CHENANGO – About 10 months ago, in late February of 2020, the New York State Health Department warned Chenango County officials there was a serious problem.
“That problem was COVID-19 and at that point we thought that it originated in China and was present in the United States, primarily from travelers coming into the major New York City airports,” said Director of Chenango County Public Health Marcas Flindt.
The concern was confirmed soon after as travelers from Europe brought the virus across the Atlantic. On average, about three million travelers passed through the city’s airports per month before precautions were put into place, he explained.
Flindt notified the Chenango County Board of Supervisors and began planning a response with Matthew Beckwith, the county fire coordinator and emergency management officer.
The emergency management office provided logistical support and helped healthcare workers obtain personal protective equipment during the initial supply shortage.
In the spring of 2020, the first residents in the county contracted the virus. A short time later the county began regular testing. At the urging of the New York State Health Department the county also began contact tracing. Flindt said without a vaccine the best way to slow the spread of the virus is with contact tracing, social distancing and wearing a mask.
County health officials reported a spike in local cases following the recent Christmas and New Year holidays. Deaths in the county, many of them in nursing homes, also significantly increased in recent months. The county reported a total of 30 deaths on January 15, 2021, but just 10 days later they reported five more.
The health department tracks COVID activity in Chenango County in many ways, including a weekly average. They also use figures to calculate how many people with respiratory infections are actually turning out to be infected with COVID.
Just after the holiday officials grew concerned when they calculated that on average 7.6 percent of those with respiratory illnesses had COVID in the county. The average across the state is 5.8 percent. Flindt said he is hopeful the figures are in decline – and as of January 25 the county’s average was down to 5.9 percent.
He said there is no trend to those getting ill and primarily infections were spreading within households across all groups. However, most deaths have involved people with serious pre-existing illnesses and many were elderly and lived in care facilities, he said.
“I think people really, truly should have hope and the hope lies in the vaccination process. In other words, the vaccine is going to get us back to normal. It’s going to take a while. It’s going to take six months to a year to get us back to normal. The more people we can get vaccinated – that’s the key to solving this whole thing, this public health emergency we’re in, COVID-19 – is vaccination,” said Flindt.

What is contact tracing?

When a person tests positive for COVID their local health department is notified and then staff from the department reach out to the infected person to get an understanding of how they contracted the illness and who else may have been exposed. Officials hope by gaining such information they can get ahead of the virus and contain an outbreak.
Anyone in close contact with a person who has been infected is also contacted. Health officials refer to the initially diagnosed COVID patient as an index case, and close contact is often defined as anyone who has been within six feet of a confirmed case for 20 minutes or more, explained Flindt, though other factors may also play a role.
Those suspected of being exposed are put on home quarantine until they are tested.
Those who have an infection confirmed by a lab are put on mandatory quarantine and become a new index case, with officials then beginning the process of contact tracing additional people who may have been exposed.
Those put in quarantine are told to wait at least 14 days, which is the average period of time COVID remains active and contagious.
Initially contact tracing in Chenango County was solely done by the health department’s nine nurses, who had to complete a special training course through Johns Hopkins University to qualify.
“So, we’ve spent the last 10 months really putting an awful lot of effort into contact tracing and as we’re speaking, (on Jan. 26) I have 647 people in home isolation and quarantine,” Flindt said.
Since the early months of the virus, the Chenango County Health Department has noticed an unfortunate trend, that those having the virus are exposing it to more people than they were a few months ago.
“When we first started this, we were in touch with an index case and they had anywhere from two to three, up to maybe five or six contacts that we had to investigate. I think that was because this was a relatively new thing. At that point, people were very concerned,” Flindt said.
He thinks that in the beginning months of the virus a lack of information led to people exercising additional caution, unsure of just how contagious or deadly it may be.
“Now, I think people are getting COVID fatigue. Maybe they’re not quite as careful as they used to be. And now we’re seeing an index case reporting anywhere of up to 20 contacts,” said Flindt.
“People do need to remain vigilant and the masking and social distancing are going to be important. Through the summer and probably until fall, even if this is what we need to do, you need to be careful.”
Flindt also said due to COVID fatigue, residents were now less willing to talk to officials than they were six to eight months ago.
“We really would appreciate when you get a call from the health department if you would speak with us.”

The toll on health professionals

Contact tracing takes a toll on the health department’s nurses who have worked seven days per week for about the last ten months. In the last month they sought aid from local departments.
Health officials began training around a dozen more contact tracers from the local Department of Social Service and Mental Health Department. Flindt thanked Chenango County DSS Commissioner Daniel Auwarter and Director of Mental Health, Ruth Roberts, for their aid.
Tracing just one positive COVID case can take up to 21 hours or more to complete.
“Right now, number one is the contact tracing. We’re getting 30 to 35 new cases per day. So, if one of them calls in and the average initial index case takes an hour to an hour and a half, and then that index case gives 20 other people, each one of them has to be called. And each of those can be anywhere from an hour to an hour and a half. The time is just amazing. There’s twenty other people that need to be called, determined if they’re put in to quarantine or not and given advice.”
“So, one case could take 21 hours and we have, say 30 cases a day, every day. I mean that’s a huge number of hours potentially,” said Flindt.
“My staff, I feel very proud of them. They are true civil servants. There’s been really no complaints. There’s a heavy workload, 10 months of seven days a week. Anywhere from eight to 14-hour days. They take a day or two off if they can, or if they need to.”
“They are really amazing. Other county health departments have actually had staff resign. It’s just too much of a workload but I’ve had no one resign,” said Flindt.
Two of the health department staff have fallen ill since the pandemic began and both recovered.
The health department requires staff to wear masks, except when they are distanced and sitting in their office or at their desk.
“I think the rule of thumb that I use for my staff, and I think it’s good for any business or any other department, is if you’re up on your feet you need to wear a mask. If your up on your feet it means you’re going to be walking around, you’re going to be within six feet of other folks. I think it’s a good rule to adhere to.”
In addition to the nurses, the health department also has about 25 staff checking on those who are in quarantine. Flindt said he took the challenges of quarantine very seriously and it was the department’s duty to help those who needed it during that time.
“They make calls to the people who are legally put into isolation or quarantine on a daily basis to see if they need anything such as groceries or a prescription picked up,” he said.
Health officials sought help from the United Way and formed a partnership with the Director Elizabeth Monaco.
United Way volunteers and department staff picked up needed items and delivered them to people in isolation.
“I remember a patient. They were not along the Route 12 corridor – in a rural town. It was a young family, young children at home. We provided groceries for them. There was a prescription that needed to be picked up,” said Flindt.
“There are a lot of details. The goal, the mission, is to protect the community. That is our overall mission to protect their family and their friends and the community, the residents of the Chenango County.”

Vaccine shortages could extend pandemic further into 2021

“What’s become our second mission? Vaccination. Vaccination is going to allow us, eventually, to ramp back, and ultimately, do very little contact tracing.”
“It is also going to provide a way for all of us to get back to a near normal lifestyle that we had before COVID-19,” said Flindt.
However, that could take several months, as vaccine shortages slow distribution.
The health department received its first allotment of vaccine on January 11, 2021. Since then the department has administered 615 doses.
The plan was for county health departments to vaccinate the top tier of their eligible residents, such as front-line health workers and the most vulnerable to the virus. The departments request a certain number of vaccines every week from New York State that they need and can dispense, and state officials do their best to meet those requests.
Around Jan. 21 the Chenango County Health Department requested 600 doses for nursing homes, emergency responders and healthcare workers, those in the top vaccination group. None were sent by the state.
“So, it’s really important to know that there is a national shortage of vaccine,” said Flindt, “I’m not holding back any vaccine. I’m not storing it or saving for anything, as soon as I get it - we have shot clinics and out it goes.”
The department must follow the distribution guidelines set by the state for how and who gets vaccinated.
“It’s a phase system. The pharmacies in the area are being expected to do the 65-plus population. I am expected to do Phase 1B, which includes law enforcement and teachers,” he said.
Going by state surveys, the public health officials only expect about half of the population will choose to take a vaccine, even when it is available.
With that trend the health department will need to vaccinate about 25,000 people in Chenango County.
“I would strongly encourage people to learn about the vaccine. There’s been a special panel put together of scientists and physicians for the New York State Health Department that have evaluated the Moderna and Pfizer vaccines to see if they believe independently that it’s safe and effective, and they have determined that it is safe and effective,” explained Flindt.
Optimistically he hopes up to 70 percent or more of the county will get a vaccine within a year from now. That would be enough to create a herd immunity in the local population.
“That will protect the people who are vaccinated, and the amount of disease will be so low in the county that those folks who choose not to be vaccinated would even be protected,” said Flindt. “So I would encourage everyone to consider vaccination.”
Those getting the Moderna vaccine, which takes two doses, need to make sure they get the two required shots about 28 days apart. He said according to research the first shot offers about 50 percent immunity, and the next rises immunity to 95 percent.

How do I get a vaccine?

If you have a primary care provider or a regular doctor you can contact them to find out more information. However, people who do contact private providers will likely be billed for the vaccine. Residents can also visit state sites that distribute the vaccine for free.
Though there were some locations in Chenango and Binghamton that offered the vaccine to those 65-plus and others who qualify, Flindt hesitated to recommend an area site to visit because things were changing quickly and he had recently been informed those that were available had stopped or slowed distribution down greatly due to the shortages.
“I don’t know their status now, but they should continue receiving vaccine in the future,” he said.
He said the department would continue to take requests and inform the public if locations became available.
“The health department is going to be vaccinating until everyone who wants a shot is able to get a shot, and if it takes a year it’s going to take a year,” he said.
Flindt said improvements in the pandemic in the next three to six months is going to depend on how much vaccine Chenango County is sent by the New York State Health Department.
“I think we’re all going to be vaccinating into the summer and into the fall. Be patient, wearing your mask does work. Do social distancing, it does work,” he said.
Residents can register to take a vaccine with the Chenango County Health Department by emailing COVID19@co.chenango.ny.us. Provide your name, email address, phone number, where you work, and job title. When the department receives vaccines and you are eligible, they will email you a link to schedule an appointment. So far more than 1,000 residents have signed up.

What to do if you may have COVID

Immediately go home and isolate yourself. Then contact the health department at (607) 337-1660. Don’t go to the hospital unless you need emergency help. If you have to go to the hospital or call 911, inform them of your condition so staff can protect themselves.
“We will then discuss your symptoms. We will assist you in obtaining, testing, send you information on how to register to be tested for COVID. We will follow up with you if you’re positive. We will talk with you about home isolation and give you support,” said Flindt.