For 12 years, Berlyne Vilcant painted for the city of Newark, NJ, as a disease researcher, which means that when there is a cluster of cases of a specific disease: salmonella in a place to eat, for example, or norovirus in a hotel – your task is to find out how it started, who posted it, and how to prevent it from spreading further. A lifelong Newark resident, she grew up in a circle of Haitian immigrant relatives and, even as a child, knew she was looking for paintings in the field of fitness. As a teenager, animated through the character of a fitness inspector at a lunch spot in the 2003 film Free Us From Eva, she put herself in public form.
In January, Vilcant was occupied through unusual epidemics: hand, foot and mouth disease in a day care center, Legionella in a nursing home, remote instances of Giardia. When she told her friends she feared a new virus would tear China apart, they reassured her. Don’t worry, they said, he might not come here. But while Vilcant was reading other articles, he remembers thinking, “Oh my God, if he gets to America, I know he might not have a life. “On Saturday, March 14, the manager of her fitness branch called her to tell her that a user in Newark had tested positive for the virus. “My waist fell to the ground,” he recalls. From that moment on, I knew it was anything that was going to be serious, and we had to treat it like it was going to be here for a long, long time.
For the next two months, Vilcant saw his worst nightmare come true, when the virus took over his city. On the peak day of April 6, there were 162 positive control results. Intensive care teams at local hospitals have approached capacity. Vilcant and his colleague were the only two disease researchers hired in the city, and there was no way the two would call each and every user who tested positive for the coronavirus. The fitness branch had to bring in seven place-to-eat inspectors to help. Vilcant’s premonition that paintings take precedence over her life is true: As the city’s lead disease researcher, she painted from 6 a. m. at 11 p. m. seven days a week. He rarely saw his two school-age children.
During those dreadful days, Vilcant felt that the long hours didn’t even make a difference. Around him, other people were in poor health and dying. Sometimes when a member of his team called someone to say they had tested positive for the virus, the reaction was hostile. How dare you imply that your circle of relatives had let the virus in? Sometimes even those who wanted to cooperate can. In Nwark, where 28% of citizens live below the poverty line, many stayed at home for two weeks. As the pandemic has progressed, it has become transparent that Blacks and Hispanics were more likely to suffer severe cases and die from the virus – those two teams represent 86% of the city’s population.
In the war opposed to the coronavirus, Newark faced great possibilities. However, about two months after the start of the pandemic, something surprising happened: cases in the city begin to decrease. The trend continued: in early May there were 50 to 60 cases almost every day, in June the numbers were reduced to the 1920s. It’s remarkable, especially given the proximity to the town, to New York, where the virus continues to ravage.
Perry Halkitis, dean of the School of Public Health at neighboring Rutgers University, attributes the city’s initial good fortune to a combination of factors: Newark Mayor Ras Baraka showed strong leadership, informing the city every day at the city hall fair on Facebook. In Vivo. La university’s public aptitude school provided experience and an organization of academics willing to volunteer and paint alongside Berlyne and his colleagues. But probably the maximum vital factor, says Halkitis, who helped coordinate the reaction to the Newark pandemic, the city’s investment in a specific strategy.
During an epidemic, infectious disease circles have a mantra: check, trace, isolate, that is, diagnose cases, look for other people that each patient has been able to expose, and look for other people who would possibly be sick until they have. The strategy, which has been subtle across public fitness personnel around the world for decades, has been a success in controlling outbreaks of tuberculosis, SARS, MERS, and Ebola. As the last six months of the pandemic have shown, implementing this mantra is less difficult said than done. Most parts of the United States are still suffering with the verification stage, let alone tracking and isolating. But almost as soon as COVID-19 arrived in Newark, the leaders, adding the possibility or, the fitness branch officials and Rutgers experts, mobilized to build a monitoring, tracking and isolation infrastructure for the city. “We were all together,” Halkitis said. The smart thing for Newark was that all hands were on deck. “
Amid the national shortage of coronavirus checks, public fitness officials in Newark developed a strategy on the most productive way to use the small number of checks they had. Trial sites in other cities were concentrated in affluent neighborhoods, however Dr. Mark Wade, director of the city’s fitness and networking branch, made the planned resolution to allow others without access to care. . Last spring, when it became clear that the coronavirus is serious in black and brown communities, the fitness branch opened more screening sites in minority neighborhoods and made a special effort to be successful in them. other older people who lived there. In other parts of the United States, cities have built self-service exam centers, but in Newark, where many other people don’t have cars, the sites have also taken patients on foot. The city also spent $ 2 million to establish a facility to check in another 2,200 homeless people at an airport hotel and to locate transitional housing for those who have been infected.
Hoping to get the most out of each of the valuable tests, Newark officials focused their efforts on touch-tracking. Because the cash-strapped city didn’t have the money to quickly rent a body of study, the fitness branch recruited volunteers. As of late April, the program was up and running, but city leaders were looking to improve knowledge gathering and put more force into the tracking effort. They looked to neighboring Massachusetts, whose state-of-the-art tracking program, the first and most ambitious in the country, was showing up as signs of success. The strength of the Massachusetts program was a global public fitness organization called Partners in Health, and its tracking approach combined thoroughly trained tracers and a complicated knowledge control system. Newark has partnered with Partners in Health and the Rutgers School of Public Health to bring its tracking system to life. Before long, the city trained 400 tactile tracers, many of whom were Rutgers volunteers.
Many of the classes learned through the PIH team in Massachusetts proved useful in Newark. For example, they worked with cellular operators to make the number on the touch tracker look like “COVID-19 information” instead of “unlisted”, for the chances of other people answering the call. But there were other more basic demanding situations that they had not faced in Massachusetts. The creation of test sites for the other most vulnerable people in the city, especially those from black and brown communities, has only solved one component of the problem.
A more serious challenge in which many citizens felt uncomfortable providing non-public data to touch plotters. Some had been discriminated against in medical offices, so they were naturally reluctant to collect medical data with foreigners. being an idea to be independent knowledge creditors – staff who were only interested in numbers, not individuals, so staff were trained to be transparent that the data they collected remains confidential; they were also trained to pay attention and attention to respond with empathy. “It’s not just about gathering knowledge,” said Katie Bollbach, the Partners in Health liaison who led the group’s newark team. “It’s about making other people feel supported and cared for. “
Bollbach, who had worked on Partners in Health’s Ebola reaction in Rwanda and Sierra Leone before the pandemic, told me that his transition to the United States was disturbing, but not as expected. She was attacked without delay by the restriction of access to Sierra Leone, one of the poorest countries in the world, The villages of Maximum had loose network clinics, as well as staff who went door-to-door to control outbreaks of infectious diseases of citizens. The great amount of help for fitness is unimaginable. “Focusing on network care as a cornerstone of smart public conditioning in Sierra Leone is really amazing in our formula here in the United States,” he told me. “Here we focus on fitness as a commodity, more than as a human right. “
What Partners in Health has learned during many years of studying outbreaks in Africa is that testing and tracking are unnecessary without the last step of isolation. The Bollbach team in Sierra Leone found that the maximum number of inhabitants may simply not receive food and other essentials during the 21-day quarantine era needed to prevent spread. Ebola virus. Therefore, officials distributed cleaning materials (gloves, soap, chlorine), as well as food, water and other materials to remote families. At first, it was Partners in Health who offered the materials, then the government took over. In addition to curtain materials, Partners in Health worked with the fitness branch to send staff to control others in quarantine: how were they?Did anyone else in space have symptoms?These undeniable gestures elevate the point of trust in the fitness service. They are also more likely to be completely quarantined by others. Regular recordings, the team said, made other people locked in their homes feel less alone.
Bollbach and her team brought those classes to Newark and created systems for others who needed to quarantine them at home, like Wendy Pillajo, who lives with her parents, stepfather, husband and three-year-old daughter in an apartment. In Newark, Pillajo, a medical assistant at an emergency care clinic, told me about her family circle’s war with the coronavirus. In May, just days after her mother attended a family circle meeting, everyone members of her household, unless her, the family members’ circle of symptoms ranged from mild (her daughter had a fever for a day) to severe: her parents had debilitating chest congestion, muscle pain, and abdominal problems. It should be noted that Pillajo, which has been tested several times, has never had a positive result. A few months later, Pillajo’s mother tested positive on her back, and the full circle of relatives was quarantined for two weeks.
During a quarantine period, fitness branch agents called Pillajo’s family circle again and another day to register. They would ask how one of the members of the family circle felt and whether anyone needed anything. After Pillajo’s parents tested positive, they told the rest of the family circle how to get to a loose test site. When Pillajo said he might have trouble getting his groceries delivered, the town sent hot meals: chicken, mashed potatoes, cornbread, rice. Pillajo told me she enjoyed racing, but moreover, she was grateful to have someone to ask questions. She was so worried about her father that she couldn’t concentrate on anything else. Through the daily recordings, “we understood what was going on and saw that they were getting better,” he said. “It helped me know they care about us. “
By August, Newark’s harsh paintings had paid off. There were only a handful of new cases on both one and both days, a steep drop of more than a hundred a day from the April peak. As Halkitis strolled around town, he saw that the public fitness culture had taken hold. The citizens wore masks. They kept their distance from others and obeyed at 9:30 p. m. “People take it very seriously,” he says.
If the extensive testing, tracking and isolation strategy has worked so well in Newark and Massachusetts, why hasn’t it been maintained in the rest of the country?Halkitis believes one of the reasons has to do with leadership. From the outset, the Trump administration has provided little comprehensive and reliable direction to respond to a pandemic, and many cities and states have been far from coordinated in their actions. In Newark, from the beginning of the pandemic, Mayor Baraka had the backing of New Jersey Governor Phil Murphy; his plans for the pandemic were aligned.
Other cities have not benefited from such a unified vision. In New York City, Mayor Bill De Blasio clashed with Governor Andrew Cuomo in the early days of the pandemic – the governor scoffed at the mayor’s suggestion in March that he might have to close schools. As the leaders fought, the virus spread uncontrollably and, until the end of March, New York City became a zero point for the pandemic. In Atlanta, Mayor Keisha Lance Bottoms took on Republican Governor Brian Kemp – undermining him every step of the way, from easing regulations for the initial shutdown to suing over the mask he enacted. (He later withdrew the lawsuit challenging the mask ordinance. ) Today, in a CDC ranking of statewide coronavirus cases, Georgia ranks fourth in the country. State and local chiefs have stood alone, forced to navigate their coronavirus plans with little direction from the federal government. As President Donald Trump told governors in April, “they are going to make a decision. “
Another challenge with test-trace-isolate, Says Halkitis, is that it doesn’t paint right away. There is a tendency, he said, “for a giant component of the American public to need simple answers. “In fact, this fantasy is evident In Trump’s insistence on selling supposedly miraculous remedies like hydroxychloroquine, once again, this kind of thinking goes beyond the existing administration (how many times has he fantasized about what he would do when the vaccine arrives?), but in genuine paintings of the fight against disease infections, Halkite says, “This disease requires hard paints , and it means you have to give up some things. “»
Joia Mukherjee, medical director of Partners in Health, echoed those sentiments: “What is a shame is that we, the United States, have certainly not been ambitious” in seeking contacts. But she sees Newark as something positive: “Newark is a very difficult position to work with,” she told me. “There is a lot of poverty. But the Department of Public Health has the same vision as Partners in Health, which is for vulnerable people.
Vilcant feels a wave of satisfaction when he sees in the graph that the decrease in coronavirus cases appears in his beloved city. In early September, there were only a handful of cases that coincided with the day. In those moments, he feels that the complicated conversations, the logistical quagmires, the 70-hour painting weeks, were worth it. But the pandemic is not over yet and he knows it would be a mistake to lower his guard. “My researchers and my contacts have this mindset to go ahead and keep doing the paintings that they’ve been doing,” he said. After so many months, it is complicated. It is a marathon. Sometimes the Vilcant youth tell him that they hate his job because it takes him away from them. “I have to tell them, ‘It may not be forever. In the long run, you will understand why Mom had to take time out of her family circle to spend my time making sure this procedure was completed. “
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