As Island health officials continue to monitor the Covid pandemic this summer while also keeping an eye on monkeypox and preparing for future health crises, they have one major thing going for them they did not have prior to March of 2020: experience.

“You know that cliche about building the airplane while you’re in the air, right? We did that,” Chilmark health agent Marina Lent said.

In a recent conversation, health agents from Chilmark, Edgartown and Tisbury looked back on the days before the Covid pandemic, assessed the rapid response required of them and other health officials, and talked about preparations for future pandemics.

Before Covid hit, health officials said, they had undergone state training for years. There was one major problem, though: They had been training for something completely different. They were ready for a deadly, short-term crisis, said Edgartown health agent Matt Poole.

“We were preparing for Bin Laden to crop-dust us with Anthrax,” he said.

Few at the state level knew what a real pandemic would require, weeks turning into months turning into years of ceaseless work that balanced public health concerns with business needs, while also providing reliable and comprehensible public messaging.

“The scenarios we trained for were, ‘How can you give the population their protection within 48 hours?’ [Covid] was a much more gradually unfolding thing,” Ms. Lent said.

Town health agents were quick to coordinate closely with other Island health officials, specifically the Martha’s Vineyard Hospital and Island Health Care, setting up what Tisbury health agent Maura Valley called a “one Island, one community” response.

Claire Seguin, COO of the Martha’s Vineyard Hospital, said that the hospital had “a very tight command and communication structure” in the event of an emergency situation — one that enabled a resilient staff to set up emergency care and symptomatic testing facilities.

“It really became about keeping up with what’s the latest and the greatest news and pivoting and adjusting our care based on that,” Ms. Seguin said.

Gearing up for a sustained health crisis has now become the primary focus of Island-wide planning initiatives. Local public health agents said they believe the most important step toward achieving this goal is maintaining a pool of available public health workers with the skill and stamina to manage a prolonged crisis — while also taking care of their regular workload, keeping tabs on everything from food safety to cyanobacteria blooms.

Early in the pandemic, public health agents drew heavily on local resources in order to set up testing and care facilities, Ms. Valley said. Town health agents also divided up their own responsibilities. Mr. Poole managed many of the business and construction protocols while Ms. Lent spearheaded contact tracing and public health. Ms. Valley led public-facing communications. This impromptu, localized response was a surprising success, they said, adding that they feel the key to future crisis prevention and response will be keeping the pandemic management skills like contact tracing — learned on the fly over the last two years — current. Cynthia Mitchell, chief executive officer of Island Healthcare, said that they have already incorporated pandemic training into their standard policies and procedures for new employees.  Ms. Lent called contact tracing a “use or lose it” skill, and wants to set up a system that keeps contact tracers engaged by calling up anyone diagnosed with tick-borne illness to talk about managing symptoms and medications.

“What I’m realizing is that skills on paper, or in a pandemic plan, or wherever you put it . . . are not going to help us that much compared to ongoing practice,” Ms. Lent said.

To this end, the team is thankful that the state has learned how important local agencies are.

“A lot of the decisions made by the state as we moved into the pandemic and vaccinating people disregarded the preparations that local communities had already put in place,” Ms. Valley said.

But state agencies have begun to come around to the benefits of regional systems and the importance of trained, local labor pools, Ms. Lent added.

A June report by the Massachusetts State Legislature offers up a sweeping host of “policy and regulatory recommendations” that encourage the transfer of state funds for pandemic prevention to local public health initiatives. The plan calls to bolster contact tracing programs, invest in “local and regional public health infrastructure” and reduce the “bureaucratic and administrative hurdles” that local health coalitions can face.

The Vineyard has already received a state grant that is paying two years’ salary for three new full-time public health workers with unique skills, including a population health expert and a sanitarian. “In Massachusetts, local health departments have always been staffed by generalists. And now we’re sort of seeing that you need to have specialists,” Mr. Poole said.

These hires, he said, should bolster the Island’s resiliency to any crisis situation.

Other non-governmental agencies are also working on future pandemic preparations. In the spring of 2020, Leah Palmer, who runs the Martha’s Vineyard public schools’ English Language Learning program, set up the Communication Ambassadors Partnership (CAP) to make sure that Brazilian families with limited English skills have access to pandemic news, protocols and relief supplies.

“One thing that is a challenge for us right now is that we don’t have a pool of interpreters... because so many of the interpreters that we’ve trained are now full time employees of organizations,” Ms. Palmer said.

Now CAP is setting up an interpreting course for high school juniors and seniors in the fall.

Public health agents also stressed that it’s not only organizations and governments that have to prepare for the next pandemic and keep pandemic-skills current. Private citizens need to do their part, they said.

“If you’re sick, stay home,” Ms. Valley said. “People used to come to work, coughing and sneezing, and say, ‘Oh, it’s only a cold.’ I think people have started to say, ‘Okay, wait a minute.’ And I think that’s the simplest thing that maybe people take away from this.”