Created during pandemic, Public Health Department planning for life after COVID |

Created during pandemic, Public Health Department planning for life after COVID

Roberta Smith, Routt County Public Health director, gives the COVID-19 vaccine to Steamboat Springs Fire Rescue Cheif Chuck Cerasoli in December 2020. Coming out of the pandemic, Smith is figuring out where the department best fits into local initiatives like childhood vaccination efforts among other things. (UCHealth Yampa Valley Medical Center/courtesy)

For the past 15 months, most Routt County Board of Public Health meetings have started the same way.

Public Health Director Roberta Smith would give a short introduction about how the past week was COVID-19-wise, and then epidemiologist Nicole Harty would walk through the data. For most of the pandemic, this happened weekly, and occasionally, even more frequently.

But the meetings have since been scaled back and now will occur quarterly, meaning just four times a year. While they may not be scrambling to contact trace hundreds of cases of COVID anymore, Smith said that doesn’t mean her team members have a lot of time on their hands.

“Absolutely not,” Smith said, putting a slight dramatic pause after the first word. “We are at a point now with COVID where … we can really start thinking about some of our strategic planning within the department.”

At the most recent meeting last month, it took about 40 minutes before the pandemic was discussed. Created during the pandemic, the department is now moving out of crisis mode and settling into the role public health departments are meant to fill.

The Public Health Act of 2008 restructured how local public health is done in Colorado by creating a set of core public health services and standards that must be met. It also requires local health agencies to create community health assessments and improvement plans that need to be updated every five years.

The department now has five full-time staff members with the recent addition of new public health nurse educator Jesse Herrgott. Smith said this is a little on the smaller size compared to departments across the state, but she expects it to grow as the county does.

While still focusing on COVID-19, which has seen an uptick in Routt County in the last week, Smith said they are turning to other community health issues.

Smith said public health had several calls this summer about encounters with bats, which can be a source of rabies. Smith said they have been coordinating with providers to see how best the department can provide rabies vaccinations and prophylaxis.

This included a session with local providers, law enforcement and animal control to improve the workflow to speed up treatment when someone is potentially exposed to rabies, Harty said.

Having to treat someone for rabies isn’t common, but public health gets many calls from people who encountered a particular animal and are worried the animal may have exposed them to rabies. For example, someone called after being bitten by a marmot, but Harty informed them marmots do not carry rabies.

“But the public doesn’t necessarily know that, so they’ll call and try to learn what they need to do,” Harty said. “It is very prevention oriented, which is what public health is all about.”

Smith, Herrgott and public health nurse Brooke Maxwell, all registered nurses, are going through tuberculosis training with the Colorado Department of Public Health and Environment to learn the latest on how they can address both active and latent cases in the county.

Vaccinations are also a big part of the department’s role, and Smith said they are beginning to plan how to roll out flu vaccinations this fall, which some experts say could be much more severe than the almost nonexistent flu season last year.

Right now public health only refers people for vaccinations, but Smith said they are working to set up their Vaccines For Children program through the state. There are still a few boxes they need to check before they can offer vaccinations, but Smith said she wants to figure out how they fit into what options there already are for vaccination locally.

“We’re in those stages of assessing how we fit into the context of that. Do we need to offer a full range of childhood immunizations? Do we need to just focus on adolescent vaccinations?” Smith said. “That’s part of our strategic planning that we’re looking at in terms of service delivery.”

Another limiting factor on services right now is space. Because the department was created during the pandemic, they don’t have a robust space intended for public health. That will change when the county’s new Health and Human Services building is finished next year.

“Once we are in a true clinical space, that will make things a little bit easier for us and a little bit more comfortable for people to come here for some of those direct services,” Smith said.

Routt County’s Community Health Improvement Plan also needs to be updated. It isn’t that old, but a lot has changed since it was approved by the state in 2019. It is actually a joint plan with Moffat County, as the two shared a public health department until the middle of last year.

Harty said she is excited about pulling together data that is already available from the state, local providers and nonprofits into a database the county can use to analyze the health of the community to better craft these plans. Harty said she prefers this work to tracking COVID-19 cases around the clock.

“It’s refreshing to have some of my projects currently be more of that slower, deliberate, absorbing the information and thinking about it really critically,” Harty said. “And talking with lots of different individuals who have insights along the way to try and come up with the truly best way to do it, which isn’t always possible in more emergent situations.”

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