BY LUCIE KRISMAN
When Dr. Thomas Marcellino became the Douglas County health officer in 2012, a widespread pandemic was not necessarily what he expected to experience in that position.
"Pandemics have been known to occur every hundred years," Marcellino said. "I think we all think about it in the back of our minds, but no one's planning that it will occur the next day."
Eight years later, when COVID-19 became a pandemic, it was clear to Marcellino and other public health officials that it was no ordinary challenge.
"Several things about this virus are what make it more dangerous to the public," Marcellino said. "Everyone in public health has had to adapt and respond by really taking a lot of extra time and work to come up with plans to help the community. It was obvious that normal measures weren't going to be enough to stop this virus."
In the midst of Douglas County’s adaption to COVID-19, Marcellino told The Eudora Times what he sees in the present and future in Douglas County and across the nation.
Evolving with the virus
As Douglas County’s Public health officer, Marcellino has the ability to order closures of businesses in the county and to quarantine people for the safety of the county in regard to infectious diseases.
Marcellino said COVID-19 is different in nature from other viruses because of how easily it spreads, the fact that carriers of the virus can be asymptomatic and our lack of antibodies to it or protection against it.
"It's also affecting people that are healthy and young," Marcellino said. "Moving forward, the ultimate hope is that we get a vaccination against the virus so we can do widespread vaccination to help protect the public. What we have to do is give our health systems a chance to prepare and plan for potential surges and sick patients so they don't overrun our hospital system, and that's what we've done here."
Marcellino said while the number of new cases in Douglas County has declined, there would need to be 14 days of a steady number of cases to signify a flattened curve before reopening the economy would be a possibility, as well as making sure LMH Health is prepared and has ventilators available for a more rapid outbreak.
"Our area is looking more optimistic toward a phased reopening plan," Marcellino said. "We have to really monitor the virus to see if it's going to be possible to initiate that. A big part of that is the ability to test and track the cases. We want to be able to have adequate testing."
Each county will make decisions on reopening possibly in phases if the state order for Kansas expires May 3. Officials including regional health officers, local Unified Command leaders and leaders from the University of Kansas and local school districts are having daily meetings to formulate plans for the next steps upon expiration of the order.
"That plan is evolving with the virus," Marcellino said. "We have to think about a plan for if the virus does not spread further, but we also have to have a plan for if it does."
Looking to present and future
As of the most recent update on April 22, Douglas County had 44 reported cases of COVID-19. 35 of which are recovered and nine of which are still being treated or quarantined. Johnson County, in comparison, had a total of 394 reported cases as of April 22.
Of the Douglas County cases, 27 were reported as travel-related, eight were reported as locally transmitted in the community and eight were reported as confirmed cases of contact with a positive case, such as a spouse or a family member. The largest amount of cases in an age group fell in the 20 to 29 range with 18 cases.
Marcellino said it is likely that the comparatively low numbers for Douglas County partially results from proactive measures from the health department to track and isolate positive cases, as well as the shrinking of Lawrence’s population density due to the timing of University of Kansas’ spring break.
"I think we had the added benefit of spring break," Marcellino said. "That decision was very important for our community because, had we allowed school to open back up, we may very well be having a different conversation right now."
Gov. Laura Kelly ordered the closure of all schools within the state March 17. Marcellino ordered Douglas County’s stay-at-home order March 22 and the order went into effect March 24.
Marcellino said the early action to initiate a stay-at-home order combined with the closure of the University of Kansas and Douglas County’s lack of outbreak in facilities such as nursing homes and meatpacking facilities has contributed to the county’s lower numbers.
As KU and universities alike plan for upcoming semesters, Marcellino said it is important to have plans to accommodate COVID-19 possibly being widely active in the fall.
"I think that this fall is going to be a very difficult thing to predict," Marcellino said. "We want to get through the summer keeping the viral number of new cases low. As we move into fall, universities and schools are probably going to have guidance from the state and from other organizations as to how they can safely open up. That's really going depend on the virus. We don't really know what the virus is going to look like this fall, but we know it's going to be here."
A new normal
When numbers of new cases are consistently low and nonessential businesses finally begin to reopen in phases with restrictions such as wearing masks and maintaining distance in place, Marcellino said it will be important for community members to be mindful of their interactions.
"Every interaction in the community is going to be different than it was before,” Marcellino said. “Just because the orders are lifted doesn't mean you should go out and interact in the community just because you can. It’s still wise to stay home, practice social distancing. It’s still wise to limit your gatherings to the recommended number of people. All of these things are being worked out as we move forward. Every business will need to have a plan in place to keep their employees and customers as safe as possible."
Due to Kelly’s superseding extension of the state’s stay-at-home order until May 3, Douglas County is currently not under an order of its own. Kelly, as well as different authorities in Douglas County and communities alike, is using a scientific perspective to determine when regulations can be lifted in counties and in the state, Marcellino said.
"I think what's happening locally and nationally, within Douglas County but also within every state in this county, is how and when do we reopen our country?" Marcellino said. "It’s got to be more dictated by our local leaders because every state and every county is different as far as viral activity and how we're going to need to proceed with opening.”
These decisions will look different for each county, especially comparing metropolitan areas to rural areas, which makes Kelly’s decision about the state as a whole more difficult, Marcellino said.
"Every county really is different,” Marcellino said. “That's what makes the decision harder on a state level. What might be right for Kansas City may not be right for western Kansas.”
In the meantime, Secretary Lee Norman of the Kansas Department of Health and Environment has been facilitating the coordination of tracking cases, testing and establishing guidelines, Marcellino said.
"Dr. Norman has been a solid leader throughout this time," Marcellino said. “He's done a good job at providing guidance and information for each individual county health department and he's been receptive to questions and comments.”
Marcellino predicts a shift in what normal social practices and business practices look like as the circumstances around COVID-19 progress.
"The social norms we've all been used to, hand-shaking and hugging, will no longer be normal,” Marcellino said. " Businesses are probably going to learn to become more resilient. If this were to occur again, businesses that have plans in place will probably be more resilient."
‘Think about the greater good’
Assuming everything goes perfectly, Marcellino expects a rollout of vaccines for COVID-19 to be available for higher-risk groups, such as frontline caregivers, in the fall at the earliest and for the general public in the spring, with summer of 2021 being the soonest possibility of a return to completely normal circumstances.
"Realistically, it's not going to be until we have widespread vaccination," Marcellino said. “When the vaccine is available, they will be giving it to certain groups first. Higher-risk groups, frontline caregivers, and then as the vaccine becomes more widely available, it will be available to the general population."
Marcellino said it is difficult to predict solidified dates or numbers yet, but as discussion and planning continues, he urges members of the community to responsibly protect themselves to the best of their ability.
"When I go out into the community, I still see people doing things that aren't smart," Marcellino said about habits such as face-touching, not wearing masks and not maintaining safe distance. "We have to start to think about how we are going to interact with our environment in the safest way possible moving forward. If we all do that, that's ultimately going to be what stops the virus."
Marcellino also said it is important to mind cautious practices once orders are lifted, such as keeping a close circle of contacts, maintaining social distancing, wearing masks in public and maintaining hand hygiene.
To members of the community who may not understand the importance of following these measures, Marcellino encourages them to think about how they ultimately affect others.
“My message to them would be that the reason we have a lower caseload is that we're taking it seriously," Marcellino said. "During times of a pandemic, we have to think about the greater good of everyone in our community. We're in this together. If people don't work together, the outcome's not going to be as good."
Reach reporter Lucie Krisman at eudoratimes@gmail.com.
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