Inside ‘incident command’: How county health workers are handling COVID-19 cases

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JASON HAWK
EDITOR

ELYRIA — The local “incident command center” for COVID-19 isn’t a bunker with armed guards.

Jason Hawk | Wellington Enterprise
Ali Corrigan, a member of Lorain County Public Health’s epidemiology team, fields calls from hospitals about coronavirus cases.

There’s no giant wall of computer read-outs, no flashing lights, no big red panic button in the center of the room.

At Lorain County Public Health on Murray Ridge Road, there are a lot of people fielding phone calls in hushed tones.

In a glass-walled office on the first floor, Ali Corrigan was on the phone last Wednesday as one member of a team that helps confirm coronavirus cases.

At that moment, there were 29 local residents known to have the virus. Within a few hours, the number had risen to 38. By Monday, the number had doubled again.

That day, Health Commissioner David Covell said there were about 100 other people under a 14-day quarantine because they’d had direct contact with those known to be infected.

An epidemiology team is assigned to trace back those secondary contacts — usually a spouse and kids who live with the patient.

Covell said sometimes the ring can include co-workers from offices with tight quarters, or folks who share a car.

In most cases, that’s where the concern ends. People who spent time with the secondary contacts don’t also have to be quarantined — unless they, too, start to show fever, cough and difficulty breathing.

TRACKING TRENDS

About five new cases were being discovered each day, though that has since increased.

A large portion of Lorain County’s cases have come from Avon Lake. Covell said that doesn’t mean the city is a “cluster” or any more dangerous than any other town — it just means that’s where a lot of tests have been done.

He has refused to pinpoint how many cases are in each city, saying Lorain County residents should assume they are everywhere.

Whether Gov. Mike DeWine’s stay-at-home order is the silver bullet that will keep cases from exploding is also impossible to tell, for now.

“We’ll know that in a few weeks, and even better in retrospect,” Covell said.

There are some good signs — the very first group of “cured” Lorain County residents left quarantine last Wednesday.

The same day, a team of nurses worked the phones, checking on others still under quarantine.

With help from school nurses, they also fielded questions from scared residents with “light” symptoms, helping determine who needed to visit a hospital and who should stay in bed.

Callers are worried, often stressed to the breaking point. Covell said his team is “really good about de-stressing situations.”

ENFORCEMENT

Another team is tasked with making sure Lorain County businesses comply with state orders to close.

As widespread business shutdowns went into effect last Tuesday by state order, LCPH received 171 calls, most from businesses posing compliance questions.

Covell said many were unsure whether they’re “essential” and allowed to keep operating under Ohio’s stay-at-home order.

The only one Covell’s crew had to buckle down on was an Avon massage parlor, he said.

Some others have been stretching logic to get around closing — “Landscapers are trying to argue cutting the grass is essential,” Covell said.

“Some of the businesses are just barely listed as essential,” he said. “Of course, you’d hope most would say, ‘We have enough stock in place’ and call it a day. But they’re worried. They’re going to lay off a lot of people who are going to go home and be out of work.”

LCPH fielded a slew of complaints last week about Green Circle Growers in Camden Township, which is remaining open. Covell said the greenhouse, one of the largest in North America, qualifies for an exemption under the state closure order because it’s an agricultural entity.

He said the company is operating responsibly, sending home many employees and keeping those who remained separated from each other.

A MARATHON

Covell said his staff felt the situation was under control but that could change at any moment.

He’s split his workforce, with workers going on and off duty each Tuesday to stay fresh for the “marathon.”

“What we’ve learned since 2001 is if you try to have everybody handling everything all at once, they’ll all be burned out pretty fast,” Covell said.

The operation on Murray Ridge Road has slowly ramped up over the past three months. At first, health officials were waiting to see whether COVID-19 is as deadly and contagious as early reports indicated.

It’s turned out to be as infectious as feared. “The good news is it’s not as deadly as SARS or MRSA,” Covell said. “The bad news is it’s more deadly than the flu.”

The challenge has been trying to communicate the danger to the public without causing a panic. Covell said some people still don’t understand the life-and-death stakes, while others have gone overboard, buying up toilet paper and wiping out grocery store shelves.

A 30-year veteran of the public health arena, Covell said he’s to people only acknowledging the threat of a disease when they need his office desperately.

STAYING SUPPLIED

Covell believes Ohio is in for at least five more weeks in the danger zone.

Dr. Amy Actor, director of the Ohio Department of Health, has said time and again she expects the disease to reach its peak between late April and mid-May.

To keep up with coronavirus cases, and keep hospital staff safe, Lorain County is getting some 3,000 N-95 respirator masks from the national emergency stockpile.

The stockpile last helped supply local health workers during the 2009 H1N1 pandemic — the swine flu scare — which was luckily contained before exploding the same way COVID-19 has.

Echoing DeWine’s words, Covell insisted that when the pandemic is over, America needs to make sure emergency protective gear is produced here.

A big part of the problem is that China makes most of our equipment. So when the outbreak started in Wuhan, China, it bottlenecked the supply at its source.