How School Nurses Are Helping to Track, Contain COVID-19

Armed with a cellphone and laptop, one school nurse makes calls to county residents who have tested positive for the virus, and she is one of 16 school nurses in Maryland redeployed to help during the pandemic.

by Alison Knezevich, The Baltimore Sun / May 6, 2020
Shutterstock/cowardlion

(TNS) — When Maryland schools shut down in March, Lansdowne Elementary nurse Kristi Lowman reported for work instead to a Towson office building, where she sat at a long folding table and answered calls to Baltimore County’s COVID-19 hotline.

“I learned, honestly, the mental strain that it was putting on people,” said Lowman, who answered calls at the county’s Drumcastle Government Center for two weeks. “They just wanted someone to talk to."

These days, Lowman works from her dining room table in Catonsville, but she’s still part of the county’s fight against the coronavirus. Armed with a cell phone and laptop, she makes cold calls to county residents who have tested positive for the virus — one of 16 county school nurses redeployed to help the local health department during the pandemic. An additional eight school nurses are set to soon join the team, which works in shifts seven days a week.

Working from home, they collect data and explain to patients how to isolate themselves and best protect their family members. They also conduct interviews to determine who these residents recently had close interactions with — a first step in a process known as contact tracing that experts say will be vital to containing the virus and allowing governments to lift stay-at-home orders. The health department then notifies the people with possible exposure so they can quarantine.

Baltimore County is among the hardest hit by the virus outbreak in Maryland — and it needs many more people to do this type of work. County officials say they currently have 52 people working on contact tracing, including the school nurses, and want to hire about 60 more people by July.

Contact tracing helps “stop this virus in its tracks” because people who may not yet be symptomatic but are still contagious are notified quickly, said county health officer Dr. Gregory Wm. Branch.

“We tell all of them, 'You need to be in quarantine,” Branch said. “They then don’t spread it to other people."

Experts say the nation will need to vastly ramp up its contact tracing capabilities — in addition to testing — to start reopening. A report from the Johns Hopkins Center for Health Security suggests the country will need 100,000 workers to conduct contact tracing at a cost of $3.6 billion.

For now, local governments across the region are looking to school nurses as a resource. In Anne Arundel County, they’ve been trained to conduct contact tracing. In Carroll County, they are helping to staff the county hotline to help free up health department staff for contact tracing.

School nurses are responding to the pandemic in other states, too. Like those in Baltimore County, often they are working on virus-related hotlines and contact tracing, said Linda Mendonca, president-elect of the Silver Spring-based National Association of School Nurses.

“Nurses want to be able to help," Mendonca said.

Over the phone, the school nurses in Baltimore County are getting a personal glimpse at the hardships the illness inflicts on local families.

“They’re suffering on multiple levels," said Kearen Jabaji, a supervisor in the county schools’ health services office. "Some of the people we’re talking to are very ill.”

It’s a far cry from the days of bustling schools treating stomach aches, conducting health screenings and helping students manage diabetes and other chronic illnesses.

They’re also hearing how the pandemic’s economic impacts are weighing heavily on families. For some, it is hard to hear that they shouldn’t go to work.

“A lot of people need to work,” said Ruth Arenas, the nurse at the George Washington Carver Center for Arts and Technology in Towson. “They worry about their livelihood.”

Jabaji said that the work appears “180 degrees away” from her typical job but draws upon some of the same skills.

“It looks different, but it’s still the basic nursing principles — educating, supporting, case management,” Jabaji said.

To help determine who else might have been exposed, the nurses ask a series of questions: Did you go to work? To the store? Did you visit any family members?

Some people easily recall the details of their daily lives, while others need more prompting, the nurses said. With stay-at-home orders in place for more than a month now, many people have curtailed their activities, which in turn limits their contacts with others, Lowman said.

Several nurses said they’ve been surprised at the wide range of symptoms that patients describe. Some people can barely muster the energy to talk. Others have symptoms so mild they’ve brushed off as allergies.

Once the nurses draw up a list of possible contacts, they give the information to the health department, whose staff notifies those people that they may have been exposed to someone who tested positive without identifying who may have exposed them.

Lowman said her experience with the county hotline showed her how important the public health response to the virus was.

“I wanted to be a bigger part of it,” she said. "As a nurse, I felt drawn to do something at this time”

She has found another way to help, too.

When she’s not working, she sits at another side of her dining room table, sewing cloth masks.

©2020 The Baltimore Sun. Distributed by Tribune Content Agency, LLC.

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