April 1, 2020 432 PM
During my nearly 27 years of experience with the Austin/Travis County Health Department, we often encountered misunderstanding as to what “public health” actually is. Many equate it with “primary care,” which is the doctors, nurses, hospitals, clinics and other caregivers that directly treat us for diseases and injuries. The “public health system” is different from, yet intertwined with the primary care system. While the primary care system resides primarily in private and nonprofit clinics and hospitals, the public health system resides primarily within government at all levels. Primary care is focused on directly treating individuals while public health is focused on diseases, conditions and injuries as they affect populations, i.e. groups of people.
The public health system is something “We, the People” do for ourselves through government. It is taxpayer funded. It’s often overlooked, but, while the pandemic of COVID-19 is a huge painful challenge, it also provides an opportunity for us to see and understand the workings of the public health system. One responsibility of public health is research and investigations. When a disease or condition arises that might affect groups of people or the public at large we have to quickly learn what it is, who it will affect, and what we can do to prevent it or mitigate its effects.
As a retired public health worker, I still read the “Morbidity and Mortality Weekly Report” put out by the U.S. Center for Disease Control and Prevention (CDC). Today, I’m reading an article titled “Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility – King County, Washington, March 2020.” I don’t recommend this reading to everyone, but the report documents the ease with which COVID-19 is spread by those who have no symptoms of illness at all. Research like this tells us why, without testing and vaccines, we must rely on social separation to reduce the spread of the disease. At the bottom of the article it acknowledges 19 members of the Federal CDC investigation team, many investigators from the local public health department in Seattle-King County and lab analysis by the State of Washington Public Health Lab. This research was done by the government while the primary care professionals cared for the patients.
Aside from its investigations, the U.S. government can play a key role in financially and logistically helping states and primary care providers obtain the equipment and personnel they need to directly combat the spread of diseases like COVID-19. These are things like test kits, ventilators and personal protective gear that clinics and hospitals don’t ordinarily stock in large quantities. We are even seeing how the Army Corp of Engineers builds hospital facilities and the U.S. military sends ships to bolster local hospitals.
Another feature of the public health system is laws and regulations at all levels from the feds down to local county, even city, officials. At the federal level there are standards for hospital operations, environmental protection laws, food, drug and product safety standards, to name just a few. States carry professional licensing standards and have their own environmental protection standards. Then, as we have recently seen, local government performs its role in the public health system with restraints on businesses, schools and individual behavior. The public health system has a feedback loop in which the research and investigation findings flow to all levels for government officials to deal with the spread of disease and to primary care providers to determine how they treat individual patients. Now that we know more about it, perhaps we will think twice about defunding the public health system. A few years back, the Trump administration defunded and disbanded the office dealing with the national security issue of pandemics. Now we’re struggling to catch up; too many will needlessly die. Doing this we endanger ourselves; that isn’t even penny-wise, but it’s definitely pound-foolish.
Mary Bell Lockhart
I would like to comment briefly on two articles in last week’s Alpine Avalanche (March 26, 2020) paper: “Hotel owner sues commissioners and county,” and, “Big Bend not so friendly anymore.”
Both articles cited the fact that as of last week there were no reported cases of COVID-19 in the tri-county. One article used this to infer last week’s actions by the City of Alpine and Brewster County to shut down all hotels, motels, RV parks, and campgrounds, as well as issuing deadlines for visitors to vacate, was questionable.
The other article, “Hotel owner sues …” cited this fact as a part of a lawsuit questioning the county’s authority to shut down the Gage Hotel. The other allegations cited in the lawsuit are:
- Neither the governor’s March 13 proclamation declaring a state of disaster for all counties nor his March 19 executive order regarding preparedness and mitigation mandated or required hotels to be closed.
- Insufficient public notice of the meeting.
- No evidence presented to justify closing hotels, and the only lawful basis for doing so would be expert testimony that leaving them open would constitute a disaster.
- And, along with the previously cited fact of no reported COVID-19 cases, the lawsuit also questioned a local pediatrician’s qualifications for giving her personal opinion for the need to close hotels and motels.
Now, I think we can all agree that a lot has changed in our country since last week. Dr. Deborah Brix, the White House coronavirus response coordinator, Sunday on CNN, citing 13 different statistical models, painted a grim picture for our country in the coming months. The models predict, among other things, that when the COVID-19 peak hits New York by mid-April, the state may find itself 60,000 to 70,000 hospital beds short of what they’ll need. In fact, as “the peak” spreads across the country in the following weeks and months, many states and counties may find themselves short of hospital beds too.
Brewster County should be working closely with our hospital board, if it isn’t already, addressing our future hospital bed needs, in light of the fact our hospital serves Marathon, Presidio, Marfa, Ft. Davis and the Big Bend, beside us.
That we haven’t had a COVID-19 case in the Tri-County area, as of last week, should be seen as both a blessing and much needed buffer for us to build up our hospital bed capacity and stockpile needed medical protective equipment and respirators.
Consider that as of March 11th, 1,301 Americans were infected and 38 dead. Yesterday, March 30th, 155,141 Americans were infected and 3,141 dead. And today, March 31st, 180,000 are infected and our country exceeded 700 deaths from COVID-19 in one day.
I feel for every business that has had to close during this lockdown. My family business is closed and, like everyone else, I look forward to reopening as soon as possible. I miss my patrons but, this is not a matter of business. As President Trump has said, “… It’s a matter of life and death.”
We’re facing something that has painted a target on all our backs.
We must work together, sacrificing now so that we may all live our lives in the future.
I believe history will prove our county judge and commissioners court’s decision to close those businesses was necessary, albeit painful, in face of the threat to us all.
COVID-19 is deadly serious. Failing to comprehend the importance of a coordinated national strategy and that a pandemic is undeterred by state borders, Nero Trump, some states’ governors and too many among us have fiddled while digging America deeper into a hole. Texas ranks 49th in a nation that ranks last in responsiveness. The numbers of infected and hospitalized increase geometrically. U.S. deaths surpassed China’s.
Fear – not to minimize legitimate concerns – is compounded by irresponsible leadership unmoved by the need for immediate, selfless actions in a WWII “all hands on deck” approach! Witness Lt. Gov. Patrick’s insane eugenics suggestion of he and seniors’ willingness to die to get the economy going again, https://is.gd/M5D6D4. “American Exceptionalism,” or a recipe for disaster?
Paul Simon’s “American Tune” laments: “… You can’t be forever blessed.” I disagree. There’s more to be thankful and grateful for than not. That’s certainly true in the company of family, old and new friends across a worldwide digital network.
The best in us has responded. A rising tide tackles seemingly insurmountable difficulties, i.e. manufacturing ventilators and making masks. We’re becoming closer through physical distancing. Love icons appear more than ever on social media and we laugh with creative posts akin to editorial cartoons.
Under-appreciated were cashiers, hospital workers, delivery people, among many more in the workforce, continuing to meet our basic needs, though constantly exposed to contagion. Hopefully labor’s contributions will be recognized and adequately compensated when this is all over. Imagine desiring a living wage, benefits including vacations, health insurance and secure retirement?
Understood is: we’re in this together. Each person is due respect within the interdependent web of all existence of which we are an invaluable part.
Rev. Barry Abraham Zavah
As you know we have been dealing with a pandemic; this is not something that happens often, and it caught the whole world by surprise. There are so many people in the world suffering right now; many of these people are family members or even friends. We all feel scared knowing that this virus, which we know very little about, is spreading fast, and we have no control over it. During the week of our spring break, it took off like wildfire. One minute we are making vacation plans with our families, and the next we are thinking about whether we should cancel plans or risk it and take off. We Presidioans always feel that things are not going to make it down here since we are so isolated. As we witnessed that week of our spring break, people were coming from all over panic shopping, not only here but in our neighbor city of Ojinaga. We all felt the impact. We patiently waited for either our board members or our superintendent to give us some sort of clue as to what was happening with our district, while other schools began shutting down, everyone kept asking through social media. Parents as well as teachers and staff were concerned. We hadn’t had any cases locally, but it started to become a reality to us when the virus made its way to the Midland/Odessa area. At that point Monday through Wednesday, all schools in our area began closing and sending messages to their communities, letting them know schools would be closing. Everyone on social media was worried, panicking, asking why we hadn’t received word from our school.
On Thursday, March 19, Governor Abbott announced an executive order that limited social gatherings to 10 people, prohibited eating and drinking at restaurants and bars while still allowing takeout, closed gyms, banned people from visiting nursing homes except for critical care and temporarily closed schools. The executive order was effective midnight Friday through midnight on April 3. Our superintendent sent us an email shortly after letting us know the school had been canceled for students, but the staff was still to show up, “business as usual.” Despite this executive order, our school district employees are still showing up to our buildings as if nothing was ever put into place. Some people voiced their opinions in person to their principals, and their responses were usually: “This is what we were told,” “I’m sorry you need to show up,” “You don’t show up, then there is no pay. If you take time off, it comes out of your sick days.” To add insult to injury, we received an email from our superintendent today, March 24, to let us know how our new schedules would work. In order to avoid “big crowds,” we were separated by A and B shifts. The teachers show up to their building, go to their classrooms and basically work from there with their students remotely. Then later, the next shift kicks in and does the same. His words to describe this pandemic were the following verbatim:
“Unfortunately, this is not a vacation. We are being paid and will be expected to work. You must be available to report to work and are on regular duty hours. Please understand that for us to continue to pay everyone on a regular basis, we MUST provide instruction to our students regardless of the challenging times we are in today. The district will only receive funds from the state as long as we attempt to educate our students. If we don’t educate, no funds to pay folks.” Anyone that is in education will tell you the same thing, and that is that you’re not in it to get rich, the children are what make the difference. To our board members, you were all chosen by the community to represent us, where are you when we most need you? Is this what we are teaching our children? That, regardless of what is going on, they are to block their human emotions, suck it up and keep working?! Is that how you want your own children to be raised?
Think about that. Mr. Vasquez when you are reading this I want you to know that we were all equally as shocked by your statement –– you showed your lack of empathy for our community that prides itself in being like family, you insulted our intelligence and assumed that we were trying to steal money from our beloved district by stating what you said. We are not uneducated ignorant people; we are compassionate human beings that are trying hard to process our emotions during this difficult time, and we are not being allowed to do so. Acting like we should keep following our normal lives is not healthy. A pandemic is NOT a normal situation, and we ALL have a right to process what is going on and feel what we are feeling, whether it be scared or anxious or sad, without the FEAR of losing our jobs or not getting paid, even though we are clearly offering to work from home. Other school districts are teaching completely remotely and are not putting anyone in danger. I know this because I have friends that are superintendents, principals, teachers and office staff in other school districts within Texas. They have all confirmed that they would not put their staff through this type of situation. Not only that, but it was stated by Texas Education Commissioner Mike Morath that the state has already said school districts with prolonged school closures due to coronavirus concerns may avoid financial penalties, as long as they can prove they are teaching students remotely. There is no excuse for how things are being handled within our district, and it shows that you are putting our lives and our families in danger.
I encourage everyone to speak up from now on and voice your opinion, if your principals won’t talk for you, then SPEAK UP! Speak for yourselves, through emails or any other means, let your voices be heard, it’s this type of closed mentality that has caused so many deaths globally. Mr. Vasquez, you always have this statement on all your emails, and we wear this proudly on our shirts: “We Inspire. We Motivate. We Care. We Teach. We are Presidio Pride!” Start by having compassion as other school districts do in order for your employees to INSPIRE, start listening to what we have to say so we can MOTIVATE, we always CARE –– it’s why we are still following your rules set into place even though we are risking our families every day, we also TEACH, not because YOU told us to but because it’s what WE enjoy doing, and you’re right: with or without you, we will always be PRESIDIO PRIDE. Our voices WILL be heard, we will not remain silent any longer, we have everything to lose in our homes, and your decision making as well as our board members’ indecision at this present time, are putting our children and our own lives in danger. That is unacceptable. I plead that you reconsider and start listening to our input. We should be in this TOGETHER. It takes EVERYONE to make great things happen.
The voice of those people that are scared to speak for fear of retaliation; the only reason we show up every day is that Presidio is OUR HOME.