By: Laurie Fickman Posted On: 06/18/2020
At the age of 29, C.J. Dale has quite the health care resume. With a master’s in public health he’s already worked five years as an epidemiologist, studying the causes of various illnesses and finding ways to prevent their spread. Though fascinated with disease prevention and improving health care conditions, Dale still felt a familiar tug to go into the family business, one that would also include disease prevention. He grew up in Washington State working in his dad’s optometry office, and always had his sights set on opening his own. So off to optometry school he went.
Two years into his time as a student at the UH College of Optometry, life went topsy-turvy when the COVID-19 global pandemic hit. Like many, Dale would read daily accounts of mounting deaths and medical unknowns. Soon he’d also read the help wanted ads from Harris County Public Health. They needed to broaden their team of infection prevention specialists to stop the spread of the virus in vulnerable populations. They needed epidemiologists. Badly.
“I didn’t feel comfortable sitting at home. I felt I could still put my degree and experience to work for a cause that would quickly help others, and I felt compelled to make an immediate impact,” said Dale. Harris County didn’t hesitate either, hiring Dale in mid-April, just as he was in the thick of optometry finals at UH.
I want to train myself to be the best optometrist I can be while still providing an impact within my own community. The UH optometry program was very flexible with me, so I was able to balance both,” said Dale, who began working 40-60 hours a week during finals. It didn’t occur to him to slow down.
“I found myself being very efficient and I was feeling very empowered. I was very busy, but didn’t feel tired. I felt I was in a groove,” he said. Dale admits to doing well on his finals, “a solid B,” all the while finding ways to limit further coronavirus outbreaks in his role as a Harris County epidemiologist.
When he isn’t studying or taking an optometry Zoom class, Dale is often behind the wheel. Harris County assigned him to inspect and make recommendations for limiting COVID-19 spread at nursing homes and long-term care facilities, where there are often one or more confirmed cases among patients.
“We’re like a rapid response team for COVID to prevent it from becoming an outbreak,” said Dale who provides on-site assessments and reports new cases and close contacts. His team includes a medical professional, either a nurse or a doctor, who specializes in proper infection control practices for managing sick residents.
Nursing home residents have been among the hardest hit by the coronavirus. A nursing home in Dale’s home state was the epicenter of the first U.S. outbreak. Unlike large hospitals, nursing homes and long-term care facilities are not subject to the same infection control policies.
“We're not compliance police, we’re more like consultants who suggest best practices and ways to prevent virus spread in the facilities,” said Dale. He makes the suggestions after a thorough assessment of site practices. The Centers for Disease Control and Prevention supplies the facilities with a nursing home preparedness checklist, and Dale reviews the list against the practices being performed to see if there are any lapses which could increase the spread of the virus.
“We look, for example, for flaws in isolation precautions in the process of nurses putting on their personal protective equipment before they enter a patient’s room and after they leave, a process called ‘gowning’ and de-gowning,’” said Dale, who also reviews written procedures in place to manage sick residents and how surveillance is done within the facility to find symptomatic patients.
Dale said most of the facilities are, sadly, understaffed and do not have the ability to handle the pandemic, though he does recommend assigning specific staff members to treat only COVID-19 positive patients and not go back and forth between those with the virus and those who don’t have it.
Dale intends to take his epidemiology and public health experience into the practice of optometry.
“I want to study chronic diseases and use the eye exam to better manage and diagnose these diseases before they become life changing or lifelong,” said Dale, who admits that most people of his generation don’t have a primary care doctor. “It’s like the optometrist becomes a primary care doctor. It is common for patients to show up with what they believe is just blurry vision that can be fixed with glasses, but in reality, it is a diagnosis of a systemic disease, such as diabetes, that has caused these issues.”
“I’d like to understand ways to improve patient adherence and self-efficacy for regularly attending these examinations,” he added.
The optometry student/epidemiologist also encourages others to get involved in health care during the pandemic. “So often people don’t think they are qualified to help, but I know from experience that just continuing to read or learning to do contact tracing can help a lot. Don’t think you aren’t qualified because you probably are. Health departments across the country could really use your education and expertise!”
Photos: Courtesy of University of Houston