Mobile testing in Long Beach

Pacific County public health nurse Lori Craig Ashley conducts a covid-19 test at the mobile testing station at the South Pacific County Administration Building.

PACIFIC COUNTY — The best advice from local public health nurses is for people to wash their hands, cover their faces and remember to laugh.

Registered nurses Lori Craig Ashley, Leah Heintz and Amanda Berube are the public health nurses for Pacific County’s Department of Public Health and Human Services. On Aug. 11, Ashley was promoted to senior public health nurse for her work as lead contact investigator for covid-19 cases in the county. The three have led the work to find and contain outbreaks in the community since the pandemic began.

Ashley and Heintz grew up in Pacific County and took chemistry together in high school. They didn’t know each other well at the time.

“Boy, do we now,” Heintz said.

Both women have about 30 years of nursing experience and have spent the majority of their careers with the health department. Berube is the newest member of the team, with little more than a year at the health department. The three women and their new Health Manager Stephanie Michael gel together well, Ashley said.

“When you’re in the firestorm, each person brings something to our team that has been critical,” Ashley said.

Evolving and educating

The novelty of covid-19 requires the team to constantly be reading up on the disease, checking in with one another and listening in on Washington State Department of Health calls. Being a public health nurse isn’t a 9-to-5 job. Living in the community means running into people at grocery stores and getting asked questions, Berube said. That’s been taken up a notch with covid-19.

Ashley and Heintz have handled disease outbreaks in the past; in particular, Ashley remembered a whooping cough outbreak with about 100 people infected. Those types of outbreaks are a sprint to get in contact with people and contain the outbreak. The response to covid-19 is more of a marathon, Ashley said.

The nurses have direct contact with the families of those affected by covid-19. Reactions to being diagnosed with the disease vary from people thinking it isn’t a big deal and they will sail through, to people who think getting the diagnosis means they are going to die.

“I’m not above crying when I talk to somebody who is afraid to lose their spouse, or is freaking out,” Ashley said. “I can’t imagine how rough that is, to know your loved one is in a hospital and you can’t be there.”

One person was happy just being able to Facetime their loved one who was on a ventilator. People on ventilators can be intimidating, because it doesn’t look normal, Ashley said. But it was a positive for the family member.

Covid-19 is a strange disease, Heintz said. A patient with very few symptoms can seem to be doing okay, and then be dead by the afternoon. The disease is very real and some people won’t realize how scary it is until it hits their family, Heintz said. But it has already affected people in the community in very adverse ways. For those who get hit with it, the nurses are there for them.

Connecting

In addition to checking in with people diagnosed with the disease and their families, everyday the nurses check in with congregate care settings to check to see if residents have symptoms. The daily check ins have led to a great relationship with the care facilities, to the point that the nurses know if the facilities have concerns or questions, the nurses are confident the facilities will reach out to them.

The nurses are also in regular contact with Public Health Officer Dr. Steven Krager, as well as local health providers from Willapa Harbor Hospital and Ocean Beach Hospital. Pacific County got ahead of a lot of other counties when it stood up its Emergency Operations Center in March, Berube said. Very early, Pacific County made a plan of how it would act when it got multiple cases, she said. Those systems being in place early on helped to prepare the nurses for July, when cases in the county spiked.

Even so, the thing that keeps Berube up at night is whether the testing captured everyone with the disease, whether it is enough to prevent the spread, she said.

“It can be very deadly and our population is on the much older side,” Berube said.

Things to know

The nurses work hard to stress to people with the disease that it is incredibly important to stay isolated and that the close contacts of those people must stay quarantined. The incubation period for the disease is 14 days, Ashley said. This means somebody can contract the disease and not have symptoms or a positive result for up to two weeks from when they were in contact with someone who was shedding the virus. Ashley dealt with a group of 10 people that attended a dinner together, and 48 hours later, three or four of the people were sick with the disease. On the 12th day, two more people from the dinner were sick.

And 14 days after one of the people was exposed to the virus at that dinner, they tested positive for covid-19.

“It is super important to understand there is an incubation of up to two weeks and you could pass it on for 48 hours before you test positive,” Ashley said.

People shouldn’t dismiss symptoms either, Heintz said. Early on, people reported things such as diarrhea, but there wasn’t enough data to say for sure that would be a symptom of covid-19. Now, the nurses know that it can develop for some people who get the virus, she said.

“Not everyone gets sick the same, not everyone has the same symptoms,” Heintz said.

No one who gets sick did anything wrong, Heintz said. It is important to remember that, she said. Ashley added it was also important to remember the nurses are there for people no matter what time of day it is, there is always someone at the health department to help.

Staying grounded

All three women share in the hope of the county and state returning to normal soon. Heintz was used to seeing people everyday and interacting in person with patients and clients, she said. She misses that.

“I’m one of those that need to see them, to see how they are doing physically,” Heintz said. “It’s just not the same through a screen.”

Berube agreed, saying there was a disconnect there. When she does get to see someone in person, she “devours” the chance. Both Heintz and Ashley went from getting to interact with students at local schools to spending most of their time at their desks.

To deal with the heaviness of their work and with the restrictive requirements imposed to keep people safe, the three do their best to laugh, to find things that bring them joy. Berube is baking and making furniture. Heintz has her grandkids. Ashley has her animals.

“We live in a beautiful area — gotta take advantage of that and remember to laugh, laugh, laugh, like Stephanie said,” Ashley said.

Michael, as health manager, has seen first hand the work of these women, she said. They are there for people whatever time of day and ready with the most recent information to help make sure they can help families when it comes to knowing how to react to the virus.

“I think people that live in Pacific County are some of the luckiest,” Michael said.

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