The Branch Hillsdale St. Joseph Community Health Agency (BHSJCHA) released a report on July 2 providing detailed statistical pandemic information for St. Joseph County, available in a document on its webpage. Watershed Voice looked into the staffing changes, capacity issues, and public pressure that served as a backdrop for the information’s release.
Early in the pandemic, BHSJCHA’s hours expanded to seven days a week, and its personnel were reassigned from everyday tasks to focus on the pandemic. The agency set to work on a variety of duties including testing, monitoring cases, sharing advice on reducing the risk of spreading the disease, and issuing press releases about specific, concentrated outbreaks around the county.
Prior to the pandemic, the agency had sufficient staff to do most of its daily work. “I would say that we were doing okay,” Health Officer Rebecca Burns said. “We’ve been able to adequately respond to what we needed to respond to. Any time there was an outbreak of whatever nature, whatever it might be, it’s always challenging here. People never sit around with nothing to do. I guess there is probably no workforce where everybody sits around with nothing to do, and we wouldn’t want it that way either, but this response to COVID has caused us to stretch more than we are able to do.”
The pandemic response has stretched both the agency’s funds and its personnel, Burns said. “We were granted additional funds to respond to COVID-19, and those funds are getting eaten up by our seven-day workweek that we’re having to do to keep up. Some of the community testing events we’ve done have certainly eaten some of those dollars up as well. There just isn’t enough funding for us to be able to add enough staff to completely feel like we have enough capacity.”
Burns said BHSJCHA depends on the State of Michigan for capacity and logistical support.
“Currently, with the increase in cases that we’re seeing, we have had to reach out to the state and ask them to do some of our case investigation. We have also offloaded our contact tracing to the state. That is something that we were doing in-house and felt very strongly that we needed to be doing that here, because it does help to inform us about what’s going on better, (but) we finally had to ask the state to step in and take over our contact tracing. There is still a little bit of contact tracing that we will do if there’s a high-risk facility that’s involved or something like that.”
Matthew Mosher, who is running for the First District seat on the St. Joseph County Board of Commissioners in November, began questioning whether BHSJCHA was sharing enough information several weeks ago on the agency’s Facebook page. Mosher called for a specific type of data, called potential exposure location data.
“It’s a mitigation technique to let the public know when and where, including a specific date and time frame and location that people have visited public places where they have determined through contact tracing that someone was positive there,” Mosher said.
“Usually the health department would do a press release, and the local newspapers would set up, they would do a press release on their own website or whatever avenue they have to disseminate information, such as their Facebook page, and let the public know ‘someone has been at (a particular location) on (a particular date) from five o’clock to seven o’clock, and if you’ve been there at that date and time, that you would either want to get tested or quarantine yourself and watch for symptoms for 14 days,’ so it’s a public health and safety measure.”
In regard to potential exposure location data, Burns said, “Quite frankly, if we had to produce a list of places where every positive person has been during the time frame (in which) they were symptomatic, I can’t imagine how any health department would be able to monitor that and keep it up to date. It would be voluminous.”
Watershed Voice looked into how health departments around Michigan are providing information and learned the results are mixed. Some do provide the kind of information that Mosher calls for. Alpena County’s District Health Department #4 provides a dashboard on its website with statistical information about the disease’s spread, as well as a running list of press releases with details about specific exposure locations. The Charlevoix-based Health Department of Northwest Michigan provides similar information.
Allegan County maintains a list of PDF-format updates similar to what BHSJCHA released on July 2, and Watershed Voice found many other, similar examples that maintain general statistics, but either do not maintain a running list of exposure location data at all or only issue periodic press releases about specific sites.
Outside of Michigan, results are equally mixed. Anchorage, Alaska has a running list of exposure sites on its website, showing three locations so far since June 27. Rolla, Missouri has provided information through press releases. Watershed Voice’s cursory internet research suggests there may be a correlation between a health department’s available property tax base and its capacity to provide detailed, location-specific pandemic information while also testing for, and treating, COVID-19 cases.
Burns said the information it provides on specific sites is consistent with how many other health departments are responding. “I reached out to my colleagues early on when this individual started making these demands. I reached out to my colleagues, and said, hey, you know, it’s being pointed out to me that this is being done. And I heard from my colleagues no, that’s not being done. And just to make sure I wasn’t missing something, I reached out to them.
“All health departments are doing this the same way. If we have a location where we really feel that there was transmission, a real risk for individuals, and we don’t know how to get a hold of those people, then we’re going to send something out. We did that for the two medical practices over in Sturgis, partly because we wanted to be abundantly cautious.”
Burns said BHSJCHA’s preferred first course of action is direct communication with traced contacts. “In situations where there was, like (at) Harper’s Bar in (East) Lansing or our two medical practices here, other things like that where, if there’s some type of an exposure that occurred where if you were at this place, you need to probably be tested, that’s the only time we’re doing those types of outreach,” she said. “At other events that occur, in general, we’re able to find out who was there and reach people.”
Burns explained BHSJCHA’s strategy also has to do with messaging. “This is a community-acquired virus. If I tell you that you need to watch out or be concerned if you were at (a particular store) from noon to one on Tuesday, you need to be concerned, but I only know about that one particular individual that was at (that store) from noon to one,” which leaves out potentially asymptomatic carriers.
In that case, Burns said, “I’m not telling you about the other 30 people that were there for the rest of the day and who were potentially respiring virus. So, from our perspective, to put out that list is misinformation to the public. It gives everybody this false sense of security that, you know, ‘Oh well, I’m OK because I was at (that store) from eight to nine.’ Well, no, you’re not OK if you were (there) from eight to nine. We don’t know that. It’s in the community, and everyone has to consider it community spread at this point.”
BHSJCHA has added an information officer since the pandemic began. Pressure from people like Mosher helped get the information out when it happened, but Burns said, “we’ve been working all along to try and figure out how to put together information for folks, so I wouldn’t say it was completely in response to that. We certainly have had more calls for it lately, but we’ve been trying to figure out how to get that done.
“We’re a very small health department with very few people, and we don’t have folks that are sitting around with nothing to do. This was a huge list for us. To put that together took taking somebody else off of work that needed to be done and having them dedicate a couple of days to putting this together. We’re glad that we are able to provide this information to folks, but we are going to only be able to update it weekly because we just don’t have the staff to be able to do it more often than that.”
Burns emphasized that cautionary measures should not be restricted to sites that people think might be high-risk. “The message we’ve been trying to spread to folks is that this is in the community. Every time people go out into the community, they’re putting themselves at risk. I mean, even going to the grocery store is risky. You need to wear a mask to protect others, and you need to limit your exposure at public locations as much as you can.”
The July 2 document is linked from a dashboard on the BHSJCHA website, where Burns said the agency will provide continued, weekly updates.
Dave Vago is a staff writer and columnist for Watershed Voice. A Philadelphia native with roots in Three Rivers, Vago is a planning consultant to history and community development organizations and is the former Executive Director of the Three Rivers DDA/Main Street program.
