Rachel Denholm, MPH
What is your current role?
Health Services Policy Specialist at the Ohio Department of Health
In your current position, are you playing a role in the COVID-19 response effort?
Yes, I am in the Bureau of Infectious Diseases, Healthcare Associated Infections Program. We are responsible for COVID-19 surveillance, prevention, control, and outbreak response at the state level. This means receiving reports from Ohio's 88 local health departments as well as hospitals, nursing homes, and laboratories into the Ohio Disease Reporting System. Each day we go through reported cases and classify them, assist local health departments with their investigations, and provide them guidance in outbreak control and response based on CDC recommendations. We compile and analyze the data for daily reports to the ODH COVID-19 dashboard. Each week, I am responsible for ensuring the weekly long-term care facility case reports have been submitted by the local health departments, as well as extract, format, and submit the data for the website update. Before COVID was detected in Ohio, I also created a survey for hospitals to complete assessing their preparedness for COVID-19 cases. With COVID-19 largely affecting long-term care facilities, I work with the department's nurses to conduct infection control assessment calls with facilities with 1 or more cases to provide guidance on controlling the spread of COVID in the facility. I am also creating an Access database to manage our COVID-19 outbreaks and response activities and regularly respond to requests for data about facilities to inform response activities.
What is the main lesson or takeaway that you have obtained during your participation in the response to the COVID-19 pandemic?
The importance of a solid foundation in the public health system that is maintained regardless of whether a pandemic is ongoing. The response has unfolded and developed so quickly that many of our processes proved to not be effective early on and we had to scramble to create and adapt processes to handle the high volume and speed of COVID-19. We are now receiving a lot of money through various grants with very little time to come up with plans for using the money.
It's also become very clear that the balance of data quality and speed of reporting is hard to strike, but especially in the time of COVID. The governor, the media, and public are asking for data at warp speed and expect it to be clean and up to date as soon as it's shared. This is not how public health data works, as it needs investigated and verified before being reported to the public. For example, due to the governor's mandate of long-term care facility reporting on the website, we have to have weekly updates which often need to be corrected after publishing.
Lastly, it has become very clear that local health departments are in need of more funds and staffing. Some only have 1 or 2 nurses or epidemiologists doing all the contact tracing and reporting. A robust public health system needs to be built to prevent overwhelming the system.
How did the VPH program prepare you for this position?
My culminating project gave me the experience in independently managing large, interrelated datasets and analyzing them. Much of my work has required fast turnaround and problem solving that I may not have been prepared for without my culminating project. The program did a great job at describing the structure of government agencies and the chain of command which becomes very important when reporting infectious diseases and communicating with other levels of government. Interestingly, the knowledge I gained about infection prevention and control on food animal farms is very relevant and has many parallels with my work in infection prevention and control in healthcare facilities.
Any other comments or pearls of wisdom you would like to share with current students and alumni?
Now is a great time to be in public health! Not only is it very needed, but COVID-19 has started a whole new chapter in public health, where the general population now have an understanding and appreciation for public health, and infection control is more on the forefront than ever.
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