Public Health Clinic workers

The Pinal County Public Health clinic staff, shown in a group photo before the COVID-19 spread to Arizona, have tried to provide care to people in need through innovative ways.

Editor’s note: Interviews for articles in this issue of Pinal Ways were conducted in early or mid-May, and reflect the state of the industry at that time.

The coronavirus pandemic has changed how a multitude of industries operate.

Beginning in March, the outbreak of the virus and social distancing efforts disrupted the education system — forcing school districts to adopt remote learning — and brought about significant changes in how a variety of companies conducted day-to-day functions and team meetings. 

Businesses that were on the front lines of the outbreak also were not immune to experiencing massive shifts in everyday operations.

Faced with a percentage of customers that were over-buying some merchandise, grocery stores encountered shortages and rationing from warehouses unlike any other time period in history.

Even health care saw shake-ups when it came to prioritizing health needs amid the outbreak. The impact extended beyond hospitals, with doctor's offices, clinics and other health services also having to take extra precautions to protect the health and safety of their patients. 

In the public health sector, the challenges were no different. 

The Pinal County Public Health District provides a wide variety of services to adults and children living in Pinal County, from family planning and sexually transmitted disease testing to immunizations and nutrition support.

In light of the pandemic, however, many of those services were placed on a temporary hold. In addition, amid efforts to contain the spread of COVID-19, some of the district's clinics were closed. They include the Coolidge, Eloy, Superior, Kearny and Maricopa public clinics — which were closed to the public in April. 

Efforts to limit the potential for exposure to COVID-19 among clinic patients and staff members have led the health district to take more innovative approaches to meeting the health care needs of the community, said Marcela Salinas, division manager for clinical services.

Up until the pandemic, providing health care through avenues like telehealth was something the division had never had the opportunity to implement, Salinas said. The pandemic, she noted, has led the county's public health department to use more web-based solutions to provide services to the community. 

"Obviously we want to continue services, and we've had to think about how can we successfully deliver services to the public and our clients who are really relying on it (right now)," she said. 

Though some clinics have been temporarily closed, a number of services are still being provided at those that have remained open. Clinics in higher traffic areas, such as Casa Grande, San Tan Valley, Apache Junction and Mammoth, remain open to the public for limited services. 

As part of many measures to stem the spread of the virus, routine appointments and annual checkups have been temporarily put on hold. 

Services currently offered during the pandemic include immunization for adults and children, STD testing and treatments and tuberculosis skin testing. In addition, appointments are still being scheduled for women who may be experiencing abnormal symptoms such as breast pain, have identified a lump or received abnormal test results. 

Because those types of visits must be done in person, the county's public health division has implemented many measures to protect staff members and the clients they come into contact with. 

Keeping the clinics clean and sanitized was among the division's top priorities even prior to COVID-19, Salinas said. However, clinics have had to implement other health initiatives like temperature checks of all staff and patients prior to entering the clinics as a precaution against the coronavirus. 

In addition, a limit on the number of individuals allowed inside the clinics at any one time has also been put into place to help clients adhere to social distancing practices.

Once the maximum number of people currently being allowed inside the clinic lobbies is reached, patients are asked to wait in their vehicles until their appointment. 

Clients, Salinas noted, are also now required to attend appointments wearing a mask. 

"Ideally we would love for our clients to show up prepared with their own masks prior to coming in," she said. "It will protect them, our staff and others around them." 

As the number of people who have tested positive for COVID-19 continues to climb, the measures will remain in place for some time, despite Gov. Doug Ducey making the call to allow the stay-at-home order to expire. 

Although the clinical services division is examining the possibility of reintegrating some services that were sidelined in April, Salinas noted that the division currently has no concrete plans to reopen the closed clinics. 

"We just want to see how the opening of the state works out, and of course, we don't want to rush anything," she said. "We want to take small steps to make sure that we continue to protect our community and our staff." 

From a health perspective, however, once the pandemic is brought under control, the long-term impacts of COVID-19 may be positive, Salinas noted. The novelty of the virus and its rapid spread around the world has made everyone a little more conscious of important routines like proper hand-washing and mindful of habits like routine face touching.

Salinas predicts that some aspects of social distancing may also continue to be a norm long after the pandemic comes to an end. 

In terms of clinics, telehealth will likely continue to be a part of the services the public health sector offers to clients as the option gives individuals who may not have easy access to transportation an avenue to obtain the assistance they may need.

Remote services have been offered to Supplemental Nutrition Program for Women, Infants and Children clients in light of COVID-19 as well, Salinas noted, benefiting a number of women and children that also may have struggled to secure transportation in the past. 

"Those are real challenges that the community sees and faces every day," she said. "The way I see it is why not embrace (services like) telehealth." 

But with the numbers of those who have tested positive for COVID-19 continuing to climb, putting the health and safety of the community first and foremost will continue to be the primary focus for Pinal County's clinical health services.