RoAnn Warden is the Green County Public Health Director. The Green County Public Health Department serves 37,000 residents. The department is located in the city of Monroe, population just under 11,000. WORH spoke to Warden on April 23, 2020.
Q: What are your biggest challenges right now responding to the coronavirus pandemic?
Warden: The amount of information overload is a challenge. Guidance from the department of health services or the state emergency operations center or elsewhere is constantly changing. We are trying to stay abreast of what’s most current. Early on, we were trying to squash rumors and making sure our community was getting valid information. We wanted to make sure that our website had the most up-to-date and credible information.
Q: I’ve heard that in some small towns, people were trying to figure out who had COVID-19.
Warden: We really stood our ground and did not give out any identifying information. And people wanted to know because they want to protect themselves and they think they need to know that in order to do that. We are doing what we can to protect the public health and protect that individual’s privacy. So, battling that has been a challenge.
The workforce has been a challenge to make sure that we have adequate workforce to do our job, to protect the public, and not get overwhelmed. For public health, we’re at the top of our game now. We need to be at the top and to do our jobs with reduced staff because our budgets are cut. Having adequately trained people to do the work and available quickly is another challenge. For our county, fortunately, they supported me bringing on limited term employees, such as retired public health nurses who had experience doing what it is that we need to be doing.
The personal protective equipment (PPE) and testing have been our most significant barriers in addition to just being able to stay on top of the rapidly information coming at us. Testing resources are more limited than they are Dane County. Those first couple of cases that we identified through testing in our county were probably spillovers from commuting to Madison.
Q: Green County is a rural county but it’s so close to the Capitol and Dane County, which has a higher level of cases.
Warden: Right. Like my sheriff shared with me at our emergency operations team meeting, he’s said, keep in mind Madison is just 30 minutes away. Madison is experiencing people in the jail and workers who are positive. There’s many more positive cases in Madison. And that’s only 30 minutes away.
Q: Are you going to be able to increase testing capacity?
Warden: Certainly, if we have major outbreaks of coronavirus, we will do massive testing. But right now, we’re following guidelines. As public health, we’re not the ones on the front lines doing the testing. Our healthcare systems are actually doing the testing, especially in smaller counties like ours. We don’t have staff that go out and test people. Testing is being done in a medical facility, such as urgent care. Right now, we’re testing people who are symptomatic.
We’ve had to follow guidelines from the CDC about priority testing and it is opening up now a little bit more. We’re seeing more community members who have symptoms that are getting tested now that we are seeing an increase in testing supplies. There’s a little bit better flow of testing supplies, but certainly not what’s needed to do testing for everybody that wants it or needs it. We’re not even close.
Q: Is childcare an issue?
Warden: No, it hasn’t been in our county. We have daycare centers that have remained open to make sure that there’s daycare available for those essential workers. And some of them have actually closed their doors because they didn’t have enough to keep open. So, we haven’t had an issue with childcare.
Q: What are some of the good things you are doing?
Warden: In our county, people have really wanted to do their part and have stepped up. I see so much social distancing going on. For the most part, our residents have been great at rule following, when I think about what’s been imposed upon them with the public health order.
This pandemic has brought out the best in people. People are stepping up to volunteer to make masks, to put together food and supplies for health care workers.
We did a joint effort with our emergency management, our Monroe clinic, and public health. Many weeks ago, we mailed all of our businesses and asked for donations, or if they had any personal protective equipment. It was great to see businesses donate their supplies of PPE for health care and long-term care and first responders. That’s been tremendous. People’s generosity and willingness look out for one another and do their part to protect their neighbors and seniors and the more vulnerable and their families has been outstanding. There’s an overall general awareness.
From a public health point of view, when I think about communicable disease and infection control, the general knowledge has just skyrocketed. Who would have thought we would be talking about “contact tracing” and “social distancing” in the general public? Those are were words that were used in public health and now it’s out there every day.
People are doing the right thing and knowing that this is the right thing and following the order for the most part. That’s been a really positive thing. Generosity is helping one another, looking out, and donating, whether it be, PPE making cloth masks and meals for shut ins. It’s just been tremendous.
The good news is that we haven’t had a death here. All of our cases have recovered nicely. So far. Knock on wood.