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Navigating the pandemic: Carroll County Health Department faced ‘difficult balancing act’ throughout 2020

From left to right, Carroll County Health Officer Ed Singer, Emergency Management Manager Valerie Hawkins, and health planner Maggie Kunz discuss plans to prepare for the coronavirus at the Board of Commissioners meeting March 5, 2020.
From left to right, Carroll County Health Officer Ed Singer, Emergency Management Manager Valerie Hawkins, and health planner Maggie Kunz discuss plans to prepare for the coronavirus at the Board of Commissioners meeting March 5, 2020. (Mary Grace Keller)

COVID-19 overshadowed all else in 2020, affecting every aspect of life in Carroll. This week, the Times is looking back at how five key sectors — business, education, government, health care and law enforcement — adapted and carried on amid the coronavirus pandemic.

On March 13, when the first case of a Carroll countian contracting COVID-19 was announced, the virus was still a curiosity to most. Only about 2,000 Americans had been infected, fewer than 50 had died, and Maryland had seen only 25 other cases.

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The significance of this communicable disease, the novel coronavirus, wasn’t clear even as public schools were shut down and executive orders from Gov. Hogan began placing limits on what Marylanders could do.

That all changed March 28, when an outbreak infecting 66 residents at Pleasant View Nursing Home in Mount Airy that included the first death of a county resident attributed to COVID-19 was announced, placing Carroll at the epicenter of the coronavirus crisis in Maryland.

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And placing the Carroll County Health Department squarely in the middle of a pandemic for which there was no template.

“That first outbreak here in Carroll County, the things we had to ask for just didn’t exist. Ultimately, we wound up with the National Guard coming out and providing some assistance,” Health Officer Ed Singer said in a Dec. 23 interview. “We were making hundreds of phone calls with that first outbreak because no one had had to deal with it, trying to get agencies to send people. We were having problems even providing staff to help backfill for [sick] staff.”

Ed Singer, Carroll County Health Officer, left, with Leslie Simmons, Exec. Vice-President, LifeBridge Health and Carroll Hospital, right, provides an update on the coronavirus outbreak at the Pleasant View Nursing home in Mount Airy which has infected 66 residents. Singer announced that one resident, a 90-year old man with underlying health conditions, has died. March 29, 2020
Ed Singer, Carroll County Health Officer, left, with Leslie Simmons, Exec. Vice-President, LifeBridge Health and Carroll Hospital, right, provides an update on the coronavirus outbreak at the Pleasant View Nursing home in Mount Airy which has infected 66 residents. Singer announced that one resident, a 90-year old man with underlying health conditions, has died. March 29, 2020 (Amy Davis)

With nearly 140 cases and 31 deaths, according to health department data, Pleasant View remains, statistically, the elder care facility in Carroll that has been hit hardest, but it is far from unique. Birch Manor Center for Rehabilitation and Healthcare in Sykesville has seen nearly 100 cases and 24 deaths. Westminster Healthcare Center has seen more than 100 cases and 19 deaths. In all, congregate living facilities in Carroll County are nearing 1,000 total cases and have experienced the deaths of 150 residents.

While dealing with the fallout from that first outbreak, the health department was also trying to educate the public on how to mitigate transmission of a virus little was known about. Singer was thrust into the local spotlight, advocating for people to wear masks and practice social distancing and regularly advising Carroll County’s Board of Commissioners and Board of Education.

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He has talked about the precarious balancing act required of him and his staff, insisting people be mindful of public health while also understanding that life can’t go completely on lockdown.

It was a particularly difficult message to get across early on, when few people knew anyone affected by COVID-19 in the wider community. In early July, well over half of all Carroll County cases of COVID-19 had originated in congregate living facilities, as had 125 of 139 fatalities.

Singer said the health department, which does not oversee nursing homes, worked with such facilities to make sure proper protocols were being followed to mitigate transmission, not just among medical personnel but among food service and cleaning staff as well, and also that they had proper personal protective equipment to wear and training on the PPE.

If there is any good news, it’s that the death rate has slowed considerably — only 11 total deaths were reported in the three-month span of August through October (although fatalities have increased in December).

“Early on, there wasn’t a whole lot you could do for folks other than hope that they got somewhat better and provide them oxygen and keep them comfortable as they were trying to recover — because there wasn’t a lot that could be done to treat the disease,” Singer said. “We have a lot more antivirals and other types of medications found to be effective now. Our medical system has learned a lot on how to treat the disease, to help people have better medical outcomes. ...

“We know a lot better how to treat people and how to help people recover.”

That’s been fortunate given the drastic increase in community transmission since just after the Fourth of July, when Carroll had seen only about 500 cases outside of elder care facilities. Less than six months later, Carroll is nearing 5,000 total cases and close to 4,000 of them are community cases.

“Early on in the pandemic you would look on social media and there were a lot of people who were like, ‘I don’t know anybody who’s got it.’ I knew some people early in the pandemic who had gotten it ... but there weren’t a lot,” Singer said. “Now, you just know so many families where the entire family has gotten it and it’s had so many impacts.”

Carroll County Health Officer, Ed Singer, answers questions during a COVID-19 planning meeting for local first responders, health care personnel and other local officials at the Carroll County Public Safety Training Center on Friday, March 13.
Carroll County Health Officer, Ed Singer, answers questions during a COVID-19 planning meeting for local first responders, health care personnel and other local officials at the Carroll County Public Safety Training Center on Friday, March 13. (Brian Krista/Carroll County Times)

Through October, Carroll County had seen more than 110 total cases in a week only twice, with a high of 144 during the peak of the first wave. For the week beginning Dec. 6, Carroll saw 418 total cases. And then 409 the following week.

Did Singer have any inkling the coronavirus would come back with such a vengeance?

“Absolutely not,” he said last week. “I looked at a lot of these predictive models at the beginning of this pandemic and they were like, ‘OK you’re going to see this spike, we’re going to get over that spike and then there’s going to be another spike.’ But I didn’t see any models that predicted a bigger spike.

“I guess we did a really good job early in the pandemic with the lockdown and all that of keeping it from spreading in the community.”

And then, as Singer and others have put it, COVID fatigue set in. Seeking a return to normalcy, people let their guard down and now it’s not uncommon to have 50 cases reported in a single day, more than 100 for a weekend.

Another byproduct of the pandemic, according to Singer, has been people’s reluctance and/or inability to make doctor’s appointments and have minor medical issues taken care of. Telehealth has gone from a novelty to the only way some physicians see patients out of necessity. Singer said some practices had to close down for stretches of the past year as entire staffs came down with COVID-19.

The FDA’s approval of vaccines has given the country a shot of hope as 2020 readies to turn to 2021. On Wednesday, the health department began vaccinating first responders, health care workers and others included in the first phase of vaccinations. It’s a process that will stretch out over months, with primary care facilities and pharmacies eventually handling much of it, according to a health department news release.

Singer is glad to have this latest tool to fight the coronavirus, but even he doesn’t have all the details about the vaccine’s rollout.

“It’s got me a little nervous because you don’t know how to plan when you don’t know exactly how much you’re going to get and when you’re going to get it,” he said. “But I’m very encouraged by the studies that show how effective it is. ... You’re looking at a vaccine that’s 90 percent effective if you get both doses.”

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The fact that a recent survey by the health department found about 50% of respondents skeptical about the vaccine and not inclined to receive it when it’s their turn also has Singer nervous.

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“A lot of people want to get vaccinated now, but just as many are concerned about it. We really need to get the facts out there, get people to look at the scientific data,” Singer said. “This is what we need to do if we’re going to get back to normal.”

Singer, effusive in his praise for his staff and Carroll Hospital during a trying year, said he expects a most difficult winter in terms of transmission and then a bit of a reprieve in the spring as more and more people are vaccinated and people are able to get outside more. After the summer? Maybe, he said, things will begin to feel more normal.

Until then, he and his colleagues will continue making recommendations — to the county commissioners, to the board of education, to all county residents — keeping public health and the need for people to live their lives in mind.

“There’s a whole bunch of things we have to balance here — this whole year has been this difficult balancing act we’ve had to do, trying to do the right things for the community,” Singer said. “A pandemic like this is a once-in-a-lifetime type of thing.”

County commissioners Stephen Wantz, Ed Rothstein, Dennis Frazier, Eric Bouchat and Richard Weaver meet with County Health Officer Ed Singer, lower right, during the Board of Commissioners meeting on Oct. 23.
County commissioners Stephen Wantz, Ed Rothstein, Dennis Frazier, Eric Bouchat and Richard Weaver meet with County Health Officer Ed Singer, lower right, during the Board of Commissioners meeting on Oct. 23. (Screen capture)

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