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April 27, 2020

UW epidemiology graduate students participating in state’s surge response to COVID-19 pandemic

A little after 10 p.m. on March 19, University of Washington graduate students Anne Massey and David Coomes happened to be online when they received an email that would give them an unexpected role in Washington’s rapidly evolving response to the outbreak of a novel coronavirus.

As context, the World Health Organization had just declared the spread of the virus a pandemic, the state of Washington had gone from having the country’s first positive test for the virus to having the nation’s first reported death from COVID-19. The number of infections had jumped to 312 statewide and 15,219 in the nation.

The two graduate students in the Department of Epidemiology are members of the Student Epidemic Action Leaders, or SEAL Team, established in 2015 in the UW School of Public Health. Roughly 20 team members had been working since early February with Public Health  — Seattle & King County, the state’s Department of Health and other agencies to track health information. Massey, Coomes and others had already helped in various ways.

And as the official response to the outbreak changed day to day, some assignments ended while others were still developing. Here was a chance for Massey, teaching assistant and student leader of the SEAL Team, and Coomes to put their nascent expertise back to work in the state’s response.

“We had the initial training we all went through in the SEAL program. The expectation was that because response to the pandemic was changing so fast, we wouldn’t know what we would be doing until we got a call. So we had to be ready,” Massey said.

Backstage access

The late-night email came from UW School of Public Health associate dean, professor of epidemiology and SEAL Team director Janet Baseman: Could they make it to the Washington State Public Health Laboratories in Shoreline  the next morning to help launch a new system registering people for a pop-up testing facility at the Tacoma Dome?

“My first thought was about getting child care,” said Coomes. “I have a 2-year-old and had to lean on my partner to cover child care for the day. But I wanted to see them get it off the ground. The response was changing all the time, because they’re constantly getting new information and dealing with resource challenges. They were throwing this together at a moment’s notice.”

The two were able to commit. The next morning, a Friday, at the lab in Shoreline, they climbed into a state vehicle with a state official and headed for the Tacoma Dome. On the way, they learned how the program worked for this particular use: People remotely filled out an online survey, and based on symptoms, risk factors or involvement in a frontline occupation, they got a unique number and appointment to get tested.
At the Tacoma Dome, the students had to wander around the essentially deserted building for a bit looking for the way in. Once they found the right door, they were sent to backstage rooms meant for concert performers and got to work training local public health workers on the registration program.

“It was all very exciting,” said Massey. “We had worked with that software application before, but this was an expedited use of the program. And, because we had the relationships with state officials and this tool was already created, we were able to quickly respond to the pandemic, to deploy skills and be creative.”

First wave

Every quarter for the past five years, roughly 20 students from across the School of Public Health get trained and can then volunteer for assignments to help state and local health agencies in outbreak investigations — such as the 2019 measles outbreak or food safety issues.

But the field assignments for this spring quarter would be on a whole other level: Helping agencies respond to the greatest infectious disease threat in at least a generation.

“SEAL students are trained to provide surge support to our public health practice partners,” said Baseman. “The fact that their skills can be applied now to a global pandemic as it’s unfolding is pretty amazing.”

Epidemiology graduate students Haylea Hannah and Erin Morgan thought so, too.

The two SEAL students had jumped into the first wave of Public Health — Seattle & King County’s efforts in early February to get a handle on who might be bringing the virus to Washington from out of the country. They made phone calls to help monitor travelers who had symptoms of the disease and talked to family members and other close contacts.

“When I did the symptom-monitoring calls,” Hannah said, “people would be really nice. I think they thought it was kind that they were hearing from the county health department. Most of them said they had heard a little bit from the CDC when they got off their flight, but they were glad to have the information and to know who they should reach out to.”

Morgan explained that they started out contacting all returning travelers, but quickly realized there were too many. Even with SEAL Team backup, the health agency didn’t have the resources to contact everyone. So she helped the agency brainstorm other strategies. They figured out a way to direct recent travelers to information they needed, without causing an investigator to contact every single traveler.

“This is such an unprecedented time,” Morgan said. “Being in public health and being a student training for a career in epidemiology, it just felt great to have an opportunity to help. It felt impactful for me to do anything that took like one additional thing off a to-do list.”

Nitty-gritty of public health

“The SEAL students came in super excited, and if they had to do something different, they were totally ready to go and do whatever needed to be done,” said Melinda Huntington-Frazier, a public health nurse in the Communicable Disease Epidemiology & Immunization Section of Public Health — Seattle & King County.

“At the time, we were just learning about asymptomatic infections,” Huntington-Frazier added. “There were so many questions. It was great seeing students growing and learning to tackle the bigger questions as new details, like the possibility of an asymptomatic contagion, were coming in.”

The SEAL Team also got experience with the nitty-gritty data work of case and contact investigation in public health while helping out at the Washington State Department of Health.

“The SEALs assisted the data management team at an imperative time during COVID-19 investigations,” said Kelsey Nichols, of the department’s Office of Communicable Disease Epidemiology. “The investigations team was doing phone interviews and transcribing the data on paper when we first began interviewing people, and that data needed to be integrated into our data surveillance system as quickly as possible.”

 

Real-world impact

The SEAL Team includes newly trained members and experienced members like Coomes, who has transitioned to helping UW’s Environmental Health & Safety department stay in contact with COVID-19 cases associated with the university. The student group continues to support various agencies combating the pandemic.

Each student can recall that moment they recognized their efforts, no matter how technical or abstract, was really about the people affected and suffering during the crisis.

“When we called the son of one of the women who had passed,” remembered Morgan, “he was just very grateful for someone reaching out and checking in on him and providing more information and making sure he was doing OK. That was probably one of the more impactful moments for me.”

Hannah’s passion for working in public health had brought her to the UW’s epidemiology graduate program, but along the way she’s discovered a strong interest in how public health agencies communicate.

“I’m familiar with data and its interpretation,” she said. “But once you have that, you have to think about how it will be interpreted by the public. How should we present it so that it’s clear? What numbers do you communicate and how do you do that? That’s the piece this experience has highlighted for me.”

Once the worst is over, Morgan hopes to be a part of research into how injuries and violence played out during the pandemic.

“There will inevitably be side effects of people being told to stay at home, and some of them are positive, such as decreases in motor-vehicle collisions. But with the uncertainty and economic fallout, there’s the potential increased risk for injury, self-inflicted or toward other people. So even when things start to calm down with the pandemic, there will be a lot of questions and a lot of research into what happened,” she said.

Massey, a teaching assistant, continues helping Baseman lead the SEAL Team, a program that was instrumental in her decision to leave a career to go back to school in public health at UW. She grew up in the Seattle area, and for much of her life has had an interest in pandemics and reading about them.

“And to be able to not only help public health efforts but to be in a pandemic in the region I grew up in, reading those books about spillover diseases from animals, all of those things coming together has been really stunning,” Massey said.

The SEAL Team story continues. Some 30 graduate student members are currently supporting the state’s health agencies.

VIDEO: Baseman and other SEAL Team members join School of Public Health Dean Hilary Godwin in her weekly webinar sharing the latest updates on the school’s response to the COVID-19 outbreak.

For more information on the SEAL Team, contact Baseman at jbaseman@uw.edu or Massey at aemassey@uw.edu.

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Tag(s): COVID-19 • Department of Epidemiology • Hilary Godwin • Janet Baseman • population health • School of Public Health • SEAL Team

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