Michael Kurtz

Like an iceberg, our collective community’s response to the COVID-19 pandemic goes largely unseen — and only a small part of the work reaches the public’s eyes. I was privileged enough to be witness to part of the work that took place. I want to share a small glimpse into their story.

I was part of the county’s Emergency Operations Center for the COVID-19 response from its inception. Those that don’t know how an EOC works, let me give you a quick crash course. It is driven by a uniform process that is used at every level (local, state, federal) of emergency response called an Incident Command System. ICS creates a structure that allows emergency responders to speak a common language and organize in a fashion that facilitates the ability to quickly operationalize and logistically support a crisis response plan.

When the EOC was stood up on March 24, the Douglas Public Health Network had already been several weeks into an operational response mode to COVID-19 and had built an epidemiological team that is still the envy of most Oregon counties. DPHN is led by their executive director, Teresa Mutschler and their medical director, Dr. Robert Dannenhoffer, who is also the county’s public health official. The delegated leader of the county’s response was Commissioner Tim Freeman. He brought in KC Bolton, CEO of Aviva Health, who oversees local federally qualified health centers — and is also a retired Army colonel and combat veteran with emergency response experience in standing up hospitals in war zones.

KC was quickly designated as the incident commander, and Teresa Mutschler later became co-incident commander. He and Commissioner Freeman built an incident command team that included physicians — Dr. Dannenhoffer, Dr. Harry “Chip” Taylor, and Dr. Tanveer Bokhari — public health professionals, trained expert emergency managers, logistical experts, fiscal experts and public information professionals, from within and outside of county government. This was an impressive group of accomplished professionals, but the question in my mind was how, having never worked together, would they coalesce into highly functioning unit?

Commissioner Freeman led this group, and the first order of business was to develop incident command objectives:

  1. Minimize loss of life for Douglas County citizens through education, mitigation and containment
  2. Protect the medical system from being overwhelmed with cases by coordinating long term strategic response plans and identifying local thresholds with appropriate local response
  3. Ensure safety of all health care providers by facilitating the acquisition and distribution of available personal protective equipment by utilizing local, state and federal resources
  4. Ensure appropriate timely and coordinated communications to cooperators and the public
  5. Support operational needs by leveraging available Douglas County resources.

These objectives were the incident command team’s guiding doctrine. Within days, individuals that hadn’t known each other before were working seamlessly together with common goals and direction. They worked quickly to gain situational awareness, and finding the key data points to guide the decision making process. As data was tracked, there was a point early on in the EOC where the trends indicated the local hospital would likely be overwhelmed with cases by Easter, if not sooner. Had that happened, plans had already been put in place to be operationalized to deal with this on a medical and community level. This involved planning and logistical efforts for contracts, securing potential facilities, PPE and coordinating with FEMA requirements. This was serious work and everybody understood the consequences of not meeting our objectives.

For several weeks I came to the courthouse, which was closed except for the EOC work, at 5:30 a.m., only to find Commissioner Freeman already in his office either meeting with key staff, members of the medical community, or on the phone with someone in Washington D.C. in regards to meeting the needs of our local community’s COVID-19 response. At one point early on, Commissioner Freeman stated to the incident command team that there is always a political risk of doing too much, then seeing the crisis fall short and having people say you overreacted. He then said politics will have no place in this EOC: “If we do too much, it will still have been a training exercise worth doing.”

Given the number of global pandemics that the Douglas COVID-19 response team has had experience addressing in the past (exactly zero, if you need reminding), trying to determine just the right amount of a response made absolutely no sense. So the incident command team planned for the worst-case scenario. Commissioner Freeman looked at the medical and public health experts in the room and said, “Tell me what you need.” Then he and the rest of the board responded by making it happen.

While the worst-case scenario didn’t happen, this continues to be a war fought on many fronts. There is the front line work of containment done by DPHN through testing and contact tracing — and through the work of local clinics, physicians and CHI Mercy Medical Center to test for and treat positive cases. There is the work of mitigation done by public education through the Joint Information Center, where multiple agencies make sure that the most up-to-date information is getting to the public in a consistent manner (as well as Dr. Dannenhoffer’s Facebook Live events). There is the planning work done by the EOC to ensure appropriate levels of responsiveness for any level of change in the crisis. Senior leaders from numerous agencies are working together to make sure all these efforts are coordinated towards the same goals and objectives — to win the war on every front.

There is a reason, not dumb luck, that Douglas County has weathered this crisis as well as it has. That reason is due to hundreds of people working hard behind the scenes to mitigate the impact of COVID-19. It is also because a responsive community has listened to its leaders and have taken precautions to prevent the spread of the disease. The county commissioners have been a part of leading and supporting many of these efforts. Attitude reflects leadership — and the attitude that I saw in the EOC from every person was to look to the collective group and ask, “What do you need?” and then make it happen.

Michael Kurtz is the Human Resources Director for Douglas County and a former Army Journalist who received the Bronze Star for his work during Operation Desert Storm. He was also appointed as the Deputy Agency Administrator for the Douglas County COVID-19 Response Team.

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(7) comments

Mike

If the United States had begun imposing social distancing measures one week earlier than it did in March, about 36,000 fewer people would have died in the coronavirus outbreak, according to new estimates from Columbia University disease modelers.

https://www.msn.com/en-us/news/us/lockdown-delays-cost-at-least-36000-lives-data-show/ar-BB14ohR4?li=BBnb7Kz

MDudley

Hindsight is always 20/20. Coulda, shoulda, woulda...

Mike

Tell that to the families of the 36,000 people who might have been saved if U.S. leadership had listened more closely to those advisors more worried about saving lives than the next election.

Mike

Public health officials in at least two-thirds of U.S. states are sharing the addresses of people who have the coronavirus with first responders, from police officers to firefighters to EMTs. An Associated Press review of those states found that at least 10 states also share the names of everyone who tests positive. Sharing the information does not violate medical privacy laws, under guidance issued by the U.S. Department of Health and Human Services.

If the U.S. Department of Health and Human Services says sharing names and addresses of coronavirus cases doesn’t violate medical privacy laws, why does DPHN continue to cite those same federal privacy laws they say are preventing them from sharing ANY information? And why isn’t DPHN sharing addresses of people who have coronavirus with Douglas County first responders so they know to protect themselves accordingly? Why is everything kept a secret in Douglas County?

https://apnews.com/ab4cbfb5575671c5630c2442bc3ca75e

Mike

Worries over potential inaccuracies from fast-acting Abbott ID Now machines that test for COVID-19, touted by the Trump administration, has prompted groups to stop using the product, after federal regulators warned the public about it. A comparative, non-peer-reviewed study of samples from 101 patients at New York University Langone Tisch Hospital found what the researchers characterized as “low sensitivity” and “high false negative results.”

https://www.msn.com/en-us/news/us/fond-du-lac-band-shelves-instant-covid-19-test-amid-accuracy-concerns/ar-BB14no1p

Mike

If your business or church defies the Governor’s plan to reopen Oregon and somebody dies, don’t expect your insurance company to bail you out.

https://chicago.suntimes.com/columnists/2020/5/8/21252579/gov-j-b-pritzker-stay-home-order-coronavirus-illinois-reopen-lawsuits-rich-miller-capitol-fax

Mike

At least 4 states overstate testing by combining numbers from two different testing methods.

https://www.msn.com/en-us/news/us/coronavirus-in-the-us-at-least-4-states-combined-numbers-from-two-tests/ar-BB14p21A?li=BBnb7Kz

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