An effective volunteer community-based COVID-19 response program: the Vashon, WA Medical Reserve Corp experience

BackgroundVashon, WA is a rural community at risk from COVID-19 due to advanced age and limited access to acute care. Medical Reserve Corps are a national network of 800 volunteer healthcare organizations that have contributed to the pandemic response in many communities. Here we evaluate the effectiveness of the Vashon Medical Reserve Corps (VMRC) volunteer, community-based COVID-19 response program that integrated public engagement, SARS-CoV2 testing, contact tracing, vaccination and material support in reducing COVID-19 transmission and severe disease. MethodsThis observational cross-sectional study compares cumulative COVID-19 case, hospitalization and death rates on Vashon with other King County zip codes and the county at large from February 2020 through November 2021. We developed multiple linear regression models of COVID-19 rates using metrics of age, race/ethnicity, wealth and educational attainment across King County zip codes. Effectiveness of contact tracing was evaluated by timeliness and success of case investigations, and identification and testing of named contacts. Vaccination effectiveness was estimated by comparing time to reach vaccination milestones. We examined vehicle traffic on Vashon ferries and King County highways to understand whether reduced mobility contributed to Vashons reduced COVID-19 rates. ResultsVashons cumulative COVID-19 case rate was 29% that of King County overall and was lower across all age groups and races/ethnicities (both p<.01). A multiple linear regression model showed Vashon to be a significant outlier among King County zip codes with an observed rate 38% of predicted (p<.05), the lowest of any King County zip code. Vashons observed COVID-19 hospitalization and death rates were 22% and 32% of those predicted by parallel regression models. Hence, Vashons demographics do not explain its reduced COVID rates. Traffic reductions on King County highways and Vashon ferries were nearly identical throughout the study period suggesting altered mobility also does not explain Vashons low COVID-19 rates. Effectiveness of VMRCs COVID-19 response program was demonstrated by 1) highly effective contact tracing that rapidly interviewed 93% of cases and subsequently tested 96% of named contacts, and 2) attainment of vaccination milestones 1-4 months earlier than comparable King County zip codes (p<.01). ConclusionVMRCs volunteer, COVID-19 response program was associated with significantly fewer COVID-19 cases than predicted from its demographics. VMRCs contact tracing and vaccination efforts were highly successful and likely contributed to reduced COVID-19 rates. The VMRC experience suggests that a decentralized community-based public health program can be highly effective in implementing epidemic control strategies when focused on an at-risk community. We suggest that MRCs can be particularly effective in extending the reach of county public health departments and should be included in ongoing pandemic planning.