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County Scales Up Public Health Workforce

(Updated at 11:15 a.m.) Arlington County has grown its public health workforce more than 10x since January amid the coronavirus pandemic.

“At the start of this emergency in January, we had approximately 15 members in Public Health leading response efforts,” Arlington Public Health Director Dr. Reuben Varghese tells ARLnow. “We have since expanded to more than 250, including many resources from other parts of the Department of Human Services, temporary reassignments from other County departments and community volunteers.”

The expanded workforce is working on a number of tasks, including contact tracing. “Testing and tracing” is key to allowing the economy to reopen while mitigating the spread of the virus.

In South Korea, a robust testing and tracing effort, coupled with technology and the widespread wearing of masks, has helped to slow new COVID-19 cases to a trickle. Some states, like California and New York are planning massive contact tracing efforts, with thousands of trained tracers interviewing people who test positive and identifying those with whom they’ve spent more than a few minutes recently.

Varghese says Arlington is doing just that, detailing the labor-intensive effort.

“We identify and interview cases to identify their close contacts and to advise the individual on how to properly isolate themselves and physically separate from others for the duration of the illness,” he said. “We also interview close contacts that the individual identified in the interview. These are people who came within six-feet of the individual for at least a few minutes, including the 48 hours before you developed symptoms. We then advise these individuals to separate from others for 14 days (from their exposure) to prevent them from infecting others if they develop symptoms.”

“We actively monitor the identified and interviewed cases mentioned above,” he continued. “This includes a daily check to see if symptoms have improved, worsened or stayed the same. We assess their resource needs to help them maintain their isolation and quarantine safely.”

One issue facing Arlington and Virginia as a whole is a lack of testing, Varghese acknowledged, when asked about the relatively high positivity rate for COVID-19 tests conducted here — around 27% in Arlington as of last week.

“The percentage you are seeing reflects the limited supplies for testing and priority being given to those who are sick and exhibiting symptoms, so this will yield a much higher positive result, he said. “These percentages fall into the range of other health districts in Northern Virginia… It is important to emphasize that the numbers reflect those that have been tested and [are] not representative of the general population.”

Varghese said the state and county are working to increase testing capacity.

“Arlington is part of Commonwealth of Virginia and Governor Northam has instituted a task force to further increase sample collection and sample testing capacity. Arlington has looked to increase testing locally as well,” he said. “As you know, Arlington was the first jurisdiction in Northern Virginia to work with a hospital (VHC) to set up a drive-through testing site. Other providers have stood up testing, and we continue to look to increase sample collection opportunities locally for testing.”

“We continue to work with our regional jurisdictional partners to see how we can further increase sample collection opportunities, as well as laboratory testing capacity,” he added.

This morning, the state health department said it is working to scale up to 10,000 tests per day across Virginia. Last week, about 100-200 tests per day were being reported in Arlington.

As of Tuesday, Arlington had 1,169 known coronavirus cases, a number that continues to increase by double digit figures daily, even through weeks of social distancing efforts. Despite the continued rise in cases, Varghese said such efforts have worked.

“We want to thank everyone in the region, including in Arlington, for the individual efforts to slow the spread of COVID-19 and for following the stay at home orders in the region,” he said. “These efforts are helping to slow the spread of the virus.”

While Virginia moves towards a partial reopening, Varghese said residents must remain vigilant about social distancing, frequently washing hands, and other precautions.

“It is important to emphasize that we know all people in all parts of the region, including Arlington County, are currently at risk for COVID-19,” he said. “The germ is here, and everyone needs to follow the steps to slow the spread… Until we see a consistent decrease in new cases and hospitalizations — for example, for over a 14-day period — we won’t recognize that transmission is declining.”

As for the contact tracing and public health workforce, Varghese said his department is sufficiently staffed for now, but more volunteers are always welcome.

“Public health has worked with our longstanding Medical Reserve Corp (MRC) to enroll additional volunteers, as well as using County staff from other departments, to support public health efforts,” he said. “While we have the ability to hire, we are using the MRC and County staff, and we currently have adequate capacity for the response. We continue to monitor the situation and for that reason, we continue to encourage people if they want to volunteer, to sign up for the Medical Reserve Corp.”

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