This is part three of a three-part series on the evolution of Multnomah County’s COVID-19 response team. Part one can be read here; part two can be read here.
‘One of the most important pieces of work I have been involved in’: After adapting to multiple emerging crises since 2020, Call Center and COVID-19 response team wind down operations
Once Bienestar de la Familia was established as the final part of the relay marathon to provide resources, the Communicable Disease (CD) case investigation team and the COVID-19 Call Center focused together on providing tailored public health guidance. In January 2021, the Call Center shifted largely from helping people access COVID-19 tests to helping people find vaccines.
According to Bob, a Call Center lead, a lot of time was spent helping people navigate not just their vaccine eligibility, but also vaccine access. Over the course of 2021, the Call Center created a vaccine calendar for the County and external partners to help people get connected with vaccination opportunities that worked best for them. The Call Center would go on to respond to over 25,800 calls relating to vaccine questions. Calls for testing also never went away, and would rise and fall with surges in the community.
While the Call Center’s main purpose was to respond to the ever-changing aspects of the COVID-19 pandemic, oftentimes the team ws called upon to assist with the response to many extreme weather emergencies happening at the same time. The first non-COVID-19 emergency response was in September 2020 with the Clackamas County wildfire evacuations and the toxic smoke that blanketed the region.
“When Clackamas County issued evacuation orders on that Friday afternoon, they asked us for help, and we were ready to go within hours,” said Bob. “In partnership with Clackamas County, we staffed up for 24-hour operation through the next ten days.”
Since then, the Call Center has responded to new emergencies, including ice and snow storms and extreme heat. One of the largest surges in demand for the Call Center occurred in the summer of 2022, when Mpox emerged as a new issue impacting community members.
“The Mpox response was another really complicated one because of the way we were quickly overwhelmed with demand for vaccines that just weren’t available. We were the primary access point for this vaccine in the metro region,” Bob said.
After the second day of offering the Mpox vaccine, the Call Center started a regional waitlist that grew to over 2,000 people at one time. The waitlist continued to grow faster than clinics could keep up, so more than 5,000 individuals moved through the waitlist. As regional partners joined in and clinic capacity increased, the Call Center called everyone back to offer and schedule appointments.
By early September 2022, the Call Center had offered appointments to everyone on the waitlist, and by the end of October they had fielded more than 15,500 Mpox-related calls and scheduled more than 9,600 vaccine appointments.
Since the team was operating with a smaller staff than during the COVID-19 call volume peaks of 2020 and 2021, the first day of the Mpox response was the Call Center’s busiest ever: on Monday, July 18, 2022, staff spoke to 470 callers and received another 434 voicemails. They extended hours into the evening and brought on additional staff to handle the high demand that continued for weeks. The Call Center ensured all voicemails received a call back within 24 hours.
Since their first positive COVID-19 case on Jan. 23, 2020, the CD case investigator team talked to 7,685 people who tested positive for COVID-19 and investigated 4,533 outbreaks. The case investigator team has now folded their COVID-19 work into the rest of the communicable disease work the team had conducted prior to the start of the pandemic.
After responding to 130,205 calls and emails in over 80 languages over the course of three years, providing over $1 million worth of groceries to households in isolation and quarantine, placing 8,704 referrals for wraparound services, and helping connect almost 80,000 callers with COVID-19 testing and vaccination, the COVID-19 Call Center will be closing in June 2023.
“The phones never stopped ringing, the referrals never stopped coming,” said Xochitl Alvarez, the Bienestar wraparound program supervisor. “Being able to work together in a time of such extreme need was amazing.”
Bienestar’s wraparound services ended on March 31, 2023, after receiving over 10,000 referrals and providing over $10 million worth of groceries, rent and mortgage payments, and utilities to households in isolation and quarantine.
Over the span of three years, the County provided $11.8 million in federal recovery funds to staff community health workers who played a crucial part in the COVID-19 response. While those funds will end on July 1, 2023, the culturally specific engagement and partnerships with community-based organizations will continue and are being actively folded into County health worker efforts.
“This collaboration has been one of the most important pieces of work I have been involved in in my career at Multnomah County,” said Jessica Guernsey, the public health director. “This work demonstrates partnerships across all County work and the commitment to meet the needs in the community even in extreme circumstances.”
Pei-ru Wang, the community partnerships and capacity building manager, also touched on how cross-divisional partnership was vital to respond to a global pandemic.
“From working with the Call Center and Bienestar to the contracts team and finance staff, this kind of work requires cross-county collaboration to be successful,” said Wang. “We all had to break our own barriers and internal silos to work across the County to help serve our communities.”
Both Julie Hackett, the Call Center supervisor, and Alvarez spoke to the fact that even though the reason for starting the COVID-19 response team was due to a global pandemic, what they were able to accomplish, oftentimes starting from nothing and activating in a short period of time, was nothing short of a Herculean effort.
“There were all kinds of intersecting needs that people brought up in those phone calls and we were trusted in connecting people back to County services,” said Hackett. “Our mission has always been to answer the phone when people are in need.”