As a public health nurse for Nevada County, Charlene Weiss-Wenzl works with local mothers and their children – especially those who lack the resources to get health care on their own. Over the course of the COVID-19 pandemic, Weiss-Wenzl has seen how her clients, both parents and youngsters, have struggled as schools shut down, childcare services closed, and both school and work moved home.
“I’d tell them that they were living through history right now. ‘This is going to be in the history books!’” Weiss-Wenzl recalled, her eyes lighting up with excitement. “‛Yeah, it’s hard, but just wait! You’re going to read about it. You’re kids are going to read about it!’”
Nevada County Maternal, Child and Adolescent Health coordinator
– Bachelor of Science in nursing, California State University, Sacramento
– Registered nurse
– Public health nurse advanced certification
– Certified lactation counselor
– Parents as Teachers certified parent educator
But living through history poses peculiar challenges. Each day has brought uncertainty, changes that call for a new plan, and new insights that trash yesterday’s plan. To work through each day’s tumult, Weiss-Wenzl relied on the passion, commitment and communication she has experienced among the professionals in the Nevada County Public Health Department.
“We’re really good at what we do, and we’re really good about thinking on our feet. We have that nursing brain, that critical thinking piece,” Weiss-Wenzl added. “That’s what saved our butts. We are pretty nimble, and we’re pretty scrappy.”
They have had to be.
COVID’s advance was ‘surreal’
Health care runs in Weiss-Wenzl’s family. With the exception of a few years in finance, she has spent most of her adult life in the medical field, including experience as an emergency medical responder, a medical assistant and two decades in pre-clinical research [updated to correct original version].
As coordinator of the county’s Maternal, Child and Adolescent Health program, Weiss-Wenzl offers support, education, and home visits for mothers before and after childbirth. She helps them learn to nurse their babies and feed their families healthful meals, get exercise. find safe housing, deal with depression and get to other medical and social services.
When the novel coronavirus started spreading across the planet, it seemed surreal, Weiss-Wenzl recalled. She watched COVID-19 cases creep from the San Francisco Bay Area into the Sierra Nevada foothills. At the time, her husband was more worried than she was.
“I don’t panic… I was like, ‘No, we’ll be fine. It’s the media. We’re going to be fine,” Weiss-Wenzl remembered saying. “That’s the lesson I learned. It wasn’t fine.”
On March 16, 2020, health officials announced Nevada County’s first confirmed case, that of a person who had traveled outside the country. “I thought, ‘Oh my God, it hit Nevada County!'” Weiss-Wenzl recalled. Back then, people didn’t understand how it was spreading or how long it would last, she added.
Already, folks in the county Public Health Department had been preparing for health emergencies. Weiss-Wenzl and others had trained at the Federal Emergency Management Administration’s Center for Domestic Preparedness in Anniston, Ala. They had drilled regularly with regional emergency responders, practicing coordinated actions through the command structure they follow during a crisis. They had operated mass flu-vaccination clinics. They had nurtured community partnerships.
But, “this was something that was really different,” Weiss-Wenzl said. “There was nothing that could have prepared us for this.”
She fought the sense of surreality with practical action. Weiss-Wenzl and others in the department began tracing folks who had been in contact with infected people during the time the virus was contagious, so those folks could quarantine for two weeks. Contact-tracing and quarantine are time-proven methods for stopping contagion, especially when little is known about a disease and how it spreads. As department staff shifted their focus from their regular jobs to COVID-19 prevention, she worked closely with Hospitality House homeless shelter, Lovett House recovery center, and later with school nurses to help them protect their clients, staff and students. When medical officials detected six daily cases countywide, she said, “it would be, ‘Oh my gosh, we got six cases in one day!'”
By mid-spring, things looked good: Illness had remained level, with 41 total confirmed cases through May 31, 2020, according to Nevada County’s COVID-19 online dashboard. “We thought, that was it, it’s going to go down,” Weiss-Wenzl said. But three weeks after people gathered on Memorial Day despite local stay-at-home orders, cases doubled.
After Independence Day festivities, cases doubled again. Then, they doubled again. Then again. Then again.
As the number of cases rose exponentially through the fall, that sense of surreality returned. On Dec. 7, 2020, the county hit a peak, with 134 new, confirmed cases reported in a single day.
“(We were) thinking, how are we ever, as a health department, going to manage this? How are we going to hire enough people to do the investigations, to keep this from impacting the hospitals?” Weiss-Wenzl remembered thinking, “Holy cow, we’re in a mess.”
‘It felt like the emergency room’
Through the daily race, the blur of weeks, the darkest months when cases soared and deaths spiked — when they felt like they were drowning — Weiss-Wenzl recalled, “we relied on each other.” Communication included long meetings, hashing out what had gone right, what had gone wrong, and how to do better.
“We had a job to do,” she said. “Getting out there and getting it done, being smart, using our resources as best we can, trying to keep people from getting sick.” In public health nursing, practitioners joke, “‘It’s not the emergency room,'” Weiss-Wenzl said. “This time it felt like the ER, but on a grander scale.”
Then, in late December, the first, small, vaccine shipment arrived at their office. “We were all so grateful. It was like, ‘Ahhh, the skies are opening!,’ but it was true.”
As health practitioners with daily public contact, the public health nurses were among the first to qualify for vaccination. “I remember getting my first vaccine and getting teary eyed, feeling like, ‘This is history, we’re making history,’” Weiss-Wenzl recalled. “I even kept the vial of my vaccine.”
Surprised by the politics
Public health nurses view all county residents as their patients, and they pour love and passion into their work for the community’s health, Weiss-Wenzl said. Yet their practices also are grounded in the most recent scientific discoveries, and the best techniques for applying that research in a community setting. So, as a self-described science nerd, she was surprised when a small but vocal minority questioned the science behind public health mandates, defied the public health guidelines proven over time to keep people safe from contagion, and directed their ire at the Public Health Department.
“It was really hard,” Weiss-Wenzl said. “I had no idea that it would be so political. Most of the time, if you’re in nursing and health care, you’re just doing the job. We’re just thinking about what needs to get done to keep people healthy.”
That focus — keeping people healthy, “it should have united us, instead of dividing us,” Weiss-Wenzl added.
And when people fed up with the mandates complained of COVID fatigue? Weiss-Wenzl shook her head and laughed an easy yet ironic laugh. “They have no idea what COVID fatigue means.”
Who, then, is caring for the care-givers?
“We’ve been at this for a year, and we’re probably going to be at this for another year. We’re really good at preaching self-care, but we’re not very good at self-care,” Weiss-Wenzl confessed. “It’s a marathon, it’s not a sprint, and we have to make sure people who are in it can manage it for the long haul.”
Passing on what they have learned
Many of the women in the Public Health Department are now nearing the end of their careers, Weiss-Wenzl observed. The knowledge and the wisdom they have earned as they nurse through a pandemic have been honed by making mistakes and learning on the fly. While procedures and protocols already are documenting many of the lessons these women have learned, when they retire, much of their hands-on knowledge will disappear, she warned.
One answer is to raise the profile of public health nursing as a career option, Weiss-Wenzl advised.
“Most young nurses want to get out and work in the hospitals,” Weiss-Wenzl said. “We really need to mentor and somehow increase the value of public health nursing.”
Then, she laughed again, still an easy laugh, but this time with just a touch of both indignation and resignation.
“It’s pretty amazing to me how we have to constantly prove our worth.”