Mauians train to aid during pandemic

UH-DOH program equipping health workers, residents to trace, do outreach

University of Hawaii Maui College community health worker students Alannah Chung (left) and Adanacio Primo Jr. practice their skills in a simulated patient-worker scenario in 2016. UH and the Department of Health are are looking to train contact tracers and community health workers as part of their joint program that launched earlier this month. Photos courtesy Selene LeGare

Eleven Maui health care professionals and two community members are training to become another kind of essential worker that’s proven crucial during the pandemic — the contact tracer.

The Maui residents are participating in the University of Hawaii and state Department of Health’s contact tracing program, which began earlier this month and has drawn interest from more than 1,300 people across the state. While not all are eligible, the response has shown a growing interest in the field.

“I knew we would have a lot of interest. I don’t know that I knew it would be this high,” said Dr. Aimee Grace, director of health science policy for UH and the principal investigator and administrator of the program. “We’re thrilled at the response from across the state and greatly appreciate the community rallying to help with our state’s COVID-19 response. It’s been really inspiring.”

The program includes two tracks: an accelerated, one-and-a-half day training course for health care professionals with an undergraduate degree and clinical health background, and a six-week training course for those with undergraduate degrees but no clinical background.

Track 1, which began June 8, has trained 77 people as of Thursday, including 11 from Maui and more expected in the coming days. Grace said the goal is to train 320 by mid-July but that they’re on track to train 374. Track 2, which started on June 15, has 31 people in its first cohort, including two from Maui. The goal is to train 250 people by June 2021.

Laura Johnson (far left) gets hands-on practice doing outreach and education with fellow community health worker students in 2016. The University of Hawaii and Department of Health are looking to train contact tracers and community health workers as part of a joint program that began earlier this month.

Contact tracing is nothing new; in fact, it’s “an age-old tool that we use for every disease,” state epidemiologist Dr. Sarah Park said last month during a webinar on the training program.

Contact tracers call the people who’ve tested positive for the virus to help them retrace their steps over the past 14 days (the incubation period for COVID-19) and identify all the friends, neighbors or co-workers whom they might’ve had close contact with. They then call up those people to inform them they’ve been in contact with someone with the virus and need to quarantine for two weeks.

The original person and their contacts will get a phone call at least twice a day from an investigator or, with the department’s new HealthSpace application, a text or email to respond to a survey. Symptoms are monitored and if a contact gets sick and tests positive for the virus, the tracing process starts all over again.

When COVID-19 first began appearing in the islands, many cases were visitors or residents coming from out of state. But as travel declined under the state’s quarantine orders, Hawaii’s cases have shifted from mostly travel associated to now community associated, “and that really is a much bigger concern from a public health perspective,” Park said during the webinar.

“Everyone is talking about contact tracing, and certainly that’s a very important part of what we do, and everyone feels that is the huge burden that we bear for public health,” Park said.

Grace said that the people who’ve expressed interest in the training program have been a mix of all ages and experiences, from recent high school graduates to registered nurses and part-time firefighters. For those with nonclinical backgrounds who do qualify, Track 2 is geared toward helping them gain that experience so they can eventually take Track 1, which “really jumps into the key details about COVID-19 transmission and symptomology, infection prevention and processes for contact tracing.”

Those who complete the contact tracing program are encouraged to join the state’s Medical Reserve Corps to be available to volunteer in the state’s response to COVID-19.

As for whether this will become more of a viable career option in the future, Grace said that depends on the DOH and the number of cases Hawaii sees.

“We want to emphasize that UH’s role is a training program, and it would be ultimately up to the Department of Health to hire a contact tracer,” she said.

Grace added that “a third arm of the program” is the community health worker training. These are people who go out in person or virtually and meet with patients. Sometimes it means visiting someone who has diabetes to make sure they’re taking their medicine. In the context of a pandemic, it can mean checking up on positive cases.

“Contact tracers often do their jobs from their phones,” Grace said. “They’re often calling the people who are identified as cases or contacts. But community health workers are out on the front lines in the communities. For example, maybe following up with an individual who is a close contact, making sure he or she is in quarantine, making sure he or she has health care, access to transportation, access to basic needs.”

The University of Hawaii Maui College and Kapiolani are the only two community colleges in the UH system with a community health worker program. Selene LeGare, Human Services Program coordinator at UHMC, said that these workers are crucial because “they have the trust, they have the rapport with the community” and know how to connect people with resources.

“As people are struggling more in this pandemic and trying to find access to food, access to SNAP benefits, access to housing assistance, these are the folks who know how to navigate these systems,” LeGare explained. “You can have a doctor tell you what to do, but if you can’t access the resources, if you don’t understand the instructions, you are a little bit afraid or struggling.

“Just having someone there to hold your hand and walk you through it is essential.”

Some community health workers are based in clinics, like Malama I Ke Ola. Others are with agencies like the Family Life Center, reaching out to the homeless. Like contact tracers, their role is “absolutely” growing in demand during the pandemic, LeGare agreed.

Both the UHMC and Kapiolani programs are available online and have local internships available. LeGare said the Kapiolani program is good for those interested in a fast-track course, while the UHMC program has a more spread out, flexible schedule. For more information, visit maui.hawaii.edu/communityhealth.

Grace said Friday that the goal is to train 100 community health workers over the next year. Enrollment hasn’t started yet, and she said they would love to have Neighbor Island participants.

While Track 1 is full, Track 2 and the community health worker program are taking candidates. To apply, visit go.hawaii.edu/AQX or email oshi@hawaii.edu.

* Colleen Uechi can be reached at cuechi@mauinews.com.


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