‘We Will Come Out the Other Side’: an Interview with Maplewood Health Officer Candice Davenport – The Village Green

Since the coronavirus pandemic began, public health officers have played an exceptionally vital role in local communities. Candice Davenport, who became Maplewood’s Health Officer in January, has been the main conduit for the town’s COVID-19 patients (of which there are 250 as of April 27) and their families.

The job begins as soon as a Maplewood resident is diagnosed. From there, Davenport and her team — Public Health Nurse Anna Markarova and part-time Registered Environmental Health Specialist Peter Dillon — provide assistance, education and reassurance to patients and families, contact trace to limit potential spread to others, follow up on patient progress through recovery, assess and analyze data, and regularly consult with other municipal officials as well as the county and state.

They also provide solace to patients who are scared and anxious, and mourn with the families who are grieving their loved ones. Maplewood has so far lost 19 residents to the virus.

“The Health Division communicates multiple times with every single resident who represents a case to make sure that they have the proper resources and support needed to get through their diagnosis,” said Mayor Frank McGehee. “They truly care about the members of our community. They celebrate every fully recovered case and grieve every time we tragically lose a resident.”

“Candice has demonstrated remarkable and unwavering leadership,” said Deputy Mayor Dean Dafis, who chairs the Board of Health. “She [and her team] have been a constant source of certainty at a time of great uncertainty — comforting, informing, guiding, triaging, compiling, assessing, and yes, lots of crying too, for the daily numbers represent precious lives in our community. All of us in Maplewood owe them a great debt.”

Davenport, a Maplewood resident, graciously agreed to answer questions from Village Green as well as some submitted by community members, to provide more insight into the grueling work behind the numbers, information on safety and social distancing, tips on self care, and a view of the “new normal” as communities look toward the future.

What is a day in the life of a public health officer like right now, in the age of COVID-19? What do you do for patients and families? Once you learn a person has been diagnosed, what are the next steps? 

Our day starts with looking at our positive cases and starting on our case investigations. Case investigations can take time; part of our job is to be disease investigators and find ways of contacting people because maybe their phone numbers are incorrect or maybe they no longer live in Maplewood. Reaching positive patients in a timely manner is critical because we want to make sure they start their isolation and quarantine precautions as soon as possible to prevent the spread of disease.

We talk to hospitals and healthcare providers who update us or inform us of positive cases. We also appreciate it when we receive notifications from residents themselves so that we can follow up with them as soon as possible.

In between our case investigations which includes contact tracing and keeping all of our data organized, we are on daily conference calls with the NJ Department of Health and routinely in contact with our colleagues at the county level and the local health departments because diseases don’t follow town boundaries. We also follow up with our cases to see if they are recovered or follow up with their status at the healthcare facilities, so we are in contact with patients for two weeks to almost a month or more. At the end of each day, we deliver care packages which include face masks, education and a temperature log to all the positive cases in order to prevent the further spread of disease. Finally, we provide the status updates to the Mayor for the daily updates.

Tell us about your team.

Between Anna and I, we handle all the case investigations and reporting. Pete helps us to field environmental health concerns. Pete has over 30 years of experience in local public health and Anna has degrees, like me, in both nursing and public health so we are very lucky to have them and their expertise to deal with this COVID-19 experience. I’d also like to acknowledge our school nurses who have stepped up to volunteer and follow up with our cases and see if they have recovered.

What are the primary concerns of patients and their families? How do you address those?

The primary concerns of the patients and their families when we talk to them is what do they do next. Having a positive diagnosis means a lot of logistical planning: how do I call out of work for 14 days? What if I am sick for longer? What if other family members get sick and how do I protect them?  Who will take care of my kids or my other family members while I am isolated in my room?  We provide them with instructions and try our best to answer their questions and we listen to them and their concerns.

The concerns are different when we are in contact with family members whose loved one is hospitalized because of COVID-19. These families are not able to see or be with their loved one while they are in the hospital because they are closed to visitors so unless they hear from the nurse at the hospital, or are able to call or FaceTime them, there is a sense of worry and uncertainty until they are discharged and they come home. When our patients come home and recover, those are the good days for us.

How do you work with Mayor McGehee? How many times a day are you in touch with him?

We talk once a day or several times a day, depending on state and local updates which change rapidly.

How do parents and caregivers build proper health habits in children in this “new normal?”

Teach them about the importance of social distancing, and washing your hands every time you come in from any public space or being outside. Teach them that when all of us wear masks, we are protecting each other by preventing respiratory droplets from getting on shared surfaces or spreading it to others because we are learning that people can have coronavirus but not show any symptoms.  We have to keep up these measures for the near future. The best way to cope is to focus on the things we can control.

The more people practice these new social norms, the more it becomes commonplace. We may not realize that we influence how people think and the decisions they make, but we can all be an example for others.

What advice can you give to adolescents and teens to get through this, when their regular lives have been turned upside down?

There is a definite mental health component to all this and all of these changes can take a psychological and emotional toll.

In this time of social distancing, I would recommend that you hug your household contacts. We all need that human touch and contact and kids need hugs to comfort them and make them feel safe.

To the adolescents and teens, I’ll be honest: sometimes your parents need that occasional comforting hug or pat on the shoulder from you to say, “We’re going to be ok”. It means a lot to hear it from you.

Focus on what you can do to expand your mind, practice self care and how to help others: be creative. Check our township recreation page and find out about art projects being planned for May.

While you are home, make music. Learn a language. Learn to cook. Read and escape in a good book, or donate books in the Little Free Libraries around town. Help your parents to work in the garden. Help out with some chores around the house. Clean your room and donate clothes or things you no longer need/ use. Journal and write about your experience. Send a letter to a family member who may be alone. Not counting your online classes for school, limit your recreational screen time, on the TV, on your phone and on your computer. Get exercise or just get moving either outside or through an online class at home. Eat healthy food to keep your energy up and use this time to get into a good sleep schedule.

I hope our kids come out of this experience feeling a sense of solidarity with their friends, classmates and community and make an effort to reach out to kids who maybe they did not before. We are all experiencing this in different ways: dealing with a tragic loss, illness, unemployment, coping with the isolation and the loss of things that are familiar or having a dependable schedule, or mental health issues- but this is a collective struggle and a historical, global experience.  It will be a place marker in their lives where things shifted and changed and alter the course of life as we knew it; similar to the children and adolescents who remember the tragedy of September 11.

I believe we are building the resilience and grit that we want to see in our children and they will be stronger in the end. I also hope that we are instilling in them a sense of how interconnected we are as a society and a sense of compassion for our neighbors and toward the world as a whole.  I hope we can all be more gentle and patient with ourselves as we go through this, and we will come out the other side.

What about public gatherings and spaces — like the pool, summer camps, outdoor concerts? From a public health perspective, should people prepare to wear masks, maintain distance, etc?

We need to prepare and anticipate that social distancing will be a social norm.

People need to understand that with every interaction that is not a household contact, we are intricately connected to all the people that person came in contact with.  The degrees of separation are small when it comes to coronavirus, COVID-19. COVID-19 is not airborne but it is spread from respiratory droplets from an infected person. The individual choices we make matter to our health and safety and the protection of our community.

I can’t emphasize enough that people need to stand six feet apart from people who are not their household contact. We need to wear a face mask when they are in a public space or have one on hand if we may be in a position where we cannot guarantee a six foot distance from others. We all need to wash our hands after coming in from any public space. We need to wipe down shared surfaces with disinfectant wipes more regularly than we used to. Most importantly, we need to stay home. It is the most important thing we can do. All of these practices will be necessary until we can find a vaccine to protect us from COVID-19.

Should I wear gloves while grocery shopping?

Latex gloves are not recommended to wear when grocery shopping. Hand washing is recommended. Wash your hands before leaving your home, after leaving the store, and again when you get home. If soap and water are not available, use hand sanitizer with at least 60% alcohol.

Do you have any other safe grocery shopping tips?

• Avoid crowds
• Make a list and shop quickly
• Shop alone, don’t bring the family
• Wear a face covering
• Sanitize carts and hands, before and after shopping
• Give the cashier some space or use the self-check out
• Choose no-touch payment when you can
• If you are anxious about grocery shopping, select the pick-up option at your grocery store instead of going inside and doing the shopping yourself

What about emotional health issues in this time of anxiety and uncertainty? What should people know, and what can they do/where can they get help?

If you need to talk to someone, you can call the NJ Mental Health Hotline: 866-202-4357 or the NJ Hopeline: 855-654-6735  They can provide resources and professional counseling to help people through this time.  Also the Bridge Access Center is offering counselors at  this time and people can call: 973-228-3000. These are extraordinary circumstances and if people need to talk to a trained professional, it is important.

Can you explain where the US stands with testing (including antibody testing), treatments and a vaccine, and what that means for people?

In public health we are looking forward to the expansion of rapid COVID-19 testing. If we can make rapid testing available and up to scale to test the population, then we can focus on individuals cases and quarantine and isolate the person and their immediate contacts to prevent the further spread of disease.  Researchers are working around the clock on various vaccine options so we are watching that development as well.

You only started as Maplewood’s Health Officer in January of this year, and you were almost immediately thrust into managing the effects of the coronavirus pandemic on the town. What has that been like for you?

I am very lucky to have supportive and highly qualified staff, supportive colleagues in neighboring towns and throughout the state and the support of the community which has been a great comfort. Township leaders are moving in the same direction to help our community get through this and there is a lot of coordination. There are many moments that are hard: emotionally, mentally, psychologically. We are on the front lines of something overwhelming, unthinkable and at times, heartbreaking. I remind myself that we have a very important job to do and we try to do the best that we can, everyday. Even when the cases and the deaths increase, we can’t give up hope that we will get through this.

Given that you are dealing day in and day out on the front lines of a global pandemic, what upsets, frustrates, saddens or angers you the most? What gives you the most hope?

What saddens me the most is when we talk to families who have lost a loved one due to COVID-19. There are families who cannot be with their family member at the hospital, and for those who are dying, they are dying alone.  This is one of the many tragedies of this situation.

There are everyday hardships that families are enduring, like a sick parent who musters up the energy to prepare meals for their children but can’t sit with them and so the parent and the children are eating alone. As a parent, I feel for them.

We are a small town that cares. Every case is a neighbor, a family member. We get to know each and every one of them and we listen to their stories and as nurses, we become someone that they trust.  Every death is not a number to us at the Public Health Division, it’s a major loss.

How can the community help first responders and other front line workers? How can they volunteer to help?

While there are many opportunities to join other local residents who are organizing making homemade face masks or face shields and providing food delivery to families in need, there are some other ways and resources that people can go to volunteer. While the biggest way to help is to stay home, here are other sites that people can go to for volunteer opportunities, now or in the future to address COVID-19:

• https://covid19.nj.gov/help This is the NJ COVID-19 Information Portal which is a go-to for all questions related to COVID-19 and the state response.
• Essex County Medical Reserve Corps, https://essexregional.org/essex-county-mrc/
• If you would like to donate blood : we are in another public health emergency with the very low levels in our emergency blood supply. If people would like to donate they can contact the following organizations:
  •  American Red Cross Blood Services
  • New York Blood Center
  • Vitalant Blood Center
  •  Miller-Keystone Blood Center
• Likewise for those who have recovered from COVID-19 and would like to donate their plasma for research on how we can find a cure or study the antibodies to improve testing, they can also reach out to the above organizations and to our local hospitals to collect convalescent plasma.

Reader Questions:

Can we have an update about mask guidelines & recommendations when outdoors?

Masks are essential to catch respiratory droplets from our nose and mouth. We have learned that people who show no symptoms can spread the disease to others. So when we all wear a mask in public spaces, we are protecting each other. We advise that you wear a mask when you go to public spaces and when you cannot guarantee a safe six feet of distance from others. If you are going for a walk outside or exercising, just have a mask on hand to throw on. Avoid peak hours of activity and go to less crowded spaces. Please be courteous and cross the street or move away from others to give everyone space. Lastly, please throw your disposable mask and gloves in a trash receptacle and not on the street or sidewalk. Additional litter does not help the environment.

What have the learnings/takeaways been from the contact tracing? Explain how you do it and how successful it is.

Contact tracing before the stay at home orders were essential because we needed to notify people as soon as possible so that they can begin their quarantine and keep their distance from others thereby preventing the spread of disease. We had to advise them that they could not go to work but can work from home, that they could not go to a party or family gathering. We had to explain the 14 day quarantine if they were exposed to a suspect or positive case, what signs and symptoms to look for at which time they would be isolated and that takes staying away from others to a stricter level of separation, including staying away from people in their own household. The success of stopping disease transmission is dependent on us providing good guidance and having them comply with these actions to prevent the spread of disease.

I’d like to know what kinds of support local health departments could use from the state and federal governments in order to do all the work they are tasked with.

At the county level, we have been coordinating communication and the acquisition of PPE through our local OEM Coordinator, Victor DeLuca and our first responders. The PPE is critical to us being able to respond and protect our first responders. At the state health department, they are communicating with us daily so that we have the most up to date information and giving us the view of the entire pandemic response across the state which has been helpful. Early on, FEMA set up two major testing sites in NJ and Essex County was able to put up a drive-thru testing site at Weequahic Park in Newark which was necessary to keep up with the load and identification of suspect cases.

As we move forward, at the federal level, we need funding and support to reinforce the public health workforce and infrastructure which includes putting funding for research for a vaccine and other testing.  Guidance and policy at the federal and state level need to continue to be guided by science and data.