Tufts Students Help Local Health Departments Respond to COVID-19
In January, Peilin Wang, MG21, in the Tufts University School of Medicine’s Master of Public Health (MPH) program, decided to spend the semester researching a health topic few people in the United States were concerned about: a virus called COVID-19.
Assigned in a class called Public Health Action, the project called for a presentation of a public health program at the end of the semester. Wang and her classmates planned to propose an educational campaign to raise awareness of the handful of COVID-19 cases in the United States.
Weeks later, after countless updates to their skyrocketing case count, the team narrowed their focus to LA county and started working on a new proposed program for non-medical industries to manufacture personal protective equipment. And a few weeks after that, as businesses shuttered, social distancing advisories went into effect, and the School of Medicine sent students home, Wang found herself staring down the subject of her studies not on a screen, but in the world around her.
“It was heartbreaking to watch things happening. A lot of stuff could have been done, that wasn’t being done,” said Wang, who is concentrating in epidemiology and biostatistics. “The numbers were crazy and I felt really frustrated and powerless.”
Then Wang got a message from Katie Donovan, director of career services for Tufts School of Medicine’s graduate programs. The Academic Health Department Consortium (AHDC), a group of eight public health schools and programs that the Massachusetts Department of Health convened in April 2019, was partnering with local boards of health to respond to the COVID-19 pandemic. Specifically, student volunteers would help with contact tracing—reaching out to those exposed to the virus to identify, contact, and advise those they may have exposed in turn. Would Wang want to sign up?
“The Public Health and Professional Degree Progam’s community’s response to the call for volunteers, while heartening, is not a surprise. It's very in line with Tufts’ culture and long history of volunteerism,” said Donovan, who has been serving as the unofficial volunteer point person for the School of Medicine and has funneled dozens of students and alumni into the effort. “This collaboration is definitely a trendsetter and a leader in this country. Other states are reaching out to the schools and the government to figure out, ‘How can we do that?’”
Wang is now one of hundreds of Tufts volunteers who have joined the effort, consisting of mostly public health graduate students, but also including alumni, faculty, and undergraduates studying community health. The state has since shifted contact tracing duty over to the global nonprofit Partners in Health, which aims to bring health care to vulnerable populations, but many student volunteers continue to help health departments in other ways, while others are joining Partners in Health as paid contact tracers. Wang and four other students from the School of Medicine, the Friedman School of Nutrition Science and Policy, and the Cummings School of Veterinary Medicine shared their experiences with Tufts Now.
A sense of control
It was tough for Wang and her classmates to work on their proposed PPE manufacturing program as the pandemic unfolded, she said—and not just because they constantly had to update their COVID-19 numbers. “All we could do was to try to control the damage—we couldn’t contain the disease,” said Wang, who was inspired to study epidemiology after witnessing her college’s health department nip a meningitis B outbreak in the bud. “The project made you feel helpless.”
But in an unexpected way, the project did end up having an effect on the pandemic. When Wang started volunteering as a contact tracer and calling Belmont residents who had been exposed to COVID-19, people were often suspicious it was a scam and reluctant to give her confidential information. She was able to talk them around by falling back on the research she had done for the project, as well as her passion as a public health student. “I would tell them how nurses were risking their lives and wearing trash bags because there wasn’t enough PPE,” Wang said. “I would tell them they were fighting not just for themselves, but for everyone.”
Volunteering gave her a sense of being where she belonged, said Wang. “Addressing COVID-19 is where public health professionals and students can really shine and really help people right now,” she said. It also turned public health into something personal rather than abstract, and provided a sense of clarity, Wang added. “It was a great experience to actually talk to the patients directly,” she said. “I felt that by talking to them and recording what they did and where they went after they were diagnosed, at least we were gaining control. At least we knew which direction we should go in.”
Wang isn’t contact tracing anymore, but she continues to volunteer with a team through the AHDC, building a database with town-by-town figures such as unemployment rates and number of health care facilities, which she hopes will be useful in fighting COVID-19. “I really like getting information out of chaos,” said Wang, who hopes to go into data analysis after graduating. “I like that when you look at data, you know what you’re looking at, and what you’re looking for.”
A duty to help
Formerly a nutritionist, Samantha Tweedie, MG20, N20, became fascinated with public health when she entered Tufts’ dual MS Nutrition/Master of Public Health program. “I loved that they recognized that public health outcomes depend on people’s access to healthy food,” said Tweedie, who is studying food systems at the Friedman School and behavioral science and health communications at the School of Medicine. “I started to recognize that I wanted to have an impact on the systems level.” When the pandemic first started, Tweedie found herself at a loss. “I felt helpless for a while, especially when we went into lockdown.”
Then Tweedie signed up as a contact tracing volunteer. Having worked one-on-one with patients, Tweedie felt prepared to deliver information and directions to people who would likely be feeling anxious about their health. She was also eager to learn how the contact tracing operation would work, and how the data collected would be used as the pandemic unfolded. But one motivation rose to the top. “It was an opportunity to comply with social distancing, but also to contribute to this work and help the system as a whole,” she said. “I felt in a way it was my duty as someone coming into the public health field to jump into action.”
Days after signing up, Tweedie began training, which included what information to gather from people exposed to COVID-19; what advice to give them depending on their level of exposure and possible symptoms; and how to follow up with their contacts up to three degrees of separation. Shortly after that, she was matched with the North Reading Board of Health and made her first call to an exposed resident. “It’s been really exciting to start using what I’ve learned in my courses, and get this firsthand experience,” Tweedie said.
When contact tracing moved to Partners in Health, Tweedie went along, taking a part-time paid job to continue doing the work she has started. It aligns with the reason she got into public health, she said. “In my work as a nutritionist, I recognized how many boundaries people faced in terms of getting not only healthy food, but services to allow them to live their healthiest life,” said Tweedie, who hopes to one day do health policy work relating to health care cost transparency or preventative services. “My ultimate goal is to start creating environments where that can happen.”
Promoting awareness—and smiles
Dual-degree student Haillie Crockett, V20, MG20, was hard at work earning her DVM from the Cummings School and her MPH from the School of Medicine when the pandemic erupted in Boston. She had planned to do epidemiology work for the Centers for Disease Control and Prevention (CDC) in person this spring, but when that moved online, she found herself with extra time—and a sense that she had a duty to help.
“Here I am about to graduate with a public health degree and all of a sudden there’s a huge need for public health resources,” said Crockett. “I didn’t know how I would be able to help, but I had all this new knowledge—it seemed like I should be able to use it somewhere.”
Crockett started out doing contact tracing for Belmont and Lexington, but pivoted after Partners in Health took over and is now providing communication services for the Uxbridge Board of Health. It was a bit of a learning curve to start working remotely with people she’d never met, but Crockett has found her groove, she said. Every week, she meets with town officials via Zoom and uses their updates to create a newsletter for local residents. She also throws in items that catch her eye, including a parade of Uxbridge fire trucks and police cars sounding their sirens in tribute to staff at the local hospital, and local students working with their science teacher to make face shields for hospital workers using 3-D printers.
“I’ll think, ‘This is good information,’ or ‘Here’s something to make people smile,’” she said. “If I can figure out the best strategy for communicating how important social distancing and face masks are and increasing compliance even at the town level, it hopefully helps the greater COVID situation and getting ourselves back to normal.”
After graduating, Crockett will be doing a postdoctoral fellowship working with foot and mouth disease and African swine fever, and hopes to use what she’s learning about population health to improve the well-being of both animals and humans. “I’m excited to do whatever I can to help, and it’s really good learning for me,” Crockett said. “Even if one day I want to work at the CDC, it’s important to understand how the local level functions, because at the end of the day that’s where the execution of public health happens.”
Adapting to a changing reality
For Ilana Cliffer, a PhD student at the Friedman School, volunteering was a way to direct her focus on COVID-19 into something useful. “I was following it very closely even before it became a big problem in the U.S.,” said Cliffer, who studied infectious diseases and earned an MPH from Emory College before coming to the Friedman School to research the prevention of undernutrition in children. “When we started to shut everything down here, I was spending all day, every day looking at the rates of increase, making my own graphs, and investigating the outbreak in my own way—but not really in a useful way.”
Cliffer is now serving as the team lead for a group working with the Wenham Council on Aging, managing her fellow Tufts volunteers as they perform wellness checks by phone on residents aged 60 or older. “It’s not just answering questions about COVID—it’s acting as a remedy to isolation for a lot of those citizens,” Cliffer said. Instead of closely tracking COVID-19 numbers and creating her own graphics, she has been contributing to the town’s communications around COVID-19, and strategizing with other team leads about how else to support town boards.
“Being able to concretely help with important local work to keep citizens safe has been an extraordinary way to feel like my obsession with COVID from an academic perspective can actually be put to use,” she said. “And it has helped me to refocus on writing my dissertation and doing other work.”
Making the world a little safer
Many public health students have been balancing their work with local health departments with a full course load, including Ric Bayly, N21, MG21. In his final semester of the dual MS/MPH program, in which he is studying epidemiology with a concentration in epidemiology and biostatistics, Bayly has been taking biostatistics, epidemiology, and fundamentals of public health, and GIS mapping—he hopes to eventually map the COVID-19 epidemic using this technology.
Contact tracing requires a good deal of concentration, said Bayly, who was doing this work for North Reading before Partners in Health took over the effort. “You have to be very careful not to say anything that can mislead or accelerate worry, and at the same time be very sympathetic and understanding of their fears.”
An avid volunteer like many of his fellow MPH students, Bayly coordinated a pilot survey for the Children’s Health Watch last summer, and started teaching nutrition and doing outreach for the Cambridge Health Alliance last spring. Like his classmates, Bayly felt the call to help. “I’m an epidemiologist in the making, and if I’m not involved in epidemiology in the middle of the COVID-19 crisis, what am I here for?” he said.
Bayly feels he is learning on the job, too—especially about COVID-19 itself. “You must have a fundamental idea of the epidemiology of the disease so you’re not providing incorrect information,” he said. “And it definitely gives me very on-the-ground knowledge of what this means for this family, or this couple and their parents, which you don’t get from reading a book.”
Bayly, who hopes to do public health work in the eastern Massachusett area after graduating, said he recently accepted a part-time job with Partners of Health to continue contact tracing. “It’s rewarding to be able to talk with people and to go away knowing they understood what quarantine or isolation measures they should be upholding,” he said. “It’s just the feeling that I’m making the world a little bit safer.”
Monica Jimenez can be reached at firstname.lastname@example.org.