Monday profile: Wrangling the latest pandemic info and data is just a day in the life of Rachel Kappler
When Rachel Kappler isn’t on the phone following up on the latest COVID-19 case in Garfield County, she’s busy studying up on a piece of history that will very likely define her time as a public health nurse epidemiologist.
“Part of my day is diving into all the research and literature worldwide that’s being written daily,” said Kappler, who is part of the team at Garfield County Public Health.
“Every day I get to learn something 100% new about coronavirus that I didn’t know yesterday,” she said.
It was that draw to the academic side of nursing that prompted Kappler to get into public health in the first place.
These days, it’s a major part of the public health job, as the novel coronavirus that was declared a global pandemic by health officials worldwide pushes past the six-month mark since the first cases were confirmed in China in December 2019.
Starting back in January — some six weeks before Colorado had its first cases — Kappler was part of the many phone calls with state health officials planning for the public health response.
“We’re still responding to and continuing to plan for what COVID-19 could become, and what it may not become,” Kappler said. “We’re all working very, very hard to keep our Garfield County residents safe.”
FROM THE ER TO PH
Kappler is part of a team of 10 nurse epidemiologists (nurse epi for short) with Garfield County Public Health led by Nurse Manager Sara Brainard.
The crew doubled in size in the months since COVID-19 first showed up in Garfield County, as public health officials have been charged with following up on each of the 189 confirmed cases to date (as of Sunday) in the county’s efforts to keep the spread of the potentially deadly virus in check.
Kappler started with Garfield County in April of 2019 after earning her master’s degree in public health at the University of Massachusetts-Maine.
Prior to that, she was an emergency room pediatric nurse at a large urban hospital in St. Louis, Missouri, just north of where she grew up.
“I loved it … it was very eye-opening,” Kappler said of her time in the ER. “What I came to realize is that a lot of medical conditions are preventable, and how much people didn’t really know about their body and wellness.”
That prompted her to continue her studies and get into the public health side of the profession.
“I wanted to make a bigger impact on communities and larger groups of people through education,” she said.
Her journey brought her to Garfield County, where, when she’s not on the clock, she said she enjoys the mountain lifestyle to the fullest, as well as cooking and reading.
But that clock has been pretty full these days, as much of her time has been spent making hundreds of phone calls as part of the county’s contact tracing efforts around the coronavirus.
Brainard praised the work of Kappler and the other nurses, including several who came out of retirement to help with the response.
“Rachel brings a tremendous amount of nursing knowledge and expertise to Public Health. Her kind, understanding personality offers reassurance to our clients,” Brainard said.
Contact tracing is nothing new. It occurs with any type of communicable disease outbreak, Kappler explained, whether it’s any of the many strains of influenza, hepatitis, tuberculosis, plague or the many types of coronaviruses that are always circulating, including the one that causes the disease COVID-19.
“It’s not a new process at all,” she said. “Any time we have a patient who has tested positive for a communicable disease, we have to follow up.”
That involves tracking them down, usually by phone, and asking a series of questions, like:
• Where they are currently;
• Do they live with others;
• Where do they work;
• Were they sick when they went to work; and,
• Any other places they had been just prior to the onset of symptoms where they could have potentially infected others.
Any family members, friends or co-workers who may have been exposed are also located and questioned and encouraged to isolate for a period of time.
All of the information is kept confidential and individual information is not released publicly, under U.S. HIPAA laws and Colorado statute.
Kappler and the other nurse epi’s start by introducing themselves, asking if the person knows why they’re calling, explaining the various roles of public health, and whether they need someone to speak to them in Spanish or another language.
“We start with that message that we’re here to protect you and to protect others,” Kappler said.
Brainard also noted that contact tracing is a critical component in curbing the spread of any communicable disease.
“The COVID cases that we have been in touch with have been very forthcoming and helpful, which has helped dramatically,” Brainard said. “But our team can’t prevent the spread of COVID alone. We will do our part, but depend on our community to continue to take key actions like social distancing, wearing face coverings and remembering to wash their hands.
“We are calling this our ‘new normal.’ These actions are going to be required of us for a long time, and it is our best defense to keep Garfield County open.”
‘MASKS ARE WORKING’
That’s where public education comes in, Kappler said.
The fact that Garfield County has had very little in the way of community spread of the new coronavirus, with the vast majority of local cases traced to one-on-one contact, is a testament to the success of that effort, she said.
“The reality is, if we can contain this COVID it will allow businesses to continue to thrive and to succeed,” Kappler said. “We’re coming from a place of educating the public about protecting themselves, their friends, their families, their co-workers … and we do want to be a part of helping in that.”
Community outbreaks in other places around the world typically have involved situations where those safety precautions were not taken.
In settings where people are wearing face coverings — “if they are wearing them correctly,” she said — the disease is not spreading.
“Masks are working,” she said.
NORMAL COURSE OF THINGS
When not responding to a pandemic, part of Kappler’s job is to investigate communicable diseases in general and to continue to improve policies and procedures within public health.
“I’ve done case management for tuberculosis. I do vaccines. And we all work together to investigate cases,” she said. “There are a lot of things people in public don’t see all year long that we do.”
Public health also works closely with other organizations on public education campaigns related to health issues and disease prevention, such as hospitals, nursing homes, schools, veterinary clinics and with animal control.
“We also are the ones to investigate animal bites,” Kappler said.
Any time there’s a large disease outbreak or public health emergency of any sort, the public health department is part of the formal Incident Command response.
“We have a whole organizational structure that’s been created to address all of the issues that go into responding to a situation,” Kappler said.
Outside of her direct job, Kappler is also involved with several professional associations related to nursing.
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