The first day of my practicum started bright and early with a 7 AM video conference. As I logged in, I began to see faces and names of individuals from dozens of member countries and multilateral organizations as we gathered to discuss the Global Health Security Agenda (GHSA) in the midst of the COVID-19 pandemic. Typically meeting in person somewhere across the world, the GHSA was having its first virtual Steering Group meeting to discuss how it can tackle its mission to improve countries’ abilities to prevent, detect, and respond to infectious disease threats at this time.
The current crisis we are facing with the COVID-19 pandemic is a crisis of preparedness, and highlights the urgent need for prioritizing global health security. Too often, our world has amnesia after facing a public health response and fails to invest in the necessary structures to prevent future outbreaks and epidemics. As the world is currently laser-focused on the response and recovery phases of COVID-19, my practicum with the US Department of Health and Human Services’ Pandemic and Emerging Threats team aims to assist countries with making the case for investing in health security at this critical time and setting up sustainable and long-term approaches to public health preparedness.
My coworker Theo, who loves taking walk breaks and resting his paws on my laptop.
As a current MPH student in Applied Epidemiology at Gillings, my professional and academic career to date has focused on using data and information to understand and combat infectious diseases. Now, as we see a global pandemic unfold and reach almost every corner of the world, epidemiology curves are a regular part of the daily news and disease modeling predictions are debated on social media. This has only further fueled my passion for infectious disease epidemiology, as I plan to spend my career improving detection mechanisms and strengthening health systems to better prevent and respond to emerging threats. However, this response has also shown how quickly protectionist politics can interfere with our ability to support the most vulnerable populations and effectively fight a virus like SARS-Cov-2, so I hope that my work as part of this practicum can help further a global, collaborative, and equitable approach, even if I’m working from my kitchen table here in North Carolina rather than on the frontlines of the response.
For my practicum, I am currently working with a team of researchers at Duke in the SER (Salud, Estrés, y Resiliencia/Health, Stress, and Resilience) Hispano Project that studies the effects of acculturation stress and resilience on the health and wellbeing of Latinx immigrants in the Research Triangle Area. Research has shown that Latinx immigrants to the United States are generally healthier than the general US population upon arrival, but their health declines over time. However, there is a lack of research on how stress influences this phenomenon. The SER project focuses on generating new knowledge on how individual, family, and community resilience among the Latinx population buffers against acculturation stress and influences both psychological and physical health, thus informing future interventions to improve the health of the Latinx community. I will be assisting with conducting and coding qualitative interviews with members of the Latinx community and producing an analysis report and literature review. As a second generation Mexican-American, I strongly believe in the significance of the work I am doing this summer and the importance of practicing global health work in local contexts.
Attempting to do work with dogs in the picture is harder than it seems.
Adapting to a remote practicum has been a challenge, but I have been able to develop techniques to get me through the day. I rely on virtual check-ins with my practicum preceptor and remote team meetings to keep me motivated and in tune with my work. I have learned to be more flexible as well as kind to myself by acknowledging my own humanity and imperfections and taking everything a day at a time. Sometimes that means I do not have a perfect workplace set up, but being able to focus on the small moments of gratitude has helped me stay grounded. I find it is more important than ever to spend time out in nature, whether it is going on daily walks with my sister and two dogs, or just hanging out in my backyard hammock.
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.
