Public health students assisting long-term care facilities with COVID-19 response

COVID-19 can affect anyone, regardless of age, race or ethnicity. However, older adults living in long-term care facilities (LTCFs) have been disproportionately affected. According to the CDC, the communal nature of LTCFs and the population served (i.e., generally older adults often with underlying medical conditions) put those living in these settings at an increased risk of infection and severe illness from COVID-19. In order to protect both LTCFs residents and staff of these facilities, a strong infection prevention and control program with emphasis on testing is critical.

A team of Medical Reserve Corps (MRC)-trained Master of Public Health (MPH) and dual Doctor of Veterinary Medicine/MPH students, along with employees from the New River Health District (NRHD), have answered the call to assist this population during the pandemic by providing testing and other key response services. For many of the students, this was their first time working with LTCF residents and staff and applying certain knowledge and skills learned in the classroom to the field.

Working with LTCF residents for the first time can be an overwhelming experience for individuals, as DVM/MPH student Ella Rak mentions, “In the face of every resident, you see your loved ones and feel the pain and loneliness that isolation has brought them. Under the unparalleled mentorship of NRHD Health Counselor Barbie Zabielski, though, our team has learned how to maintain quality and efficiency when communication is limited, resources are constrained, and risks are high.”

Residents of LTCFs tend to have more functional limitations, including vision and hearing impairment. MPH student Jaclyn Abramson noted witnessing the challenges this population faces, which are heightened during a public health crisis, “Many individuals living in LTCFs are hearing-impaired and rely on reading lips and facial expressions for communication. While masks help to protect the residents of these facilities, they also provide an added barrier. Luckily, we were able to supply face shields to LTCF staff to help give a sense of familiarity and comfort back to the residents.”

The team of students are learning from each other how to work through the challenges that face this population. “Prior to COVID-19, I had little experience working with individuals in LTCFs, and I was unsure of what to expect when I was asked to assist with testing services. With the guidance of my fellow peers and mentor on how to approach this daunting task, I have been able to assist in this crucial service with confidence,” MPH student Hannah Reed mentioned. Reed continued, “Testing these individuals is one of the hardest things I have ever had to do, as it is a super uncomfortable experience and not all of the patients are able to truly understand why they have to go through it. However, I find solace in knowing that this population is being served by one of the most compassionate and competent groups that I have ever had the privilege of working with.”

MPH coursework and classes from across the university have provided the skills and knowledge for the students to be successful during this experience. MPH student and NRHD Public Health Outreach Worker Teace Markwalter noted that responding to the COVID-19 pandemic has been a unique opportunity to combine real-world experience with her public health education. “Providing testing services for LTCFs has been very impactful as a public health student. I have seen the importance of my MPH concentration, Public Health Education, in teaching others about proper infection control and hygiene as well as other varying aspects of the virus. These experiences have also helped me understand the importance of interprofessional relationships between public health professionals and healthcare providers in order to best protect and care for this population as well as others. Using my passion to serve my community shows me the value of my classroom and practical education in the field as public health continues to grow in importance during this time and into the future.”

Before starting as an MPH student, Sarah Work knew she wanted to pursue a career in infection prevention and control in LTCFs. Applying what she has learned in the classroom through MPH Infectious Disease concentration coursework, and courses taken towards her Graduate Certificate in Gerontology, which is offered through the Center for Gerontology in the College of Liberal Arts and Human Sciences, has given her the opportunity to see firsthand what it is like working with this population. “I have been able to further develop my skills by testing residents and staff of LTCFs, educating staff about effective infection control and prevention practices, and even connecting facilities to supplies of PPE in partnership with our local health department and the New River Valley Regional Task Force,” Work said. “The pandemic has had devastating effects on residents in LTCFs across the country, but with the knowledge I gained in the MPH program and the mentors I have met and learned from through this experience, I am confident that I can continue to assist facilities in their recovery from COVID-19.”

The student team’s mentor and NRHD Health Counselor Barbie Zabielski summarizes the impact these students have had on the COVID-19 response in this population, “I have the incredible privilege of working with a group of students that are so exceptionally bright, motivated, and competent that everyone at the health department refers to them as the Dream Team. I am constantly in awe of them and inspired by their dedication and professionalism. I am also heartened by the kind and loving manner with which they engage this population. Working with these students and watching them tirelessly and cheerfully take on the most tedious – and often odious – tasks and consistently overcome obstacles with creativity and flexibility gives me great hope in the future of public health and instills a sense of optimism that we can ultimately triumph over this disease.”