When COVID-19 hit, Oregon State’s College of Public Health and Human Sciences responded to the needs of the community, and students were a significant part of that response.
Kathryn Stroppel, CPHHS’ director of marketing and communications, recently sat down with Jeff Bethel, associate professor of epidemiology, and Sandi Cleveland Phibbs, innovation, evaluation and research manager for the OSU Center for Health Innovation, to reflect on the college’s outreach efforts.
When did you realize COVID-19 was a threat to population health? Did you know you were going to be part of the response?
JB: Once COVID-19 inevitably started spreading to multiple countries, I knew our lives were going to be very different for a very long time. I worked at the CDC during the 2009 H1N1 influenza pandemic and knew COVID could be much worse.
My training and background are in infectious diseases and disaster response, so, I anticipated being a part of a response at Oregon State. I did not know what that response would look like for a few weeks.
SP: My moment of realization was connected to reading social media posts coming out of China. And as soon as there were cases in California and Washington, I knew it was coming here.
I remember having this sinking feeling, but also that it was finally time to use all the pandemic training, plans and tools we’ve been working on collectively for as long as I can remember being in public health.
I also remember thinking how carefully I needed to communicate about the threat. I discussed immediate plans with my spouse — supplies we needed and how we would adjust our lives — and then called my parents. I remember saying, “It’s time to stop going out. You need a month of supplies.” And they totally flipped out — they thought I had lost my mind.
Jeff, can you describe how you mobilized to confront the virus?
The deans of OSU’s College of Public Health and Human Sciences and College of Science were in discussions to bring researchers together to leverage capabilities across campus and those of a land grant university to mount a community response.
People who did not know each other previously came together and quickly got to work. We knew that with limited testing and asymptomatic infections, public health authorities did not have a reliable estimate of the prevalence of the virus.
In response, the dean of CPHHS and myself were co-principal investigators of the project, what would later be called TRACE (Team-based Rapid Assessment of community-level Coronavirus Epidemics), that had the goal of rapidly estimating the prevalence of COVID-19 in communities across Oregon. This was going to be a huge undertaking and ended up being even larger than we had thought.
The team developed a methodology that included field teams going door-to-door to a random sample of households in 30 neighborhoods of a community and inviting all residents to complete a short questionnaire and self-collect a nasal swab specimen. Field teams included students and public health practitioners from the local communities.
The results from the testing of the swabs were used to estimate the prevalence of the SARS-CoV-2 over 13 separate sampling across six different communities across Oregon. TRACE provided vital information to its public health partners to aid in their response to the virus.
Sandi, can you now describe how you mobilized to confront the virus?
We call it the Surge Bench – undergraduate and graduate students integrated within the COVID-19 Response and Recovery Unit of the Oregon Health Authority. The program operates under an intergovernmental agreement.
Our students do everything that public health professionals do for pandemic response – contact tracing, case investigation, data entry, data management, outreach, vaccination efforts, etc. The students receive hourly pay and valuable professional experience. Since August 2020, our students have been deployed to 24 different LPHAs in Oregon and have contributed over 15,000 hours of pandemic response activities.
Another effort, funded by PacificSource Health Plans Foundation, was to promote vaccination in hard-to-reach populations. We again leveraged undergraduate and graduate students to support vaccination clinics around the state.
There were notable collaborations with Juntos en Colaboración, focusing on Spanish and Mam-speaking populations in coastal Oregon; OSU Extension’s EXCITE Program, also promoting vaccination to Spanish-speaking/Latino population; and Medical Teams International, focusing on rural areas. We also developed partnerships to support specific vaccination needs in Marion, Polk, Jefferson and Crook counties.
What were the biggest challenges you had to overcome?
JB: TRACE had numerous challenges to overcome, from appropriate lab certification to the Institutional Review Board. However, one challenge, which ended up being a success story, was the rapid recruitment and training of field teams.
Field teams comprised a team lead and a student. Team leads were people with backgrounds in health, health care, public health, allied health, etc. and led all interactions with household residents including introductions, obtaining informed consent, administering a short interview, and walking participants through a self-collected nasal swab specimen.
Students were vital members of the field teams and were in charge of navigating assigned neighborhoods, maintaining all paperwork, and completing a tracking sheet to document the outcome of each house visited.
We were able to leverage existing relationships in counties across the state to identify team leads who were, importantly, from the communities where we were sampling. CPHHS Family and Community Health Extension faculty were critical in making these connections and getting the word out that TRACE would be in the community.
The response from OSU students was astounding! Students from across campus, not just public health, eagerly joined the team and performed extremely well in the field. The application to join TRACE included a question asking why the students wanted to join, and the most common response was that they wanted to contribute and make a difference in the community. They certainly did!
SP: Integrating and on-boarding students to the state’s data and surveillance systems was technically complex, and there wasn’t enough IT support to work through IT issues. Once trained, it took our students an average of six weeks to get access to OPERA and they could not begin case investigation without this access.
The situation with state and local public health partners was highly dynamic – plans changed quickly and often. We thoroughly trained our students to be flexible and adaptable, and communication and coordination became everyone’s job.