Dr. Taylor Leads Battle But Takes No Steps Alone

Nicole Taylor, M.D., arrived at the Department of Children and Families (DCF) as its new Director of Pediatrics in March 2019 welcomed by a Commissioner who had only been on the job a mere 3 months. Commissioner Dorantes committed to an open-door policy for whatever the new "top doc" needed to get acclimated to DCF. Little did the new Agency head know, she would need Dr. Taylor infinitely more in the year that followed.

In her first 10 months with the Department, confidence in Dr. Taylor's attention to detail, healthcare acumen and leadership abilities was solidified. While establishing that trust, Dr. Taylor had no way of knowing what would confront her and the Agency when COVID-19 hit the public consciousness in January 2020.

Dr. Taylor found herself leading the effort to keep children and families as safe as possible during a worldwide pandemic that as of this writing, has killed over a half a million Americans……..and counting.

But rather than feel overwhelmed, Dr. Taylor said she felt supported in a way that enabled her and the Department to respond to the crisis while doing the work of strengthening families in challenging circumstances.

"I started the first memo to staff about COVID in January 2020, and since that time it has felt like a race and also a rollercoaster," she said, referring to the quickly changing information about the disease and how to best contain it. 

She said the early information from the federal government underplayed the deadly nature of the pandemic. "We quickly learned how impactful it would be," she said.

Oddly enough, COVID-19 thrust Dr. Taylor into the realm of public health that motivated her to join the Department after serving individual patients during most of her career.

Most of her experience prior to 2019 was as a primary care physician specializing in pediatrics serving one patient at a time.

"I've always wanted to get into public health," said Dr. Taylor who graduated from UCONN medical school. She defined public health as "an approach to influence the population instead of one person."

"You get so busy as a primary care physician focusing on the individual, but you need them both - individual and public health - because what happens to the overall population can have dramatic effects on individual patients," she said. "It's hard to be innovative and come up with policies that will affect the broader population when you're seeing 20 patients a day."

Indeed, when Dr. Taylor came to the Department motivated in large measure to conduct macro or population-level public health, she got a crash course in it.

In order to limit the virus' spread, health officials made contact tracing - the process of identifying who might be exposed to someone else with the virus - a key strategy.

"Quickly it became obvious that to mitigate the exposure, we had to be very systematic," said Dr. Taylor. "A lot of my energy went toward learning about contact tracing and applying those principles when a staff person tests positive. Every touchpoint that one person has who is  (COVID) positive can affect multiple other individuals."

There were several "touchpoints" of risk that became her focus:

• the risk to client families and children and to social work staff from in-person contact in the families' homes;
• the risks for children in foster care and for the families that cared for them;
• the risks to court and private agency personnel; and
• the potential to transmit the disease between DCF staff themselves who share offices, workspace and vehicles.

Dr. Taylor was instrumental in helping to:

• inventory and determine PPE stockpile needs of the entire agency including burn rate projections;
• coordinate initial point prevalence testing with the secured vendor;
• offer additional support to DCF facilities and medical teams on their very successful infection control protocol adherence; and
• assist the DCF Executive Team in answering questions for contracted providers who secure placements for children in their custody

By mid-February 2021, more than 800 people: staff, children in care, and their caretakers - would test positive. Tragically, four of the caretakers have died from the disease.

Dr. Taylor also developed surveillance protocol to ensure children in the Department's care were followed closely following a COVID-19 positive diagnosis-watching for any indication of the Multisystem Inflammatory Syndrome (MIS-C) as well as instructions to foster parents to detect and report potential symptoms.

Dr. Taylor said that over time the Department has improved how it conducts the contact tracing. "We're getting significantly better at it," she said, adding that it used to take her hours to conduct the contact tracing herself. "We are quicker in our response, as well as more consistent and systematic. After doing this the 100th time, you get a great rhythm."

DCF Commissioner Vannessa Dorantes said, "Dr. Taylor is our resident subject matter expert - She has helped us make some of the most critical decisions in my career. The steady confidence she has instilled has allowed the Department to weather this tumultuous (IM)perfect storm. I cannot imagine enduring this without her."

"Dr. Taylor has been a huge factor in enabling the Department to conduct our core function of safely keeping families intact and strengthening their capacity to care for their children. Going through a pandemic, I can't think of a better person to do it with than Dr. Taylor," stated Deputy Commissioner Michael Williams.

Dr. Taylor isn’t the least fazed by the challenge. "Honestly, I never felt like I had time to panic," she said, referring to the 24 hour, seven-days a week demands placed on her, Commissioner Dorantes and her executive team. "I wasn't going to allow myself or the Department to be even one step behind the changing information. There was so much to do, there wasn't time to worry about it."

Dr. Taylor cited the culture of support at the Department for enabling her to do the job as well as possible. "I don't feel like it is a burden," she said. "I never felt like I was carrying the burden. Within the agency, there was true partnership and consistency at all levels."

Dr. Taylor has also co-chaired one of the DCF COVID recovery subcommittees which were stood up to advise the Executive Team on specific considerations and workplace implications.

In addition to crediting Commissioner Dorantes and her Executive Team with creating a team environment, Dr. Taylor also highlighted the work of the Department's Human Resources and Engineering Divisions with collaboration that made the effort possible. "If there was any burden, it didn’t feel like I had to carry I alone," she said of the partnerships within the Department.

She also praised the Department of Public Health, the Center for Disease Control, the court system, and private service providers for offering the expertise and collaboration necessary for staff and clients to mitigate risks.

Dr. Taylor has been the DCF GPS - Our Coronavirus Navigation System!

"I don't feel overwhelmed, I feel very supported," she said. "I don't feel like I take any steps alone at DCF."