Submitted by Stephanie Paulmeno, Greenwich Health Dept, Submitted by Dr. Stephanie Paulmeno, DNP, RN, NHA, CPH, CCM, CDP, Public Health Promotion Specialist
National Public Health Week is once again upon us. Public health is in the vanguard for monitoring and responding to the many health, mental health, and safety issues and concerns that beset communities.
Normally public health operates in the background, but it’s been yet another difficult year for the local, state and national public health workforces that deal with the wide range of issues that impact public, population and community health.
Along with the many routine issues that are continuously monitored and addressed, the infectious agents behind COVID-19, Influenza, Syncytial Virus (RSV), mpox, and even Ebola rose to distinction this past year. COVID-19 is now the 3 rd leading cause of death in Connecticut following heart disease and cancer (https://www.cdc.gov/nchs/pressroom/states/conecticut/ct.htm).
At the start of 2023, the CDC was still listing Fairfield as one of seven Connecticut counties in the High/Orange COVID-19 (risk-level) category (https://portal.ct.gov/DPH/Press-
Room/Press-Releases—2023/CDC-Update-Jan-13).
The Greenwich Dept of Health continues to outreach to every person testing positive for COVID-19 on a lab (not home) test in order to offer monitoring and support, check on unmet needs, and do contact tracing. In Connecticut alone this past week we had another 625 new COVID-19 cases for a cumulative total of 1,065,725 since the start of the pandemic. We had another 112 people hospitalized in Connecticut with COVID-19 this past week, and an additional 23 COVID-deaths over the prior week. That brought the cumulative number of Connecticut deaths to a staggering 12,293 since COVID-19 hit our state borders.
Public health also routinely addresses non-infectious public health issues such as motor vehicle accidents, substance use/misuse, and violence to name but a few. In America in 2020, gun violence surpassed car accidents as the leading cause of death for children 1 to 19 years old, and drug overdoses and poisonings in this age group increased by 83.6% in that same one-year span (https://www.nejm.org/doi/full/10.1056/nejmc2201761).
We are now in the fourth year of a tragic and deadly pandemic that has taken so many lives, including the lives of the health and public health workers working to save the lives of others. COVID-19 mortality grows weekly, albeit with diminishing numbers of additions to our death tolls. During National Public Health Week 2023 please take a moment to recognize and acknowledging our Town, State and nation’s public health workforce.
These multi-disciplinary health professionals, para-professionals, and support staff have worked diligently over these years to keep their communities and populations safe, which at times has been an arduous uphill battle due to misinformation, disinformation, and misunderstandings of the often technical data that underlies public health theories and practice.
A pandemic, world-wide by definition, is a public health nightmare of massive proportions.
It has taken our having to live through a nationally disastrous pandemic for many in our current generations to see and feel the tragic impact. People alive now were not here to experience the pandemic of 1918. There are accounts of the Spanish Flu epidemic of 1918 in Connecticut (https://connecticuthistory.org/the-spanish-influenza-pandemic-of-1918/).
About 9,000 people of all ages died. Our current pandemic has lasted much longer, is still actively on-going as seen by the numbers of new cases, hospitalizations and deaths each week, and it has taken far more lives.
Public health theory takes a “One Health” approach in that it recognizes that the health of the world’s people, animals, plants, and insects, along with our environment (including our air, water, and soil) are all intertwined (https://www.cdc.gov/onehealth/index.html).
As the Pocahontas song, Colors of the Wind by Judy Kuhn said, “We are all connected to each other in a circle in a hoop that never ends” (https://youtu.be/MpLnqOvGuMs).
Even with COVID-19 and other contagious viruses, what we do and don’t do affects not only us, but also those around us.
The community public health workforce is broader than just those working at their local and state Departments of Health. Public health departments and health districts have long been understaffed, underfunded, and under-recognized, unlike many other of our more visible public health partners. The activities that comprise public health are generally only seen in a new light when something goes awry or when a public health catastrophe such as our current pandemic and tridemic strike.
We’ve seen this most recently during COVID-19 and with other infectious entities that do not normally hit U.S.A. communities (e.g.: mpox, Ebola, and Respiratory Syncytial Virus (RSV). We in public health
recognize, support, and appreciate all the members of our public health system and the many different support people whose work is so essential to positive and good health outcomes. We’re only as strong as our weakest link and in public health we cannot afford weak links anywhere in the system including in funding sources before, during or after a crisis.
Departments of Public Health are mandated to be led by a qualified and public health professional who is educated minimally at the Master’s level of Public Health, not in another related health profession, because public health has its own vital core areas of study and essential knowledge. Public health is a distinct and separate discipline from medicine, nursing and other health professions. While experienced and educated Directors of Public Health are assigned responsibility for safeguarding the health of their populations and communities, they do not act alone. Local and state Directors of Health, respect, embrace, and need all the vital services of our partners in other healthcare sectors
including social services, safety, and emergency services. The public health process depends on the skills, talent and involvement of all contributors to public health from many diverse health disciplines and essential support roles.
Even in our fourth pandemic year, extensive hours of paid and unpaid time are devoted by staff and volunteers alike. The GDoH, under the decades long leadership of Director Caroline Baisley, MPH, RS, has an active and dedicated volunteer Medical Reserve Corps (MRC) comprised of physicians, veterinarians, dentists, nurses, advanced practice nurses, physician’s assistants, and social services workers, along with EMTs/EMSs, laboratorians and other clinicians, as well as law enforcement and numerous essential support staff.
The Greenwich MRC is sworn in annually and takes the same oath as our military, legislators, and President of the United States. Training was provided in our session last month on how the GDoH has monitored, tracked & trended the three disease entities comprising the recent tridemic (COVID-19, Influenza, and RSV), and how this data was used to help safeguard our community. Other contagious diseases are regularly tracked by the GDoH’s Infectious Disease Nurse Specialist. Another specialty clinician addresses HIV/AIDS & other sexual, blood-borne, and body-fluid transmitted illnesses. The GDoH’s Environmental Services Division includes an impressive laboratory and monitors our food and beverage service establishments and many environmental health issues including water, air, soil, and well water quality, as well as our recreational water sources; and also vector-borne illnesses, lead levels, mold contamination, and so much more. The Family Health Division addresses health and well-being across the age span with various clinics; a dental hygiene program that visits children in their schools; and the services of the Town’s public health nurses. Family health is the force behind the Department’s highly acclaimed vaccination & immunization clinics, which are done with full GDoH and Greenwich MRC collaboration, all with the active on-site management of the Greenwich Director of Health and the Department’s Director of the Family Health Division.
Kudos is due to the Greenwich Board of Health, the Greenwich Director of Health, and the Greenwich Department of Health’s managerial, professional, clinical, and support staff; as well as to the Director and the Volunteers of the Greenwich Medical Reserve Corps.
Praise also goes out to the administration and staff of all the member-agencies, facilities and organizations that comprise the full Greenwich Public Health System.