Kaua‘i Medical Reserve Corps volunteer shares about her first day collecting data on mask-wearing behavior

A behind-the-scenes look at a new metric on the COVID-19 Data Dashboard:

On a sunny weekend morning in the Garden Isle, Sharon Gottfried would typically be at the beach distance swimming. But today is different. The North Shore resident is heading to the Hanalei Farmer’s Market. But Sharon’s not here to buy fresh fruits and vegetables. She’s on a special mission – to collect observational data on who is and isn’t wearing a mask and who is wearing theirs properly.

The Kaua‘i Medical Reserve Corps volunteer is one of a cadre of volunteers participating in a program developed by Dr. Gary Glauberman, Advanced Population Health Nursing Program Director and Assistant Professor at the University of Hawai‘i at Mānoa Department of Nursing, in a collaborative partnership with the Department of Health. The pilot run of the program kicked off with 27 volunteers from the University of Hawai‘i and the local Medical Reserve Corps. This will be the first day volunteers, deployed in pairs, will collect observational data on Kaua‘i, O‘ahu, Maui and Hawai‘i – primarily at commercial or shopping areas where people are expected to be wearing masks.

As a veterinarian, Sharon is no stranger to stepping up in the face of community-wide challenges. Until 2018, she was a member of the federal veterinarian disaster relief team and has helped communities devastated by Hurricane Katrina, and more recently, her own community, which was impacted by catastrophic flooding in 2018. Before the pandemic hit Hawai‘i, her veterinarian friends in other states had begun volunteering through their local corps. When Hawai‘i’s statewide call for MRC volunteers was put out in early March, Sharon immediately stepped forward. With both medical and disaster relief experience, she had already completed many of the required federal training courses and was ready to head to the frontlines.

Thankfully, Kaua‘i has continued to maintain a low number of positive COVID-19 cases – 58 total since late February – and has had only one positive case within the past month. The opportunity to participate in this pilot program interested Sharon.

“It sounded easy. I live close to Hanalei. Many potential volunteers with medical experience lived much further away from this observational site,” she said.

At the designated Hanalei site, one of four on Kaua‘i, two community events are taking place – the farmer’s market and swap meet. Sharon and her counterpart volunteer, a retired nurse, decided to divide and conquer. Finding a shady spot under a tree with a good vantage point of the market entrance, Sharon tallies her findings in real-time on a smartphone app by pushing one of three large buttons on the screen: Wearing Mask Appropriately, Wearing Mask Inappropriately (not covering the nose and mouth of the wearer), or Not Wearing a Mask. The smartphone app, developed by the University of Hawai‘i Applied Research Laboratory and UH Mānoa Nursing faculty, records volunteer observations in real-time to allow for rapid reporting.

“Here, we don’t see anyone get out of their car and put on their mask if they’re going to the beach or walking on the street. When people can’t keep their distance or when they’re indoors, that’s when they mask up,” says Sharon. “While I was sitting under the tree with a mask, I did catch some people’s attention. It’s unusual to see someone outdoors, who is keeping their distance, also wearing a mask. The community is not resistant. They feel like they’re following the recommendations.”

Volunteers will collect data for two hours or until 100 people are counted, whichever comes first. On this first day, Sharon meets her quota after 45 minutes and concludes her observational session.

Mask-wearing: Easy to observe and telling of community health outcomes

Prevention is essential in fighting the pandemic but often the most difficult to track because it largely relates to personal behavior and choices. Dr. Janet Berreman, MD, MPH, FAAP, the Department of Health’s Kaua‘i District Health Officer, shares why mask-wearing behavior is being studied:

“Mask-wearing is one of the most effective actions to prevent community spread. At a population or community level, mask-wearing, when practiced consistently, reduces cases, hospitalizations, and deaths,“ says Dr. Berreman. “It is also easily observed. With the help of UH students and MRC volunteers, we will have more information to help us depict how preventative measures are impacting our communities’ health outcomes.”

Each volunteer participating in the pilot project is required to complete a live or recorded virtual training from Dr. Glauberman.

“The training session provides volunteers with information about the purpose of the project, instructions on how to conduct and record observations, and safety precautions for volunteers,” he says. “It also provides a walkthrough of the mobile phone app developed at UH to record observations.”

Data will be collected every Saturday morning for the next four months. The DOH hopes to expand the volunteer base and the number of observational sites.

As of September 10, 2020, the new COVID-19 Data Dashboard has been updated with data collected by Sharon and other volunteers on Saturday. The data shows 79% of those observed on O‘ahu are properly wearing masks, and 73% of those observed on the neighbor islands are also practicing proper mask-wearing. The data from the first week represents approximately 2,700 observations across the state. At this time, volunteers are only collecting observational data, so demographic variables such as socioeconomic status and ethnicity are not being captured.

“The first round of data collection shows us that our communities are doing a good job of protecting themselves and each other, and that there is still room for improvement,” says Dr. Berreman. “Following these observed rates over time will allow us to see how they change with variations like disease rates, outbreaks, or increased travel and tourism.”

Back on Kaua‘i’s north shore, volunteer Sharon shares: “The project is interesting. I’m curious to know how the data will be used. I’m continually reminded of how lucky we are to be in Hawai‘i. Those here on Kaua‘i are immensely grateful to our government leadership. This is an area with a very tight-knit, unique community. We’re doing our best to keep it this way.”

Mahalo to our Dr. Glauberman for leading this effort and to Sharon Gottfried and many volunteers who are lending their expertise to this statewide effort to slow the spread of COVID-19 and to protect our community. For persons interested in volunteering for this effort, please contact Dr. Glauberman at glauberm@hawaii.edu.