Since the first COVID-19 case was reported in Colorado on March 5, more than 150 ColoradoSPH students have volunteered their time to support health agencies, labs, and local health organizations.
“Most of my fellow students have this sense of wanting to help our communities. That’s why we went into public health,” said Colorado School of Public Health DrPH student Olivia Zarella when asked about the reaction she’s seen to the COVID-19 Student Response Initiative. “ColoradoSPH students have an incredible skillset that’s really valuable. And it would be an absolute waste if we didn’t put our skills to fight the pandemic and help our organizations and agencies out during this time.”
The Student Response Initiative
Many of the student volunteers have signed up to help through the Student Response Initiative, a campus-wide program on the CU Anschutz Medical Campus that matches students with organizations in need of volunteers with specific skills and talents. The initiative was created by medical student Halea Meese and dual MD-MPH student Jacob Fox to connect the schools on the CU Anschutz campus and bring together students interested in volunteering through a centralized program.
Zarella got involved after her summer practicum in Ghana was canceled due to COVID-19. She started looking for a way to put her time toward supporting COVID-19 response efforts and was connected with Dr. Lisa Miller, a professor of epidemiology and former state epidemiologist who is now the faculty advisor on the project. Miller put out a call for volunteer requests through her connections with local health agencies and the Colorado Association of Local Public Health Officials. Managing the Student Response Initiative and being responsible for matching students and organizations has now been formalized as Zarella’s practicum experience.
Students are matched with opportunities based on their interests, skillsets, and availability. When Zarella receives word that an organization needs a volunteer, she’ll find a student whose interests and skills match the needs of the organization and connect the two. The first wave of students who were matched are helping in a CU Denver lab that’s creating personal protective equipment (PPE) and working with Assistant Professor of Epidemiology Molly Lamb to develop graphics and messaging for the Colorado Department of Public Health and Environment (CDPHE) to use on their social media channels.
Continuing Operations
Six ColoradoSPH students have already been working with CDPHE since the early days of the outbreak in in the state. These students had previously been trained to do interviews in the event of a foodborne illness outbreak. While CDPHE and local health departments are typically able to investigate cases of foodborne illness on their own, two to three times a year an outbreak will occur that’s large enough to require extra investigative manpower. That’s when they call in the students who have been trained by the Colorado Integrated Food Safety Center of Excellence, a CDC-funded collaboration between ColoradoSPH and CDPHE.
Enteric diseases like Campylobacter and Salmonella are routinely reported to both local and the state health department. Normally, the local health department is responsible for calling the patients and doing a case-by-case investigation to learn more about what might have caused enteric illness and to detect outbreaks. But when COVID-19 hit Colorado, many of the staff members at local health departments were redirected from their routine work, including monitoring cases of foodborne illness, to pandemic response. “I couldn’t have imagined back in early March that the majority of my colleagues in the Communicable Disease Branch would be deployed, sometimes with very short notice, to provide their skills and expertise in responding to the various COVID-19 outbreaks across our state,” said Ann Shen, enteric disease epidemiologist at CDPHE. “This meant that our regular responsibilities of responding to routine disease investigation, assisting with outbreak response, and providing assistance with surge capacity to local public health agencies, were no longer filled.” The trained students stepped up to fill the gaps.
When a case of foodborne illness is diagnosed, this information is entered into a statewide database. The students are assigned five to 10 cases at a time to call over a one-week period and ask individuals about their symptoms, what and where they had eaten before getting sick, and if anyone else is sick. They then flag the cases that need follow up by health department staff.
“This is the bread and butter of public health. It’s fundamental disease control activity at a local level,” said Elaine Scallan Walter, co-director of the Colorado Integrated Food Safety Center of Excellence and Associate Professor of Epidemiology. “It’s a great experience for the students. They’re interviewing cases, learning about how disease surveillance works, and learning how to enter data into a surveillance system.”
First-year epidemiology MPH student and pediatric nurse Grace Fleming agreed. “I’ve learned a lot about interview skills and how to conduct formal case interviews in a public health department. I’m learning to ensure that I’m following all the protocols and structures—the formalities to talk about private health information with basically any person.”
Having the infrastructure to support continuing operations of health departments is critical to keep the health system from being overwhelmed by other health problems at a time when they’re already facing surges of COVID-19 patients. “Without the student interviewing team, we would not have been able to maintain a volume of high quality enteric interviews, comparable to typical disease reporting, but would have likely had to reduce what efforts we could provide and miss the identification of routine diseases and/or outbreaks as a result,” said Shen.
Some states have stopped doing this type of routine monitoring entirely, and even patients may feel like their symptoms are less important in the face of the pandemic. This is where the student volunteers really shine. “Cases try to get off topic, they try to talk about coronavirus and I have to tell them ‘Yeah, but your Salmonella case is still really important,’” Fleming said.
Into Summer and Fall
CDPHE is expecting it to be several more months until local health departments have the capacity to take on these routine functions again, and ColoradoSPH students will likely continue to volunteer into the fall semester.
“I’m happy to keep working with them as long as they think that my position is needed in order to best utilize everyone’s resources and skillsets, especially as a student where I can pick up and help support work where people who have already earned their MPH or are established epidemiologists can focus on other high-end priorities,” Fleming said. Meanwhile, Zarella expects to see demand rise for public health volunteers going into summer. “Right now, a lot of the prioritization in on healthcare workers. A lot of these organizations are going to provide more opportunities for our students in the next few weeks as they create these positions.” CDPHE, for instance, has created 20 student positions to help with contact tracing and case investigation after the initial round of social distancing requirements is relaxed. To fill the expected wave of new positions, Zarella has kept the student volunteer survey open for people to sign-up after the semester ends.
She has also found a form of self-care in managing the Student Response Initiative. “It’s been incredible for me to help others and match them with organizations to get them on the forefront of response,” Zarella said. “Especially in places where they may have grown up, where they can help protect their communities and their families with the knowledge they’ve learned from ColoradoSPH.”
