Tank tops and overalls, sunglasses and sandals, tattoos and hair colors spanning all colors of the rainbow: It was a truly Portland picnic in Peninsula Park on Wednesday, June 28 as former and current COVID-19 case investigators, contact tracers and epidemiologists gathered to celebrate, honor and in many cases, meet one another for the first time.
Balancing plates of beans and rice, fruit salad and chocolate chip cookies, staff hugged and laughed between frequent trips to an ice cream truck parked nearby. Guests scanned the plump faces of 26 baby photos affixed to a poster, looking for traits that would give away their colleagues (No. 16 looked like Isabelle. No. 18? Impossible to tell.)
Even the senior manager couldn’t be sure.
“This is the first time I’m meeting a lot of these people in person,” said Communicable Disease Manager Lisa Ferguson, who has led the team. “It feels so rewarding to see all these people who put so much into the response.”
Nick Rivas, sporting a green frog bucket hat, gathered with coworkers and greeted former colleagues. Rivas has eased into a routine of predictable hours and days, but it’s not hard for him to recall the months of unpredictability, fear and frustration.
“That first winter surge was really rough,” he said of the Delta variant wave that began in September, 2020.
Six months into the pandemic, as Multnomah County raced to meet the growing case counts, Communicable Disease Services swelled from 15 staff responding to all reportable communicable diseases to 95 case investigators and contact tracers focused entirely on COVID-19. They had the resources to conduct outreach and education. But as positive tests piled up, staff struggled to enter new cases into the state’s database, OPERA.
“The system would freeze every time you tried to enter a case,” he said. “It had been slow before the surge, but that winter it felt like our wings were clipped. We had the human resources. We had the financial resources, but not the technology.”
Today, after 28 months, 141,103 cases, 3321 outbreaks and 1,247 deaths — it’s not hard for staff to pinpoint the worst moments of the pandemic.
Nursing Supervisor Sara McCall points back to the beginning, when public health knew so little about the virus hitting the United States.
“It’s just travel-related,” she said with a humorless smile, referring to the first information local and state health officials —her among them — shared with a community group in February, 2020. Early on, health officials were most concerned for people who had symptoms after traveling to a specific province in China.
There was so much yet to learn, and so much heartache yet to suffer. Within weeks, McCall was working frantically to keep people from dying in long-term nursing facilities.
“I came to work every day and learned about a new death,” said McCall, who led efforts to impose infection controls and support staff who feared for their patients and themselves. “I remember trying not to cry during debriefs, when I had to tell our team how many people were sick and how many people had died that day.”
Before it was over, 30 people would die in a single facility.
Like so many public health professionals who served during COVID-19, McCall has been offered — and has considered — other jobs. Her life would be easier. Less stressful, fewer hours. But she repeatedly chooses to stay.
“It’s this team, the people I work with,” she said. “When we were in a small outbreak team we just developed such close bonds. We worked so well together. We loved each other. It was a really special group of people.”
This spring, as the virus evolved, the County’s response also shifted, away from contact tracing and individual case investigations to focus entirely on outbreaks. And McCall integrated more than 20 new members into that work. And she isn’t the only one who chose to stay. Most of the pre-Covid case investigators stayed too — among them Marta Fisher and Anne Schwindt, Kevin Jian and Noel Silhan, and Russell Barlow.
And as easy as it is to recall the pain, they can also point to some good that came from a global pandemic.
“We got to do the coolest epi work,” said Barlow, an epidemiologist who conducted disease surveillance and analysis that was often more equitable, accurate and timely than information coming from the state or federal government.
Communicable Disease Services epidemiologists, among them Barlow, Jian, Allison Portney and Taylor Pinsent, gathered detailed race and ethnicity data on their own during the course of case interviews and interpreted the data so County leaders could allocate resources in a more equitable way.
They pushed for access to state vaccination records and negative COVID-19 lab results. Coupling those data sets with the case data allowed Multnomah County to track vaccine effectiveness in real time.
“It allowed us to automate things in a couple of weeks that normally would take months and months,” Barlow said.
County leadership allowed Barlow and others to push the boundaries, to take risks. It was also that leadership they turned to when things got too heavy to carry alone. For many on this team, Communicable Disease Manager Ferguson was not only the boss. She was their emotional support, as well.
“When you’re busy it can be difficult to make space for people,” Barlow said. “But Lisa does.”
Kate Horn, a nurse who joined the COVID-19 team in June 2020, nodded.
“She's the best boss I’ve ever had,” Horn said, who met Ferguson in person for the first time on Wednesday. “She’s kind. She’s genuine. She's available. She’s transparent.”
The COVID-19 team kept their coworkers spirits up too. During virtual huddles someone would offer up the “stupid joke of the day.” Then Katie Beaumont, who had a drum set at home, would sound off a loud “ba-dum-bum-CHING.”
They would blast Boyz to Men, display their dogs, cats and children in show-and-tell, and photoshop one another's heads atop Spice Girl bodies.
For decades, governments have defunded the public health work that keeps people well — programs like WIC, the Healthy Birth Initiative, immunization programs, violence prevention, and the data systems that allow for effective disease surveillance and timely intervention. The COVID-19 pandemic infused local and state public health with new funds for the first time in years, allowing them to hire staff, launch new initiatives and invest in tried-and-true prevention.
Ferguson, who has worked in public health for 16 years, knows the federal investments in public health are unlikely to last.
“This has been the first time in this job that I feel like we have the resources to focus on prevention and outreach,” she said. “ But it feels tenuous. That funding is constantly under threat.”
For much of the pandemic, Ferguson, like other public health leaders, gave up her personal life to the response. “There was a point where I realized my time is no longer my own,” she said. “24 hours a day, 7 days a week. There was never a time when I wasn’t working.”
As she worked, her son Ethan and her daughter Emelia worked their way remotely through high school and her husband Ken worked his way remotely — often in flannel pajamas — on curriculum development. But Ferguson rarely had energy for conversation. Dinner often doubled as an insider's report on the latest COVID trends.
It was hard. It was lonely. But it was necessary.
“I'm really proud of her,” Ferguson's husband, Ken, said. “Here we are in a global pandemic and no one knows what to do. But she’s there, she’s in it. She’s doing the work.”
Right now, fewer people are dying from COVID-19, but the virus continues its steady spread. After six surges, COVID has settled onto a plateau. But other diseases, like Monkeypox, lurk on the periphery. Knowing that — that there will always be a crisis demanding her attention — Ferguson has learned to make time for family vacations and weekends.
“Thankfully I’m in a much better place now,” she said. “I’ve figured out how to give myself some space and spend time with my family. And events like this give me an opportunity for optimism, just the energy of the people here.”
Ferguson’s family joined her Wednesday, along with their dog Sasha, who darted joyfully among zooming children, some dressed as Stormtroopers. They slurped on SpongeBob popsicles and bit into ice cream sandwiches as Lisa made the rounds.
As the evening set in, staff and their families gathered around a COVID-19 virus pinata ready for destruction. Children took turns wielding a long baton, swinging, missing, striking the large gray orbe.
When it finally broke apart, a pile of little bodies launched themselves at a truly public-health bounty: bags of popcorn and sheets of salted seaweed, with a few Dum Dums mixed in.
Ferguson slipped into the fray and emerged again, holding aloft a red paper mache rod.
“I’m keeping a spike protein,” she shouted.