In this week's edition of Local Motion, KVNF's weekly public affairs program, we talk to Leah Rawson and Shirley Tatto of Delta County Public Health. Lawson is a public health nurse with the agency, and Tatto is its Emergency Preparedness and Response Coordinator.
Topics include the current measles outbreak in West Texas and New Mexico, flu vaccines, the West Nile virus, and the availability of Narcan to help address the opioid crisis.
Interview transcript
This transcript has been edited for length and clarity.
Lisa Young, KVNF: Today, we want to begin with Delta County Health Department, which recently underwent a name change to Delta County Public Health. Leah, maybe you can tell us why that took place.
Leah Rawson, Delta County Public Health nurse: We felt that that better reflected what we're doing in the community and also that the word department itself was more of an institutional word. So removing that helped and the kind of services and the relationship that we really want to have with the public.
Young: Shirley, do you have anything to add on the importance of the name change and how you think that's going to help the community going forward?
Shirley Tatto, Emergency Preparedness and Response Coordinator: I think it really reflects our community connection that we are trying to develop. We've had it going for a long time, but we're really trying to reach the community more than we have.
Young: What is public health?
Rawson: Public health encompasses many things. The main thing that we think about would be prevention. We want to prevent things before they happen. Some of our services, such as immunization, would cover the vaccine-preventable diseases, investigating communicable disease. Trying to prevent further things from happening and inform people so that they'll know what's going on. Some of our other services that we have here, family planning, sexual health, many of those are about prevention and helping people.
Young: Shirley, maybe let's take a minute here and talk about the structure of public health in the United States because we're sitting here at the county level, but there's a couple of levels above us.
Rawson: So we would report up to CDPHE (Department of Public Health and Environment), and then they would report up.
Young: So would that include the Centers for Disease Control, the CDC?
Tatto: Yes.
Young: We know that there's a lot going on with the new administration, a lot going on at the CDC level, at the federal level, and things do tend to trickle down into the state and to the county levels. With the new administration coming in, what has it been like so far? As far as your day-to-day operations? Is everything still going pretty smoothly here at the county level?
Tatto: At the county level, we are still the same as always. We just are moving forward. We hear things sometimes that grants are going to be cut or held, but so far, everything has been working as it had in the past.
Young: Leah, do you have anything to add to that?
Lawson: I would agree with Shirley. Our day-to-day structure and activities are much the same at this point. There has been some lack of communication, which they've not been able to put out certain information. So we don't actually know some things at this point, but I think that's getting better. I'm hoping,
Young: I want to talk about an interesting situation taking place in west Texas and now in New Mexico, which is a measles outbreak. Leah, what can you tell us about the current measles outbreak? What does the public need to know?
Lawson: We know that there are 124 cases. We did learn just today through the news that there has been one death of a school-aged child. So it's very concerning. One of the reasons that they're having that outbreak is because they had a very low vaccination rate in that community. That's how it began. Here in Delta County, if we look at our school population, we have statistics from the 2024 year. Our immunization rate for measles, mumps, rubella is 78.4%, and that puts us at a very high risk for an outbreak.
Young: But my understanding is that you wanted above the 80% or higher. What is the goal if you had a goal for Delta County, where you'd like the people to be vaccinated for measles, mumps, and rubella?
Lawson: So 95% would be the best that we could probably get to and that would put us at a very small risk. Even getting to 90% would increase that. The majority that are not vaccinated are due to exemptions, which is something that we can't really change. What we can do is communicate to the public about the vaccine, how safe it is, the ages and that they should get vaccinated and just encourage folks to do that. We do not want children to be affected by this. We do not want an outbreak here, and we want to protect our community.
Young: What can you tell me about measles? How it, I mean, I understand it's one of the highest as far as being contagious viruses out there and that it can spread very quickly. You could be someone who is carrying it for maybe four days or so before you know have it.
Lawson: Yeah, you are correct on the four days. Somebody could have measles and be contagious, although they do not have symptoms, and the symptoms could show up four days later. At that point, they would know they were contagious. Even if they were in a room and you came into the room later, it's in that room for two hours. So it's one of the most contagious diseases that we have.
Young: What would be some of the symptoms in someone who has been infected with measles? How does it begin, and how does it progress?
Lawson: It would be the typical symptoms that you would get with a virus, which would start with a fever, a cough. You could have red, watery eyes. You could have what's called koplik spots, which are white spots that appear inside the mouth and on the cheeks. And then, of course, at the point where that rash appears, most people know something is terribly wrong. The fever typically would be all those viral symptoms that would be happening.
Young: If someone were to be infected with measles, what's the next course of action that they should take?
Lawson: They should notify their healthcare provider. They should not go into any building. They should not go there and tell them that they think they have measles. They should call them ahead of time and tell them what's going on so that they can be prepared to provide an environment where it's safe and nobody else is exposed.
Young: Does this even apply to the emergency room?
Lawson: They should call the emergency room, yes, because some of these folks may, with measles need to go to the emergency room. They could be that ill.
Young: I understand that it is also a live vaccine, so there are certain folks in the population who would not be able to get a booster if they wanted to. Is that correct?
Lawson: That is correct. Anybody who has a condition that causes certain immuno-compromising conditions, folks that have had organ transplants, folks that have had stem cell transplants, blood cancers, those are the ones I can think of right off hand that cannot receive live vaccines ever.
Young: But we do want to dispel the myth that the vaccine itself causes measles, which it does not. It is there to help prevent measles. If people want to get the vaccine, are they able to do that here at public health?
Lawson: Yes, we do have it available and we have it for all ages. If somebody of an older age never received it or wasn't sure about their vaccination record, they can receive the vaccine. Typically age one would be the first dose, and then age four to six would be the second dose, and that provides 97% effectiveness with the two doses.
Young: There are other health concerns in the county. Leah, what are a couple of other issues here in the county that you think folks need to know about, especially with warmer weather coming on?
Lawson: So one thing we've seen this respiratory season is a very high rate of flu hospitalizations through the information that we get through the disease reporting system. We can't tell exactly how many cases are in our county, but we can tell how many hospitalizations for flu there are, and it is quite high. We have been seeing a lot less of COVID and RSV. Very little, actually. The flu this year has been mostly the Type-A, which has more severe symptoms, which can, of course, cause people to be sicker and possibly be hospitalized. So we would encourage people to come get the flu vaccine. We also have the high-dose flu vaccine available here for people who are over 65 who are at higher risk for hospitalization. Even now, they can get that vaccine all the way through June 30th, when it expires. So if somebody hasn't gotten it, they can come in and get it.
Young: We also have to talk about West Nile Virus in the summer months. So, what would you say about protecting against West Nile virus?
Lawson: There's personal protection where we don't want you to be exposed to the mosquitoes themselves and be bitten. So, of course, a mosquito repellent would be important. Long sleeves, long pants, trying to stay away from those mosquitoes. And then the other part of it would be, and Shirley, you might be able to speak to this a little bit better than me, she was responsible for a campaign with West Nile that I think was very effective.
Tatto: I call it the Four Rs. So we want you to repel the mosquitoes by using an EPA-registered insect repellent. Remove standing water from around your home and in the yard to keep them from breeding. You should repair or replace damaged window screens. And you should remind your friends and neighbors because mosquitoes don't know you have a fence around your house. They'll fly miles for a meal.
Young: What is that peak season for West Nile Virus and your concerns from the public health side of it when you're really, this campaign will gear up at some point? When will that be?
Tatto: We start in June, and we will start putting out the traps in the community. They will start the mosquitoes and bringing those pools in, and they will be checking to see if any of them have West Nile. Last year, we actually didn't pull any positive pools, but we ended up with a few people in the community who ended up with West Nile.
Young: We're going to switch gears here just a little bit. (Shirley,) tell me your title again.
Tatto: I'm the EPR coordinator, which is Emergency Preparedness and Response, and that's within public health. It is not part of emergency management, although we work hand-in-hand together.
Young: Tell me specifically what your job is, what you do on a day-to-day basis.
Tatto: So we do a lot of preparedness. I put out a lot of communications on things. When it's flood season...how to pack a go-kit. Specifically, public health is considered a functional section under emergency management for health, and that's why COVID actually had fallen under public health as part of that emergency response.
Young: COVID is a really good example. What would be another example where the public health, your group would get involved with the county response?
Tatto: We fall under emergency management, but we take care of the healthcare portion. So we would be working with long-term care facilities, home health, the hospitals, and we work together to take and come up with a response that would be appropriate for the particular issue that's going on.
Young: And I take it, this is probably something where you already have some plans that you've thought about and how you would incorporate those plans.
Tatto: Yes. We have complete plans for that, and every time there's an incident or anything, we then go back, and we do an after-action report, and then we will go ahead and tweak those plans to make them better for the next time.
Young: Tell me about Narcan (and) the availability in the county.
Tatto: It's difficult sometimes to talk about, but it can save a life. The importance of Narcan is that it can reverse an overdose in somebody who is suffering an opioid overdose. And in our community, there's a lot of fentanyl, and they're now bringing in another product called xylazine. Xylazine is animal tranquilizer that they're mixing in with drugs and they're doing that to take and extend the high, but Narcan won't actually reverse the xylazine, but what it will do is it'll reverse the opioid that it's mixed with and you can save a life that way.
Young: Firefighters and police have access to Narcan, but what about just the general public? Is it something that's available to us?
Tatto: Yes. So public health has it available. Anybody can walk in and ask for some as well as we've put some kiosks around the county. We have a kiosk at each one of the libraries. So if you're out in Crawford or you're in Paonia, you can go to your library there. It's a white box outside of the library. You can open it up, it's not locked, and you can get yourself some Narcan that way. And it's very simple to use. It's a nasal inhaler. If you were to see somebody who you think is overdosing, you would try to see if you could wake them up by yelling their name really loudly.
If they are not responsive, you should first call 9 1 1, then lay them on their back, administer the Narcan, and then roll them over onto their side to keep them from choking. And then you would give them the second dose. Each box contains two doses.
Young: I wanted to ask each of you: What is your greatest challenge for you in public health?
Tatto: I think my biggest challenge is communication. That is because I am trying to reach everybody. It's trying to find the right channel to get the right people at the right time, where they're at. We do push a lot of things out through Facebook. And please call me at the health department and let me know if you have a way you would like me to communicate with you. Because I would love to communicate with you through our newsletter, through phone calls, emails, texts, however you'd like to receive the information.
Young: Shirley, what is one of your greatest rewards of working in public health?
Tatto: I love the community. And so when we can touch people every day (who) come through our doors, that is for me, personally rewarding.
Young: Leah, how about you? Your biggest or greatest challenge working in public health?
Lawson: I think one of the things I think about is dealing with vaccine hesitancy and trying to overcome that and work with people on that. We would always encourage people to talk to their healthcare provider if they have concerns about a vaccine or getting a vaccine. We're here also to answer their questions.
Young: I see that challenge becoming a little more difficult.
Lawson: I believe in the current environment, it could be more difficult, but not impossible.
