How Massachusetts is learning from the Global South
Care resource coordinators support people in COVID-19 isolation and quarantine by providing social and economic supports to address the whole of their health needs
Imagine that you’ve been asked to quarantine following suspected exposure to COVID-19. You want to do the right thing to prevent the spread of disease, but can you really stay at home for two weeks? What will you eat? Can you continue to work? What do you do if you start to feel sick?
Challenges like these help explain why contact tracing, or identifying people who may have been infected with COVID-19 and temporarily quarantining them so they can’t inadvertently spread the infection to others, has yet to make an impact in much of the United States, even though this approach has successfully slowed the pandemic in countries such as Senegal and Thailand. In their COVID responses these countries have combined clinical services with socioeconomic supports that address people’s non-medical needs.
U.S. health systems typically aren’t set up to address broad social and economic supports. But some state and local health departments are now tapping the community health experiences of countries in the Global South and their own community health workers to boost the reach and impact of COVID-19 contact tracing.
For example, the state of Massachusetts is collaborating with Partners In Health (PIH), drawing on the Boston-based nonprofit’s more than three decades of experience in community-based health care, including responses to epidemics and outbreaks such as Ebola in West Africa, cholera in Haiti, tuberculosis programs in Lesotho, and HIV programs in Rwanda.
Together, the state and PIH have created a corps of care resource coordinators to follow up with each individual that contact tracers advise to quarantine or isolate. These coordinators work to ensure that people have whatever they need to stay safe at home – food, medicine, cleaning supplies, rental assistance, legal advice – even virtual cooking classes.
One in five people reached by the contact tracers say they could not quarantine without some form of social and economic supports. LIke community health workers in many parts of the world, the care resource coordinators help to bridge communities and clinics, with a particular focus on supporting the most vulnerable.
“Successful contact tracing is not just an exercise in data collection, it’s an exercise in care,” says Katie Bollbach, director of PIH’s U.S. Public Health Accompaniment Unit. “It’s not enough to simply tell people to stay home. We have to connect them with the services they need to stay healthy, and that includes much more than clinical services.”
WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Looking at the whole of a person’s health needs – including food, security, shelter as well as medical care – is helping Massachusetts mitigate the impact of COVID-19.
“This moment is an inflection point to reimagine and reconfigure the health systems we need for the future,” says Bollbach. “Our work in the U.S. has been surprisingly similar to our work in Sierra Leone and elsewhere, and the lessons we’ve learned in the Global South point the way toward the work we need to do here at home.”
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