# data[].attributes.body
Iso-Q facility - MRC didn't know about opening until a couple of days before opening. Didn't understand that there is time involved in getting volunteers and expectation of scheduling training. Lack of awareness on how to utilize in hospitals. Not talking to the right people (EMs vs. CEOs/COOs).

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Multiple POD exercises with CRI events/Prophy events, we had basic materials to set up first events.  Staff members already trained in dispensing and throughput, easy to train to vaccination.  Both testing and vaccination.  Signage and other supplies

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MOUs and agreements with CCSD and other venues to partner with as POD locations.  Partners worked with us even though not in MOU.

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Really good working relationships with hospitals, EMS, and fire. Facilitated activity so didn't have to cultivate. They deferred to us. Partnered with them and went smoothly with our relationship.

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Good relationships within the health district. PIO putting out notifications, knowing who was in finance. Exercises using ICS. Not starting from zero.

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Administration support. COOP situation, full support to use HD staff to support COVID response versus being sent home to wait it out.

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Volunteers were a strength and contributed positively. Filled in when first ramped up until positions could be staffed. Ended up hiring some of the volunteers.

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Volunteers working with community partners for dispensing drills pre-pandemic. Multiple people did multiple jobs to support community efforts as well as COOP process. Staff flexibility.

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Online screening form - already had iPads. Used online screening form we already had to convert to online testing by SNHD IT. Converted to vaccinations. Already knew barriers when moved to Salesforce.

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Planning - dispensing plan - written as all-hazards.

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Online screening form - already had iPads.  Used online screening form we already had to convert to online testing by SNHD IT.  Converted to vaccinations.  Already knew barriers when moved to Salesforce.

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PPE stockpile. Had N95s available. Able to provide fit testing to community partners.

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Able to do quantitative fit testing. Fit testing staff that don't normally get fit tested.

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Communication. Not everyone who needed information kept in the loop on public health matters.

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Relationships with closed POD partners could not be used because of tier groups, even though they were front tier infrastructure group.

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Didn't have a good handle was specifically. People wanted vaccine right away and people felt like we weren't being responsive. Felt like we didn't have a plan. Didn't understand we had no control over the process. People's fear shaped our response. Misunderstanding of how much control we had over the response. People in the policy group should have been listening to SMEs instead of directing activities.

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Politics got in the way of public health.

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Not including appropriate people in meetings (e.g. first 12 days not including ESF 8 and MSST in hospital meetings).

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Hospitals are reluctant to request medical volunteers because of licensing issues even though there are emergency licensing procedures. Coalition hasn't provided the platform to inform hospitals in who MRC is and the process to request.

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Power of partnerships - developed the partnerships for many years and really come to fruition with this response in particular.

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Exercises - requested from healthcare partners the OSCAR. Provided situational awareness. Keep up with relationships so that you're not meeting people the day of the emergency.

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Administrative infrastructure that we are highly trained and integrated with partners.

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We stand above all other jurisdictions with the number of partners we have and work together for as long we have that play well together. Above and beyond what we see when we go to national conferences.

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Finance/Purchasing process was horrific to get supplies purchased and received in time. Took months to get supplies. had to use Clark County with the IMT to assist.

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OPHP has been working ICS instead of SMEs to ICS and doing our jobs for the community. Can't get people to step out of their daily role. Do have some people who have stepped up, but certain roles could not be filled by others outside OPHP.

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OPHP has been working ICS instead of SMEs to ICS and doing our jobs for the community.  Can't get people to step out of their daily role.  Do have some people who have stepped up, but certain roles could not be filled by others outside OPHP.

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Not just personnel, it's also processes that are affecting other people. Sign-in sheets were not being transferred for weeks/months before they got to Deb due to going through multiple layers.

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Not just personnel, it's also processes that are affecting other people.  Sign-in sheets were not being transferred for weeks/months before they got to Deb due to going through multiple layers.

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Space was a huge problem when new staff came on board. Had to come up with new space for temp and new hires, even when space was a problem before the pandemic.

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Hiring Contact tracers was an amazing idea! Allowing us to staff pods, we were able to not only understand what was really happening but to be apart of the response team.

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Review COOP plan for pandemic conditions. Hiring of new personnel/temp personnel. Adding telework into COOP plan.

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Contracts - hang-ups with wrap-around services at LVCC. Contracts/Legal in general. Couldn't get the same waivers that the county did. Interlocal agreements took years to get completed (Clark County Non-essential employees).

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Legal was a barrier with contracts and interlocal agreements in the amount of time it took to get them executed.

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Contracts - having to use venue vendors with very little payoff from vaccinations. Political pressure on this venue.

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Convention Center was a great partner.

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Partnerships ahead of time. ESF 7 and MACC - could talk about it and be more informal.

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Use of the ARF and ESF 7 put in the state form. Having access to the state ESF 8 board to see where the status was of resources. State access was new for MSST.

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MACC needs to understand that they are responsible for activation of MSST. Start meetings on time. At the start of the pandemic, the only staff was public health. Healthcare was not participating. Hospitals need to identify specific people for day/night shifts. UMC identified liaison, but were not in the room, so there were delays.

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Notification went well. OSCARs were received in the first 12 days so could see what was going on in the hospitals.

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Hospital systems - work through BOH and hospital leadership to invite them to get trained and be in the MSST who would be the ones to get information and decision-making authority.

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Lack of awareness of MRC with the Type III IMT.

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COOP - continued to provide services, but didn't have access to full cadre of staff.

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Having disaster workers working from home was a challenge and not being able to respond

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Everything that came down was confusing.

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CDC edicts were just as confusing as state.

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State - CSC took a while to come down.

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Being able to keep up with tier groups changing overnight without letting us know was difficult at the PODs. Forget that our demographics/climate are different than theirs.

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Received guidance, policies, procedures months too late. But were supportive in subsequent surges.

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Communication/Coordination - due to ESAR-VHP integration on SERV-NV website. State decided on their own not to require ICS courses. Now she has untrained volunteers with no incentive to get them trained.

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State - would not communicate when they would do a press release for volunteers and she would suddenly get a surge of volunteers.

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At the federal level - grants were flexible and coming in quicker than before. At the state level, it was fragmented and made 15 subgrants, but were trying to get the money to us quickly.

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Staffing - multiple vacancies with no administrative support to provide to COVID teams. Left to OPHP admin who was only one person.

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HD made it difficult to get MRC volunteers within our own HD, eg. lab.

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Partnerships

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Wastewater

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ICS and 213s

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N95 stockpile and streamlined fit testing process.

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IT result reporting

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Expand out contact tracing internally to Nevada: AAA, Wynn, Deloitte, UNLV
County Manager, Social Services for NCS and alternate care
Battelle for mask disinfecting.
Call center.

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Using plans already developed. Good layouts coming out of COVID and inventory.

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Lab took a long time to ramp up to be able to do number of tests.

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Ability to use UMC to expand capacity and other private labs.

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Online tools to help coordination of volunteers from CDC. Use of Google Sheets.

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OPHP has the best trainers who were knowledgeable and there to get people up and ready to go with just-in-time training. Great ICs.

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Train-the-trainer with vaccine for partners.  Training for T-t-T with NG for testing.

Document curriculum and publish.

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Change in variants - continue to get spikes and waves.

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Continuing public health funding.

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Uniform guidance for procurement of goods and services after declaration. Adds more time for administrative processes to get supplies/staff.

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COVID subgrants - one is going to end 2023, a lot have already ended.

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Misinformation in the public.

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Work that Office of Communications has done has been phenomenal in trying to correct misinformation.

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Partnerships in combating misinformation.

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Attrition in the healthcare sector and public health.

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The state reactive in providing surge support. E.g. get out the vax, MABs, federal vaccination teams for 6 weeks.

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Pulling supplies from POD cages because they were spread out across the valley.

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Volunteer software that is shared with the state failed.

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Communicating between departments through Zoom was difficult, esp. without camera.

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Forced to go paperless for volunteer management.

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Didn't imagine being isolated and was difficult with communication.