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Small City, Big Steps

Posted on Tuesday, Mar 31, 2020


By Michelle Jones, MPH, Epidemiogist for Public Health Department of the City of Brownsville 

It was mid-January that our small urban health department, located in Brownsville, Texas, took notice of the danger COVID-19 threatened to launch upon us all.  Prior to this, members of our team spoke about the devastation China was experiencing, acting as simple observers of a destruction which we prayed would not visit us.  Then the virus left China and landed in South Korea. The tone with which our Director, Assistant Director, Epidemiologist, and Emerging Threats Consultant began to discuss the Coronavirus (COVID-19) implications intensified. These same individuals would become our Coronavirus team. As each new country reported their first infection, the realization of a pandemic circumventing the world and reaching the tip of Texas began to take root.

On January 27th, our team sat down for our first CDC conference call titled CDC Telebriefing: Update on 2019 Novel Coronavirus (2019-nCoV).  This call compelled our Public Health leadership to move from observation to active engagement in situational awareness and begin the process of gathering any and all information on COVID-19.  The following day our designated Coronavirus team sat down to our first, of what would become daily, Texas Department of State Health Services (DSHS) situation briefings. Armed with what limited information was coming out of China, the World Health Organization (WHO), and news stories, we sat in silent contemplation while David Gruber, Dr. John Hellerstedt, and Dr. Jennifer Shuford reported on the latest authoritative information available at the time.  This call would be our daily contact with the Texas Department of State Health Services.

The following 3 weeks were mostly routine.  We conducted our essential functions with the alteration of a small portion dedicated to monitoring the cases in the United States for community spread and researching articles coming out of China, World Health Organization, various journals, and news sources.   The goal was to decipher what were legitimate sources of information, what could be disregarded, and what was plausible but not stringent enough to change our position on the virus. Research and information was being released at speeds and quantities that made deciphering the good from the bad difficult.   It was with this flood of information and need for action that the department made the move to begin a public health outreach campaign with information on preventing influenza. Texas was experiencing an influenza outbreak and the move to push influenza prevention steps would allow the department to begin preventative measures for COVID-19 and avoid any unnecessary fear or panic among our community.  The department has one community health worker, and she was given handouts on personal hygiene and proper hand washing techniques, in English and Spanish, to distribute at all public health events and to her participants of the Tu Salud Sí Cuenta project. The public health outreach campaign to prevent the spread of COVID-19 had begun in the form of Influenza prevention strategies and evolved into COVID-19 outreach as information and resources became available.

On the 3rd of March, the Public Health Department held its first All Hazards Preparedness Workgroup meeting. The Fire Department, Police Department, Office of Emergency Management, and Communications were briefed on the situation we had been monitoring.  The Public Health Department discussed situational awareness of the nation and of Texas. At this moment Texas had not experienced any community spread. These meetings were intended to be informative and an arena to discuss strategy. In subsequent meetings, the city’s call center was brought in and a script was developed for concerned citizens.  A Coronavirus webpage was established the same week, with print and educational materials and resources. On March 6th, a meeting was held with our metro station to discuss disinfection of busses and terminals. In addition, information was provided to our airport on hand hygiene and mitigation strategies.

The week of March 9th, the department was engaged in the White House Briefing call, continued the daily All Hazards Preparedness Workgroup calls, and an informational meeting was held by Cameron County.  Friday an emergency meeting was called with our Communications, Enterprise Applications, Business Analysis, and Health Department to discuss the enhancement of our message and develop a telework time frame.

The Emergency Operations Center was activated and the Office of Emergency Management took over the Coronavirus response the following week on the 18th. The mayor read in a declaration of local disaster, Continuity of Operations were completed for all departments within the city, and daily conference calls were established beyond those previously established

The week of March 22nd, the city began discussions with Valley Medical Urgent Care and became the first city in the Rio Grande Valley to establish a drive thru testing site that same week.  The health department went on to submit a resolution to the city to expand the department to include surveillance and monitoring of COVID-19. This resolution passed with unanimous support from our commissioners and mayor. 

 

References

  1. CDC Telebriefing: Update on 2019 Novel Coronavirus (2019-nCoV) https://www.cdc.gov/media/releases/2020/a0127-coronavirus-update.html

  2. Nicolaides, C., Avraam, D., Cueto-Felgueroso, L., Gonzalez, M.C., & Juanes, R. (2019, December 23). Hand-Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network. Retrieved from https://onlinelibrary.wiley.com/loi/full/10.1111/risa.13438 
     


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