Photo of the drive-through COVID-19 testing site on Vashon Island (Photo by Mike Urban\CPI)
Today, we had a chance to talk to Dr. Osborn about his role as physician and as conservationist during the COVID pandemic, and the new Test & Trace initiative developed to support indigenous and rural communities across the country.
How do you see your experience as both a physician and as a conservationist informing your work against COVID-19?
During these tumultuous times, we must continue our efforts on the climate crisis and advancing environmental justice, while also tackling the coronavirus contagion sweeping the globe. We don't have the luxury of doing one or the other.
We have tools in our advocacy toolbox. Let’s use them to slow the spread of COVID-19.
Our community-based public service in environmental and public health, and our relationships with Tribal nations has led us to advancing a new initiative, Rural Test & Trace Toolkit (RT3), to save lives and jobs in tribal land and rural America.
What is the Test & Trace initiative?
The Rural Test & Trace Toolkit was developed by our local Medical Reserve Corps (MRC) serving Vashon Island located between Seattle and Tacoma. Our COVID-19 team of physicians and logistics experts is led by Dr. Jim Bristow (pediatric cardiologist and genome scientist) and Dr. Zach Miller (Infectious Disease specialist). Our team is networking with leading experts at universities, foundations, and commercial labs along with county and state staff.
Our team created a beautifully simple, drive-through program involving patient self-collected nasal specimens, volunteer medical professionals, and limited PPE. For positives, we do contact tracing.
The Test & Trace initiative is focused on Indigenous communities and rural America, why is that?
Geographical isolation cuts both ways. It may delay the arrival of COVID-19 in rural versus urban areas, but once COVID-19 arrives, it poses a potentially catastrophic risk for Tribal lands and America’s rural communities because acute care resources may be limited, drive times to access care are long, rural populations are often older with complicating health issues, and multiple generations may live together.
Isolation has thus far been associated with even greater delays in essential responses such as testing for the virus followed by vigorous contact tracing. To save lives and jobs, that must change.
Why is testing so important to controlling the spread of the virus?
This is a killer virus. If we can’t test, as clinicians we are left flying blind. Diagnosis is the first step to treatment - and that requires testing.
In late January into February, we didn’t have the capacity to test for COVID-19. When tests were finally available, resources and access were limited. But, after those first COVID deaths at Life Care Center in Kirkland, testing requests skyrocketed. An ER colleague was on hold for 5 hours trying to get approval for a test. Two months, 50,000 American deaths, and millions of lost jobs later, testing is better. But much more is needed.
Why did you decide to go with the Test & Trace strategy?
Rural realities drove our strategy. Our drive-through testing station is all-volunteer, and patients collect their own specimens from their nostrils with medical supervision.
Once operational, we realized other advantages - including massive scalability and universal patient acceptance. Knowing what we know now, there seems little reason to test any other way.
Where are you now in setting up this program?
We’ve created a web-based Test & Trace Toolkit to make information more accessible to rural and tribal incident command teams. Right now, we are helping the Quinault Indian Nation and Lower Elwha Klallam Tribes establish COVID-19 testing programs, and beginning work with other rural communities.
Are there any last pieces of information or advice you’d like to share with Sierra Club supporters?
A COVID-19 vaccine is 18 months or more away. Confronted with risk in Tribal lands and rural America, we now have a science-based test and trace model that works. While attending to our other public-service commitments, we will need to find ways to support grassroots mobilization of volunteers and health care providers. To save lives and jobs, we must test and trace as a bridge to a vaccine.
While our long-term work on the climate crisis and other pressing issues must continue, COVID-19 is a new threat. As the pandemic unfolds, here is what you can do to help today:
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Act locally: support local groups doing testing and responding to your community’s needs; sew and wear masks to help stop COVID spread.
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Health care professionals (active or retired): volunteer with your local MRC.
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Ask Congress to strengthen America's MRC network nationwide to support COVID-19 test and trace now - stop the spread into Tribal lands and rural America.
John Osborn is a physician and conservationist. He directed the HIV/AIDS program at the Spokane VA from 1986-2010, and now provides ER care for Veterans in Seattle, coordinates the Vashon MRC, and directs the Medical Division for the COVID disaster activation on Vashon Island. Dr. Osborn is also physician adviser to Camp Chaparral, a joint DVA-Yakama Nation project for VA staff focusing on care for Native American combat Veterans with PTSD.
He has served as conservation chair for Sierra Club’s Upper Columbia River Group since 1983, and currently leads Sierra Club’s Columbia River Team working with tribes and First Nations to modernize the Columbia River Treaty and restore salmon above Grand Coulee dam.