The Bedford Board of Health last week began its detailed self-assessment of the response to the COVID-19 pandemic, folding the town Health Department into the process.
Using a table format designed by member Maureen Richichi, the board considered three of six overlapping “functional capabilities,” and listed what the board and department did well on each, as well as challenges they encountered.
At upcoming monthly meetings, board members also will ask themselves what was learned, how performances could have differed, and how to prepare in each category for another pandemic.
The discussion followed two months of debate about timing. Member Ann Kiessling recommend that the board prioritize evaluating the entire community response to the coronavirus, with a particular focus on schools and businesses. The other four board members did not disagree, but favored conducting the internal assessment first.
Kiessling and member Anita Raj were absent from last week’s meeting.
Board Chair Susan Schwartz, introducing the process, said the format was to list responses to each question, not to discuss or prioritize the items. That will take place at a future meeting, she said.
Not only board members, but also Health and Human Services Director Heidi Porter and other departmental staff members, participated in the analysis.
The first category was titled, “Emergency Preparedness and Response.” Participants compiled a lengthy list of what they felt “worked well,” ranging from relations with town and school employees; support for the organization of a food bank; and connecting services with isolated residents to a plan in place to dispense vaccine; development of the online Covid dashboard; and use of the Community Emergency Response Team.
Many of the challenges identified transcended the control of Town Hall and the board: changes in defining a positive case; testing not available in the early weeks; lack of funding and logistical problems in executing townwide testing; difficulty in obtaining Paxlovid; and changing definitions of the town’s population (some agencies included Hanscom Air Force Base and the veterans hospital, for example).
Other challenges were the speed of Covid transmission, difficulty in reaching people for contact tracing, defining specific responsibilities of the schools and the Health Department, and ongoing isolation and quarantine protocols.
The second category addressed was “Communication and Community Engagement.” Board members and staff listed the early execution of the dashboard, the effectiveness of the website, customized communications, the use of sign boards, the availability of staff, and encouraging public comments at meetings.
Challenges in this area included dealing with misinformation at the national level, rapidly changing information that was incorrect, politicization of mandates, the strain inherent in working remotely, the physical demands of communicating, and lack of a single medium to reach the entire community.
Also mentioned were the belief among some residents that their rights were being compromised, lack of information to answer questions from residences and businesses, and not knowing the sources of information.
The session also considered how the department and board did with surveillance as well as case investigation and management.
The list of pluses included an existing vaccine distribution plan, partnership with volunteers and first responders, existing avenues of communication, following applicable state guidelines, and strong relationships with staff in the schools and town department.
Participants agreed that the novelty of the virus posed a challenge. Other impediments mentioned stemmed from state and federal policies and practices: protocols prohibited local boards from vaccinating, guidance was changing often, there was initial confusion about terminology, the federal response was delayed, and funding wasn’t immediately available.
Infection prevention and control, community partnership development, and maintaining essential health services and systems are the remaining categories to be explored.