Annette Groves, public health nurse for Ramsey County, is busy. Like almost every public health worker, she’s living out a year unlike what anyone in the field expected — with many local counties’ health care workers shoving normal community outreach to the side to focus on the pandemic.

Public health is a full-time job, and that’s as true as ever. Groves took a pause on a recent weekday to tally up how many hours she’s working nowadays.

“Oh, today?” she said. She put down the receiver for a second and said goodbye to someone leaving the office — a glimpse into a nonstop river of activity. "I'm going to go out there on a limb. I haven't had a full day off, especially of COVID-related activities, since early August. And before then, there's been a couple of days (taken) off. But we're available basically 24/7."

So what does that feel like?

"You're going to write this, aren't you?" she said with a laugh. "You know what: we're in a pandemic. And this is public health.”

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In conversations with health officials throughout the Red River Valley, that can-do attitude is typical. But the summer has also brought serious worries of professional burnout, and there are still thorny questions of how much extra funding is available to support workers who are suddenly working far beyond the normal demands of their jobs.

Local leaders are already well aware of it. At the Aug. 18 Grand Forks County Commission meeting, Commissioner Diane Knauf suggested a task force to take on the problem — not just for public health workers, but for those in emergency management also bearing the brunt of pandemic labors.

“I don't think anyone can truly fully grasp the effects of the pandemic on the very limited number of front-line staff that we have, whose impossible and unsustainable workloads continue to increase each and every day as a result of the pandemic,” Knauf said. Those front-line workers, she added, “truly are the victims of this crisis and are the silent heroes who have put the public's health, welfare and safety above their own 24-7."

Debbie Swanson, director of the Grand Forks Public Health Department, said staff has grown by 13 positions — some full-time and some part-time — that are helping with the pandemic. Mostly that’s contact tracing and testing, with a few more focused on data and communications. Through it all, she said, she’s enormously proud of the way they’re holding up.

“Everyone has the necessary stress from COVID, but they're also taking care of their families, making sure their kids are educated, taking care of elderly parents,” she said. "All of those things really compound the stress for our staff. But I am so very proud of the work that our team is doing.”

Concerns continue as cases surge. Grand Forks County in particular has seen an extraordinary uptick in local infections, suddenly leading the state in active cases. As of Thursday afternoon, the county had 289 active cases. Statewide, there were 2,353 active cases as of Thursday, Sept. 10.

And as of early September, Grand Forks County also had the 35th-fastest growing case counts per-capita in the country, according to tally by a New York Times database.

Grand Forks County Commissioner Cynthia Pic said worker burnout is worrying not just as a morale issue, but as a financial one, too. It would be nice to expand the county’s ability to respond to the coronavirus, but right now it’s hard to see into the financial future.

"These CARES Act dollars are available for us to use with COVID-19, but this is not an ongoing stream of money,” she said. "If we use CARES Act dollars (to support staff), what do we do once those dollars are gone?"

That’s not clear yet. Congressional and White House leaders are still deadlocked on a new relief bill as of this writing.

Knauf said that, since the Aug. 18 meeting, local leaders have met with Swanson to explore what she needs. Some early ideas include more nursing staff to support the local correctional facility and local schools, but Knauf stressed that plans are still in early stages.

"All of this work would be easier if everyone would follow public health guidance — of wearing a mask when you're in public, maintaining distance from others, washing hands, sanitizing surfaces,” Swanson said. “That would greatly help us do our jobs, and it would help ensure an economic recovery from the pandemic, and prevent us from needing to close any businesses.

“That’s been our advice all along,” she added. “And if there's really good participation from the community, we could have really good outcomes and prevent a lot of disease."