Juliana Anastasoff, MS, has been here before. In the 1980s and 1990s, she was working in health care education and outreach in a Philadelphia hospital when the human immunodeficiency virus (HIV) was running rampant through the United States.
"The science was changing every 90 minutes – you couldn't even get a rest from the day because you had to go home and read so you could figure what you're going to do different about your job the next day,” Anastasoff recalls.
Now, the COVID-19 pandemic is giving Anastasoff, the north-central regional Health Extension Officer for The University of New Mexico’s Health Extension Regional Offices (HERO) program, a sense of déjà vu. “That's kind of the same way that it looked in the first few weeks of this."
For Anastasoff – who describes her job as connecting the UNM Health Sciences Center with the communities she serves – the changes to her daily life were swift and dramatic.
"(My community partners) had immediate concerns in their clinics, in their agencies and in their organizations around transmission and safety," she says.
Anastasoff typically drives many miles a day from her Taos office to the four counties she covers to meet with her partners. But for now, all of those interactions are done through the computer or on the phone – and that makes her job more difficult.
"There's some formula of x amount of personal contact that enables an x amount of productive relationship and trust, distance-wise,” she says. “It's hard trying to keep those accounts balanced."
To continue balancing those accounts, Anastasoff is using her experiences from the HIV crisis to help northern New Mexico communities adapt to this new threat.
As an expert in the social determinants of health, Anastasoff is a resource for helping rural community organizations decide how to respond. She has already advised a small independent library on what precautions to take, how to protect employees and how to organize curbside pickup to stay open.
"They really appreciated having rapid access to someone who has a background in public health, infection control and epidemiology to help them think things through to make decisions," she says.
Anastasoff also connects her partners with outside resources, like helping a small clinic quickly get updates from the federal and local governments in order to continue their work. “In almost real time, I was able to get them the revised telehealth regulations from the Feds and the billing codes so they could bill,” she says.
But one thing she did not anticipate was how she could provide more personal assistance to her partners on the frontline of the COVID-12 response.
Anastasoff says phone calls from community colleagues asking for help from the HERO office are often turning into conversations about how they’re coping. "Sometimes I find out that maybe they're not doing so well – that they're feeling overwhelmed and isolated, and some with chronic conditions like anxiety and depression are getting exacerbated," she says.
Had she not already been connected to them through the HERO program, they might not have had access to that level of help, Anastasoff says. "In the evenings now, I'm just extending a lot of peer support," she says. “A lot of it’s texting and humor: ‘Hey, are you doing all right? Haven’t heard from you in a while.’”
Now, she is being asked to join community COVID-19 strategic coalitions. "I can show up with my toolset and the toolset of my virtual colleagues around the state to supplement my gaps,” she says. “And I have the entire Health Sciences Center that I can tap into for other things that might come up that we can't handle out here."
Though she knows that the rural communities she covers are going to be hit hard by this pandemic – and that we’re all in it for the long haul – Anastasoff’s previous experience taught her to be ready.
"That's the way we (HERO’s) all work,” she says. “The relationships we bring from our previous work, our background and the experience that we have gotten over the years is what gets leveraged as a service of UNM HSC to these community and clinical partners who already know us, because they've been working with us a long time."
Anastasoff remembers how the HIV epidemic exposed hidden social and health issues. “Likewise, I'm hopeful that we will come out of COVID-19 knowing how to do a lot of things better, smarter, more thoughtfully and with a deeper sense of how the health of everything and everyone is connected,” she says.
“The months ahead will be a unique opportunity to build on the public awareness, public support and public health literacy we gained as a result of the challenges we are working though right now.”