A new report will be used to identify actions the Chelan Douglas Health District can take to improve its response to future public health emergencies.

The two county Health Board approved the COVID-19 Response After Action Review Monday, which pinpoints the health district's strengths and weaknesses in responding to the pandemic.

Data was collected through surveys, interviews and focus group discussions involving current and former CDHD staff, community-based organizations, faith-based leaders, education/school representatives, first responders, long-term care facility staff, and health care clinics and hospitals among others.

The report found that the health district lacked resources and was not prepared to respond to the pandemic early on, but its performance improved over time.

The health district is credited with coordinating community-wide efforts, including a strong vaccination effort.

Among the strengths and weaknesses found in the Chelan Douglas Health District (CDHD) response to the pandemic:


Internal Operations

  1. Staff worked well as a supportive team throughout the pandemic
  2. CDHD ultimately established an effective Incident Management Team with clear roles and responsibilities

External Operations

  1. CDHD played a key role in providing access to testing
  2. CDHD’s work on the mass vaccination site and other vaccination pathways provided

communities with consistent access to vaccination

  1. CDHD successfully provided Personal Protective Equipment to partners
  2. CDHD was able to create an isolation and quarantine facility


  1. CDHD provided strong support to schools
  2. CDHD facilitated teamwork and resource sharing across health providers
  3. CDHD built and leveraged relationships that helped CDHD serve the community
  4. With time, CDHD became a valued and trusted partner in the response

Communications & Outreach

  1. CDHD used a variety of methods to reach communities with information
  2. CDHD’s convening of health providers enabled agencies to put out aligned messages to the community quickly and effectively

Responder Health & Safety

  1. CDHD consistently prioritized staff physical safety in terms of COVID exposure

Weaknesses - Areas For Improvement

Internal Operations

  1. CDHD was understaffed throughout the pandemic and saw high rates of leadership and staff turnover
  2. CDHD was unable to successfully develop a consistent cadre of volunteers to support the response efforts
  3. Underutilization of preparedness plans and inadequate training of staff contributed to an underperforming Incident Management Team and hindered the overall response
  4. Fiscal staff turnover and the complexity of COVID funding sources impacted the first phase of the response
  5. Decisions and policies were often set at the state level, without enough local decision making or resources to implement

External Operations

  1. CDHD had a difficult time maintaining essential public health services
  2. CDHD’s approach to contact tracing was inefficient and unsustainable
  3. Vaccination appointment scheduling systems were difficult for the public to navigate


  1. CDHD was slow to offer leadership, guidance, and organization to partners and the overall response
  2. Partners and staff felt attitudes and actions from the Board of Health undermined CDHD’s ability to partner and respond effectively early on in the response
  3. CDHD had early missteps in partnership opportunities with first responders that impacted effectiveness of the response

Communications & Outreach

  1. CDHD was slow to get information to the public
  2. There was room to improve communication and outreach to several specific communities, such as elderly, homeless, and people living in rural areas
  3. Early on, the needs of the Latinx community were not fully addressed

Responder Health & Safety

  1. Staff were overworked, leading to physical and emotional fatigue and burnout
  2. Unclear and inconsistently enforced norms and policies regarding uneven workloads across teams had negative impacts on morale
  3. Staff felt their morale and well-being concerns were largely overlooked

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