COVID-19 Hotline Responds to Residents’ Calls in Anxious Times

After the City of San Antonio’s COVID-19 Hotline opened on Super Tuesday, March 3, the hotline received 20 to 30 calls per day that first week – a time when most headlines around the nation focused on the 2020 presidential primary election.

On Tuesday, March 24, the staff took more than 1,000 calls after City and Bexar County officials announced the new Stay Home, Work Safe order that required non-essential businesses to close and instructed residents to stay at home as much as possible.

“We really are the intake valve for a lot of the city’s anxiety right now,” said Jennifer Hixon, the City’s violence prevention manager who has been reassigned to run the hotline. “The vast majority of [callers] are very kind. … They’re just looking for guidance. They want to do the right thing and they want to comply” with the new rules.

As of Thursday morning, three people have died from COVID-19 in Bexar County, where there are 84 confirmed cases. That number is expected to grow exponentially once more tests are made available through public and private labs and could trigger more calls to the hotline.

“It’s a little bit hard to listen to people who are anxious all day,” Hixon said. “But we really are trying to be mindful of the fact that we have the opportunity to be a calm voice for people, and that’s a really useful thing to be doing right now.”

More than 45 City employees are working in shifts at the City and County’s joint emergency operations center at Brooks to try to answer any question related to the public health emergency and local stay-at-home measures: What are COVID-19’s symptoms? Should I be tested? Can I get help paying my utility bills? Am I allowed to walk my dog? Is my business exempt from the Stay Home, Work Safe order?

The latter question has accounted for a majority of the calls since the new order was announced Monday evening, Hixon said. The call center was armed with answers from the City Attorney’s office.

“There’s a much broader range of businesses in the world that I never would have thought existed,” she said. “We’ve had a lot of very specific questions about mobile dog grooming and other businesses that don’t clearly fit into one category or another.”

If the hotline staffers can’t provide a definitive answer immediately, the caller is put on hold or told they will get a call back when officials can determine the answer, she said.

Those answers are then collected and saved for future reference in binders filled with fact sheets, which are updated and shared with the staff. At the end of each shift, staffers fills out a feedback form to find out “what worked well and what issues we need better answers [for],” Hixon said.

There are currently 12 stations at the emergency operations center for general line operators and three stations for nurses and medical students to help screen callers for COVID-19 symptoms. If a caller fits the profile of someone likely to have the virus, they can be connected to a health care provider for further screening and, potentially, a test.

The City has also set up a free online, self-screening form here. More information is available through the 311SA mobile app.

The type and quantity of questions the hotline gets depends largely on the news cycle, she said. There’s a high call volume midday, and they “tend to get a bunch of people [calling] around the 5 o’clock [television] news.”

Hotline workers also connect residents to public and nonprofit agencies who can help them get access to food or other resources, said Brea Moore, a health program specialist who has taken hundreds of calls and is now a shift manager for the hotline.

The hotline was set up with less than a week’s notice in the Las Palmas Library branch before it moved to mobile trailers set up outside the emergency operations center. Once a room was cleared out last week, the hotline operations moved inside.

They’re working on making room for four more general operators in the room, a configuration that would break with the Centers for Disease Control and Prevention’s 6-feet social distancing guidelines.

“We’re definitely doing the best we can given the space constraints – but we’re also working mainly with Metro Health employees,” Hixon said. “You’ve never met a group of people more aware of the importance of washing your hands. … There are frequently lines [for the bathroom] just to wash their hands.”

To keep up morale, operators leave Polaroid photos and notes for the person coming in to take the next shift. They’ve also started a friendly betting pool trying to guess how many calls they’ll have that day.

“It’s been a little bit of a departure from my usual work, but it’s been really rewarding to help provide as much information as possible to the public,” Moore said.

Most hotline staffers are Metro Health employees, but some were reassigned from other areas, such as the public library system.

Metro Health employees’ daily duties may have changed, but their mission remains the same as it was pre-coronavirus, Hixon said.

“In both situations, you have people who are in crisis or in need, and our job is to give them information and get them to the right place to get the help that they need,” she said. “Our job is making sure that we look out for the health of the community. Right now that means talking to them on the phone. We usually talk to them in their homes, but it’s still the same principle.”

While working on the hotline, employees continue to work on other pre-coronavirus duties as well. For instance, Moore started setting up the City’s new Positive Parenting Program (Triple P) aimed at stemming domestic violence in Bexar County.

“Those classes equip parents in the community with the tools they need to be the parents that they want to be and provide safe, engaging environments for their kids,” Moore said, noting that they were able to certify providers for Triple P online. “We’ll still be able to roll out those classes once it’s safe.”

The health and safety of its residents is the City’s top priority, Hixon said, before and after this crisis. Bexar County has the highest rate of homicides related to domestic violence in Texas.

“Relationships involving violence don’t get better in times of stress,” she said.

The hotline also can provide information to callers about programs set up to assist those in abusive relationships, she added.

Assistance agencies across the country can expect an increase in demand for their services as families deal with lost wages, health care bills, and an economic downturn in the wake of the pandemic.

“It’s really hard to predict the impact that this is going to have,” Hixon said, and the systems and people responding to the COVID-19 crisis are the same ones that are working to fight other social problems such as domestic violence. “Our social service providers are not just waiting for this to be over to try to start figuring that out. They’re definitely thinking about what they’re going to do and how they are going to help people.”