Underfunded, Overburdened, Health Departments See No End in Sight

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A lot of the work health departments perform happens behind the scenes and out of the public eye.  According to their directors, most of those public health employees have not had a break since this pandemic started.

"It seems like superhero hours, nights and weekends without breaks,” said Jennifer Muggeo, the deputy director for the Ledge Light Health District in New London.

"Crisis after crisis after crisis,” added Central Connecticut Health District Director, Charles Brown.

Employees have been tasked with inspecting every business that's reopened, responding to complaints, delivering PPE, helping schools reopen, and following up on cases of COVID-19, all while trying to keep up with ever-changing protocols during the pandemic. 

"Usually, when the guidance changes it doesn't change a little bit, it changes pretty drastically,” said Brown.

The pandemic has elevated the role of public health districts which were already responsible for responding to the opioid crisis, food-borne illnesses, and the flu.

“It’s been seven days a week, multiple multiple hours per day above and beyond what we normally work,” said Torrington Area Health District Director Robert Rubbo.

He said his district has 19 employees dedicated to the public health of 20 cities, towns, and boroughs.  He added that for the past 25 years his district, like many others, has been underfunded and understaffed.

"That has really played a role in the response because we need the capacity in order to respond from a personnel perspective,” he explained.  “We really needed that capacity built beforehand. We’re kind of trying to build the capacity in the middle of the response.”

Despite the pandemic, the state's $4.2 million budget for health districts has remained unchanged.  Instead, limited federal funds have been doled out to cover mounting overtime (most public health workers are hourly) and other COVID-related costs.

Ledge Light has already spent the extra $40,000 it received. Torrington's $60,000 is gone, too.

"As of last month we exhausted it,” said Rubbo.

That money was supposed to last until next March.  

Muggeo said the lack of financial resources has caused them to delay some programs, but they're still meeting all critical needs.

"To provide clear and consistent information and to some level of reassurance in these very very unpredictable and for some people very scary times.  I think we've fulfilled an important role,” she said.

Meanwhile, Brown said the Central Connecticut Health District in Rocky Hill is stretching its dollar by using volunteers for contact tracing.

Connecticut received upwards of $20 million from the feds in a second round of public health funding.  That money, which has yet to be distributed, will be used for testing, contact tracing, and disbursing the coronavirus vaccine once it's available. 

School Reopening Adds Additional Strain on Districts

From the flu to food-borne illnesses, and even the opioid crisis, local health districts have always played a major part in keeping us safe.

“The one positive that has come out of all this is public health was always on the backburner, nobody really knew what public health was, and more people know what public health is and what public health does,” said Rubbo.

The reopening of schools and additional contact tracing it has required has stretched departments even further.

Students just headed back to class and already 20 school districts and counting have reported at least one case of COVID-19. 

Half a dozen have been forced to close while the rest have directed individual students or certain classrooms of kids to self-quarantine.

“In the hybrid model being able to cohort effectively really allows us to do less than that.  It gives us options,” Brown explained.

The Central Connecticut Health District has been working closely with Newington schools, which decided not to close the high school despite a case of COVID-19 among either a student or staff member.

“The individual had not had significant contact with really anyone in the school setting because they had kept a six-foot distance, they were wearing a mask, and they were following all of our protocols appropriately,” he said.

However, if it is unclear how many people the person comes into contact with, Brown said a district may have to close at least for a few days, to allow for proper contact tracing. 

The school district will focus on the people the patient had contact with at school while the health department focuses on everyone else.

“If they go to an afterschool program, they have friends and family that they visit with in the evenings and afternoons, siblings,” said Brown.

He said the biggest challenge continues to be the lag time on test results, with it sometimes taking up to a week to be notified of a positive case.

“If we get that result very late in the game, contact tracing doesn’t do a very good job because people have been out there that have been potentially affected going about their daily lives,” he explained.

Brown said some cases have even come in as the person in question is ending their isolation period. 

Still, contact tracing remains one of the state’s most important methods of containing the virus’s spread.

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