DURHAM, N.C. – While being pressed into service handling the influx of COVID-19 patients, Boston-area family physician Mary Ann Dakkak was also keeping an eye on the health of her 73-year-old father-in-law, a tough and independent retired Marine Corps Colonel with a heart condition.
He said he was fine. But then somebody found him passed out behind the wheel of his car after it had gently rolled into a fence. He wasn’t okay. He had a fever of 102 degrees.
“He had lost 12 pounds because he was unable to keep anything down,” Dakkak said. “But he hadn’t told anyone!”
After the early-April traffic incident, which put him in the emergency department for 6 hours to get some fluids, Dakkak persuaded her father-in-law to enroll in a new COVID-19 response program being built at Duke University to help keep him safe.
He signed up for a program called Community Health Watch, a research study that provides symptom support and guidance, in both English and Spanish, for people caring for themselves at home during the COVID-19 pandemic. Six weeks after launching the program, more than 1,500 people across the United States receive support from a team of Duke clinical professionals.
The program was designed to support people trying to manage symptoms at home with daily texts and emails and providing telephone follow up to people with severe symptoms. But study leaders quickly discovered people were facing additional challenges, such as lack of access to primary care providers, food insecurity, and even access to reliable information about the pandemic.
The Duke team began meeting with other organizations trying to keep people safe and connected – and the Pandemic Response Network (PRN) was born.
The PRN is a network of organizations aligned to serve the needs of individuals and communities during the pandemic, especially those that are hardest-hit by COVID-19. PRN partners serve essential service workers and individuals who work in long term care; advocate for Hispanic communities and communities of older adults; provide medical care to vulnerable communities; and provide software products focused on employee information security and social service referrals.
Current partners include the IEHA, the North Carolina Health Care Facilities Association, the North Carolina Assisted Living Association, the North Carolina Farmworker Health Program, Office of Rural Health, the National Hispanic Council on Aging, Curamericas Global, Union Community Health Center Bronx, NYC Health + Hospitals Harlem, Truework, and Unite Us. Duke and IDEO.org are collaborating to ensure that PRN programs are designed to meet the needs of vulnerable and historically marginalized communities.
The creation of the PRN represents a major shift in response to the COVID-19 pandemic, according to Becky Smith, MD, associate professor of medicine in infectious diseases at Duke University Health System.
“Rather than just collect data on who has the virus and where, we are focused on helping people stay safe and connected,” said Smith. “We have medical teams and networks of community-based organizations aligned to ensure that people get the right services at the right time, especially people who are from traditionally underserved groups who also happen to be hit hardest by COVID-19. We're already reaching over 1,500 people across the U.S. and look forward to continue growing our response through these vital partnerships."
Each PRN member organization is promoting the Community Health Watch program to provide symptom support to their members and stakeholders. At the same time, each group within the network is contributing thought leadership and capabilities to enhance PRN service offerings and ensure that the programs are accessible to diverse populations.
There is also an urgent need to provide COVID-19 services and information to Spanish speaking communities across the United States, who are among the hardest-hit.
“The National Hispanic Council on Aging is delighted to join the Pandemic Response Network to support and empower families during this difficult pandemic,” said Yanira Cruz, DrPH, MPH, president and chief executive officer of the NHCOA. “COVID-19 is severely impacting Latinos across the country. Resources and services that are culturally and linguistically appropriate, like those offered by the Pandemic Response Network, are badly needed among Latinos.”While the retired Marine wouldn’t necessarily tell his daughter-in-law the doctor how bad he felt, he did open up to the nurse on the phone, Dakkak said. “He really appreciated having the nurse check in with him. She called him three times in a week and it made him feel safer.”
PRN partners are working together to provide this type of support to many more individuals across the country and are actively improving their programs to address social needs as well. To learn more about PRN and the Community Health Watch, visit pandemicresponsenetwork.org.
The Community Health Watch study is supported by funds from Duke University and Duke Health.