Case Study: COVID Delta in New York
A Classroom Case Study Note: This case study is based on a real-life outbreak investigation undertaken in New York City in 2021. Certain aspects of the original investigation have been altered, however, to assist in meeting the desired teaching objectives and to allow completion of the case study within the allotted time. Students should be aware that this case study describes and promotes one particular approach to outbreak investigation; however, procedures and policies in outbreak investigations can vary by country, state, and outbreak. Instructions: Pretend you are a member of the New York City Department of Health and Mental Hygiene (NYDHMH) surveillance team. Read the narratives below, and answer each of the questions to the most explicit abilities. Feel free to use notes, the readings, lecture videos, and other scholarly sources to help inform your responses. Part 1. Outbreak Detection On the evening of January 5, Lena Horne, a 24-year-old executive director and choreographer for the Dessalines ballet company called the New York City Department of Health and Mental Hygiene (NYDHMH) to report that a mysterious illness was spreading among her staff. According to her statement, 13 of her dancers reported the following symptoms: cough, headache, fever, and loss of smell. Among the dancers with symptoms, Horne reported that the family members of two had to rushed to New York Presbyterian Hospital. When following up with Horne about the status of her staff, she stated that all 13 dancers were sent home to quarantine for 14 days, followed by a doctor’s visit before returning to work. 1. What suggestions could you provide Ms. Horne and her staff, to help manage the spread of this illness. 2. Identify why two of 13 dancers could have been rushed to the hospital? Part 2. Follow up On January 24, and NYDHMH followed up with Mrs. Horne about her case. She has complied with the initial suggestions that they provided her. NYDHMH environmental health investigation team members undertook a comprehensive evaluation of the Desalines ballet company case, and followed up with the staff members who provided an initial report of symptoms, as well as others who previously reported positive for COVID 19 during January 5. Four of the dancers reported receipt of concerning notes, with racial slurs and threats of violence towards them, if they did not quit the troop. When reporting these concerning notes to Ms. Horne, she responded by mandating a diversity training, in hopes of the behavior ceasing. This did not result. The Associate Health Director has called a meeting with a representative of the NY District Office of Equal Employment (EEOC) about the feedback from Desalines staff. The EEOC representative has stated that they have received many reports from several individuals about harassment and abuse cases relative to COVID scapegoating, while in the workplace. 1. What suggestions can you provide the Ms. Horne to improve the safety of her employees at the dance company site? 2. What suggestions could you provide to the EEOC to ensure the safety of working New Yorkers, and challenge the discriminatory behavior towards former COVID 19 patients and other scapegoated for the existence of COVID 19? Part 3. Vaccine Mandate? Ms. Horne has followed up with NYDHMH to state that she has since tried to mandate that all her staff are vaccinated for COVID, in order to protect her staff, during performances, and to prevent the spread of this condition. Horne stated that when implementing this mandate, she received quite a bit of feedback from staff, stating that such a mandate was discriminatory and unreasonable. 1. Why might some of the opposing staff be concerned about receiving the vaccine? 2. What suggestions could you provide Ms. Horne, in response to the critical feedback about her mandate?