When The Ohio State University medical student Amy Xie signed up for a fourth-year elective rotation, she was hoping to expand her training in clinical medicine by experiencing some “big picture medicine.” To her surprise, the opportunity turned out to be the experience of a lifetime.
“I was interested in experiencing the role of the physician in the context of public health, to see what happens when a new health threat emerges,” she says. So she signed up for a fourth-year elective in epidemiology that placed her in a field experience working with the Centers for Disease Control and Prevention (CDC) in its Atlanta headquarters. Unexpectedly, Amy was sent to Phoenix, Arizona, to join a team assisting the Maricopa County Department of Public Health in investigating the state’s exposure response to coronavirus 2019 (COVID-19). Arizona was one of the first U.S. states to have a returning visitor from Wuhan, China, test positive for COVID-19. The CDC deployed a multidisciplinary team to support the state and local health departments with clinical management, contact tracing and communications.
The confirmed case in Arizona is one of 15 cases in the nation, according to the CDC. Globally, more than 2,000 people have died from COVID-19. Hundreds of Americans have been quarantined at military bases after returning from travel abroad. For people who have been exposed to COVID-19, the response protocol starts with a 14-day quarantine period.
Amy became a “point of contact” for communicating with persons under investigation (PUIs) for exposure to COVID-19, as well as for potentially exposed individuals. She informed the PUIs of their exposure to an individual who has a confirmed case of COVID-19 and provided instructions for symptom monitoring and diagnostic specimen collection. As part of the process, she collected patient histories and established a record of the individual’s health status, including a timeline of symptoms and preexisting conditions.
“The first step in a public health outbreak investigation is oftentimes an astute clinician noticing an unusual frequency or atypical presentation of a disease,” Amy says. “Interdisciplinary team effort is required. I worked alongside physicians, nurses, epidemiologists, data scientists and even finance and communications experts during the response. Although each person’s role may be just a small piece of the process, collaboration was essential to making progress.”
The experience has fueled Amy’s interest in public health and the social determinants of health, and has taught her about the importance of working with a team of health professionals to communicate accurate information to the public.
“There is a lot of fear surrounding the unknown from both health care providers and members of the community,” she says. “Correcting misinformation and sharing evidence-based guidance is part of public health. My work in the future cannot be just limited to working in a hospital or in a clinic. Physicians are needed as part of the public health workforce.”
After spending 10 days in Phoenix working on the COVID-19 investigation, Amy returned to the CDC’s National Center for Injury Prevention and Control – Division of Violence Prevention headquarters in Atlanta to complete her rotation. She will return to campus in March.