Behind-the-Scenes: COVID-19 and Your Greenwich Dept of Health

By Dr. Stephanie Paulmeno, DNP, RN, NHA, CPH, CCM, CDPPublic Health Education Specialist/Greenwich Department of Health

Not long ago we gathered, shook hands, and hugged one another. We worked at worksites. Children went to school with friends. It’s hard to believe just a year has passed in our now altered reality. Coronavirus struck hard; it altered our lives. The pandemic disrupted our way of life, and it took the lives of loved ones. It wreaked havoc on many who survived.

Asymptomatic and unsuspecting people with COVID mingled amongst us, often without masks or social separation. They unknowingly spreading the contagious virus about and our numbers grew. Information blended with misinformation throughout 2020 made it hard for many to separate fact from fiction.

What had happened to our previously robust national public health system? That answer is water-under-the-bridge, but pandemic-related public health is and has been alive, well, and active here in Greenwich for decades.           

Step with me behind the curtains of your Greenwich Dept of Health. It is led byCaroline Baisley, a Master’s-prepared Public Health Authority. The Board of Health has enjoyed long-term stability under Chairman Robert Carangelo. As a Nationally Board-Certified Public Health Professional, I profess that it is one of the Town’s most under-recognized jewels. This is often the case because when public health operates effectively, it is invisible. We become aware of public health when things go wrong. Connecticut was divided under prior Governors into 41 regions so as to coordinate resources for Connecticut’s Mass Dispensing and Vaccination Site Program. Each region designated a full-time health department to be responsible for this function. The Greenwich Department of Health is identified as the Lead Agency for the Public Health and Emergency Planning for the region that includes Greenwich (Connecticut Network of Info provided by United Way of CT, 2-1-21)

Let me tell you about your health department’s long-time readiness for a disaster such as today’s pandemic. Early in 2000, during the SARS-CoV-1 pandemic-scare, Director Baisley had the foresight to create a Community Health Planning Division, a job I had the privilege of holding from its inception in 2002 until my retirement in 2009.

A SARS Pandemic Plan and Avian Flu Plan were created for Greenwich, along with a Computer-interactive Pandemic Planning Template for Nursing Homes. This was picked up by facilities across Connecticut and remains relevant today. Our pandemic plans and, yes, a Multi-contingency Mass Immunization Plan for Greenwich was created and tested way back then! Your Greenwich Dept of Health has been pandemic and mass-immunization-prepared for decades.

Mock disasters and tabletop exercises were practiced and refined in order to be ready if and when needed, up to and including for today’s pandemic. A Bioterrorism Disaster Public Health Plan for Greenwich was created with education modules for all potential bioterrorism agents. Director Baisley took the lead as several of us accepted smallpox vaccines so we would be prepared to vaccinate Greenwich if that need ever arose. 

Do you know that Greenwich Dept of Health’s Contact Tracers conduct all the daily monitoring of COVID-positive people in Town, as well as those who were exposed to someone with COVID-19? They are drawn from the small staff of your Greenwich Dept of Health and from trained volunteers from the Greenwich Medical Reserve Corp. This was implemented about 2 decades ago by Director Baisley in preparation for just such a contingency as we now have. As of this week, there have been 4,059 COVID-positive cases in Greenwich, plus each of the people who were exposed to them.

As a volunteer Contact Tracer I have had up to 21 people per day on my list alone. Contact tracers are expected to contact each case on the day it is received, and to track them on a daily basis. Many are very ill and very frightened. Sometimes it is entire families and extended families with whom we are working. It is time-intensive and heart-rending. We identify contacts and sources, isolate issues, make referrals, provide tangible and emotional support, and complete documentation. It is heartwarming to hear from those whom we call, what it means to them to have a one-on-one professional contact to help them through their crisis. Some cases have taken close to an hour per call. Thus the logistical problems become apparent for Dept staff with other essential daily duties. I recently returned to work for the Dept for a few hours/week doing public health education. Prior to that I, too, was a pure volunteer.

When misinformation or confusing information is noted on or in the news, the Dept is flooded with phone calls that we try to return that same day. People in Greenwich were surprised to get late hour calls from their public health professionals about their COVID-19 inquiries and for vaccine guidance. 

Much of COVID-readiness involves the Dept’s ability to plan, implement, manage and execute each aspect of a flawless COVID-19 vaccination clinic. The public arrives, gets registered, gets vaccinated, gets educated and monitored, and leaves on time.

Our record shows that practice makes perfect. Your Health Dept has run multiple forms of vaccination clinics annually for decades. This year the Greenwich Dept of Health teamed up with GEMS to offer joint COVID clinics.

An EMT is on-site at all times to render emergency care should that ever be needed. Together we vaccinate and educate those attending our vaccination clinics that run three to four times a week.

All staff and volunteers took hours of training on the VAMS scheduling and recording system as well as on the vaccines themselves.

We are administering the mRNA vaccine, Moderna that has complex temperature, storage, handling, and administration requirements. Vials, once thawed, can only be unrefrigerated for short, designated amounts of time. Every vaccine drop has to be accounted for.

Controlling waste is a critical element when the vaccine is as precious as liquid gold. I stand in awe of the meticulous oversight provided by Deborah Travers, MSN, APRN, FNP-BC; the Director of the Division of Family Health, who is the Clinical Coordinator of the Department’s vaccine clinics; Director Baisley is well-known for her hands-on oversight of every clinic ever run by the Greenwich Department of Health. The people of Greenwich are in very capable hands!           

Few know what health departments do to keep “normalcy” alive, or that this is accomplished with small staff and limited budgets. While the Health Dept’s staff is being assigned to cover numerous COVID-related duties in clinics and with contact tracing, all their routine work continues as usual. Nothing can be sacrificed because everything being done routinely is an essential function of public health.

Your Greenwich Department of Health has an Environmental Division with a multi-service Environmental and Clinical Laboratory; a Maternal, Child and Family Health Division that provides wellness-clinics, routine immunizations, the monitoring of patients with TB and asthma, homebound residents, and the school dental health program.

They develop the well-attended annual flu clinics throughout Town every year. There’s a Special Clinical Services Division that does HIV/STD testing and education programs, and there is a part-time director for the Public Health Emergency Preparedness and Response Program who collaborates with the full-time director of Public Health Emergency Planning. Oversight of the Contact Tracing Program was put under that section as; the director is also a trained Respiratory Therapist. Many of the Health Dept’s non-nursing staff serves in essential support roles during COVID-clinic operations which run 3-4 days/week.

The Greenwich Dept of Health Administration and staff from nursing, non-nursing and essential support roles appreciate our GEMS partners for their essential collaboration in this historic vaccination effort. Make no mistake; public health history is being made by those being vaccinated, by the clinic organizers and vaccinators, as well as by all of those providing volunteer support services through the Greenwich Medical Reserve Corps.  The hospitals, retail pharmacies, American Red Cross, medical practices and other agencies that collaborate with State and local departments of health are all part of our Public Health System structure and we are all stronger together.

Dr. Stephanie Paulmeno, DNP, MS, RN, NHA, CPH, CCM, CDPPublic Health Education Specialist: Greenwich Dept of Health