Going Behind the Numbers

The Bahamas
The Bahamas

Still groggy and sleep-deprived only hours removed from turning in my final midterm projects, I wandered the terminal of Raleigh-Durham International Airport at sunrise, attempting to find the gate for my Delta flight to JFK. Despite not having secured a practicum project for the summer at that time, at that moment the only thing on my mind was getting on that plane and meeting my friends in the Bahamas later that day. Obviously, I really needed a break from school. All over the monitors up and down the terminal, news on the novel coronavirus (COVID-19) appearing in a few U.S. cities dominated local and national TV stations. Little did I know, we had all possibly already been exposed, and in the coming week, the conditions in the United States and across the world would change drastically.

As someone who has always been captivated by epidemiology, infectious disease, and One Health (the intersection of animal, human, and environmental health), the arrival of COVID-19 brought some excitement, in addition to uncertainty and fear felt by most of those attempting to keep up with the status of the virus’ spread. I had just spent the fall semester in a One Health elective sitting alongside other graduate students, physicians, veterinary students, medical students, and other public health professionals and academics from Duke, UNC, and NC State learning about One Health issues, and delineating what the approach means, and how to embrace this holistic lens in our academic and other career endeavors. Thus, I had a significant amount of background knowledge as to the epidemiology of this zoonotic virus. Yet, mostly due to being swamped with midterm projects (or at least I like to blame it on this in hindsight…) I remained fairly unaware of the COVID-19 happenings until I returned from my spring break trip. I had definitely heard my fair share of broad sweeping statistics and general info from my friends who had been keeping up with social media and were in communication with their families, but hearing these things caused general stress and tension in our group of friends on the trip. With 13 of us isolated on a  catamaran with only each other for 8 days and no means of spreading the virus to others, we somewhat regrettably attempted the “ignorance is bliss” strategy until we got home and could isolate.

The novel COVID-19 pandemic response affected me in a vastly different way from many of my peers. People in my concentration had applied, interviewed for, and been offered jobs working on global projects with organizations in North Carolina that the conditions of the pandemic significantly altered, or even cancelled. A few of my peers had once in a lifetime opportunities to study and work abroad cancelled, and have been forced to work remotely on these projects this summer. As someone who was fortunate enough to study global health abroad earlier in my life, these are experiences you can’t replace, and I empathize with my classmates whose career-defining practicum experience has been so drastically affected by the pandemic. I, on the other hand, arrived back from spring break, and relocated to Madison, WI to be near my family during the pandemic, still devoid of a practicum. A couple of weeks later, I was so fortunate to be offered the opportunity to work on the COVID-19 Behind the Numbers project with the North Carolina Institute for Public Health. While the pandemic caused many of my peers hardship or significant change in their experience, it presented me with an opportunity. For that, I am incredibly grateful.

Along with three other MPH students, I will be working on the COVID-19 Behind the Numbers project, an initiative through the North Carolina Institute of Public Health to discern and share qualitative stories of frontline healthcare workers during the coronavirus pandemic. It strives to take advantage of the unique and timely opportunity to document the impacts of the COVID-19 outbreak in a way that provides context and depth to the impacts of the outbreak at the individual level and beyond. I will be heading up the North Carolina focus area, while three of my fellow MPH students will head up National (United States and Territories), Global, and Equity areas of focus. So far, we have been scouring news articles, Twitter, Instagram, YouTube, and all other platforms of social media for stories from frontline healthcare workers. From there, we will determine underlying themes throughout the stories we can examine and analyze in more detail later this summer. I have learned a lot about the timeline of COVID-19, and how much frontline healthcare workers have been through during this pandemic, but the project remains in its infancy.

Global health is local health and vice versa, and so many lives have been threatened and lost unnecessarily due to the improper handling of this crisis on a state, national, and global level. I hope as a world we learn from this experience, the shared experiences of others across the globe, and most importantly, learn from the stories of our frontline healthcare workers who can directly attest to where things went wrong, and help to fix them for the future. Out there somewhere exists another virus that may be a few simple steps from being virulent and transmissible enough to cause a much deadlier pandemic. We need to recognize the impending danger and do all we can to prevent unnecessary morbidity and mortality going forward.

Hope everyone is well and staying safe!

Kris

Seeing the lemur through the trees: adaptation and resilience amid a global health crisis

What started out as a summer full of plans… was ultimately turned upside down. Due to the COVID-19 pandemic, I—like many of my fellow Gillings MPH students—will be completing my practicum remotely from my home in North Carolina instead of abroad. While I am crestfallen that I am not able to travel as intended, it is safe to say that global health work does not begin and end with plane tickets to worldly destinations. Indeed, global health is “more than just public health somewhere else” . . . it is a collaborative effort that cuts across disciplinary and geographic contexts to achieve shared health goals – an endeavor that feels most salient amid the current health crisis, where global solidarity is critical.

Working under the mentorship of Dr. Nora Rosenberg, and collaborating with colleagues at UNC Project-Malawi and the Tingathe Program, this summer I am supporting several research projects focused on HIV testing, treatment, and prevention in Malawi. My experience thus far has underscored the ways in which global health practitioners must be resilient and adaptable, not only in directly responding to the current crisis, but also in finding innovative ways to continue other vital, ongoing work in global health. Existing health threats like HIV, tuberculosis, and malaria are expected to get much worse in the context of COVID-19, turning back the clock on decades of global health progress. Amid such challenges, we must find new and creative ways to problem solve.

Greetings from… my home desk!
Greetings from… my home desk!

Where my practicum work will inevitably be impacted by COVID-19, the scope of my summer projects may change in the coming weeks – responding to the needs of an ever-evolving situation. In addition to being flexible in my work, the current crisis has provided a reminder of how important it is to take care of our physical and mental wellbeing through activities that sustain us . . . as we do our best work when we care for ourselves. In the current moment, what sustains me is regular interactions with my colleagues on Zoom, going on long walks outside, and finding good news to be excited about—like this recent announcement from the Duke Lemur Center on the healthy birth of a critically endangered blue-eyed black lemur!

As we all find ways to adapt to the current situation—which can feel isolating as we work remotely—and while I remain uncertain about what the future holds, I am comforted knowing that I am not in this alone.

Stay safe and be well,

Hanna

My Global Health Experience in a Pandemic

By Shannon Applegate

In February, I bought a plane ticket to travel across the world to embark on a 10-week research experience. In March, the world shut down. This pandemic is a true representation of how connected, yet disconnected we are as a human race. The coronavirus has impacted every country but misinformation, denial, and lack of unity between countries persists. Public health research and interventions are needed now more than ever as this virus affects so many and health disparities increase.

The new normal… wearing a mask while taking a nature break with my dog.
The new normal… wearing a mask while taking a nature break with my dog.

Many people, including me, are now having to transition to working from home. I had originally planned to travel to Cebu, Philippines this summer to complete a research project at the Office of Population Studies (OPS) at the University of San Carlos. While I am no longer able to travel to Cebu to complete a formal qualitative research component, I will still be researching the same topic using data from the Cebu Longitudinal Health and Nutrition Survey (CLHNS), a collaboration project between UNC Chapel Hill and the University of San Carlos. The CLHNS is an ongoing study that has over 30 years of data from a now multigenerational cohort. The longitudinal study covers a wide range of topics including infant feeding practices, reproductive histories, socioeconomic factors, environmental factors, schooling outcomes, and more. With the mentorship of Dr. Linda Adair, I will be exploring the primary barriers to exclusive breastfeeding within this cohort. The unique multigenerational study will allow me to look at determinants of breastfeeding, such as education attainment and household income level, across generations and time.

My work from home set up
My work from home set up.

The current pandemic has caused this internship to look a bit different than expected, including using Zoom regularly to meet with Dr. Adair to discuss my project. We are able to share screens to look at the data sets together in Stata. I complete my work at home at my kitchen table where I am lucky enough to have reliable Wi-Fi, a laptop, and a quiet environment to focus. I like to split up my day by taking my dog on walks through nearby neighborhoods and trails and enjoying an afternoon tea or coffee. I am excited to continue my research and am thankful that I am still able to complete this internship during the pandemic.