The state is temporarily handling COVID-19 case investigations and contact tracing in Island County after the majority of the county’s public health nurses quit and on-call staff is being trained on a state software program.
In addition, the county’s community and family health director also quit and the health officer isn’t renewing his contract that expires at the end of the year. In emails and reports obtained by the Whidbey News-Times, they both cited poor communication and other concerns regarding county Public Health, alleging the problems are so bad that they put their licenses at risk.
Coupeville resident Larry Behrendt, president of Indivisible Whidbey, has been asking questions about contact tracing for the last six months and was repeatedly assured all was well. He was alarmed by the latest news.
“It’s like we are fighting a war,” he said, “and most of our troops have left.”
Yet it’s not unusual for local health jurisdictions to ask the state for help with contact tracing when there’s insufficient staffing or when there’s a surge in cases. Contact tracing is a proven method of slowing the spread of disease in which people who were exposed are contacted and asked to take certain measures.
Currently, 15 of the 35 local health jurisdictions are sending cases to the state’s pool of contact tracers, according to a spokesperson with the state Department of Health.
“These requests vary widely, even day to day,” Teresa McCallion, communications consultant, wrote in an email.
The state’s contact tracing, however, has come under some scrutiny. The state’s goal is to reach 80 percent of contacts within two days of receiving a positive test in a case. The latest report of contact tracing metrics, which covers the first week of December, showed that only 24 percent of contacts were reached within that time frame.
It’s unclear how successful Island County’s contact tracing has been. The county’s website says those metrics will be provided in future reports.
At a meeting Tuesday, Commissioner Jill Johnson said she was frustrated that Public Health staff hadn’t provided her with information about the contact tracing program that she had asked for twice.
“And respectfully, that’s how we get here,” she said, referring to the staffing problems. “I’m waiting for the (COVID response) budget that we asked for in May. I’m waiting for the hires — we’re hearing that we’re hiring people that we asked for this summer.”
The county had four public health nurses and a supervisor earlier this year. Currently, there are 1.5 nurses on staff, according to Don Mason, the COVID response manager.
Mason told the commissioners Tuesday that the county had started advertising for additional positions due to “capacity needs” prior to the vacancies and received a robust pool of applicants. He said the county has more applicants than clinical positions available and replacements will be hired as soon as possible.
Mason said the team of one lead and eight on-call contact tracers are being trained on case investigation software, provided by the state, which will make the process more efficient. He said the program sends priority cases, like outbreaks at schools or nursing homes, to the county clinical staff for focused attention.
Having the software and contact tracers trained to do case investigations will lessen the workload for the public health nurses, who have been handling case investigations as well as their regular duties, according to several county officials.
A workforce estimator for contact tracing, a joint project of the National Association of County and City Health Officials and George Washington University, shows how many tracers each county should have based on cases and demographics.
As of Tuesday, it showed that Island County should have 47 contact tracers.
Jenna Dran, who was the third community and family health director this year, outlined a series of problems she sees in Public Health in a situation report and a letter of resignation this month.
“It is with grave concern for the community and particularly the COVID-response efforts that I share this news with you,” she wrote.
Dran wrote that there is a staffing shortage; a lack of relevant, clinical experience in leadership roles; inaccurate information being conveyed to commissioners and the state; a lack of training for new employees; and no organizational chart.
“As a result, many staff members have been over-worked since the onset of the pandemic,” she wrote. “They have not been offered needed supervisory support for much of the response and do not have clear direction on how to manage competing workloads.”
Both Island County Commissioner Janet St. Clair and commissioner-elect Melanie Bacon said in interviews that the unprecedented surge in cases was overwhelming for staff members.
Bacon, who is the current human resources director, said it’s not just a problem here. Public health nurses across the nation are dropping out.
“They are frustrated,” she said. “They feel that people aren’t listening to them.
“They feel like the agencies they work for aren’t listening.”
St. Clair said she has a great deal of gratitude for the nurses and for public health staff as a whole.
“I believe they are dedicated and hardworking folks who put their hearts and souls into their work,” she said.
St. Clair said she remains confident in the Public Health leadership and team, who have done great work despite great challenges.
Tuesday, Mason said the county is also working with the state to temporarily provide a health officer, who is a physician versed in public health tasked with assisting the board of health and public health staff.
Mason said the individual at the state is well known — often appears on TV — and works as a health officer for other counties as well.
Dr. Joel McCullough, Island County’s current health officer, outlined his concerns in a Dec. 13 email to Public Health Director Keith Higman. He noted “a pattern of inadequate communication with myself on key personnel and clinical issues.””
“Given the serious nature of the outlined problems above, I do not have confidence in Island County Public Health’s ability to navigate these challenging times,” he wrote.
“I believe it is in your best interest to find another health officer as soon as you are able to.”