Test, trace, advocate

Back in the spring, and practically overnight, the COVID-19 pandemic ground life as we knew it to a halt. At the time, few understood precisely how the novel coronavirus spread; everyone and everything felt like a potential carrier (and threat). In Chicago and in other cities across the country, unsuspecting people were falling gravely ill. For Amy Luke, chair of public health sciences at Loyola University Chicago, watching the carnage from the sidelines was numbing. “I think we all felt very frustrated sitting on our hands, stuck at home,” she says, “and not having an avenue.”

Luke has worked on the Health Sciences Campus (HSC) in Maywood for 26 years. She also lives in the western suburb. In mid-April, she received a call from Nathaniel Booker, a trustee on Maywood’s village council, wondering if Luke knew of any plans at Loyola to run a COVID-19 community testing clinic. Luke didn’t, but found the idea appealing.

She figured some of her equally frustrated friends and colleagues might feel the same way. “Loyola has an awful lot of faculty and students who come here because of their focus on social justice,” Luke says. “Identifying people (to get involved) was not difficult.”

These conversations were among the early sparks that eventually fueled the COVID Equity Response Collaborative: Loyola (abbreviated as CERCL, pronounced like the shape), an interdisciplinary network intent on minimizing the harm of COVID-19 in at-risk Chicagoland populations. Working groups assembled, with students and faculty from the Parkinson School of Health Sciences and Public Health, the Stritch School of Medicine, the Marcella Niehoff School of Nursing, and the schools of law and social work. Each division focused on separate approaches to outbreak mitigation.

Contact tracing was an early priority. Lead by Abigail Silva, an assistant professor of public health sciences, CERCL looked to existing training methods developed by Johns Hopkins University and the Association of State and Territorial Health Officials to serve as the basis for their own personalized training curriculum.

Right away, Silva noticed an existing gap: Neither training reviewed the soft skills needed to trace effectively, especially among people leery of disclosing personal information to a government official. “How do you cold call someone and keep them engaged?” Silva asked. “What’s the process like?”

Following public health guidance, CERCL built a soft skills supplement and formally established the Contact Tracing Corps (CTC), a free training program open to students, faculty, staff, and community members. Through July, nearly two dozen people had completed CTC, safely expanding the state’s tracing capacity in the process; another 90 had signed up for CERCL’s interest list.

A testing initiative followed in CTC’s wake. For four weeks in August, CERCL volunteers organized and operated COVID-19 sites—Wednesdays at the Rock of Ages Baptist Church in Maywood and Fridays at the Casa Esperanza Community Center in Melrose Park, Illinois. Drive-through and walk-up options were available at both locations, along with opportunities for families to access Loyola Medicine’s Pediatric Mobile Health Unit. The pop-up clinics had enough supplies to run 100 individual tests each day, free of charge, at a time when affordable tests weren’t necessarily easy to come by.

Kate Mitchell, a clinical professor of law and the director of Loyola's Health Justice Project, was at the Rock of Ages Baptist Church on that first Wednesday. Research suggests that low-income patients seeking medical treatment have, on average, two or three corresponding unmet legal needs. In the case of COVID-19, a person who tests positive might have difficulty isolating because they lack adequate space in their home, or they need to work, or care for family members. Making sure those infected understand exactly what legal, economic, and social support is available to them could potentially save lives.

And so CERCL set about educating its clientele through a screening process they devised and then deployed during testing days. On that first date, Mitchell and her team interviewed 20 people and identified six with “potential health-harming legal needs.” “We can connect them,” she says, “give them advice, and ultimately represent some of these folks in cases.”

Just because the summer testing has concluded doesn’t mean CERCL will disband anytime soon. In October, CERCL was added as a project to the Chicago Coronavirus Assessment Network (Chicago CAN), an initiative supported by the Walder Foundation, and secured a corresponding grant worth $1.1 million. CERCL's steering committee is on the hunt for additional grants and donations, which could further fund future testing efforts and paid staffing. Mitchell’s Health Justice Project, meanwhile, is in the midst of launching a new medical-legal partnership in Maywood, at the Loyola Family Practice Center on Roosevelt Road, with assistance from a newly hired attorney and recent law school graduates. “We’re making inroads in our community, figuring out how to operate with them,” says Silva. “That will come in handy when we have to start raising awareness about vaccinations.”

The use of Zoom, meanwhile, has helped negate geographic and departmental barriers between those stationed at HSC and at Loyola’s Lakeside campuses. Mitchell feels like the collective came together organically “with people who have similar values and intentions.”

“We had the expertise, we had the passion, and we’re surrounded by communities that have extremely high infection rates,” Luke adds. “That’s the driving force—we know what needs to be done.”