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MANCHESTER, NH – Employees in the city’s Health Department usually go about their work without fanfare, out of the public’s view, but COVID-19 has put them on the front line in the battle to contain the deadly disease.
The health department, with a staff of 60 including 30 school nurses, is out straight.
“I am just very proud of how our team has stepped up to lead in this crisis,” said Phil Alexakos, public health administrator for the city’s health department.
He said he also couldn’t thank the school district enough “to allow their nurses to be flexible. They’re still seeing families and kids in the community but in a different way.”
School nurses are devising health plans for the more medically fragile kids in the school district and speaking with families on a daily basis, he said
Another group of nurses is working at the city’s Emergency Operations Center, located in the Manchester Fire Department’s downtown headquarters, answering COVID-19 questions and scheduling appointments for the city’s mobile testing operations. The number to call is 668-1547 between the hours of 9 a.m. and 3 p.m., seven days a week.
Additionally, staff is helping people coordinate those who are isolated or quarantined because of exposure.
“We’re working on getting food and medication to folks that have to stay home and don’t have any means of accessing essential materials,” said Alexakos. “Our nurses are working with our community partners to meet those needs.”
One of their most important jobs is contact tracing. Nurses record the individual’s symptoms and then try to track down every encounter an infectious person has made within the past two weeks.
Manchester, with 714 people testing positive for COVID-19 in the city as of Tuesday, accounts for about 24 percent of New Hampshire’s 3,160 cases.
The first step in the investigation is to talk with the individual, ask about their symptoms and who they have come into close contact with.
“That presents another group of people who must be quarantined,” Alexakos said. Those individuals must stay home for 14 days from their last exposure. They are called every day.
“So some of our school nurses, some of our infectious disease nurses are making those calls every day from 7 in the morning until 8 or 9 at night,” he said. On any given day, between 300 and 500 calls are made.
A week ago, the department was following 347 cases. Alexakos said each case, on average, would have two contacts resulting in 1,439 cases and 2,875 people being monitored.
The staff, he said, is being run ragged. He said the department has used volunteer medical reserve corps – some are retired, some repurposed and one furloughed. They are doing some work on the hotline. A handful of volunteers also came from the state’s list of medical volunteers.
The department repurposed its environmental health teams, those who do testing of mosquitoes, water testing and food inspections, to help with the COVID-19 testing.
He said in addition to his own department staff he also couldn’t thank the school district enough “to allow their nurses to be flexible. They’re still seeing families and kids in the community but in a different way.”
Contact tracers are part detective, part therapist and part social worker, Johns Hopkins epidemiologist Emily Gurley told the Washington Post. Gurley is the lead instructor of a six-hour course to teach Americans how to become a contact tracer.
The course is free and can be accessed here through Coursera.
The health department also is focusing on Manchester’s homeless. Since last summer, the department has worked to address the growing number of people experiencing homelessness. Early testing of the population has thus far found three people who were infected but no one they had been in contact with was diagnosed with the disease.
When the homeless shelter was filled to capacity this past winter, homeless camps sprung up along the Merrimack River, railroad tracks and other areas across the city.
Once a handful of shelter people became infected, many fled outdoors forming encampments under the Amoskeag Bridge and along railroad tracks.
Alexakos said guidance from the Centers for Disease Control say cities should not try to disperse the homeless but keep them in place to minimize transmission of the virus by stopping people from moving from one location to another.
Temporary fencing, portable toilets and hand-washing stations were provided by the state for two large encampments. The state also paid for Manchester police to patrol the areas around the clock. Food is delivered daily.
