The Man behind the Mask - Health Commissioner Greg Kesterman kicks off the Podcast

Heart and Hustle in Hamilton County is a podcast about the people, places, and policies that govern our local response to the COVID-19 outbreak. Hosted by County Administrator Jeff Aluotto, Heart and Hustle discusses the issues, challenges, and opportunities Hamilton County, Ohio faces as we battle a global pandemic. 

On Episode 1: Health Commissioner Greg Kesterman takes a look back at the whirlwind that was his first month on the job at the helm of Hamilton County Public Health. Greg talks about how his department is rising to the daily challenges of contact tracing and messaging out about the dos and don'ts of safe behavior (spoiler: no partial credit for wearing a mask incorrectly).  

To learn more about Hamilton County, Ohio, our services and job openings, visit hamiltoncountyohio.gov.

Transcript

Bridget Doherty  0:01  
All right. 321 cue talent.

Jeff Aluotto  0:16  
Greetings everyone and welcome to Heart and hustle in Hamilton County, a podcast about the people, places and policies that govern the work of Hamilton County, Ohio, and in particular, our local response to the covid 19 outbreak. I'm your host, Jeff saludo. I'm county administrator in Hamilton County, and I'm here with my co host Communications Manager Bridget Doherty green divergent

Bridget Doherty  0:39  
Hello, greetings on our inaugural podcast.

Jeff Aluotto  0:44  
So over the next several episodes of this podcast, we're going to be discussing and talking about the issues, challenges and opportunities Hamilton County faces as we battle this global pandemic.

Bridget Doherty  0:56  
So first of all, I thought it might make a little bit of sense to kind of go through why are we doing a podcast? And right now there are so many things happening in the media, there's a lot of noise. I feel like right now is a great time for us to cut in and try a new medium.

Jeff Aluotto  1:14  
Yeah, it's a great point no great, especially for our first episode. So in talking to a lot of people and a lot of positions through throughout the county, whether they're employees or not employees, it seems like there's there continues to be this real lack of information about what counties do compared to say what the city does or what state or federal government does. So bridging that information gap is something that's always been a priority of mine. And it's been a priority the Board of County Commissioners, but it's actually a lot harder than than you think to do that.

Bridget Doherty  1:44  
It is I feel like sometimes counties aren't as tangible is cities. And so also with civic lessons in the past. I mean, you know, people think back and they really remember what is it that a county does? And, you know, which is kind of a shame when we're in this terrible pandemic counties actually account for a large amount of what the frontline workers do and the activity in battling this pandemic.

Jeff Aluotto  2:10  
Absolutely. I mean, when you think about it, I mean, we do public counties do public health, we do the Emergency Management Agency. We're the 911 dispatchers that people call when they need help, the economic development agencies that help keep the local economy strong. The caseworkers that are out there protecting children and the elderly, Sheriff deputies running the jails, the courts, the coroner's office, I mean, there's just so much that counties do on a day to day basis, a lot of which meshes right into the response to the covid 19 pandemic.

Bridget Doherty  2:43  
So I'm kind of hoping this podcast is a direct way for residents and even employees, the media to kind of connect in a casual conversational way to all of that what Hamilton County is doing, especially in this space with the pandemic.

Jeff Aluotto  2:59  
That's right, and really wanted to focus these first few episodes on work responding to that pandemic. Because right now, as you said, Bridget is just so, so fundamental and so central and everyone's minds right now, in that regard. Kind of segwaying here, I don't think we could really pick a better person, to be our inaugural guest on heart and hustle. Then Hamilton County Commissioner of Public Health, Greg, customer, Greg, welcome.

Greg Kestermann  3:28  
Well, hello, good to be here. Nice

Jeff Aluotto  3:31  
of you to be here. And great to have you here, Greg. And first of all, before we get into the the meat of the show, I just want to take this opportunity to thank you and the staff of Hamilton County Public Health, for everything that you all have done over the better part of this year, I know probably seems like a decade to you now, Greg, but to keep the county safe and to keep the pandemic from spreading more rapidly than it has here locally. I'm just just constantly amazed by how immense of a job you have. And all of your staff has me you've got a relatively small staff, you got nurses, epidemiologists, but the work that you guys have done has just been absolutely magnificent. So on behalf of the County, and the community just wanted to say thank you.

Greg Kestermann  4:20  
Thank you, Jeff. And I'm very lucky to have such a great team. We have clearly a lot of dedicated people that are working tirelessly, seven days a week, and it's been an honor to work with them.

Jeff Aluotto  4:30  
Excellent. And so I think that the meat of the show, and again, this is the inaugural episode of heart and hustle. And so what we really want to do is just engage people who are on the front lines of activity in the work of the county and just find out a little bit more about what they're doing in a way and the things that you're doing that the employees of the county and the general public in the county would find interesting and some of the behind behind the scenes information on What goes into the work of, of doing the county's work? So just to get into it? Again, we said at the beginning that you came on as health commissioner earlier on this year, but it probably seems like much longer than that. What was the first when were you officially installed as as full time permanent Health Commissioner? Right.

Greg Kestermann  5:23  
So I started as interim Health Commissioner in February, and then just a couple months ago, I was named full time. And you're right, February seems so long ago. And it was just around the start of the pandemic, right, we were talking about cases. And we saw airports starting to shut down and changes nationally on how we were, we're responding. I've, back in February, things were so different. I remember in one of my first weekends having to call about 10 folks in to be in the office on a weekend. And we were adjusting and dealing with a potential case back then we talked about probable cases at COVID-19. And it was my medical director and epidemiologist and we're sitting around talking with the director of health Dr. Amy Acton at the time, and we're making big decisions on whether or not we should sample this one individual, which would ultimately call them a probable case and have a bunch of people quarantined. And to transform from that moment in time to where we're at today, where we're having 500 cases a day of COVID-19 and quarantining 1000s of people as a result of that it's just been such a crazy ride over the last nine months.

Jeff Aluotto  6:29  
Absolutely. I remember that. At first case, you're waiting on that first case. And again, it does seem like a decade ago.

Greg Kestermann  6:36  
That's right. Yeah, I actually called called you if you may recall. And you know, I'm very new at my shoes. I'm not sure if at this point, I'm supposed to call the county administrator for a potential case of COVID-19. But we've just come such a long way in that period of time.

Jeff Aluotto  6:49  
Yeah. And they've been good things. And obviously, there's been ups and downs, good, good and bad, but obviously the spread of the virus, no one wants that. But again, I think the positive thing here is the way that public health is responded to it. So before we go much further, just to level set, we are on November 25. That's the date right the day before Thanksgiving. So someone is listening to this in a timely manner. Here. Tell us just a little bit about what the state of COVID-19 is in Hamilton County right now.

Greg Kestermann  7:21  
So over the last month, we have seen cases skyrocket in a way that we've not yet seen throughout the pandemic. We went from a couple 100 cases a day quickly to 500 cases a day over the last two weeks. And luckily right now we've kind of plateaued things drop back down a little bit. But our hospitalizations are so high they we have 650 people in the regionals hospital system. And so as we looked at tomorrow, Thanksgiving, we have such a high level of concern, and an ask of the public and our communities and our employees to be careful tomorrow. The last thing I want is somebody to celebrate with grandma and grandpa and ultimately cause them to end up in the intensive care unit, or worse.

Jeff Aluotto  8:03  
Absolutely, and, and part and parcel with that. Greg, was a week ago, maybe I think public health issued a stay at home Advisory Board of County Commissioners weighed in on that supporting that advisory. Talk to us a little bit about that advisory, because that obviously is still in effect today and what the impact of that has been.

Greg Kestermann  8:25  
So I've been fortunate throughout this pandemic, to have state leadership that has been very clear in the expectations as we move through the various steps of this pandemic. And they've issued orders necessary to slow the slow the curve at various times. Right now, we're at a point where we really want to keep the economy open, because there's such big implications of shutting things down. But we're seeing rampant spread. So I issued an advisory a Public Health Advisory, really encouraging people to reflect and to think about the need to lower their COVID footprint, now is the time that you should maybe make that choice to stay home more often to not have people come over your home to not go over others, other people's homes, and to do what you can to keep your family safe and healthy. Realizing that it does have an impact on the number of people in the hospital systems. So that advisory, it encourages folks to stay home and encourages folks to follow all of the current directors orders. There's a curfew in effect right now from 10pm until 5am that you shouldn't be out and about. We want people to follow these things so that we can as a community, begin to heal those numbers and to help our hospital systems.

Jeff Aluotto  9:32  
Yeah, it's a great point. And I think when we got into that you mentioned things like shutdowns, etc. When we got into this, we knew they were going to be none of these measures are perfect, right? That's right. And there's no silver bullet to addressing a pandemic, you know, until you get to something until you bridge the gap to a vaccine, right. So we knew there'd be some conflict over some of the heavier non pharmaceutical intervention. Like, shutdowns and business closures and things like that, but as health commissioner, did it surprise you, the level of anxiety and and community conflict over what seemed to be some of the more subtle intervention measures like masks.

Greg Kestermann  10:16  
You know, Jeff, it's very disappointing as the three of us sit here today doing the inaugural podcast, all three of us are wearing masks. And I would much rather see your facial expressions and have that full effect. But this little piece of cloth has potential to reduce the pandemic in our community, and to save lives. And so it's so selfish when somebody chooses not to wear that mask. And it's so disappointing that people are willing to make that choice. So I plead every day. And I hope more people wear masks. And we go through periods of time where you walk into a grocery, and almost everybody wears masks or other periods of time where for some reason, it becomes political, and there's individuals not wearing the mask. I just look around. And I don't understand why people can't make that small sacrifice for our community, for our country. And ultimately, for those friends and family that that will ultimately get sick.

Jeff Aluotto  11:05  
Yeah. And once we do get everyone wearing masks, and we can move on to getting my son to pull it actually pull the mask up over his nose. People do it correctly is the other thing as well. But once we get people wearing them, that's the first step. Right.

Greg Kestermann  11:20  
I was on a press conference today with Commissioner Driehaus. And Dr. Rich from the University of Cincinnati made a comment that there's no partial credit for wearing your mask. You got it, you got to wear that mask correctly, if you want full credit exactly,

Jeff Aluotto  11:33  
is exactly right. And you mentioned you're trying to just stop the spread and contain the spread. Greg, something that goes hand in hand with that talk to us a little bit about contact tracing, because I know you've got a number of people that are doing that for you. And that's really at the heart of identifying cases and making sure that this case is don't spread. So for someone out there who may not understand how that works, what goes into contact tracing

Greg Kestermann  12:02  
quite a bit. You know, we've changed how we've done contact tracing throughout the pandemic, we've gotten very efficient with it. And we've had to ramp up clearly as the number of cases have increased, we now have 85 individuals doing contact tracing, which seems astronomical to go from zero to 85. Over the course of a half a year. When we get a positive case, our goal is really to call that case back within 24 hours, we know the sooner we can keep their close contacts or people that have been within six feet for 15 minutes, the sooner we can get them to stay home in a quarantine, the less spread will have the disease. So our first step is getting a positive case we pick up the phone we call them and we conduct an interview and ask them questions about who they've been around. And then our next step is to follow up with those individuals and ask them to stay home and to provide them information so they know how to stay safe.

Jeff Aluotto  12:53  
What's been the typical reaction, you got the 8020 rule on anything? 80% of people respond one way 20% another What have you seen in terms of when you do when your contact tracers make those calls? Are they are the receptions positive. Are people happy to be here hearing from them that someone is following up with them? Or is there any level of angst involved there?

Greg Kestermann  13:18  
You know, we've seen some shifts throughout the pandemic earlier on in the pandemic, I think we were often the first point of contact with the patient. And people were surprised that they had contracted COVID-19. And we're disappointed and scared. And so our team would work through that and talk to them and become a point of information throughout their 14 or their 10 day isolation period. close contacts often similarly, we're surprised that they were around somebody with COVID-19. Scared as well, but little less because they don't have it. And as the pandemic went on, and information nationally changed about the severity of COVID-19, we've had some more resistance to contact racing people indicating that they're not willing to share names or they'll call their friends on their own. And, you know, that shift has kind of worn my team out as well. It's very hard when your job is calling people all day and you're not always well received. So we've worked through it we we try to support our team as best we can. But it's been a long process. Yeah.

Bridget Doherty  14:18  
Along the same lines, you know, how is your team hold not because this is you know, as we said this morning on the briefing is no one's taking vacation. These are long hours, there are weekends involved. Yeah, manage that with your staff.

Greg Kestermann  14:31  
It's been such a wild pandemic for my team clearly where the front line, we went from many of us working seven days a week to kind of forcing people to take weekends, although not Friday, Saturday, or not Saturday, Sunday, kind of weekends, but Monday Tuesday's your new weekend and making sure they're taking care of themselves. In addition, we've tried to really staff up to make sure that they're supported so we went from 95 staff back in February to 115 staff Now, in addition to the 80 Five contact racers that we have. So it's been just a huge massive shift and undertaking and I'd like to say my team's holding up. But I know many of us are tired and doing the best we can until that vaccine comes and trying to figure out how we'll get that vaccine into the community, in addition to contact racing,

Bridget Doherty  15:18  
definitely, definitely the unsung heroes of this pandemic. Yeah, working behind the scenes, and Can we switch over to vaccines? Because I wonder if one question you might have gotten from some of the community is, you know, we hear that there's a tiered system, how it's coming in? And how do I get to the top of that tier and get the vaccine first? So what do you tell people on the on the, on the, on the streets.

Greg Kestermann  15:41  
So ultimately, vaccine will be available for the individuals that have been identified by the Centers for Disease Control. And there is a four tier process and the individuals that are in the top tier, or tier one a, are those individuals that are actually working with COVID patients. So we're talking about hospital workers, Ms folks that are writing in the ambulance, taking those sick individuals to the hospital, they will get the vaccine first. And then we kind of go down from there to individuals that are in the essential workforce, and people that have underlying health conditions will be next. So essential workforce could be somebody who works at the 911 Center, it could be somebody who works at the grocery store, we know they need need to be in the community to keep us providing groceries that are an essential, essential for everyone. And then tier four is anyone in the community.

Jeff Aluotto  16:30  
On the kind of on the on the same note, so when we talk we're talking about vaccine, we're talking about contact tracing, something else that I think the approaches changed on a bit over the course of the pandemic, Greg is just testing in general man remember back to the, to the beginning, and we were reserving testing for certain populations or certain contacts and, and there was a shift in terms of whether you wanted people without symptoms to be to get tested, as we are now ramping up the amount of testing going on with within Hamilton County and the county has launched its testing protect program through the health collaborative or in partnership with the health collaborative. What do you want to tell people about testing? We've got Thanksgiving coming up, people are traveling all that type of thing, what do you What's your advice to people now on getting tested, whether you do or do not have symptoms.

Greg Kestermann  17:19  
So I think it's a good idea, if you have any concerns, with or without symptoms to get tested. You know, results are available, typically right now within two days. So you're not waiting for a week, like we saw early in the pandemic. And so it's not very inconvenient to get tested. And thanks to Hamilton County, there's so much available testing locations. So you're not driving far to a testing site. The lines aren't wrapped around the corner, they're short and manageable lines. And that test does give you a nice snapshot in time and gives you some relief and understanding. The one fear I have is as we enter into Thanksgiving that people will say, Well, I can get a test today, and then not be safe on Thanksgiving and be with my family. That test is merely a snapshot in time. So if you are sick with COVID, but haven't built up enough of the virus in your body, that test still can come back negative. And so if you If that's you, and you go celebrate Thanksgiving with Grandma, you still run the risk of making grandma sick. And so it's really about behavior. We need to we need to social distance, we need to wear a mask and have good hand hygiene to control this virus. And testing is just one more tool to help us understand and take it to the next level and do isolation when we do have positive cases.

Unknown Speaker  18:28  
That's great advice.

Bridget Doherty  18:29  
So one question that I noticed that you get over and over again, is about enforcement. And I know that that you know a lot of reporters want to know, well, what are the consequences to not paying attention to this? And you had a great story about, you know, the soccer complex that you recently visited? Sure. Could you share that?

Greg Kestermann  18:53  
Yep. So recently, Governor dewine kind of re instituted a masking requirement in retail settings. And I think anytime he reissues an order, it brings new awareness, and it helps our businesses and helps individuals have a new heightened sense of needing to do that activity. So the new order requires businesses to not allow customers to come in without masks. And I was at a soccer complex and two gentlemen walked in in front of me without masks. And the four high school kids that work there asked them to put on their mask and they refused them actually walked away. And the students walked over the employees walked over and reiterated that they'd like him to wear a mask and they refused and they said well if you're not going to wear a mask, you have to leave and they refuse to leave as well. And so ultimately, the the the employees contacted the police and the police came and remove the two individuals without incident. You know, it's so disappointing though these individuals are were there to watch their daughter play soccer. And it's such a selfish decision to leave the facility to not watch your daughter play soccer over a piece of cloth that is required by by Ohio law. So really disappointing, but as Everybody else in the complex that I'm asked on, and that puts a smile, you can't see it because I'm under a mask, but that puts a smile on my face.

Unknown Speaker  20:06  
I'm just so impressed with the high school students due to follow up. Absolutely.

Unknown Speaker  20:10  
Yeah. I mean, scary situation for for a younger person. And even as an adult, I mean, nobody likes to call the police and, and deal with something like in that fashion,

Unknown Speaker  20:19  
or just to confront someone. I mean, we've all been those huge sporting events, we know how they can be in time. So that's a really tenuous position to put, put a employees like that in. So yeah, so people that are listening to this, again, as Commissioner custom and said, you know, if we just abide by some of these simple measures, whether it's mass washing hands, doing socially distant things will work out, hopefully, better for all of us.

Unknown Speaker  20:46  
And for those of you that are doing it right every day, I want to say thank you. And for those of you that are doing it right every day and appreciate the workers at the store, I'd like to ask you to take a moment and say thank you next time you run through the checkout line at a grocery store, or you see a worker doing the right thing. It's really worth us working together as a team and supporting each other as we're dealing with this pandemic as well.

Unknown Speaker  21:07  
So just one one last question for Greg. And this is really just speaking broadly about the field of public health and emergency management. So, you know, before 2020, when we talked about public health and emergency management issues. Now, you guys have been in the, in the business of disease prevention for for a long time. But this obviously is, is to a different level. But typically, when we're talking about responding to disasters, we're thinking about tornadoes, we're thinking about floods, etc. even remember, back with h1, n one, that was something that you guys had set up, vaccine pods are points of distribution, for those, but it was a relatively containerized thing from from a time perspective, if I remember correctly, this has gone on from the beginning of the year through now. So just as you think about leaving a public health department, from your perspective, day in and day out, what's what's been the hardest thing about leading that response on a day in and day

Unknown Speaker  22:14  
out basis, you know, I think, truly reminding my team that this is a marathon, and reminding folks that we will make mistakes throughout this marathon. And that doesn't mean we'll lose the race. So there are times, you know, last weekend, when we saw our case, count go from 300 to 500 cases, we weren't perfect. We didn't call everybody back within our standard of 24 hours, we just physically couldn't. And the truth is, that's not ideal, but it's going to happen. And just remind our team that they're doing the best they can and to thank them as we maneuver through these unprecedented times. And we got through it, we added 15 staff in the last seven days to do contact racing. And we're back up and running. And that little blip is now a thing of the past. And so as we continue to run on this marathon, I think just continuing to remind our team to take breaks, pace yourself. And we'll get to the end at some point. And now with the vaccine coming, the light is at the end of the tunnel, and we see the end. So keeping that in check is important.

Unknown Speaker  23:14  
Yeah, well, please pass along. Our thanks. And thanks to the entire county, to all the staff that are doing such a great job on this day to day out, Greg, and thanks to you personally. You have every time I've needed to contact you, you are always there the return calls within within two minutes. So just your level of dedication to this. It's just been absolutely phenomenal. So I just want to thank you for that.

Unknown Speaker  23:39  
Yeah, we're glad to help out. And like I said at the beginning, I'm lucky to be with such a dedicated Board of Health and such dedicated employees. We're really lucky.

Unknown Speaker  23:47  
And Hamilton County's lucky. I think so definitely. That's I think about all the time we have for this first inaugural episode, Bridget, anything you want to add before we close out here today,

Unknown Speaker  23:57  
just imagine how good we're gonna sound when we don't have to wear masks.

Jeff Aluotto  24:03  
Continue to move onward and upward. So, to everyone listening, thanks for tuning into this. I hope that this has been useful today. And that's really the goal is going to be the goal of this podcast is to give you the opportunity to hear from some people who are doing the real work behind the public service that Hamilton County provides. And from my perspective has been a real honor talking with you, Greg, as we'll be talking with all the different public servants that we're going to have on this particular podcast. So, again, thanks to everyone for listening, I want to remind you to subscribe to the podcast. So Bridgette, how do you go about doing that?

Bridget Doherty  24:36  
Great question. We are going to be on all the podcasting. So at the bottom of this link, you'll be able to hit subscribe. Fantastic.

Jeff Aluotto  24:47  
Great. So on behalf of myself Commissioner Greg Castleman, Communications Manager Bridget Doherty. Want to wish everyone a Happy Thanksgiving and we'll see you next time on heart and hustle

Transcribed by https://otter.ai