On a daily basis, staff at Ft. Wainwright Public Health perform a variety of jobs to support the overall health of the Ft. Wainwright community. Monitoring drinking water, hearing protection and tracking communicable diseases to determine the health of the force are just some of the services they provide every day.
In times of widespread disease such as COVID-19, Ft. Wainwright Public Health comes to the forefront of installation preparation and planning.
“Our department is the driving force behind preparing for a pandemic, or any other community hazard,” said Lt. Col. Kyndra Jackson, Ft. Wainwright Public Health chief.
While the public health team is always in a planning and preparedness posture for an emergency response, deliberate and focused planning for a COVID-19 response started back in late December 2019.
“We began paying attention to COVID-19 surveillance, Centers for Disease and Prevention guidance being put out,” said Jackson. “We pulled out department and installation plans, validated our role in supporting the installation and our capabilities to make sure we had the needed personnel and resources to respond.”
Collaboration with civilian and other military agencies has been an important piece of a public health response to COVID-19. Regular contact with Fairbanks Public Health provides the opportunity to talk about joint resourcing, info sharing and response. Constant awareness of federal, state and local medical capabilities, staffing, open hospital beds, ventilators available and testing number are necessary to ensure a coordinated response.
According to Jackson, the collaborations is invaluable, but it can also be a challenge. Being a federal agency and working with civilian agencies for a synchronized COVID-19 response requires taking into consideration rules, regulations for both the military and civilian organization.
“As part of the community we have a responsibility to make sure we are able to support and assist each other within these boundaries,” said Jackson. We are truly all in this together and we cannot accomplish this mission in our own silos.”
Within Ft. Wainwright Public Health, three sections took on the majority of the COVID-19 workload based on their expertise: public health nursing, industrial hygiene and environmental health.
Public Health Nursing
With a team of three nurses, public health nursing is responsible for the tracking and monitoring of all communicable diseases, carrying a large part of the COVID-19 response.
The first few weeks of the response were challenging due to the fluid nature of the situation and the large amount of information coming from many different sources.
“The team was working to put out the most accurate information in a timely manner,” said Jackson. “Many times, though, within an hour the information was outdated. It was frustrating for us and for the community to try and keep up with all the changes”
One of the first needs to be recognized was that of a call center to help direct beneficiaries, as well as DoD civilians and contractors, to the right plan of care. 24 hours after recognizing the need, the team developed the process and took their first calls March 17. According to Jackson, the majority of calls were to report recent travel, discussing symptoms or look for guidance. In the past six weeks the call center, which operates 24 hours a day, has taken just under 875 calls.
With travel restrictions put in place, the public health nursing team began overseeing those placed in quarantine. As of April 27, that number totaled 964 people. Upon entering quarantine, each person received education to help them reduce the risk of exposing family in the home. For the duration of each person’s 14-day quarantine, the team daily to discuss and record their symptoms.
Some patients were thankful for the calls while others felt they were an inconvenience, said Jackson.
“It was a mixed bag of reactions to the calls,” said Jackson. “Some hung up on us, others never answered, but others looked forward to the calls and were chatty.”
While Ft. Wainwright has had no confirmed cases of COVID-19 as of April 30, Ft. Greely reported one positive case. This set into action yet another responsibility for the team; contact tracing. Through telephone interviews, the patient who tested positive was asked to report their movemnts from two days before they noticed symptoms to the day they went into quarantine.
“It is an extremely hard, time-intensive process for the individual to recall where they were, who they were with and for how long,” said Jackson. “We do the best we can with the information provided and then we begin the notification process for anyone they had close contact with.”
Responsible for identifying potential mechanical hazards in facilities throughout Ft. Wainwright, industrial hygiene provided expertise for the potential expansion in the event additional space is needed to care for COVID-19 patients.
As the Bassett ACH facilities team prepared to set up a COVID-19 screening tent and an expansion of rooms to the multi-service unit to take care of positive COVID-19 patients, industrial hygiene provided guidance. They ensured the plans included proper ventilation to convert some rooms to negative pressure and confirmed the construction of temporary walls did not cause a detriment to other areas in terms of ventilation.
On a more individual level, industrial hygiene works to protect healthcare workers and Soldiers by performing fit testing for Personal protective equipment. The process starts with a medical evaluation from occupational health to ensure the individual is healthy enough to wear a respirator. Industrial hygiene then meets with each person individually to ensure the PPE fits correctly. Because PPE only works properly if it fits the person wearing it, industrial hygiene meets with each person individually to find the right respirator.
“Each fitting takes between 10 to 15 minutes,” said Jackson. “There are several different types of respirators and the team makes sure they are wearing the right one to provide a seal for maximum protection.”
Throughout the year, the environmental health team works to help provide a safe environment where people work, live and plan on Ft. Wainwright. While the task has not changed for the COVID-19 response, the purpose and recommendations to protect essential personnel while working have.
The team provides weekly courtesy inspections at Ft. Wainwright dining facilities and Family, Morale, Welfare and Recreation facilities such as the Child Development Center, The Zone and the physical fitness center. The environmental health team provides staff training on how to implement and enforce social distancing, proper cleaning procedures and putting mitigation strategies into place so patrons can still use facilities with the least amount of risk to themselves and the staff.
As Ft. Wainwright begins reopening services, environmental health inspections provide guidance to managers and staff in order to open for patrons in a safe manner by operating in a social distancing environment.
The team looks at the space in each facility, and based on that space, determines what looks right.
“How to place chairs, organize waiting lines and the frequency of cleaning equipment and supplies are all looked at,” says Jackson. Additionally the space may not be conducive to waiting lines, so the team helps determine a way forward, such as requiring appointments to eliminate walk-ins and control the number of people in the space.
Ultimately, the team is helping to put mitigation strategies into place so patrons can use facilities with the least amount of risk to themselves and the staff providing services.
These three sections within Ft. Wainwright Public Health may be on the forefront of the COVID-19 response, but Jackson is quick to recognize they did not operate alone.
“The flexibility of our entire staff at public health and across MEDDAC-AK has been essential to our success,” said Jackson. “We may be small, but we are a mighty team and we understand the importance of working together to support our mission."