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Home > Featured > Health District embarks on aggressive expansion plan

Health District embarks on aggressive expansion plan

By Sudhiti Naskar

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New staff, training and technology employed in the fight against COVID-19

The Washoe County Health District is quickly expanding to meet the unprecedented challenges posed by COVID-19 in and around the county.

District Health Officer Kevin Dick said during a phone interview with This Is Reno that “staffing was around 155 FTEs (Full Time Equivalent employees),” and “now around 100 are working in COVID-19 response, so we have doubled significantly.” 

By the end of September, the district will have four Disease Investigator Team Leads and 48 Disease Investigators.

All of the new staff are being trained and certified in cutting-edge knowledge about the pandemic. 

Volume and complexity of work

In the first week of March, the district had its phone numbers buzzing with calls from concerned citizens. 

On March 12, the district announced its COVID helpline (775-328-2427), which “started as one line and…morphed into a full-fledged call center in a matter of days, which was an extremely difficult task to pull off,” said an official statement by the district to This Is Reno. 

By mid-March, the call center was fielding thousands of calls per day–on March 17 taking 32,636 calls and logging 10,777.10 minutes, according to official data. 

The district in its original shape and form wasn’t ready for the labor intensity and technological infrastructure required to deal with the calls, contact tracing and disease investigation, said Dick.

Both disease investigation and contact tracing are people-centric jobs requiring advanced interpersonal skills, data management and monitoring. 

The Centers for Disease Control and Prevention (CDC) Emergency Operations Center (EOC) staff is hard at work keeping Americans safe 24/7. In response to the coronavirus disease 2019 (COVID-19) outbreak, the EOC has sent teams to help with clinical management, contact tracing, and communications.
Contact tracers at the CDC’s Emergency Operations Center. Image: CDC

According to the Centers for Disease Control and Prevention, disease or “case investigation is the identification and investigation of patients with confirmed and probable diagnoses of COVID-19.” 

Contact tracing is the process after case investigation. It works toward identifying, monitoring and supporting close contacts of an infected person who has a confirmed or probable case of COVID-19. People feel emotionally distressed when they come to know that they may have been in close contact with a COVID patient. Contact tracers support them in their efforts to cope. 

Training the expanding team

The Nevada Public Health Training Center at the University of Nevada, Reno, has been training personnel operating at the drive-thru testing site at the Livestock Events Center, said Dick. 

Also, they have been training the new district staff for “several months,” to certify them as contact tracers, said the center in an email to This Is Reno.

The Nevada Contact Tracing certification consists of three online contact tracing trainings developed by the Association for State and Territorial Health Officials Organization (ASTHO), Johns Hopkins University (in partnership with Coursera) and Washoe County Health District, the center said. 

The disease investigators are trained on the basics of the SARS-CoV-2 virus transmission, motivational interviewing techniques to conduct effective contact tracing and maintaining data confidentiality. 

Many of the disease investigators have also participated in a series of COVID-19 Webinars hosted by the Nevada Public Health Training Center to talk about special issues related to the disease, including mental health, dealing with grief and loss, and supporting African American, Latino, and Indigenous communities. 

Adding work space

Health District sign.
Image: Bob Conrad.

In addition to hiring and training more staff, the health district also had to find more square footage to not only provide workspace for the new employees, but also to provide it in a socially-distanced manner.

The expansion started in late March-early April as the district moved its staff around in different buildings within its premises to create safe and physically distant work environments.

According to Dick, the staff were moved from Building B to D on the east side of the county complex where the Truckee Meadows Fire Protection District had their offices. “They had moved off-site, and so we were able to use some of the space over there where we housed the call center,” said Dick. 

Through call drops, computer and logistics issues the district has taken steps to accomplish the ongoing expansion, he said.

Why so many contact tracers?

Early on in the pandemic, Nevada sought to get contact tracers on an unpaid, volunteer basis, but it soon changed tack. 

On June 3, state officials announced that Nevada would get an additional 600 contact tracers as Nevada kickstarted a $221 million plan to map the COVID spread. 

County manager Eric Brown explained why the district shifted from volunteer to paid contact tracers. 

“At that time, it wasn’t clear how long we [would] be needing the contact tracers,” he said. “I think it’s clear now that going forward, because there are going to be other pandemics, other illnesses like influenza that may cause us to do this.”

Washoe County Manager Eric Brown

The district is transitioning away from the temporary volunteer “in favor of more long-term employees.”

The district is also mindful of the resources it takes to train the staff. 

“It takes time to train people [between two to six months] and get them contacting people who have been infected,” Brown said. “You are asking them questions about who they made contact with, in some cases, these are sensitive information. I think we have learned over the last four to five months that we are really better off approaching this as part of our ongoing workforce.”

Technology, funding still unclear

According to Dick and an official statement from the health district, automation of contact tracing is underway to fast-track the process. The State of Nevada and the governor’s office have contracted with Deloitte to implement the Salesforce platform for the purpose. 

“It’s a statewide initiative that is mainly used in Clark County right now, but we were told soon the technology would be available to us here in Washoe County,” said the statement.

The said tech-solution might be a cell phone-based application, the likes of which are currently being used by England, Singapore, China, Iceland, South Korea, India and some states in the U.S. Countries have debated the controversial nature of such apps as they have the potential for active surveillance of citizens. 

Efforts to clarify with the state and health district as to how Salesforce works in the context of the pandemic, when it will be implemented in Washoe County and how it will help the taxpayers were fruitless.

Likewise, it is unclear how the health district’s expansion is being funded, how much money is being funneled into it and how it will impact the taxpayers. 

Both the district and state pointed to each other for answers and dodged the question of funding. This Is Reno will update this article when the information is available.

Getting a “faster time frame”

Aside from the lack of information on certain issues, it is clear that county officials are pooling resources to turn the corner in the fight against COVID. 

“We are currently working every day to provide that support to Washoe County, and we are operating our post and testing large numbers of people,” said Dick. 

“What we hope to do is get a faster timeframe for the follow-ups with that disease investigation, test results, to get the close contacts notified,” he added.  

Read more news about COVID-19 in Reno

UNR reports 135 COVID-19 cases

The University of Nevada, Reno on Sept. 4 reported its highest COVID-19 new case count yet: 24 students, faculty and staff.

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