Through the adapted ICS model utilized to create the COVID-19 Division, HCPH has been able to successfully respond to several recent emerging disease threats, including COVID-19, mpox, and the Sudan Ebola virus, while continuing to provide other essential public health services. Outcome evaluation data was collected internally to measure the scope of services and outreach that HCPH has been able to provide to the community. To date, the COVID-19 Division has:
Provided 11,299,366 COVID-19 PCR tests
Administered 798,607 doses of Pfizer, Moderna, J&J, and Novavax COVID-19 vaccines
Includes 771 doses provided to 539 homes for residents who are home-bound and their caretakers
Assembled and distributed 308,440 COVID-19 care kits which include masks and easy-to-understand information on COVID-19 prevention, vaccines, and resources available including assistance with food, childcare, legal inquiries, and more
Distributed 806,953 masks
Administered 6,399 doses of JYNNEOS vaccines for protection against mpox
Engaged directly with 1,911,459 residents via outreach
Served 620,624 people at community-based events
Served 90,482 through community canvassing
Canvassed 1,003 apartment complexes, serving 202,169 units
Submitted 2,692 resource navigation program applications to connect Harris County residents with various community resources through collaboration with state public benefit programs
Made 53,907 phone calls to local organization to raise awareness of nearby HCPH services
In the past year, several other milestone accomplishments were achieved, such as:
Accomplishment #1: Utilizing the existing COVID-19 vaccine site structure to provide other types of vaccines. The ability for HCPH to quickly adapt to provide other types of vaccines for flu, mpox, and all FDA authorized COVID-19 vaccine formulations is a significant achievement. This highlights how, as a team, operations were successfully expanded to meet the needs of the community served.
The COVID-19 division's operations section focused on COVID-19 vaccine administration throughout 2022, specifically rolling out new COVID-19 booster doses. Every new vaccine rollout included internal offices and divisions, the Local Health Authority (LHA), and Legal Counsel. Through communication, coordination, and cooperation, HCPH has successfully rolled out new vaccines within 1-2 weeks of approval by the FDA, CDC, and DSHS. To date, the following booster doses have been administered:
959 Moderna 2nd booster doses from 3/31 to 9/2 (before bivalent boosters were approved)
1412 Pfizer 2nd booster doses from 3/31 to 9/2 (before bivalent boosters were approved)
1024 Moderna bivalent booster doses through 12/1/22
1346 Pfizer bivalent booster doses through 12/1/22
Since August 15th, 2022 the operations section has incorporated JYNNEOS vaccines that offer protection against mpox into daily operations to serve high-risk populations, including the LGBTQIA+ and Black and Hispanic communities and administered over 6,500 doses. Approximately 40 staff members were oriented with a new electronic medical record (EMR) software, conducting several just-in-time training (JITT) sessions for field staff and call center agents, developing new policies and procedures, and creating a workflow that minimized risk and emphasized safety. Within the emerging disease response team, several branches across different sections worked together, including the Vaccine Operations, Site Scheduling, Clinical Oversight, Call Center, Grants and Strategy, and Emergency Management branches, to ensure the quick turnaround was successful. Internal communication, coordination, and cooperation led to the successful vaccine rollout, increased vaccine awareness, and helped reduce misinformation and stigma related to the disease. The call center branch answered over 3,500 related calls and scheduled appointments across multiple sites. Additionally, HCPH was able to partner with over 90 unique organizations during this time to administer the JYNNEOS vaccine.
Since October 17th, 2022, Vaccine Dispensing Units (VDUs) within the vaccination branch began incorporating administering the influenza vaccine into daily operations. The implementation was completed quickly by conducting multiple just-in-time training (JITT) sessions and ensuring proper supply procurement and delivery to begin administering before peak flu season. Various branches within the adapted ICS structure worked together to coordinate sites with partners, adjust workflows to maximize operational efficiency, and collect and retain operational data. Externally, this increased HCPH's partner reach and community access to the flu vaccine. Site location and partnership selection focused on serving vulnerable populations, strengthening the community's capacity to recover from disease threats, and maximizing resources by utilizing partnerships, preexisting resources, and coordinating internally. Since implementation, the emerging disease response team's operations section has administered a total of 1,031 doses of flu vaccine while also providing COVID-19 and mpox vaccines at various locations across the county.
As a result of the implementation, HCPH has improved access and reduced barriers, resulting in thousands of vaccines being provided to the community at no cost to residents.
Accomplishments #2: Prioritizing health equity through specialized teams to focus on vulnerable populations. A specialized team was formed to vaccinate and test special populations, including those in nursing homes, long-term care facilities, and group homes. Additionally, the team provides at-home services to individuals who are bed-bound and immobile. This Congregate/At-Home Team has serviced 38 congregate facilities from January through November 2022. During this time, they have also traveled to 138 homes and provided 185 COVID-19 vaccines. Success is attributed to excellent coordination, communication, and flexibility within the team and Operations Unit. The Congregate/At-Home Team has increased access and removed barriers to care for vulnerable populations. The team has identified and mitigated health disparities, responded to disease threats, and maximized resources by strengthening HCPH's relationship with congregate facilities and servicing vulnerable populations.
Accomplishment #3: Creation of a new flu portal platform for schools within Harris County to report cases of flu and ILI. The flu portal helps strengthen flu surveillance in the county by monitoring flu trends through the reporting of daily absenteeism due to influenza-like illness (ILI). It allows schools to report baseline information as well as potential increases in ILI reports; this information is helpful when determining if a particular school is experiencing an outbreak. Since October 20, 2022, when the flu portal went live for schools to register and report, 217 schools have reported ILI data electronically.
Since the flu portal was created in October 2022, public, private, and charter schools in Harris County were recruited on a rolling basis, with plans to recruit a wider number of private and charter schools and child-care facilities in the future. Detecting flu outbreaks in schools can facilitate the development and implementation of timely public health recommendations to prevent the spread of disease to high-risk populations. ILI data can also provide more targeted outreach and resources more appropriately. Through the utilization of the flu portal, epidemiologists were able to conduct active surveillance for several ILI outbreaks at schools and school nurses can electronically report daily numbers at their convenience and view previous ILI trends for their district or school. The implementation of the flu portal and the data collected complements existing influenza and ILI data to better monitor trends in the community which allows for outreach activities and vaccination events to be better targeted if a certain area or school is experiencing an outbreak.
Through the various dedicated teams, HCPH reached new levels of engagement within the community that would not have otherwise been possible. The engagement and partnership management accomplished through this team was an invaluable asset in the health department's readiness. The partnerships that the emerging infectious disease team developed mirrored the community's diverse residents. Thus, HCPH was able to reach specific target populations that were the most vulnerable against the respective infectious disease threat. Established Ryan White HIV/AIDS Program partners and partnerships with organizations serving the LGBTQ+ community played a crucial part in reaching communities disproportionately impacted by the recent mpox outbreak when stigma presented as a significant barrier. When the 2022 outbreak of the Sudan ebolavirus in Uganda was identified as a potential threat, the emerging infectious disease team was able to reach out the local Ugandan community directly to promote situational awareness about the threat and provide information on precautions taken to limit risk of transmission, such as the travel screening requirements. Additionally in 2023, further initiatives are planned that will continue to make this program a success by creating and implementing a more robust capability to monitor and track current and emerging diseases. Implementing enhancements for data monitoring and reporting will significantly improve disease surveillance including the agency's ability to operationalize critical resources to the community.