Public health processes and the role of communities during COVID-19

4/29/2020

​​Information for Health Directors and Community Leaders

Health Directors and Community Leaders may have many questions about the roles and responsibilities of different health care partners in terms of managing and supporting cases of COVID-19 in Community. This article will talk about public health processes and the role of communities during the COVID-19 pandemic.

Public Health Processes​

Regardless of where a person lives in British Columbia, Regional Health Authority (RHA) Public Health staff members are made aware when a test comes back positive for COVID-19. Those public health officials have the responsibility of preventing the spread of disease by identifying those who are sick (cases) and those who were around them when they were getting sick (contacts). This is known as contact tracing. Cases and contacts are given instructions as to how to prevent spreading the disease further. For example, they will be required to stay home. Contact tracing is an effective strategy for containing illness and has been used for hundreds of years.

In addition to direct case management and contact-tracing, public health also gives advice related to community prevention. The most successful and effective strategies to prevent spread of the virus are:

 Stay home as much as possible

 Stay home if you are sick

 Keep physical distance (at least two meters or six feet) between you and people who do not live in your house

 Wash your hands often, with soap, for 20 seconds, and try not to touch your face

 Cover coughs and sneezes with your elbow

 You may choose to wear a cloth mask when going out. Wearing a mask protects others from small droplets that can come out of your mouth when you talk, cough or sneeze, and may reduce the spread of illness. Information on when and how to make and wear a mask see: https://www.fnha.ca/about/news-and-events/news/homemade-face-masks

By using these community prevention steps to protect yourself and others, you are doing the very best to keep your community healthy.

The Role of Nurses

1. Regional Health Authority (RHA) Medical Health Officers (MHO) receive notification of all positive lab test results for COVID-19 and other communicable diseases.

It is the job of the Regional Health Authority (RHA) nurses to call people who have tested positive for COVID-19. Nurses working within your community may help the RHA nurses – they will talk together and decide what each of them will do.

The role of the FNHA Communicable Disease (CD) team is to help the nurse in your community gain the skills and processes they need to follow-up any cases and contacts. If your community needs additional supports or supplies the FNHA regional nursing staff can support your nurse to get these items.

2. When people test positive for COVID-19 they will be told to stay at home for a certain number  of days. This means not going out and not having other people come into the house. If a person cannot safely stay at home for this amount of time, they should contact their community leaders or FNHA Health Benefits to get support finding a safe place to stay.

If there are other people living in the home who have been there while the person was sick, they will need to stay at home too. The number of days they have to stay at home will be different for different people. The nurse decides the number of days based on the information they gather.

Most people with COVID-19 do not need to be hospitalized and will get better on their own. People cannot spread the disease once their fever has stopped and 10 days has passed. A person with COVID-19 is no longer infectious 10 days following the end of their fever. People may have a dry cough for some time after this. Depending on the situation, the nurse may check in with them daily to see how they are doing.

3. When the nurse contacts a person to tell them about their positive COVID-19 test, they will ask  for the names of the people they have been around and the places they have visited during the time they were getting sick. When the nurse has these names, these people will be called and told to stay home for a certain number of days. The amount of time could be different for different people. The nurse decides upon the number of days based on the information they gather from talking to both the person who is sick and the person who was around them.

4. People who are told to stay at home will be called by a nurse to make sure things are okay and that they aren't getting sick. They will be asked to keep a record of any symptoms to see if they are becoming ill. Once all the number of days has passed and they don't become sick, they can leave their house. They still need to stay home as much as possible and keep distance between themselves and other people when they are out shopping for groceries or doing other essential errands like getting medicine – just like the rest of us. If the person becomes sick, they will be assessed for COVID-19. They will have to stay home for at least 10 days from when they got sick. (see steps above)

Why Don't Nurses Tell Us Who Has COVID-19 In Our Community?

There are two reasons for this:

1. ​Nurses are not permitted to discuss the health information about a person with people who are not directly involved in providing medical care. This is to protect the rights of the person who is sick. If a person isn't sure that their health information will be kept private they may be less willing to get tested for COVID-19.

2. Knowing the name of the person who is sick will not help you prevent illness in the community and may cause that person mental and emotional harm. It is important that we all play our part in the process. Nurses will follow up with the people who need to be tested and can help you give advice to community members who are worried about being exposed to COVID-19. Unfortunately, it is not possible to identify everyone with the virus as some people have only very mild symptoms or possibly no symptoms at all.

What To Do If Someone Tells You That They Are Sick Or That Someone Else In The Community Is Sick. 

1. Refer people with questions about their health to the nurse in your community, if you have one. The nurse will help the person determine the best thing to do.

2. If you don't have a nurse available, there are a few things you can suggest:

a. Have the person call the 811 line. A nurse will ask them how they are feeling, whether they have a cough, etc. and give them advice on what to do.

b. Have the person go through the online self-assessment. https://bc.thrive.health/covid19app

c. If a person has a cough, fever, sore throat, sneezing, aches and pains or if they know they spent time with a person who has COVID-19, they can have a test to see if they have COVID-19. This can be arranged with the local Regional Health Unit or through your nurse/community health provider.

d. If the person is very ill or is having a hard time breathing, they need to be seen by a medical provider right away. In an emergency, call 911. If your community is close to a town, they can go to the medical centre or hospital in town. They should call the medical centre before they go there so that the medical staff are ready to receive them. Please see the following link for transport of a person who is sick in remote communities. https://www.fnha.ca/Documents/FNHA-Infection-Prevention-and-Control-Measures-for-Client-Transportation.pdf

e. Remind the person to stay away from others or protect those around them while they are sick. ​http://www.bccdc.ca/health-info/diseases-conditions/covid-19/about-covid-19/if-you-are-sick

Communicable Disease Emergency (CDE) Plans

Now is a great time to check in on your CD Emergency (or pandemic) plan. If your community does not have a Communicable Disease Emergency (CDE) plan in place, it would be good to get started on one. If you need help to put a plan together, email FNHA at covid19@fnha.ca. Having a plan in place will help you make decisions about topics such as how to transport people who are sick and many other issues that will arise.

If you need more information, visit the FNHA COVID Information page. There is information that may be

of interest to community members, leaders and health professionals. https://www.fnha.ca/coronavirus

Download this communique in PDF format here​.

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