Using incident command system, plenty of emergency planning
By Katherine Nettles
When Governor Jared Polis’ office issued a press release on Tuesday morning with an updated list of new cases of coronavirus 2019 (COVID-19), Gunnison County’s own public health officials were well aware that the count might include a case in Gunnison, but also irked by the communication methods that gave the agency about 45 minutes of lead time.
County leaders have been diligently preparing for this day and had their methods in place. After the announcement was made, the Gunnison County manager and commissioners had an emergency meeting with the county health and human services leaders to discuss the situation and protocols going forward.
Joni Reynolds, director of Gunnison County Health and Human Services, said in that meeting that the understandable flood of calls coming from residents, media outlets and other agencies requires both organization and accuracy from those who answer the phones.
“Because this was the first positive case in Gunnison County and we thought it would likely garner some attention from the media, we really wanted to have a single point of contact, so I am serving as that spokesperson in response to all these inquiries and we are trying to just be succinct and consistent in our messaging,” Reynolds told commissioners.
“The notification this morning was messy,” said Reynolds of the messaging from the Colorado Department of Public Health and Environment (CDPHE) to the state government. “It seems as though the governor’s office is taking the lead in making announcements and [they are] giving little to no notice to the local [officials] to which they have been announcing cases. And that doesn’t seem like a partnership. And it certainly doesn’t seem like the best way to support and instill confidence in local public health.
“This is not a state run public health system; it’s a decentralized public health system. It’s your folks here that are doing the rounds on public health work, and treating these patients,” she told commissioners. “I did get an email about five minutes before the governor issued a press release.”
Fortunately, Scott Morrill of Gunnison County Emergency Management got a prior notification about 40 minutes before that.
“Joni’s been really nice about this. I’m not going to be quite as nice. It is just ridiculous the way CDPHE is handling this right now. They are setting the local [agencies] up for failure,” said Morrill. “Especially in the rural areas, we are the ones that have to deal with the consequences of that announcement,” he said.
However, Reynolds and Morrill put their grievances with the state’s notification system aside and got to work with county manager Matthew Birnie to determine the next, and coming, course of action. This includes putting together a unified incident command, pairing clinical expertise from some people with others who have large-scale incident command experience.
“We’re really overlapping intentionally so that we’ve got both perspectives and systems engaged,” explained Reynolds.
There are also contingency plans for any of the county’s leaders who may become indisposed if they themselves fall ill. Morrill said he had reached out to federal agencies on Sunday night, before even having an unconfirmed case, and there is now an informational center set up to help with public outreach and calls coming in. At some point down the road, there may be a need to defer calls coming in, to prevent overwhelming the dispatch system or other emergency medical response agencies. Birnie said the plan is to set up remote locations so people can respond to a call without having to co-locate with other agencies.
A lot of calls are going to doctor’s offices and if there are other cases that appear to meet the COVID-19 criteria, said Reynolds, EMS is going out to those patients to do testing and keep them out of the hospital. She discussed how that would not be sustainable if higher volumes occur, but despite test shortages in many parts of the country, there is no lack of them available here. Birnie reviewed that there are criteria for testing people, and there are many who will not meet those standards and do not warrant a test, as there are other viruses going around.
Reynolds also reviewed how previous experience with viruses such as H1-N1 has taught the department a good deal about strategizing. Reynolds said Western Colorado University and the Gunnison Watershed School District have both done a great job of coordinating with a centralized system, as has Vail Resorts.
“I feel really confident that we will continue in that way, and it is important,” said Reynolds.
“Coordination has been strong,” said Birnie. He talked about preparing network resilience in several different ways to adapt to changes as they come.
Birnie reviewed that he has the authority to declare an emergency if needed, and after seven days that declaration has to go back to the board of commissioners. Birnie also has the authority to act as the board to pull in resources if needed. “There’s a long chain of command,” he said.
“We are really fortunate as an organization that all our departments have contingency plans in place,” said Morrill. He also said it was great to be able to reach out to other counties for resources and to shift and make changes as needed. “I feel really confident right now. We’ve got a lot of work to do… but here we are.”
“One of the reasons the structure of the county works the way it does with emergency plans and a lot of practicing, and relationships built with other jurisdictions, it is incumbent on us to let folks know we are going to figure this out as we go along,” said commissioner Jonathan Houck. “We have the protocols in place, and we have the ability to scramble and be flexible.”