It was Friday, March 6, 2020 when a group of government employees gathered in the Commissioner of Health's conference room to discuss the symptoms of an Ulster County resident. The Department of Health's (DOH) nurses had long nasal swabs and were collecting a sample to be tested. After calling the state lab to see how late they would be open, then considering courier service, Deputy County Executive Marc Rider stood up—he'd drive the sample to Albany himself. On Sunday morning in the lobby of the county office building, County Executive Pat Ryan delivered the somber news to an audience of local media that Ulster County had confirmed its first case of the novel coronavirus, COVID-19.
The next day, inside the DOH, through a hallway accessible only by key code, the nurses' conference room had become a small situation room with 12 telephones arranged on the table: the communicable diseases line. A public health nurse turned to me; she needed to go make calls to symptomatic people who required daily check-ins. I took her place while the rest of the Innovation Team worked with Information Services to set up a dedicated COVID hotline in a larger conference room in the opposite wing. We were anticipating an unprecedented amount of calls coming in for the nurses.
The Ulster County COVID-19 Hotline went live on March 11, just three days after the first COVID case was announced. Approximately 60 county employees and over 100 Ulster Corps volunteers streamed in and out of the conference room over the next two weeks, answering at its height about 300 calls in a 12-hour day. I updated scripts for the hotline operators almost hourly with new state guidance, as we tackled the public's questions and identified the most critical cases—people reporting symptoms or recent international travel—for transfer to public health nurses in the back of the room and to the data team across the hall.
As public health officials grappled with messaging about the pandemic and we learned more about COVID-19, fears about workplace exposure made it clear that it was no longer safe to work in one room, touching the same equipment, sharing pizza. DOH staff who had them began answering phones in their N95 masks.
For a week, every night after hours, then-Director of Innovation Timothy Weidemann and Deputy Director Jeff Kalpakis video conferenced late into the evening with local consultants on the redesign of the COVID-19 Hotline's underlying tech stack, so we could take a team of 16 county employees to 100 percent remote operations by March 26.
The Lines Are Open
When the county launched three mobile test sites over the course of four weeks between March 23 and April 27, the hotline lit up with calls for help in accessing and understanding the evolving universe of COVID testing. When the county launched the Project Resilience program on March 17 to provide food delivery to constituents who were cooperating with the Governor's NY on Pause orders or self-quarantining, we answered questions, entered status updates, and provided tech support for enrollment.
This summer, when New York phased its re-opening, we saw increasing need for business guidance, housing and tenant-landlord support, and economic resources. County Executive Ryan asked us to reimagine the hotline and evolve it into a long-term COVID recovery contact center.
One of Ryan's priorities coming into office was to make county government more responsive and responsible. In March and April, we were just doing our best to pick up the phone and be there for people who were terrified about what was unfolding in their communities. Over time, we found that a key strategic value of the hotline was as a window into constituents' needs. We designed the Recovery Service Center (RSC) to serve as a friendly and helpful "front door" to Ulster County government.
Over the course of 10 months, we've built a knowledge base of COVID guidance and county services related to COVID recovery. Since July's Get Tested Week, the RSC does weekly check-ins with COVID test providers, maintaining a database of information on each. The RSC works closely with the contact tracing and data teams and plays a key role in NY on Pause enforcement by conducting regular courtesy calls with businesses and individuals who have received complaints, to discuss best practices for compliance with state mandates.
Our team members are nominated by their various departments for this fellowship—the RSC, a lab for cross-departmental coordination, remote work, and professional development. In December, we onboarded a new cohort to work with those who have been on the phones since March, giving our team both institutional knowledge and a fresh perspective. By December, the county's call center had received over 33,000 inbound calls–that's over 17,000 conversations with constituents.
Darn Curve, Still Not Flat
The day after Thanksgiving was a county holiday, and an RSC skeleton crew started the day with a thread on Microsoft Teams guessing the day's call volume: Would it be slow, or would it be bananas? Then the cellphones in our home offices began to ring with reports of exposure and positive tests, business owners wondering about closures, and teachers advocating for remote schooling through the holidays.
In mid-December, it feels like April 2020 again. We're watching the positivity rate and hospital capacity for indications of potential state-designated restrictions; by December 1, the data line tracking active COVID cases on the county's dashboard surpassed April's. The anticipated second wave has arrived. Contact tracers and DOH nurses are working tirelessly to protect and support the exponential ripples of people impacted by a single positive case.
As a community, we need to refocus on flattening the curve: avoiding gatherings and travel, washing our hands, helping our neighbors. Come January, as we await vaccination, ideally we'll hunker down for a quiet winter, enjoying the outdoors, socially distanced, and always wearing a mask.
Hillary Harvey is on the Ulster County's Innovation Team and Knowledge Management Specialist for the Recovery Service Center. Harvey is a former Chronogram editor.