COVID-19 brought public health workers from the shadows to the front lines. Now that the pandemic is starting to ease, some of them feel like they’ve been through hell and back.
“It’s almost like a PTSD (Post Traumatic Stress Disorder) we’re suffering from now,” said Christine Schuyler, public health director and commissioner of Social Services. “How do we go on? How do we go back to all the other work that we always felt was critically important but it’s gotten lost in these last few years.”
Those comments were made at the end of an hour-long conversation with this newspaper, Schuyler and six other public health employees. All shared their stories of what it was like caring for COVID patients, being required by the state to enforce public policies, and trying to protect themselves and their own families from this dreaded disease.
On March 11, 2020, the World Health Organization officially declared COVID-19 a worldwide pandemic. Five days later then-Gov. Andrew Cuomo ordered New York schools be shut down and the majority of businesses to either pause or have their employees work remotely.
At the time, no one really knew how long things would be on hold, including those in public health.
“I felt a lot of uncertainty. I never really thought, ‘When would it end?’ I was just getting through every single day,” said Janelle Hartloff, a registered nurse who has been with the county Public Health Department for 14 years. “There were so many changes. The guidance was ever-changing.”
Shelly Wells, also a nurse and public health planner with the county Health Department, agreed. “For me, you just lived in the moment. You didn’t really think about how long it was going to be.
You just made it through the day and then you started again the next day,” she said.
PROTECTING THE STAFF
Cathy Burgess, the director of community health nursing, said one of her main concerns had to do with the staff and keeping them healthy. “In the beginning I think my biggest worry was how were we going to handle this because we are a small department with nine public health nurses,” she said. “It’s just a small group of us but we were very lucky that we could reach out to other departments and people pitched in to do jobs that they’ve never done before.”
Breeanne Agett, an epidemiologist, had a baby in early 2020. When it came to concerns about contracting the virus, it was an issue for her. “I’m not necessarily high risk but my parents are aging and I was worried, not necessarily for myself getting sick, but sharing that with my parents who watch my children and putting them out and worrying about them,” she said.
Natalie Whiteman, the county’s emergency preparedness coordinator, could relate, as her mother who is in her 90s lives with her. “I was absolutely worried about bringing it home,” she said, referring to the virus.
In fact, Whiteman worked at every one of the testing spots and every one of the clinics. Thankfully, none of the staff got COVID-19 while working. “We were all concerned but we knew what we needed to do to protect each other,” she said.
One of the responsibilities the county’s Public Health Department had was to do contract tracing, something Emmy Desaulniers, a public health nurse, spent a lot of time doing. “In the beginning people were very receptive. Throughout, plenty of people were very grateful but I’d say by September of 2020 going through March of 2021 it was the peak of almost nobody talked to us. … As people got more fatigued by it and more disinformation was out there, they just got frustrated and took it out on the voice at the other end of the phone,” she said.
Whiteman helped out with contract tracing only once. “Four letter words were said and the person hung up on me,” she said.
Wells was in charge of posting on the county’s Facebook page. “At a certain time every day we posted a message for a very long time and you couldn’t help but read the responses and that’s when I think it was really hurtful. We were doing the absolute best we could and that people didn’t appreciate it and didn’t think that we were doing a good job,” she said.
The criticism wore on the department. “You wanted to have a camera in here and say what else could we do? Every single one of us was working every single second as hard as we can and you don’t see that,” Wells said. “We are people. We have families. We’ve basically given that up to help you as a community and you’re not receiving that.”
Schuyler took the criticism of her staff personally. “We sacrificed a lot over this pandemic personally, professionally,” she said. “Yes, we chose to do that, this is what we do. This is our job and we understand that. I think every single person in this department went above and beyond what anybody could reasonably expect from a human during that time. And then to have some of the backlash was just … you couldn’t help but take it personally when you give your heart and soul.”
The complaints continued at public meetings. “At one legislature meeting, someone said, ‘Throw them a pizza party.’ It’s all I could do to control myself. Nobody ever appreciates us. … And we never got that pizza party,” Schuyler said.
STATE VS. LOCAL CONTROL
A lot of the public criticism had to do with regulations, which were set by Cuomo. Right from the beginning that was something that Schuyler disagreed with. “As a local health official — I think all of us across the state felt the same way — we’ve all worked for years and years on public health emergency preparedness plans, specifically for pandemics,” she said. “We had our basic ideas and basics of what we were going to do, where we were going to do it, and how we were going to do it. The governor at the time chose not to follow any of those plans and decided there would be no local control in dealing with the pandemic, that everything should have to come from the state.”
Schuyler believes once the state made that decision to take control of all the regulations, it made things more difficult. “It really wore at the credibility of local health departments because I think for most of us who had been in public health, we’re kind of those nice health people that people turn to for help, they turn for guidance, they turn for advice on how to handle different things. People were turning to us and rightfully so. We should have been empowered and enabled to do what we needed to do at the time without being so constrained by the state and then not having the resources from anywhere to adequately test, and do what we needed to do,” she said.
And when the vaccine first became available, the state’s scrutiny continued. There were various age and employment requirements that had to be met in order to get the vaccine in the beginning. “The fines that we were threatened with if we did something wrong with the vaccine and the stress of that…,” Agett said.
Once the vaccine was readily available, many health officials thought this would mean the end of the pandemic. But that was not the case. “You think all we’ve got to do now is do what we do best — let’s get people vaccinated and then we’re going to get through this. And when I think there was just so much hesitancy, it was defeating,” Schuyler said.
Whiteman, who has worked for the county for more than 20 years, was surprised at the anger people had with the vaccine. “I never saw the scrutiny and the divisiveness that we’ve been seeing with whose going to get vaccinated and who’s not,” she said.
Wells said she understood some of the anxiety of the vaccine, because she felt it herself. “I would say I was hesitant (to get the vaccine) but then my public health understanding took over. … I listened to science,” she said.
Unfortunately, the availability of the vaccine didn’t stop the virus from spreading. The first spike hit in early January 2021. At that time, the vaccine had only been approved for a month and many of the cases that hit in January appeared to be the result of holiday gatherings from the past two months, before anyone was vaccinated. According to Agett, on Jan. 8, 2021, the county reported 265 new cases that day, which was a record at the time.
It was more than Schuyler thought they were prepared to handle. “I remember meeting with the doctors, the county executive, the sheriff, our team, and they asked, ‘What’s that number going to be when we need to get extra help, when we can’t do this ourselves anymore?’ and I’m thinking this was right before Thanksgiving 2020, and I think we all decided about 200 cases was going to be our cutoff,” she said.
But even with that surge, the county got through it.
Cases began to drop in the spring and summer of 2021. But then the Delta Variant hit. “We had expected a fall surge and we really thought that was going to be in the fall, but it was mid-August when they started to climb again,” said Agett.
She admitted it was discouraging. “Even though they (state Health Department) said a fall surge is coming, I didn’t believe it. I didn’t wanted to believe it,” Agett said, half laughing, half crying. “I was thinking we’re vaccinated, we’re going to get there, we’re going to be OK. And then it got worse and worse and worse.”
One week in December 2021, the county saw 16 deaths. That was hard.
Hartloff said as they made phone calls, it was apparent how much the Delta Variant was taking hold. “I think some of the scariest phone calls we made were how sick people really were. People said ‘I don’t want to go to the hospital, I’m not breathing very good, what can I do?’ Or calling a husband and finding out the wife had died. She had been hospitalized and she was dying but he couldn’t go because he was isolated. Just to hear what these families were going through with the hospitalizations and with the deaths, it was difficult, it was very sad,” she said.
Immediately following the Delta variant was the Omnicron variant. That variant saw the daily cases surge even higher. In January 2021, the daily high was 265 cases. But a year later, the daily high hit 352 cases on Jan. 18.
Hospitals were challenged as well. “One of the fallacies everybody thinks is our little county wasn’t very impacted; well as the person who was tracking hospitals during this, they were slammed,” Whiteman said. “ICUs were full, emergency departments were boarding patients because there was no room on the floor for them. It wasn’t any different here than it was for the big cities.”
‘PEOPLE WORKING TOGETHER’
Even though cases surged during the two recent variants, county staff and volunteers came together.
“A positive that came out of this effort is people working together, not just our department, but people in the community. One of the things we did is provide food for people in isolation and quarantine that didn’t have any other access to get it,” said Wells.
She worked with the Sheriff’s Department and groups in the community to make sure needs were met. “It’s all that working together not just amongst us but among people the community. We all worked together to get accomplished what we had to get done. I think that’s a positive,” said Wells.
Eventually, the positive cases slowly subsided, more people were vaccinated and testing became much easier. In fact, so many people are using at home test kits, the county health department stopped publishing the daily positive cases, because they know it’s not a complete picture.
Schuyler hopes the basic health principles learned during the pandemic continue. “I see that people are more cognizant of washing their hands, of staying home when they’re sick,” she said. “We’ve got companies, including county government, that need to look at policies that pay people and give a bonus if you don’t use any of your sick days. We need to encourage and continue to encourage people to do the disease prevention and mitigation efforts that are out there everywhere during a pandemic, but it works for everything. It works to keep your distance, to cover your cough, cover your sneeze and stay home when you’re sick. Keep your kids home when they’re sick. Those things do work. If we do all those things, hopefully we’ll see not just less COVID, but less influenza, less rhinovirus, less colds, and less normal virus in all that we see.”
Agett hopes the funding for public health stays in place. “We need support for public health,” she said. “Right now we have resources, we have funds to support people here and we have funds to work on projects but we need that to stay in place so the next time this happens we can come in prepared and not start all the way over.”
Desaulniers wants the public to know the nurses are there to help. “We’re not some great huge entity. We’re this group and we do care and we try to provide the best information we have in that moment,” she said.