Protecting Their Own on the Front Lines

In mid-March, Matt Case was settling into his temporary surroundings in Washington D.C., where he was starting a two-month training stint with the Occupational Health and Safety Administration, when his phone rang.

On the other end was Carol Epling, Duke’s director of Employee Occupational Health and Wellness (EOHW), and one of Case’s mentors. She told him that as the COVID-19 outbreak spread, Duke needed to develop a comprehensive response system to keep employees on the front lines safe. She wanted to know if he could return to help build it.

“I packed up my apartment in trash bags and drove down here,” said Case, a Duke Occupational and Environmental Medicine resident. “I got back in the middle of the night and made it to the first meeting the next day.”

Over the next week, Case, Epling and the EOHW team constructed a system that has helped Duke employees with potential exposure to COVID-19 quickly get testing, medical evaluation, monitoring and, in many cases, clearance to return to work.

“We built a system that allowed us to essentially track everything COVID-related and be able to process it very quickly,” said Case, a lieutenant commander in the United States Navy who will wrap up his residency at Duke this summer. “I was happy I was able to put it together.”

From providing seasonal flu shots to treating employees after workplace injuries, the top priority of EOHW is the health of the 40,000 people who make up the Duke workforce. But with the outbreak of COVID-19 affecting the entire Duke community, and with thousands of Duke Health employees serving on the front lines in the fight against the deadly virus, EOHW faces a challenge unlike any it’s seen.

“We needed to be able to respond quickly and well in support of this huge looming threat to our workforce,” Epling said.

With the COVID-19 response system now up and running, EOHW rose to the challenge.

“During the past several months, there have been hundreds of heroes," said Duke Vice President for Administration Kyle Cavanaugh. "Some of those have been Dr. Carol Epling and members of her team. They have been working tirelessly to support all of our faculty and staff.”

As of 11 a.m. April 27, there are 9,142 cases of COVID-19 in the state of North Carolina and 306 deaths, according to the state Department of Health and Human Services, which maintains a dashboard of cases in the state.

Duke employees who feel they may have been exposed to COVID-19 or are experiencing symptoms call the Duke Health COVID-19 hotline at 919-385-0429, option 1 between 8 a.m. and 8 p.m.

A member of Duke’s emergency management team, Epling and other leaders at Duke had followed the spread of the virus, which first appeared in Wuhan, China, since it emerged. In late January, EOHW set up an online symptom monitoring program for Duke employees returning from Duke Kunshan University.

But Epling knew that, once COVID-19’s spread reached Duke, that wouldn’t be enough.

That’s where the software platform that Case constructed looms large. He built it using the REDCap database system with crucial guidance from REDCap experts at the Duke Office of Clinical Research. The system tracks Duke employees with potential exposures to COVID-19, facilitates testing, allows employees to track any symptoms during self-quarantine and creates documentation that can allow them to return to work.

The system is the roadmap for the workflow of EOHW’s team of  staff members and physicians, nurses, residents, and fellows who volunteered to help Duke colleagues on the front lines of COVID-19. Since March 23, 2020 over 50 redeployed staff and off-service residents have served on the EOHW response team. 

“We went from a handful of people with the phones ringing off the hook, to now we have a call center that’s staffed 12 hours a day,” said Libby Carver, a nurse practitioner with EOHW who has helped manage the COVID-19 response system.

A month after it came together, EOHW’s COVID-19 program has evolved into a multi-layered system that gives affected employees a high-level of human touch.

At Epling’s direction, the first contact with Duke employees who have potentially been exposed to COVID-19 comes by a phone call from a physician from the EOHW team, who is able to ease fears and answer questions. At every step of the process, members of the team help monitor symptoms, arrange for testing and answer work-status concerns.

“We want every employee here to feel like we’re taking care of them on a personal level and they’re not just another number,” said Trisha Stagg, a Duke University Hospital nurse on the EOHW team.

In addition to providing a personal approach, EOHW’s system also offers speed. If an employee qualifies for a test, they can get scheduled quickly and get results of the test back the same day. If they test negative, they can return to work fast.

“That’s a lot of reassurance,” Case said. “It’s not just that you came out of work and now you’re back, it’s that you reported your symptoms, your symptoms were documented, you’re now enrolled in symptom monitoring, you’ve also been tested, you have the results of your test so you can tell your family and co-workers that, at this time, you are COVID negative. That’s a lot of reassurance, so people can feel good about being at work and at home. It makes a lot of people feel better about everything.”

Help share the proactive and extensive work being done by all Duke community members during the COVID-19 outbreak. Send ideas, shout-outs and photographs with us here or write us at working@duke.edu.