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Garfield County public health workers manage pandemic's extra challenge

Enid News & Eagle - 3/21/2021

Mar. 21—Once she'd draw each dose from a vial of the Pfizer vaccine, a "tap-tap-tap-tap-tap" would then ring out as Cheryl Peters flicked her middle finger against the glass syringe.

It's not just a thing people do in movies, the advanced practice registered nurse explained — the taps push tiny air bubbles back into the vial to prevent discomfort or air embolisms upon injection.

Peters then put the filled syringe onto the small silver tray at the edge of the table for volunteers to administer to patients at Garfield County Health Department's daily clinic on Friday — the first day the vaccine clinic had been open all day since it started at Oakwood Mall in January.

Peters had already placed the vial's red cap into a tiny wicker basket on the Pfizer-focused table next to where she stood drawing doses.

She and another volunteer joked that the caps were for arts and crafts projects like necklaces or brooches.

"That's for our own personal fun, I guess," she laughed, loosening up at the end of her work day.

By closing time at 7:30, over 850 people had been vaccinated, using up all of the day's allocated doses. Each vial of the Pfizer coronavirus vaccine can be drawn into six syringes, Peters said. Moderna, the other vaccine at the clinic, can be drawn into 10.

Leadership from Tyson Foods'Enid complex had coordinated a vaccination hub for its employees. The Health Department then decided to keep the clinic open for all appointments so to accommodate people possibly getting off work.

Clinic coordinator Blanca Solis said the morning shift saw a massive crowd of around 500 appointments. But after a half-hourlong wave of Tyson employees at 1 p.m., fewer and fewer folks continued to wander through the fluorescent-lit maze of yellow caution tape and white linoleum flooring.

"We'd rather be rocking and rolling," Solis said standing near the vaccine refrigerator by 6:30.

Repeating patternsEven before the city of Enid effectively closed its doors a year ago Sunday because of the spreading pandemic, the staff at the county Health Department had been on a constant rock and roll.

"We haven't really stopped much since it started," Solis said of the pandemic. "We haven't really slowed down."

Maggie Jackson, who oversees community engagement and planning at the Health Department, said the addition of the virus to the staff's regular workload was an extra challenge.

"That's the word of the year," she said, "just wave and wave and wave, for the health community ... of new challenges."

All through winter, the Health Department's so-called "strike team" staff first ramped up testing at nursing homes and long-term care facilities.

Team members worked in all weather conditions and in freezing cold temperatures to test around 300 to 400 people at highest health risk from the coronavirus, Solis said.

As Jackson and other department staff worried about where to get personal protective equipment such as masks, gloves and goggles, others suddenly had to figure out how to investigate tracing back possible exposures from positive cases, once the county's first positive tests were reported by the end of March.

Jackson said this task fell to department RN Vickie Bright, who normally handles tracing communicable disease cases such as norovirus or syphilis.

Because coronavirus was novel, Jackson said health professionals at first didn't understand how it was transmitted — primarily through respiratory droplets via close contact in the air, as well as longer-term airborne transmission, according to the CDC. Surface contact through "fomites" is still a possible, though far less common, transmission source.

That contact tracing process has been extended through nurses in the Enid area public school systems, where even by August, health officials didn't know as much on the risk or transmission levels for children, so Jackson said "so many hard decisions were being made."

By spring 2020, the department had also moved to doing larger testing events for the entire public. Jackson said the first drive-through event on April 3 at the Chisholm Trail Expo Center was "daunting to plan."

Over the summer, the process of swabbing people's noses for either the PCR or rapid COVID test became routine, Jackson said, as Health Department staff and other providers such as urgent care clinics and pharmacies made appointments more readily available.

With vaccination distribution, she said staff have been experiencing the same phases of overwhelming demand, then a plateau.

Once the state opened up doses to those besides medical workers and staff, demand for the vaccine was "really high," she said. For the first three months, regular testing slowed down at the Health Department as staff focused on vaccinations.

"Every single phone line was off the hook" starting in December, Jackson said. "We've all had to deal with that challenge, not just me."

She said the influx of daily vaccinations started declining a couple weeks ago — both as the state's vaccination rollout moved to a larger phase 3 population and as more access points to the vaccine such as pharmacies or providers became more available.

Solis, who organizes volunteers through the Medical Reserve Corps., said since January, she's reduced the number of volunteers from around 15 support staff and 10 medical to eight support staff and six medical.

'Wearing a lot of hats'Solis, a patient care assistant at the HD, said she now has half the time to do her job seeing around 30 patients for direct observational therapy.

At 6:30 a.m., she'll go see patients, then come to the clinic, which runs until noon, and then return to the department in the afternoon.

"I'm wearing a lot of hats right now ... so I don't have a lot of time to do my regular duties that I'm assigned to," she said. "I'm working a lot of extra hours, but I'm OK with it. I'm a very high-strung personality, so this is right up my alley."

Jackson said a lot of the department's regular services have moved to the tele-health model, including the Sooner Start childhood program and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).

She said health educator Rae Johnson was trying to coordinate physical education and nutrition programs last summer that "dropped to the bottom of the list" in the wake of COVID — turnout was low, or staff realized group activities weren't wise during a pandemic.

"So much was unknown in the beginning," said Jackson, who began her current job under OSDH's regional administrative director, Jan Fox, shortly before the pandemic hit Oklahoma. "It caught everybody by surprise by how it grew in our country and our state.

"I definitely was not expecting a year like this."

After having effectively become the face of public health in the Enid area community during 2020, Jackson said the last year was one of growing and learning, "a lot about myself."

"... I think just how I want to carry myself in the community. I can't really control how people respond to the political environment or to the policy recommendations. I think I can say that publicly," she said. "We've lost lives, we've had lots of hardships, but I think as a person, I've learned a lot. I'm trying not to be too Pollyanna, but that's where I'm at right now."

Solis said the current mall clinic will be open all day again next weekend, from 8 a.m. to 4 p.m. both Saturday and Sunday.

Saturday's is the second hub planned for county pre-K-12 school staff who received their first COVID vaccine dose a month ago. Jackson said sign-up appointments outside the pod will also be available.

A team from OSDH has also begun mobile vaccinations with the newly available, single-dose Johnson & Johnson vaccine. These teams will focus on vaccinating on-site at eligible congregate locations and other large businesses in the Enid area like Tyson, Jackson said.

Solis quote

Next week, the team will visit the Hanor Family company headquarters and the Koch Fertilizer nitrogen production facility to vaccinate any willing and able employees. The team also will provide vaccinations to clients coming to the Enid soup kitchen Our Daily Bread.

Outreaches are also scheduled in eight other counties for anyone who can't get to a clinic or vaccine event or would prefer access in a place they're comfortable or with people they can trust, Jackson said.

Since Solis started working at the Health Department over 23 years ago, Garfield County had been holding practice vaccination clinics with care facility resident volunteers annually at the Expo Center.

"So when this came up, it's like, 'Oh, this is why we practice. This is why we do this.' So it's been really neat, it's been pretty cool," she said before correcting herself. "Well I don't know about 'cool' and 'neat.' But to just see how many people go ... we're making history with the vaccine."

Solis then realized Friday evening that around 2004, the Health Department had operated a flu shot clinic that'd also been at the mall.

"It's like we're back to where we were before," she said.

Later editions of the News & Eagle will continue looking at a full year of the COVID-19 pandemic in the Enid area.

Ewald is copy editor and city/education reporter for the Enid News & Eagle.

Have a question about this story? Do you see something we missed? Send an email to aewald@enidnews.com.

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