All Hands on Deck

Oakland County Executive Director David Coulter speaks about the county's approach at a March 13 press conference.

The Oakland County Health Division has been tracking the spread of COVID-19 since it appeared in Wuhan, China, late last year.

From those early efforts to opening a donation center for desperately needed protective equipment on March 23, Oakland County has taken a multi-departmental approach to combating what has become a worldwide pandemic.

The outbreak of COVID-19, a respiratory illness caused by the quickly spreading novel coronavirus, prompted County Executive David Coulter to declare a state of emergency on March 13 — the same day President Donald Trump declared a national emergency. Coulter’s move allowed the county to more easily shift resources to address the crisis, opened the county’s Emergency Operations Center (EOC), activated parts of its Emergency Operations Plan and paved the way for federal disaster relief to the county when and if it is authorized.

“We’ve taken this very seriously since the beginning, and we are employing all resources to meet the challenges with the pandemic,” Coulter said on March 24.

As of the morning of March 25, Oakland County had 515 confirmed cases of coronavirus, 116 people hospitalized because of it and 10 deaths from the disease. On March 23, Michigan Gov. Gretchen Whitmer announced a stay-at-home order intended to keep people at their residences and close physical places of business — except those deemed essential — in an effort to slow the spread of the virus. County officials have been urging the public to follow Whitmer’s directive.

“It was a tough but necessary decision because, very simply, the way you slow this virus is to reduce interactions, and we have to do everything we can,” Coulter says.

Coulter says testing needs to be increased dramatically and that the lack of test kits coming from the federal government has been the most frustrating part of managing the crisis.

“We have to do a better job as a country” to increase testing capacity, he says.

Around the Clock

The county-level emergency declaration has the county’s medical and emergency preparedness professionals working long hours, whether to investigate newly reported cases in efforts to find out how and where the virus has been traveling, communicate the best information during a fast-developing situation or track down supplies of the protective equipment needed by medical professionals, among many other tasks.

Dr. Russell Faust, medical director at the Oakland County Health Division. Photo courtesy of Oakland County

“There is no typical day,” says Dr. Russell Faust, medical director at the Oakland County Health Division. The situation is “different and crazy every day,” and staffers on the department’s communicable disease and epidemiology teams are putting in 12- and 14-hour days, Faust says.

Among the steps the health division has taken are putting extra nurses on its Nurse on Call phone bank (800-848-5533) and expanding the investigative team from eight to 12 people while ramping up coronavirus investigations.

“We’re basically shifting resources to do what we can on COVID-19,” Faust says.

The division’s detective work has revealed what Faust says is a predictable pattern in the spread of the virus. Early on, he says, the patients who tested positive had recently traveled, which likely put them in contact with the disease. Then cases began appearing among those who’d had contact with someone who was known to have tested positive. Now, coronavirus is being spread in the community by those who may not know they have the virus, Faust adds.

“We’re rapidly moving toward majority community-acquired,” he explains. “It’s what you’d expect in an outbreak like this.”

Putting Plans into Action

For Thomas Hardesty, manager of the county’s Homeland Security Division, planning for coronavirus — and a host of other possible disasters — is an ongoing part of the job, even in ordinary times. A pandemic response is included in the county’s Emergency Operations Plan, Hardesty says, though — as with the response to any emergency — “the fine details get added and adjusted” as the situation unfolds.

“We’re always trying to plan,” Hardesty says. “We’re planning for next week and a few weeks from now.”

Communicating up and down the chain of command between officials calling the shots and the people on the front lines, such as first responders, hospital staffers and other medical professionals, is the most important task right now. Hardesty is also in touch with state and national officials.

Homeland Security’s staff of nine is getting assistance in its coronavirus response from many facets of county government, Hardesty says, including the sheriff’s office; the health division; and legal, finance and purchasing professionals.

“It’s not just the occasional meeting. It’s constant communication,” he says. That makes it difficult to run emergency operations remotely, Hardesty says. Still, even at the EOC, people are maintaining social distancing and minimizing personal interactions.

“We’re trying to minimize people being here as much as we can,” he says.

The donation collection site at the Oakland County Farmers Market for personal protective equipment or medical professionals. Photo courtesy of Oakland County

On top of that, everyone who needs to enter the building is given a quick health screening, including a temperature check, first. It’s the same type of screening that’s being done at other county properties and at many health care facilities.

And on March 24, Coulter invoked an order that calls for businesses and operations that remain open under Whitmer’s directive to implement a daily screening program for all staff.

Hardesty says Coulter has been the effective public face of the county’s COVID-19 communications effort.

“Everything is changing constantly,” Hardesty says. “He’s a great communicator, so he’s constantly trying to update that message and push it out to the community.”

Homeland Security on Monday opened a drop-off center (at the Farmers Market, 2350 Pontiac Lake Rd., Waterford) for the collection of personal protective equipment (PPE) for medical professionals: masks, face shields, surgical gowns and the like. Hardesty says the department has already collected a “significant amount” of gear from medical sites, such as dental clinics, that are closed during the emergency, and is redistributing it to health centers that are most in need.

“Until that’s fulfilled, that’s going to be one of our primary” duties, Hardesty says. Before the donation center opened, workers went out in the field to collect PPE donations.

“We’re scrambling to find all these items where we can, but it has limited our ability to respond,” Coulter says. The shortage also includes test kits and ventilators, which are used to treat the most severely affected coronavirus victims.

This week, the county was mapping out ways to provide temporary shelter to people who might be displaced by, for example, overcrowding at hospitals or the need to isolate carriers of the virus away from others. Temporary shelter would also include provisions for the county’s homeless population, he says.

Steps taken so far include the possible activation of a Michigan National Guard mobile hospital unit and contacting hotels, motels and colleges with dormitory space they might provide.

Coulter isn’t sure temporary shelter arrangements will be needed, but says the county is preparing for a worst-case scenario.

“If we don’t reduce infection levels,” Coulter says, “there’s no question it will be necessary.”