TarrantCounty MedicalSociety

Public Health Notes

By Catherine Colquitt, MD, Tarrant County Public Health Medical Director

This article was originally published in the July/August 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

In 1994, the Public Health National Center for Innovations and the de Beaumont Foundation collaborated with partners to establish the Essential Public Health Services (EPHS), and on September 9, 2020, the first updated version of the original EPHS was released.^1,2 As we celebrate a much-needed decrease in COVID-19 cases and deaths, it seems timely to review the updated EPHS, take stock, and plan for the future.

First, here is the 2020 version of our EPHS:

Analysis of our public health response to COVID-19 reveals successes and shortcomings. The successes include scaling up to investigate COVID-19 cases, clusters, and contacts in real time, even when hundreds of cases were occurring daily, and ramping up, with our partners, to administer 2,995,204 doses of vaccines in Tarrant County since the first vaccine allocations became available in December 2020.³ As a result, 85.87 percent of Tarrant County residents 65 years or older and 61.37 percent of Tarrant County residents aged five years through 64 years are now fully vaccinated.⁴ We have also worked effectively with state and local agencies, municipalities and other partner entities to vaccinate staff and vulnerable people in congregate settings. Alongside all of this, we have expanded our communications apparatus to keep our county residents informed of changing COVID-19 guidance, vaccine and testing availability, and to bridge language, cultural, and other social and systemic barriers that have prevented some in our community from accessing COVID-19 related care.

But we have much to do. Many in our county still experience barriers to health care access and are confused by widely circulated myths about COVID-19 infection, control measures, and vaccination. While current COVID-19 infections, hospitalizations, deaths and outbreaks are falling, we and our partners are working to provide accurate and culturally sensitive messaging to residents in North Texas who may have felt excluded from access to COVID-19 related care and information thus far. Tarrant County Public Health is embedding mobile healthcare in communities in need; it is a move based on advice from community leaders and aided by precision mapping and real-time syndromic surveillance.

Challenges to COVID-19 response include differences in approach to the pandemic among local, state, and federal entities. There have also been disparities in not only healthcare access, but also public transportation services to facilitate travel to sites for COVID-19 vaccination, testing, and treatment. An addition, access disparities between rural and urban North Texas communities and language, cultural, and religious barriers to COVID-19 related care have further complicated the situation.

Building a more diverse public health workforce and collecting detailed community needs assessments with guidance from respected community leaders and partners are important steps toward improvement. Using innovative strategies for our outreach efforts will help tremendously in the development of verifiably successful measures to make our community safer during the next COVID-19 surge, and during the next public health challenge – like maybe monkeypox!

References

1. Harrell, JA, Baker, EL. The essential services of public health. Leadership Public Health. 1994; 3(3): 27-30

2. Revised 10 Essential Public Health Services, launched virtually by the de Beaumont Foundation and Public Health National Center for innovations on 9/9/2020. Available at http://www.cdc.gov. Background information of steps leading to the revision of guidance available at http://www.PHNCI.org

3. Texas COVID-19 Vaccine Tracker (by county)

4. Texas Department of State Health Services COVID-19 Dashboard

Network at the TCMS Card Swap

TCMS physicians, do you want to expand your network of colleagues? Then be sure to join us for our Referral Night & Card Swap!

The event, which will take place at TCMS on August 25, will give you the chance to mingle and then participate in a speed dating-style card swap. We hope you join us – it is a great opportunity to build connections with other doctors throughout Tarrant County.

Dinner will be provided, so be sure to RSVP to Melody Briggs by Friday, August 19. Details are included below.

Tarrant County’s First Positive Human Case of West Nile Virus in 2022 Season Confirmed

Tarrant County Public Health (TCPH) confirms the first human case of West Nile Virus (WNV) for the 2022 season. The first positive mosquito pool was reported in May 2022.

The individual involved resides in northwest Tarrant County. The person presented the mild form of the disease which is often referred to as WNV fever. Symptoms include headache, fever, muscle and joint aches, nausea, and fatigue. People typically recover on their own, although symptoms may last for several weeks. It was reported that the individual had outdoor activities within the incubation period. There have been no WNV-positive mosquito pools in the associated area. Additional details are not being released to protect the identity of the patient.

To date, TCPH has found a total of 7 WNV-positive mosquito pools within Tarrant County. Monitoring for the virus in mosquito pools is ongoing throughout the season (April through mid-November). Local cities and Tarrant County for unincorporated areas may perform mosquito treatment as needed.

TCPH reminds residents to take measures to safeguard against the WNV. Residents should dump standing water on their property, use repellent, and whenever possible, dress in long pants and long sleeves.

MORE ABOUT MOSQUITOES:

Mosquitoes need water to breed. They don’t lay their eggs in the air or on the ground, so dump ALL standing water.
Infected mosquitoes transmit WNV to people after feeding on infected birds.
Birds don’t transmit WNV to people. Mosquitos do.
Larvicides are products used to eliminate mosquitoes before they become adults.
Apply larvicides directly to water sources that hold mosquito larvae.

For more information about West Nile Virus visit the Be Mosquito Free webpage.

Sign Up for TMA’s 2022 Fall Conference

TMA’s annual Fall Conference will be here before we know it! Register now to join the event, where you will have the opportunity to network with other physician, conduct TMA business, and go to CMEs and lectures centered around top healthcare issues and interests.

Here are the details:

When: September 16-17, 2022

Hotel: Hyatt Regency Lost Pines Resort and Spa
Rates start at $229 plus $10 resort fee. Room cut-off date is August 17, 2022.

Parking Information: Daily self-parking is $12.00 for attendees and hotel guests. Guests not staying overnight can pick up a voucher at the TMA registration desk. Overnight valet parking is $38 plus tax, no in/out privileges.

Agenda

Friday, September 16

7:30am – 7:30pm Registration Hours
1:00 – 5:00pm Exhibits, Lost Pines Ballroom Foyer
Many boards, councils, and committees hold business meetings in conjunction with Fall Conference.

Saturday, September 17

6:30 – 12:30am Registration Hours
7:00-noon Exhibit Hours
7:30-8:30am Dawn Duster, Lost Pines Ballroom 57:30-8:30 am Networking Breakfast and Exhibits, Lost Pines Ballroom Foyer9-11:45 am General Session, Lost Pines Ballroom 5
9-9:30 am Welcome and TMA Update
9:30-10:30 am Take Charge of Your Career: Harness the Power of Negotiation (CME)
10:30-10:45 am Break and Exhibits
10:45-11:45 am Legislative Panel (CME) Hear from our physician legislators with a recap of the 87^th Legislative Session and what to expect from the special session next month.

You can view the full schedule here.

CALL FOR MUSICAL PHYSICIANS: Join Fort Worth’s First Medical Orchestra

by Allison Howard

This article was originally published in the July/August 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

Physicians, dust off your instruments—Fort Worth’s first medical orchestra is looking for healthcare workers who have a dual passion for music and medicine.

The group, which is being organized by retired physical therapist and flautist Susan Fain, is expected to begin rehearsing this fall. While the details are still being ironed out, Susan says that everything is falling into place.

“We are collaborating and negotiating for a space, conductors, and music,” she says. “And it looks really good.”

Susan, who holds doctoral degrees in both physical therapy and flute performance, was first inspired about 10 years ago when she heard the Doctors Orchestral Society of New York. She soon discovered there were over 30 such orchestras throughout the U.S., and she saw it as the perfect opportunity to marry her passions.

“In medicine you’re helping people, and in music, you really are helping people,” she says. “You’re helping yourself, learning to create, and all of that discipline is across both professions.”

She believes this could be a step toward work-life balance for those who love sharing music with others but have set their instruments aside due to lack of opportunity. Now, she is ready to create that opportunity, and she is thrilled to do so in a city that is rife with a passion for the arts.

Susan, whose career was divided between practicing physical therapy, pursuing music, and raising her five children, has played flute in both civic and professional orchestras. And her experience organizing events and groups is extensive, ranging from planning classical concerts to putting together a small orchestra (where she served as the conductor!). Now, retired from physical therapy and ready to devote herself fully to her love of music, she is thrilled to start this next endeavor.

“I want to be like Esther – ‘You might have been born for such a time as this,’” Susan says. “To bring the two halves of my life together and make them both count.”

It seems she isn’t the only one that feels that way. As the word spreads there has been a lot of interest; so far, 10 instrumentalists have committed to the orchestra, and more have expressed a desire to get involved.

Ultimately, Susan’s goal is to form a full orchestra that will perform a handful of concerts each year to raise support for local charities. She believes it will enrich the community and be a chance to cut through much of the noise created by the constant challenges in the practice of medicine.

“Performing is like creating an oasis for the audience,” she says. “This is a moment where you can forget the outside world, and all the things going on in society that we struggle with, and we can sit for a moment and just stop and reflect on truth and beauty. That, to me, is what it’s all about.”

For more information about the Fort Worth Medical Orchestra, contact Susan Fain at sdfain1@gmail.co m or 405-830-2107.

Tarrant County Public Health Back-to-School Immunization Clinics

Tarrant County Public Health Back-to-School Immunization clinics kick off on August 1, 2022. The clinics will be offering all recommended immunizations.

If available, parents and individuals should bring their vaccination records. The cost of vaccines for children 0-18 years of age is $8 per shot and Adult Safety Net vaccines for those 19 years and older with no insurance is $15 per shot. Only cash, check, CHIP, or Medicaid will be accepted. Families with private insurance should contact their primary physician to obtain their immunizations.

During the Back-to-School Immunization clinics, COVID-19 vaccines at our brick-and-mortar locations and our weekly pop-up vaccine clinics are postponed to focus on ensuring students receive their immunizations before taking on a new school year. COVID-19 vaccines will be available at no charge at the Back-to-School clinics for persons aged 6 months and older who are interested in receiving them. Our six TCPH brick-and-mortar clinics will resume all vaccine operations on August 29, 2022, and pop-up COVID-19 vaccine clinics will resume in September.

Please see the Back-to-School Immunization clinic locations below:

Arlington Athletic Center
August 1-13
M-F: 9 a.m. – 6 p.m.
Saturday: 9 a.m.- 2 p.m.

1001 E. Division St.
Arlington, TX 76011

Ridgmar Mall – Food Court Entrance
August 15-27
M-F: 9 a.m. – 6 p.m.
Saturday: 9 a.m.- 2 p.m.

1888 Green Oaks Blvd.
Fort Worth, TX 76116

Diamond Hill Jarvis High School
August 1 – 6

Monday: 12 p.m. – 6 p.m.
T-F: 9 a.m. – 6 p.m.
Saturday: 9 a.m.- 2 p.m.

1411 Maydell
Fort Worth, TX 76106

Brookside Convention Center
August 8 – 13

Monday: 12 p.m. – 6 p.m.
T-F: 9 a.m. – 6 p.m.
Saturday: 9 a.m.- 2 p.m.

1244 Brookside Dr.
Hurst, TX 76053

First Methodist Mansfield
August 15 – 20

Monday: 12 p.m. – 6 p.m.
T-F: 9 a.m. – 6 p.m.
Saturday: 9 a.m.- 2 p.m.

777 N. Walnut Creek Dr.
Mansfield, TX 76105

Rising Star Baptist Church
August 22 – 27

Monday: 12 p.m. – 6 p.m.
T-F: 9 a.m. – 6 p.m.
Saturday: 9 a.m.- 2 p.m.

4216 Ave. M
Fort Worth, TX 76105

Additional information on the Back-to-School Immunization Clinics can be found on our website or by calling the Tarrant County Public Health information line, 817-248-6299, Monday – Friday 8 a.m. to 6 p.m.

Fort Worth OB/GYN: “There’s no hard and fast line where…the mom’s life is at risk.”

TCMS President and OB/GYN Dr. Shanna Combs spoke with Dallas Mourning News journalist Allie Morris about the impact of ambiguous reproductive health restrictions on the health and wellbeing of women suffering from severe pregnancy complications. Here is an excerpt:

Texas is now preparing to ban all abortions, following the reversal of Roe vs. Wade, with no exemptions for rape or incest, only for cases that put the pregnant person “at risk of death or … of substantial impairment of a major bodily function.”

Doctors say the problem is that those situations are not black and white.

“There is no hard-and-fast line where all of a sudden the mom’s life is at risk,” said Dr. Shanna Combs, an OB-GYN in Fort Worth. “So she’s infected, but she’s not septic. Does she have to be hemorrhaging before you can intervene?”

You can read the full article here.

TCU names medical school to honor the late Anne Burnett Marion

Texas Christian University today announced that the School of Medicine will be named the Anne Burnett Marion School of Medicine in honor of the late Anne Burnett Marion’s lifetime of friendship and support and her extraordinary generosity to the TCU School of Medicine.

The estate of the late Anne Burnett Marion and The Burnett Foundation, a charitable foundation based in Fort Worth, have made a second $25 million gift to The Anne W. Marion Endowment in support of the TCU School of Medicine operations in perpetuity.

“During her lifetime, Anne Marion’s support of the university through her service as a trustee and her philanthropy played a vital role in strengthening TCU’s academic profile and reputation. Her investment of $50 million in our School of Medicine enhances her legacy and will have a momentous influence on TCU for the next 150 years,” TCU Chancellor Victor J. Boschini, Jr. said. “The history of TCU is beautifully intertwined with the Burnett family’s legacy. It is impossible to imagine where we would be without their generosity and longstanding loyalty. We are grateful to Anne’s daughter, philanthropist Windi Grimes, for the honor of establishing this tribute to

her mother, marking her indelible contributions to TCU and generations of physician leaders.”

The first gift ever made by The Burnett Foundation, formerly known as The Anne Burnett Tandy and Charles Tandy Foundation, was to TCU, an endowment in her mother Anne Burnett Tandy’s and Charles Tandy’s names. Marion gave to nearly every area of the university, culminating with her final gift of $25 million to TCU through The Burnett Foundation, among the most generous gifts in university history. It was a pivotal one for the TCU School of Medicine as it established The Anne W. Marion Endowment to support the students, faculty and programming of the school permanently.

“This level of generosity will create a lasting legacy through the many doctors who will go onto be physician leaders in their communities and in the field of health care, serving others and changing lives for the better for generations to come,” Boschini said. “We could not be more proud to have our School of Medicine bear her and her family’s great name forever.”

Anne Burnett Marion was a native of Fort Worth and was deeply committed to her community and supporting the future of medical education. Her family ties to the Fort Worth community date back nearly a century. They have a long history of supporting the priorities of the city and its institutions. The Burnett Foundation has been a generous patron of the city, investing significant resources to enhance the community in myriad ways. The foundation focuses on building capacity in organizations and people through the arts and humanities, education, community affairs and health and human services.

“Legacy and loyalty have always been Burnett family traits,” Windi Grimes said. “My grandmother’s first foundation gift was to TCU, and it seems fitting that my mother’s last foundation gift goes to support the University as well. My mother was inspired by the TCU School of Medicine, and we hope that the Anne Burnett Marion School of Medicine will provide a profound impact to all those it serves.”

The gifts that total $50 million for the School of Medicine strengthen TCU’s endowment and propel the university closer to its $1 billion goal for Lead On: A Campaign for TCU. This historic fund raising effort fuels the university’s strategic plan and positions TCU for even greater success in the future.

“The Anne W. Marion Endowment will provide funds to support our students, faculty and programming for the medical school and continue to fuel our mission of transforming health care by inspiring Empathetic Scholars ®,” said Stuart D. Flynn, M.D., the founding dean of the School of Medicine. “This generosity empowers us to continue recruiting and nurturing talented and diverse students who are shaping the future of medicine and health care in an abundance of ways. We continue to carry out the vision of creating physicians who are knowledgeable and compassionate care givers.”

The Anne Burnett Marion School of Medicine, which will be known as the Burnett School of Medicine, welcomed its first class of medical students in July 2019, and they will graduate in 2023. The Burnett School of Medicine’s fourth class began in July 2022 bringing the school to full enrollment.

TCU is also expanding the university’s footprint in Fort Worth into the Near Southside area and Medical District to open a new campus for the Burnett School of Medicine. The four-story, and approximately 100,000-square-foot medical education building will sit at the northeast corner of South Henderson and West Rosedale streets. It will be the academic hub for 240 medical students and hundreds of faculty and staff. Completion is planned for fall 2024, and additional facilities are part of the master plan.

Fort Worth OB/GYN: More parents seeking birth control for young patients

TCMS President Dr. Shanna Combs spoke with Andrea Lucia of CBSDFW about the rising rates of birth control requests in light of the recent Supreme Court ruling. Here is an excerpt:

Politics is not something Doctor Shanna Combs brings up with patients.

Increasingly, though, it is something they bring up with her.

“It was a little disconcerting at first in September when I started having parents be like, ‘So… Senate Bill 8,'” she said chuckling.

Dr. Combs is an OBGYN who specializes in treating children and adolescents. She’s long prescribed birth control to help manage their periods.

“It can make them lighter. It can make them less painful and, you know, basically make life livable if you have really bad periods,” she said.

You can find the full interview here.

This Week’s COVID-19 Vaccine Clinics in Tarrant County

Tarrant County Public Health hosts numerous pop-up COVID-19 clinics across Tarrant County each week in partnership with public and private organizations listed below. Each site has the Moderna and Pfizer vaccines and at times the Johnson & Johnson. Infants 6 months and older are eligible for the vaccination. Parents need to bring proof of the child’s age and their own ID for the vaccination. Booster vaccinations are available at all of the vaccination locations.

TCPH would like to bring a COVID-19 vaccination clinic to businesses, churches and organizations in the community who are interested in hosting a pop-up clinic. It’s easy and free to host a clinic.

In addition to the vaccination opportunities below, the cities of Arlington, Fort Worth, Mansfield, North Richland Hills, Hurst, and Tarrant County College have also added opportunities for vaccinations. To find a local vaccine site, the County created a vaccine finder page: VaxUpTC website.

Pop-Up COVID-19 locations:

Greater Saint Stephen First Church
Monday, July 18: 1 p.m. to 5 p.m.
3728 E. Berry St.
Fort Worth, TX 76105

The Connect
Community Crossroads
Tuesday, July 19: 9 a.m. to 1 p.m.
1516 Hemphill St.
Fort Worth, TX 76104

Tarrant County Public Health CIinics:

Northwest Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
3800 Adam Grubb Road
Lake Worth, TX 76135

Bagsby-Williams Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
3212 Miller Ave.
Fort Worth, TX 76119

Southeast Public Health Center
Monday to Friday: 9 a.m. to 12 p.m. and 1 to 5 p.m.
536 W Randol Mill
Arlington TX, 76011

Main Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
1101 S. Main Street
Fort Worth, TX 76104

Southwest Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
6551 Granbury Road
Fort Worth, TX 76133

Watauga Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
6601 Watauga Road
Watauga, TX 76148

The Vaxmobile is a partnership between Tarrant County Public Health and Trinity Metro to bring COVID-19 vaccines to underserved communities throughout Tarrant County. The 60-foot bus converted to a fully equipped mobile vaccine clinic, will make weekly stops in the areas with the lowest vaccination rates on Thursdays. Vaccinations are also available at the six Tarrant County Public Health clinics listed above every day of the week.

For more information go to coronavirus.tarrantcounty.com or call the Tarrant County Public Health Call Center, 817-248-6299, Monday – Friday 8 a.m. to 6 p.m.