INTERVIEW | PART 2 Transitioning from Public Health Nursing to Epidemiology With Melanie Rogers, MPH, RN

*Transitioning from Public Health Nursing to Epidemiology during COVID*

What impact did COVID have on your day-to-day role, and how has it evolved?

I wouldn’t say there was a big difference between what I did before COVID-19. I’ve always been a part of a team that focuses on communicable disease control activities. I am part of the local public health department’s clinical services nursing team. My role is to investigate and interview cases of reportable diseases, i.e. enteric illnesses and vaccines for preventable diseases. However, COVID-19 quickly exploded in our area and surpassed what a team of 5 nurses could do. We shut down the health department’s clinical services because of a stay-at-home order and started working remotely.

A shift in my role 

I helped train health department staff who had never done communicable disease control to do case investigation and contact tracing. Eventually, we provided minimal services in sexual health and immunizations once or twice a week. We rotated during this time, one nurse cared for patients, and others focused on pandemic response.

County focused pandemic responses

•  Individual case investigation and contact tracing
• Dealing with COVID-19 outbreaks in ancillary care facilities (jails, long-term care, assisted living, etc.). 
• Targeted COVID-19 outreach testing to populations with barriers to testing, such as homeless encampments

Did COVID and the response to the pandemic influence your transition to the field of epidemiology? 

I had been trying to break into epidemiology since I finished graduate school at the end of 2018. During that time, my local area’s opportunities were sparse; most positions required statistical programming skills that I didn’t have yet. The pandemic brought the CARES Act funding to both state and local public health departments. This opened several epidemiologist positions in my health department.  Since I had experience working in pandemic response and schools, it was easy for me to transition to an epidemiologist positions.

As someone who works in Public Health, how do you feel about the U.S response to COVID-19?

Frankly, it leaves quite a lot to be desired. The lack of national strategic planning for COVID-19 has hindered local public health’s ability to act effectively in many areas. There’s so much suffering and mortality that could have been prevented. I think the U.S’s actions during the pandemic will probably be written about in future public health textbooks as examples of what not to do, which is unfortunate.

What are some steps that could have been taken in response to COVID and testing?

Here are some steps that could have been taken in the early stages of COVID

• A national plan and framework that prioritized science and not political expediency
• Using the Strategic National Stockpile and associated programs to distribute test kits besides other needed items like PPE
•  Ramping up production of useful test kits once officials identified better technology
• Adoption of policies i.e guaranteed paid sick leave and financial support.
  • For households that wouldn’t have to choose between staying home when needed and potentially exposing themselves to COVID-19
• Better science communication about the importance of using masks and face coverings in public spaces earlier on in the pandemic

Bonus Question 2

Is there anything you’d like for our readers to know about epidemiology or the work you are doing now?

I don’t think the stories of people who had COVID and continue to experience long-lasting health effects months and months after their initial infections are being talked about enough. When I hear someone chaffing COVID-19 precautions because they are inconvenient, it is often because of their understanding of the infection.

Many believe individuals who are elderly or have pre-existing conditions are the only ones susceptible to the virus or assume that COVID is a flu-like illness with quick recovery time. I’ve seen some of these long-haul health effects of COVID-19 in the hospitalized cases that I monitor until we know their outcome—discharge alive or death. There need to be more studies around the long-lasting effects experienced by COVID-19 patients and science communicators to break down these findings and publicize them. 

I’ve been following the work of Trish Greenhalgh, a researcher at the University of Oxford, who is doing on the long-term effects of COVID-19. I’ve been following the updates on her work on Twitter (@trishgreenhalg), where she details her co-authorship process with people who have experienced problems long after their initial bout of COVID-19. I’m very excited to read the findings once it’s published. Other researchers working on this literature gap often use the #LongCOVID hashtag to talk about their work if your readers wanted to find more of them.  

Melanie Rogers is also involved with the American Public Health Association Public Health Nursing Section as the Communication Chair. If you have questions about Public Health, Epidemiology, and Nursing or want to talk about all the fantastic initiatives she’s a part of, you connect with her via Twitter at  @MRogersRN.

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