Healing Chicago’s Frontlines With COVID RRT
As a precautionary measure in direct response to the COVID-19 pandemic, the City of Chicago joined the State of Illinois in issuing a Stay-at-Home order effective Saturday, March 21st, at 5pm CT. At that time (March 31st), there was a reported 937 additional coronavirus cases and 26 more deaths. In addition, there have been 5,994 known cases of COVID-19, including 99 deaths, in 54 of the state’s 102 counties since the outbreak began in Illinois in late January. Now, 974 new known cases of COVID-19, and 23 additional fatalities, have brought the total number of known cases to over 121,000 and the death toll to around 5,500 statewide since the start of the pandemic. Officials also reported around 20,000 new tests.
The current data delineates some empirical evidence supporting a decline in both COVID cases and deaths. The exact cause of the decrease can be debated. However, we know tactics such as social distancing, hygiene, and wellness (exercise, nutrition, etc.) can be beneficial. One crucial element that cannot be overstated to public well-being is our healthcare workers.
COVID Rapid Response Team (RRT) is a collective of independent community members, healthcare students, and clinicians supporting healthcare professionals and underserved areas. With the insurmountable pressure and stressors inflicting our healthcare workers, it is beneficial to see communities uniting for a common good. Please read our exclusive interview below with Carrie Chui and Sara Majewski to learn more about COVID RRT. Please note that all views are their own and not affiliated with any particular institution.
What is the mission of COVID RRT Chicago?
We are a collective of independent community members, healthcare students, and clinicians connecting the various “frontlines” of the COVID Crisis to our communities’ resources. We aim to connect, amplify, and serve as a vehicle of local efforts to address key COVID-19 crisis points in the Chicagoland Area. We also aim to support sustainable, organized, safe, and thoughtful support of local community efforts to support survival during the COVID Crisis. We offer our resources, skills, and time to scale-up critical life-sustaining services to marginalized communities in Chicago during the COVID Crisis.
It's awesome that COVID RRT Chicago is supporting healthcare professionals. How did COVID RRT collective form?
Student leaders from Northwestern Feinberg School of Medicine, University of Illinois Chicago School of Medicine (UIC), and Rosalind Franklin University of Medicine and Science (RFUMS) first connected informally through mobile communication applications, GroupMe and Slack, on Thursday, March 19. Realizing they were developing similar but redundant initiatives within the student bodies of each individual institution, these student leaders coordinated a conference call for the next day and COVID Rapid Response Team - Chicago was born. Student leaders from fellow medical institutions, including University of Chicago Pritzker School of Medicine, Rush Medical College, Loyola University Stritch School of Medicine, and Midwestern University Chicago College of Osteopathic Medicine, were soon looped in, along with international medical students from Saint George’s University who had been stationed in Chicago.
Is the collective mostly medical students?
Currently, we’re a collective of over 800 members. The collective consists mostly of medical students, but we also have members who are healthcare professional students more broadly, as well as Chicago creatives involved in community work throughout the city.
Testing for COVID-19 is slowly becoming more available across the country. How is Chicago handling COVID-19 testing?
This is a complex question, and I’m not sure we are the most qualified people to answer this to its full extent. However, we can share how we have seen testing made available from our own first-hand experiences in the field. We know testing has increased, and it has been made available at more locations than just medical clinics and hospitals. As we learn more about the virus, we know asymptomatic and presymptomatic shedding and transmission of COVID-19 does occur, which not only stresses the importance of social distancing and stay-at-home orders, but also rapid and widespread testing. Without these measures, people will continue to unknowingly spread the virus, making the reopening of the country a challenge.
COVID RRT helps provide tests for various at risk groups. Can we talk about test availability? Do you have guidelines on who should get tested (age, those with underlying health conditions, etc.)?
The main group we have been supporting is Chicago’s homeless population. Our student volunteers have been volunteering as part of a larger coalition of volunteers, comprising physicians, nurse practitioners, and nurses, mainly from Rush University and University of Illinois. The people experiencing homelessness in Chicago are disproportionately affected by COVID-19 due to congregate living conditions that make social distancing impossible, as well as the higher prevalence of medical comorbidities that make this population more susceptible to the devastating effects of COVID-19. The need to serve and protect this vulnerable population was recognized by individuals at Rush University Medical Center and Franciscan Shelter, who then formed a coalition of people from University of Illinois at Chicago and other hospitals, congregate living facilities, city agencies, and advocacy groups. The efforts of this coalition include, but are not limited to, widespread COVID-19 testing, increased access to medical care, infection prevention and management education to facility staff, isolation of COVID-19 positive individuals, alternative housing options for higher risk individuals and those infected with the virus, and continued efforts in advocating for permanent housing and access to medical care that was taking place before COVID-19 and will continue long after. The field team has been testing on-site at shelters throughout the city for the past eight weeks, conducting thousands of tests. The actual testing kits have been donated from university labs as well as through the Chicago Public Health Department.
Homelessness is a huge issue here in New York and other large cities, like Chicago. Many cannot abide by social distancing practices nor have the resources to maintain a basic hygienic regimen. What is COVID RRT and the city of Chicago’s strategy to help the homeless?
There are three acute pieces involved in the city of Chicago’s response to homelessness: (1) shelter screening and surveillance, (2) shelter decompression and shield housing for high-risk negative homeless, and (3) shelter testing and individual isolation in spaces created specifically to house shelter residents who are COVID positive. These three acute pieces all have contributed to the most important component of Chicago’s response, which is (4) to create models for sustained clinical care in the shelters with the expectation that COVID will resurface again in the future. I will explain each of these briefly:
1) The foundation of COVID infection control for the homeless starts with basic symptomatic screenings and temperature checks in the homeless shelters throughout the city. As previously mentioned, shelters are ideal congregate spaces to propagate infection, so the baseline screenings were a great tool to monitor symptom onset and potential COVID in shelters.
2) With the realization that infection control in these crowded spaces was nearly impossible, the city has created temporary shelters (usually within a YMCA or similar facility) to decompress the shelter populations and allow for social distance practices within shelter spaces. To my knowledge, there are 2-3 of those temporary shelter spaces currently functioning in different locations. In addition to the decompression sites, our working group and the city have created shield housing for high-risk negative residents in shelter spaces. These residents have all tested negative for COVID, but they are the most vulnerable to severe COVID infection and complications. Residents in shield housing include those over the age of 65, those with chronic lung disease, heart disease, obesity, diabetes, and other chronic illnesses that can compromise their immune system and recovery capabilities.
3) When daily screenings alert to potential outbreaks in a shelter space, the rapid testing team is mobilized and performs nasopharyngeal swabs for all residents and staff in that shelter. COVID positive guests are moved to designated respite centers to receive treatment and self isolate. The shelter continues to receive testing from the city and its partners until infection rates reach <5%. Those who are isolated are returned to their original shelters.
4) The final piece, and arguably the most important in my opinion, is the establishment of models to help continue to provide standardized clinical care in these shelter spaces beyond the acute needs of COVID infection control. We have just begun this process, but these models will include general primary care, COVID surveillance screening/testing, and other modes of care including behavioral health care and social work. The COVID response has really opened a door for providers, advocacy leaders, shelters and the city to collaborate to provide longitudinal care to shelter residents and fulfill a longstanding need for consistent clinical presence in many of these shelters across the city.
Can you talk about COVID-19 infections in the prison systems? What are the most optimal changes necessary to remedy the issue?
COVID-19 has spread widely in the incarceration systems in Illinois. Cook County Jail was cited by the New York Times as being the “top hot spot” for the virus in the country and, as of today, seven people incarcerated at the jail and three jail staff have died and more than 500 incarcerated people have confirmed cases of COVID-19, and that does not include the staff (1). 1 In prisons, COVID-19 has proven deadly as prison populations are aging. In Stateville prison, at least six people have died, according to news reports, but the number could be higher as there is not transparency on the impact of COVID-19 in the Illinois Department of Corrections.
These deaths were preventable if the Cook County Sheriff, Illinois Governor, and the head of the Illinois Department of Corrections, heeded the advice of medical experts who have said that the best way to slow the spread is for a large decarceration of jails and prisons (2). The two decisions by our elected officials to not decarcerate jails and prisons not only put incarcerated people and staff at greater risk of contracting and spreading COVID-19, but these decisions also put unnecessary stress on our medical systems in Chicago when our doctors and nurses were already trying to treat the large number of people with symptoms who are not affiliated with our carceral systems.
What are your thoughts on the protests outside the state capitol and the Thompson Center in downtown Chicago calling an end to Gov. J.B. Pritzker's Stay-at-Home order?
The pandemic is distressing on numerous levels. Economically, the pandemic has had devastating effects, and we're now only starting to understand the full scope of the economic crisis. Many will agree that it is important to get our economy back on track as soon as possible. However, it is also important to realize the scope of the pandemic as a public health crisis and to balance public health concerns with our economic goals. In order to minimize both the human and economic toll of the pandemic, we ought to be thoughtful in establishing a timeline for reopening — one that takes importantly into consideration our most vulnerable populations and essential workers who risk their safety once they return to work. Indeed, business shutdowns, park closures, border closures, and large gathering limitations are measures that may feel extreme just moments ago. Under normal circumstances, measures like the Stay-at-Home order may also be an alarming infringement onto our civil liberties. However, so much of this situation is unusual and may as well call for unique measures to be taken. In these frustrating times for everyone, we are also reminded that the pandemic affects us all, and are hopeful that we continue to have needed dialogue with each other as we fight this crisis together.
Can you talk about your collaborative efforts with Project Vida and the Howard Brown Health Center?
Project Vida is a culturally-focused HIV/AIDS prevention and direct services community-based organization located on Chicago’s West Side. Project Vida was founded by a consortium of volunteers in 1992 to address the unique needs and concerns of Latino and African American individuals at risk for, or currently living with, HIV/AIDS. In 2010, Project Vida’s mission was newly revised and is now “to improve quality of life and reduce health disparities in underserved communities by promoting self-empowerment and providing holistic health education and direct services.” When the COVID-19 pandemic began, Project Vida stayed true to its mission and partnered with Howard Brown Health to open the first free COVID-19 testing center in the Little Village neighborhood. This testing facility has been a crucial piece of outreach to the Latinx community, specifically the uninsured and undocumented in these areas; everyone is eligible to receive testing through the Project Vida/Howard Brown collaboration site, regardless of insurance or residency status. Our work with Project Vida is mainly focused on guest registration for testing appointments (basic name, phone number, appointment time, etc.), but it has also developed further to include basic education regarding COVID-19 infection control, basic masking and hygiene techniques, and how to determine red flag symptoms that warrant visits to the emergency room. The population that Project Vida serves is almost entirely Spanish speaking, a majority of which are monolingual, so this has proven an extra challenge for our volunteers. We have utilized informational pamphlets, written scripts, and other methods of translation to overcome these obstacles and help residents receive both confirmation of testing and general COVID education.
How can those who wish to contribute to COVID RRT support your cause?
CRRTC broadly supports a range of hospital systems, coalitions, partnerships, and collaborators on the ground. We are proud to say that we work in community with many grassroots efforts to do what we can to mitigate harm in the midst of the COVID Crisis. Our current fundraising focus is expanding community-based COVID screening. CRRTC currently works to support the work of the Lower West Side Covid Response Team for the Homeless, and so far our volunteer members have conducted over 3000 individual screens and have assisted in identifying COVID-19 outbreaks in the City of Chicago. All donations will support supply purchases; there are no administrative costs.
A donation of $300 would help us continue to perform screenings at a 350-person shelter for another week.
A donation of $250 would allow us to add a new screening site with 80 guests.
An additional donation of $200 would help us continue these screenings on a weekly basis
A donation of $300 would help us expand our screening capacity to medically underserved Chicago neighborhoods with higher rates of COVID infection.
CRRTC is fiscally sponsored by Crossroad Funds, a 501(c)(3) non-profit organization focused on supporting local Chicago communities. Donations can be made through our website at https://crossroadsfund.org/covidrrt
What is your motto in life?
"Do what you can with what you've got." This motto has resonated with one of our volunteer members, who is a recently graduated medical student. From caring for patients on clinical rotations to now helping with social media for CRRTC, it is by being of service to others, no matter the form, that has given her day-to-day life a sense of purpose.
To learn more about COVID RRT please follow them via the below platforms:
Those interested in volunteering with CRRTC can sign up here: https://www.covidrrtchicago.com/new-volunteer
Instagram: @covidrrtchicago
Twitter: @covidrrtchicago
Facebook: www.facebook.com/covidrrtchicago