After Action Report Reveals Hepatitis A Outbreak Helped Refine COVID-19 Response

After Action Report Reveals Hepatitis A Outbreak Helped Refine COVID-19 Response

San Diego County was quick to take the COVID-19 pandemic seriously, declaring a local state of emergency on February 14, 2020, weeks before the state followed suit on March 4.

Along with UC San Diego and the Padres, the local public health department collaborated on what became the state’s first super vaccination station, which opened near Petco Park on January 11, 2021.

And those who oversee the region’s emergency medical system were among the first in the state to request special permission for paramedics to help deliver vaccines when demand for doses was fiercest.

The region was ready to take early action as the novel coronavirus began to spread across the United States and, as a recently released after-action report notes, local efforts have benefited greatly from recent prior experience.

State law requires local governments that have declared local emergencies to complete and submit these reports to the California Office of Emergency Services within 90 days of the end of the declaration.

San Diego County supervisors commissioned Illinois-based Hagerty Consulting Inc. to research and write what, with appendices, is a 281-page review of the local COVID-19 response.

After reading the documentation and conducting their own interviews, the consultants wrote that they detected a strong influence from the region’s response to the 2017 hepatitis A outbreak, which spread widely among residents without housing in the area, sickening 592 people and killing 20.

An after-action report of this incident recommended that the county train more public health personnel in proper emergency management and coordination of resources within a broader group of organizations, including those outside the government of the county. county.

This work, analysts say, paid off in early 2020 when COVID-19 emerged.

“The response to the hepatitis A epidemic has also played a vital role in establishing and enhancing countless partnerships at all levels of government and the private sector,” the report states. “These relationships translated immediately into the response to COVID-19, putting the county ahead of most other jurisdictions.”

The report’s writers praised the use of a special “political group” made up of local leaders and others with significant interests in how the pandemic was handled, providing a conduit for more two-way information to flow. faster than when hepatitis A was the problem-causing virus.

The reviewers also found that financial controls were in place as hundreds of millions of dollars in federal funding for the COVID-19 response arrived, that social distancing programs adequately prevented outbreaks among county staff. forced to work in person and produced “accurate and actionable information in his communications with the public.”

A total of 16 recommendations for future improvements are free of big shocks.

The advice ranges from continuing with table top exercises, training and drills to reviewing civil service rules to “identify and remove barriers to hiring staff in temporary situations”.

Several recommendations relate to better processing large volumes of public health data, which has proven difficult during the pandemic using equipment that is not necessarily designed to quickly analyze tons of incoming information in reports. newspapers intended for public consumption.

But the report doesn’t assess what many members of the public care about most: the decisions that have upset so many people for so long, from stay-at-home orders to masking regulations.

Katie Freeman, COO of Hagerty Consulting, said in an email that those kinds of questions were outside the scope of the report.

“The After Action Report focuses on emergency response activities; our scope does not include the evaluation of public health decisions made,” Freeman said in an email.

After reviewing the document Friday morning, Amy Reichert, director of Reopen San Diego, a group that has been critical of many local, state and national pandemic decisions, said she was surprised to see some missing elements.

The county’s monoclonal antibody clinics, she said, should have been mentioned. These clinics, she said, were underutilized and “could have been lifesaving” if not for the fact that “many people weren’t even aware of this life-saving treatment.”

“Instead, county messaging was more heavily focused on vaccination even after CDC Director Rochelle Walensky admitted on CNN that vaccines no longer prevent transmission,” Reichert said in an email. mail.

“There could have been more hindsight on the proportion of vulnerable people who were educated and/or received treatments available in the county, such as monoclonal antibodies.”

The county’s temporary accommodations program, which paid for hotel rooms for those who needed to quarantine but had nowhere to stay where they couldn’t infect others, was another area where the activist said the after-action report failed.

A review of the program authored by San Diego State University researchers and published in 2021 found that it was effective in increasing the number of people who managed to self-quarantine after being infected, thereby preventing the spread of the disease. But there were also a significant number of noted issues.

“The biggest concern is that services, especially those who were sick, were inconsistent and sometimes inadequate, including: nursing and medication services; the supply of towels, sheets, toilet paper and cleaning products; food services; interactions with staff; and admission and discharge services to consolidated groups,” the SDSU report states.

“In addition, significant challenges in serving people with behavioral health needs were noted, and given that staff have reported drug overdoses, suicide attempts and other critical incidents, these challenges warrant consideration. more in-depth.”

These types of observations, Reichert said, deserved to be included in the final analysis.

“Overall, it is crucial to recognize the shortcomings and shortcomings of San Diego County’s COVID-19 response to ensure lessons are learned and improvements are made to protect people and save lives. “, said Reichert.

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