Commentary: Preparation and prevention point toward reopening Delaware

By Dr. Kara Odom Walker

As the state nears the first steps toward a broader reopening of businesses June 1, I wanted to share my perspective as Delaware’s Health Secretary about our ongoing response to the COVID-19 pandemic and our plans for managing the public health of Delawareans going forward.

On March 11, we announced the first presumptive case of COVID-19 in our state. Just a few days before that historic announcement, Public Health Director Dr. Karyl Rattay said our state was prepared for the long haul. “This is a marathon,” she said that day, “not a sprint.” Dr. Rattay was right, and her admonition reminds us of what we’ve been through and the public health response yet to come.

Dr. Kara Odom Walker

Less than 10 weeks later after that announcement, COVID-19 has changed our world in previously unimaginable ways. Since that first case, we have announced more than 8,000 positive cases. We, sadly, have lost more than 300 Delawareans to COVID-19. Yet today, we see hope in a declining number of people currently hospitalized (less than 240) and are heartened by the more than 3,700 people who have recovered from this new and serious respiratory disease.

The heartbreaking losses we have suffered up and down our state have been mitigated by the Emergency Orders that Gov. John Carney implemented: closing schools, ordering Delawareans to stay at home except for those working in essential businesses, closing beaches, prohibiting out-of-state visitors, requiring people to wear face coverings in public, providing for widespread community testing and contact tracing, and many more. The governor took all of these actions to keep us safe and to protect the most vulnerable – seniors 65 and older, individuals with underlying health conditions, people living or working in close proximity, and individuals with disabilities.

We will never know how many lives those actions saved or how many people were spared the uncertain future of a positive test result. We do know that those measures came with a huge financial cost to individuals, families, businesses, nonprofits, health care systems, educational institutions, and governments.

As we begin to reopen the economy, we also know that our recovery will take time, resolve and patience.

It also will take an unprecedented public heath response. Going forward, we cannot let up on the measures that have helped us to flatten the curve. While we thank the health care workers and other first responders for their courage and dedication in serving our neighbors suffering from COVID-19, it will take all of us to prevent outbreaks of this disease going forward. The virus is still here. It’s the measures we have adopted collectively that have limited transmission so far.

We need to continue to embrace social distancing when we are in public settings, including in our workplaces, our places of worship or at the beach. Wearing face coverings in public is now a new way of life as well. We must continue to wash our hands regularly, use hand sanitizer as often as possible, wipe down commonly used surfaces with disinfectant, and cough or sneeze into our face masks or our elbows.

Preventing flare-ups is our shared responsibility. It is the only way we will protect ourselves and our neighbors.

This point is critical: If you are sick, you must stay home from work and not go out into public areas. If you have any of the symptoms of COVID-19 – fever, cough, shortness of breath, sore throat, muscle fatigue, chills, shaking with chills, or loss of smell or taste – you need to call your doctor to see if you should be tested. If you don’t have a doctor or are uninsured, please Delaware 2-1-1. If you are deaf or hard of hearing, text your ZIP code to 898-211.

Widespread community testing is one of the public health pillars that will allow us to move forward with confidence. The state has bought 200,000 saliva-based viral tests that can help determine if people are currently infected with the coronavirus. We are partnering with Delaware’s hospital systems, primary care physicians and other providers, Federally Qualified Health Centers and other community partners.  Our goal is to perform 80,000 tests per month, or four times what we have been doing statewide. It’s an ambitious goal, but it is doable.

As we test more Delawareans, we also are preparing to do more contact tracing. On May 12, Gov. Carney announced that Delaware had entered into an agreement with the nonpartisan research institution NORC at the University of Chicago to build our contact tracing program. Because of the thousands of positive cases in our state and the contagiousness of this disease – one person infected with the virus can infect two to three more people – we need to move quickly to alert people who may have been exposed to someone who tested positive, and to advise them of their need to self-quarantine.

That is basic public health work to slow the transmission of a highly contagious disease. Through NORC, we are prepared to hire as many as 200 Delawareans to help with this work, including people who live in and know their communities. To break down barriers, this diverse workforce will include people who speak Spanish and Haitian-Creole and know the cultures of the people they will serve.

As we work to build our testing and contact tracing systems during this month and next, we also will plan for a possible second wave during the fall or winter. Our Division of Public Health (DPH) and the Delaware Emergency Management Agency (DEMA) will work with health care systems to build our supply of personalized protective equipment, ventilators, and other medical equipment. DPH and health care providers will order additional doses of flu vaccine, expecting more people will want that extra measure of protection in the fall. We will continue testing of vulnerable populations, including seniors and members of low-income communities, front-line workers, symptomatic individuals, and anyone with a known exposure to COVID-19. And we will identify, isolate, and, if needed, care for our neighbors with COVID-19. Until we have a coronavirus vaccine, we will continue to prepare for what comes next.

Dr. Kara Odom Walker is the Cabinet Secretary for the Department of Health and Social Services and a practicing family physician.