Our Plane is Sturdy and Stable

By Lisa Dickey

Edited by Kat Richter

In the beginning, we didn’t know how long the COVID-19 pandemic would last. “Shelter in place,” they said. Most places were closed, there was no toilet paper for sale, and people got creative about their homemade face coverings. But this you already know.

Two months into it, someone remembered me and thought I could participate in the extraordinary public health effort. I already had experience with public health and case investigations and was familiar with the most vulnerable communities in Marin. I can see problems and create solutions.

I started working in May 2020 with the COVID-19 Case Investigation and Contact Tracing Team. The team was in its start-up phase, trying to figure out how to do the work and get it done. The phrase “building the plane while trying to fly it” was used ad nauseum by all involved to describe what we were doing. It quickly became cliché, but it didn’t matter because there was no better way to explain what we were doing. We had no choice in the matter because time was not on our side.

Many of our clients feared for their health, housing, livelihoods, etc. Our case investigators would often vicariously feel the stress of those we interviewed. When our clients didn’t express any pressure or responsibility for helping curb the spread, we would feel anxious because we knew that people were putting others at risk.

It has been a little over a year since it all began, and because of the success of the vaccines, it seems like the worst is behind us. We did well with what we had, and I realized that our plane was sturdy and stable somewhere along the way. Throughout this process, I have worked with countless incredible people. They are strong, intelligent, caring, and funny people. Bonds have been formed, and emotions have been felt that I wouldn’t have ever imagined would be possible in government work. Together we have made a difference in the fight against the pandemic and the lives of many. We have made history.

The First Law of Public Health

By Dr. Stephen McCurdy

Early in 2020, it dawned on me what we were facing from the coronavirus. I contacted Drs. Willis and Santora and offered assistance, suggesting that my background as a recently retired professor of public health sciences was well suited to case investigation and contact tracing efforts. In my naïveté, I imagined volunteering between 10 and 15 hours per week. Two days later, I had a (more than!) full-time position as a Deputy Health Officer. Little did I know that, despite having devoted much of my career to training public health professionals, my education in public health was about to begin in the third year of my retirement.

I suspect that the decision to bring me on board was clinched when I mentioned to Dr. Willis and his team what I call the First Law of Public Health — Public Health is a Team Sport — and its corollary: “All of us is smarter than one of us.” The team approach is our “secret sauce,” and I have emphasized it every chance I get. (My apologies to those who roll their eyes for having heard it perhaps once too often . . .)

And now, nearly a year has passed. Amid our pain, the year’s greatest gift has been a sense of gratitude for me. I have worked with the most dedicated, influential, collegial people I have ever met. I found these qualities everywhere — in the Marin Medical Reserve Corps volunteers who saved us from collapse in the early days of the pandemic, in the public health professionals and redeployed county and state workers unmoored from their everyday work to a world of “All COVID All the Time,” and in our new hires now introduced to the world of public health. Many have discovered the magic of public health in this experience — it will be a unique inflection point in their personal and professional lives.

I am fortunate also to be among those little more than inconvenienced by the pandemic. We are among the lucky, housed, and with an unthreatened livelihood. Yet even in California’s wealthiest county, there are much less fortunate. Unsurprisingly, we encounter a rainbow of responses from those we attempt to help: darkest anger, impenetrable denial, and tears of gratitude — sometimes all in the same individual. Our privilege and challenge are to treat all with charity and grace, sometimes through gritted teeth.

I am deeply grateful to my community and you, my friends, and my public health colleagues for the opportunity to contribute and partner. Together we are saving lives, protecting livelihoods, and making history.

I’m Going to be a Doctor

By Eduardo Portella-Parra

Edited by Amanda Hyslop

As a future medical student, I highly value the ability to build rapport with my community and help people during difficult times. That is why I decided to work as a case investigator for the county of Marin. Case investigators not only attempt to dive into people’s minds and figure out the origin and potential directions of viral transmission to minimize spread but also act as a bridge to facilitate accommodations to those who are both affected and in need.

With a tired, half-broken voice, “Miguel” told me that he had been sleeping in his car two nights before because he tested positive for COVID-19 and did not want to infect his roommate. His roommate had been leaving John fruits and sandwiches on the car’s roof. Right after the interview, I connected him to the resource department so that they could lodge and isolate him in a motel room. I called him a couple of hours later that afternoon to find out if he was already isolated in the motel room. He thanked me and said: “It’s starting to rain right now. It would have been rough for me in the car tonight.”

I also had the opportunity to help “Ana,” an 18-year-old single mother who was taking high school classes online. The baby’s intense and spontaneous babbling gave us a laugh and made communication slightly challenging. The four-month-old baby had tested positive for COVID-19, causing Ana, her brother, and her mom to remain in quarantine. Ana told me she had never been under so much stress, worried about her baby and the isolation/quarantine orders. They were worried about their inability to work and what it meant financially. Fortunately, I could connect them with the county’s resource department so that they could assist the family with money for rent and supplies for the baby.

Sometimes, cases and close contacts avoid our calls. Occasionally, we cannot convince them to disclose relevant information for optimal risk management. However, interactions like those with Miguel and Ana make this job worth the time and effort. Being able to influence the community’s quality of life during a devastating health crisis has been mentally taxing but significantly fulfilling.