Close your eyes and listen to the audio version.

I know you’re restless, and you’re not alone. A National Plan to Enable Comprehensive COVID-19 Case Finding and Contact Tracing in the US published this weekend and addressed the shortages that currently disadvantage the US.

Test, Trace, Treat

We need the three T’s: Test, Trace, and Treat

ONE

Volunteer for blood testing that aims to understand where the virus has already been. Testing is largely out of the average American’s hand, but if there are public calls, you can volunteer a blood sample. No, sadly, we are unlikely to find that the virus infected everyone in November and December, though I find that theory tempting, too.

“People interested in joining this study should contact clinicalstudiesunit@nih.gov. For more information on the COVID-19 Pandemic Serum Sampling Study Launch, see the Questions and Answers. For more information on this study, please visit ClinicalTrials.gov using identifier NCT04334954.”

With regular testing, like when people present at a hospital with symptoms of COVID-19, if that person tests positive, someone must retrace their steps to find who else may have caught the virus.

We lack enough people to do this. Korea, Singapore, and Taiwan have all had aggressive test and trace campaigns that have controlled their spread and whether it’s Ebola or COVID-19 contact tracing works.

TWO

Donate to the convalescent plasma collection if you have had and recovered from COVID-19. At this time, this is the most effective therapeutic option. It’s possible it could be used to protect high-risk individuals or healthcare workers. Find out more about the process and option here.

Although Chloroquine has received much attention, I have spoken with those involved in validating therapeutics for the US. Their impressions conveyed an underwhelming opinion though testing is happening now. I wish it was a breakthrough. We all do, but the evidence just isn’t there and harm can still happen. Just today, the negative effects on the heart led researchers to end a controlled study.

If providers prescribe it, they must NOT use azithromycin or fluoroquinolones with HCQ because of additive risk for QTc prolongation.

— JHMI Clinical Guidance for Available Pharmacologic Therapies for COVID-19

COVID-19 Convalescent Plasma Project

THREE

Organize a community group of people who will assist isolated and quarantined people so they don’t need to leave their homes. We cannot ask people to stay locked up if we won’t help them meet their basic needs. Don’t assume everyone has family or friends nearby.

Reduce trips by getting their groceries when you get yours. Combine tasks when possible. Call to notify you’ve dropped something off rather than handing it to them, which breaks the ideal distance.

Free, open-source, telemedicine software could assist, but other nonspecific technology like google hangout, a local Facebook page, or scheduling software often used by small groups like churches may serve well. Flyers at a hospital or in a local newspaper can all help you to reach the people you intend and maintain social distance while planning.

If resources allow, consider also offering this assistance to elderly persons in the community who are at an increased risk for serious outcomes with COVID-19.


FOUR

Mental health has taken a hit at the national and individual levels. Many are struggling. While professional services would be ideal, it’s possible that many may only need an active listener. Those needing more than listening can access services like BetterHelp.com, which offers some need-based financial aid for tele-counseling services.

Distribute a number where someone can be reached. Apps like SmartLine provide a number for $10/mo that allow someone to answer a different number on their phone for call or text. Any phone with the app can receive the calls, so calls to the SmartLine number ring on your regular phone.

This could rotate between volunteers. Anyone with the app can receive the calls. Do take care to distinguish chatting with someone and listening from professional help.

Whether you want to listen locally or offer to listen to people anywhere in the world, 7 Cups offers free training to become a “Listener.” The training could be used by local groups attempting to offer a similar resource.

FIVE

Designate a local public health/COVID-19 resource. Right now, people are struggling to know what to believe and trusted members of a community will have a much easier time communicating and answering questions. Reach out to your state public health department for guidance, or turn to any of the reliable resources found in major public health research institutions.

Have a local FB page or group. With risk communication — expressing information about a crisis situation using methods shown to be effective — incorporate these essentials.

Communicating about Coronavirus

SIX

Volunteer for contact tracing. Record numbers of people are unemployed, so this could help those struggling financially and help communities contain the spread.

City, state, or federal level incentives could generate people who can train and assist in this effort. Contact tracers need a high school diploma, a computer and internet access. They are an important part of controlling the spread. Maximize impact by equipping them with the basic information they may need or be asked of those they help.

The Johns Hopkins Center for Health Security called for a public health force of 100,000 people this past weekend. While the number sounds extreme, it comes out to just one person per 3,000. We can manage that. I know we can.

Teams should be managed by someone with public health experience.

“If we take the Massachusetts approach and apply it across the country, that will mean about 50,000 additional contact investigators are needed in the United States. However, it is likely that many more will be necessary, considering the large number of cases already in the United States, that COVID-19 has been circulating widely for many weeks, and that we still do not have sufficient levels of testing. Therefore, it would make sense to at least start by adding an extra 100,000 contact tracers across the United States.”

We need to add more people in multiple places. How can we do it? I don’t have the answers and hope you’ll contribute your ideas to the discussion.


Massachusetts has already begun with its 1000-person contact tracing force.

Maybe you’re a community organizer, whether community or state level, who can contact your public health departments and ask what can be done? Don’t be afraid to offer to lead. We need leaders, and we need people willing to help. No one knows your community like you do, so no one is better suited than community members to determine what you need.

Ideally, planning to maintain some contact tracers long term to support our depleted public health infrastructure would be possible, but don’t let that stop you because we need tracers now.

These people could become Community Healthcare Workers who fill the gaps between the home and the healthcare setting and have improved outcomes around the world.

Building A Community Health Worker Program

And who is going to pay for this? Does this lady think money grows on trees? I assure you, she is mostly sane. As luck would have it, a local community healthcare worker could save money and improve lives in the long term. If not now, in the future, communities should definitely consider it.

These can be peer lactation consultants, people who advocate for the elderly, who offer to listen — the possibilities for this layperson’s role are endless and every community defines them differently.

Building A Community Health Worker Program

I hope this helps you to think of the ways in which you could help your community and feel free to brainstorm, ask questions, or point out an issue with a suggestion listed.

The only way out of here is together, so let’s do this.



________________________
E. Rosalie | Graduate Student
Public Health Biology
Johns Hopkins Bloomberg School of Public Health
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Disclaimer: The views expressed in this article reflect only me and are not affiliated with nor approved by any other persons or institution.

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