me ‘no.’ And I feel a little bit spoiled,” said Krauss of her staff. “They knew what we needed. And they knew that they needed to help and they wanted to help.”

Public health departments also had to establish partnerships with local institutions, like schools, nursing homes and hospitals. And those working relationships have never been stronger.

“We already had very good relationships with many of our community partners, but their pandemic response, with the all-hands-on-deck-necessary approach brought us even closer together.” said Miller, who “absolutely” considers the pandemic the most challenging part of his public health career of more than 35 years.

Miller and others also pointed out that the pandemic made the work of public health departments more visible than it ever has been. Many leaders hope it stays that way.

“People now have a better understanding of who and what local public health is and does that they never had before. We were fighting for attention before the pandemic,” he said.

On the flip side, Krauss said that, while towns were extremely supportive with funding, getting money they needed from the state was more frustrating. For example, she’d apply for funding to increase vaccine clinic capacity during a surge and wouldn’t receive approval until demand subsided.

“I understand why there’s a process in place, but to be quite honest, it always felt like we were behind a little bit,” she said.

Every person who spoke for this story also agreed that the politicization of the pandemic made it much more difficult to manage.

“Instead of the public health experts taking the lead, we had political leaders taking the lead. And that’s not a party-specific thing. It was across the board,” said Purcaro, adding that he hopes the biggest takeaway from COVID is to let public health lead the way.

The future of COVID

Even though the pandemic has moved beyond its most horrific phases, local public health departments remain vigilant to ensure they can manage future surges.

In Vernon, Purcaro’s team no longer directly delivers care, like vaccines, but they still have warehouses full of stockpiled PPE and maintain strong relationships with community groups in case they have to coordinate efforts again. In New Haven, Bond and her team keep a close eye on wastewater data and hospitalization rates to understand the level of risk in the community.

And COVID still continues to present challenges, over three years later.

In the late summer, as hospitalizations ticked up, residents and businesses called into the West Hartford-Bloomfield Health District with the same questions that society has been juggling since March 2020: Should we mask up? When should we test?

Krauss’s team also continues to provide COVID vaccine appointments once a week. The most recent booster roll-out, the first managed by the private sector and not the federal government, got off to a bumpy start. People in Connecticut and elsewhere reported appointment cancellations and difficulty getting new time slots.

“There was a little chaos in the beginning,” said Krauss. “That felt familiar.”

Krauss said she also hears from people, many of whom are elderly or immunocompromised, who are navigating how to continue taking precautions as much of society moves on from the pandemic.

“We are in such a better spot now than where we were three years ago,” said Krauss. “But it’s never gonna go away.”