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Student Op-Ed: Pursuing Enteric Diseases in the Midst of a COVID-19 Pandemic

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I went to a quaint college nestled in the western foothills of Vermont named Castleton University. It was there that I pursued my fascination in all living things micro and molecular. After graduating with a Bachelor’s degree in cellular and molecular biology and chemistry in 2019, I took a job as a biology teacher at a small private high school in Vermont. While teaching, I became aware of my deep love for illuminating those around me with wonders of biology and, specifically, infectious diseases. I realized towards the end of my first year as a teacher that I wanted to harness this energy and pursue a life full of chasing infectious diseases and fighting the perils of their microbial afflictions by informing and supporting people around me.

And so, with the support of previous professors, I was encouraged to delve into the field of public health—a field foreign to me at the time. After much examination and research, I came to the conclusion that seeking a Master’s degree at a public health  school would be the initial doorway to pursuing the field of epidemiology. With my new found ambitions, I settled on the Colorado School of Public Health at the University of Colorado Anschutz Medical Campus. ColoradoSPH’s program was robust and the beauty of the CU Anschutz campus backed by the majestic Colorado Rocky Mountains filled me with excitement and wonder.

Upon being accepted into the school, I was elated. However, those feelings began to mix with emotions of concern as I began to prepare for my journey westward while also hearing about the early signs of a potential pandemic, COVID-19. 

Creating Connections in the Midst of a Pandemic 

Upon arriving in Colorado, and beginning my first semester remotely when the ‘stay at home’ mandate was in full-swing, I felt like my ability to connect with fellow students and professors was at an all-time low. 

However, early on in my semester, I was able to connect with my academic advisor, Dr. Elaine Scallan Walter, who instantly made me feel like I belonged and that the effects of the pandemic should not keep me from seeking meaningful, professional relationships at the school. Shortly afterwards, I applied for a position with Scallan Walter as a student interviewer for a case-control study. I felt like the study, being conducted with CDPHE, would help me to better understand the community exposures associated with COVID-19.  

That is how in March 2021, I began my first job in public health—in the midst of a global pandemic. I was excited to conduct public health work that would ultimately contribute to Colorado’s public health knowledge of the novel virus. I was eager to be a part of a study whose results would have an impact on the pandemic and provide more insight to the mitigation and control measures within the state of Colorado. Aside from taking an active role in the pandemic, the position also provided me with the stability I needed in a foreign city without the comfort of friendships. I was able to extend my grasp beyond the isolation of my apartment and reach out to fellow classmates and professionals within the public health department remotely.  

The Enteric Disease Interview Team (EDIT) 

The skills and professional connections that I was able to build during my time as an interviewer for the COVID case-control study provided my with another job opportunity with the Enteric Disease Interview Team (EDIT) at the Colorado Integrated Food Safety Center of Excellence (CO CoE), a collaboration between ColoradoSPH and the Colorado Department of Public Health and Environment. This thrilled me, not only for its boost that it would offer me professionally, but it also gave me the opportunity to spend more time interacting with classmates and peers, and to get a better glimpse of infectious diseases from a public health practice perspective rather than through the lens of a biologist. 

“The EDIT program allowed Colorado to continue the essential work on conducting enteric disease interviews during a pandemic. We hope that, in the process, we enticed some students to join us in the wonderful world of foodborne, enteric, and waterborne disease epidemiology."  
Rachel Jervis, Foodborne, Enteric, + Waterborne Diseases Program Manager 

Prior to the pandemic, local public health agencies in Colorado were responsible for following up on routine cases of enteric disease. However, with much of the public health workforce overwhelmed by the COVID-19 pandemic, CO CoE took this opportunity to rapidly develop a student interviewing team of public health graduates. As a result, EDIT was created and trained to respond to routine enteric disease cases within most of the state of Colorado as well as some jurisdictions in Nebraska and Wyoming. In addition, we were trained and had the opportunity to support local public health agencies with outbreak investigation interviewing, which involves in-depth questioning pertinent to the outbreak. 

Having the opportunity to do some of the work of a professional public health practitioner as a student was informative and required intensive training. Prior to interviewing our first enteric cases, we were trained across a wide array of topics, from the etiologies of foodborne illness and ‘red-flag’ situations that would require work exclusions to learning how to navigate and communicate effectively when encountering difficult interviewing scenarios. 

Once fully trained, I began calling and interviewing new enteric disease cases that were reported to CDPHE. For the interviews, we would ask questions to help us identify outbreaks, track trends and implement disease control measures. Effective interviewing goes beyond simply asking the questions; it requires a combination of dynamic communication and interpersonal skills, cultural competency, and tactful language. It’s also important that the interviewer builds rapport and maintains trust with the case while being empathetic to their condition. I’ve encountered multiple cases where individuals of refugee status seemed uncomfortable about being contacted by an individual who has access to their personal information and is outside of their close-knit community. I learned it’s important to immediately establish trust with concerned cases by providing the reason for calling, and assuring them of the confidentiality of their information. It’s also important to bridge any language barriers through an interpreter and to be mindful of any cultural or religious issues relevant to enteric disease interviewing. 

Maintaining an empathetic mindset and addressing people’s concerns establishes a foundation of trust and opens communication for the interviewing process, so that you can make strides towards identifying the cause of outbreaks and preventing the transmission of these pathogens.  

Looking to a Bright Future 

Due to the pandemic, work and school has been almost entirely remote. One way I was able to meet other public health students was through the EDIT weekly Zoom meetings. Aside from discussing job-related issues, we’ve also used these meetings to meet public health professionals in other areas such as regional epidemiologists; respiratory disease, injury and prescription drug epidemiologists from CDPHE and epidemiologists from other organizations like the U.S. Food and Drug Administration (FDA). Graduated EDIT members also spoke with us about their current positions within applied public health and provided advice on job searches and interviews after graduation. They also discussed how the skills we developed on EDIT are transferable to many public health positions, and how to leverage this for job applications. Members of EDIT are also invited to weekly CDPHE communicable disease branch meetings, where we learn about all of the reportable infectious diseases throughout Colorado, and to meetings held by the CDC about multistate enteric disease outbreaks we’re involved in. 

With an anticipated graduation date in May, I hope to continue to help individuals with infectious diseases in a medical setting with greater ambitions of one day working as an epidemiologist for the CDC. As a student interviewer, I feel more prepared to step out into the real world in preparation of future epidemiology work. I am incredibly grateful for the support and advice that I have received from my mentors at the CO CoE, CDPHE and ColoradoSPH and only hope to continue to create supportive relationships.