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COVID-19: Reflections from the Emory Outbreak Response Team
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Rosemary Pitrone

Four student members of the Emory Outbreak Response Team — Emi Grill, Aaron Holton, Chiqui Laird and Baffour Otchere — joined faculty leader Jodie Guest, PhD, to reflect on how the experience enhanced their understanding of public health outreach and changed their career goals.

When the pandemic began, a group of students at Emory University’s Rollins School of Public Health came together to bring COVID-19 tests and vaccinations to areas of Georgia hit hardest by the virus. Led by Jodie Guest, PhD, professor and vice chair of the department of epidemiology, the group first responded to the devastating COVID-19 outbreaks among north Georgia poultry plant workers in April 2020.

“At our very first testing event, we tested more than 1,000 people in three hours and caused massive traffic jams in Gainesville,” says Guest. “Since that time, we have performed more than 10,000 COVID-19 tests and brought vaccinations to communities where vaccine uptake was low and where access was limited.” 

The group, known as the Outbreak Response Team (ORT), is part of the Emory COVID-19 Response Collaborative (ECRC), a team of dedicated public health professionals engaged in practice and research focused COVID-19 activities around the state of Georgia.

Four students from the ORT — Emi Grill, Aaron Holton, Chiqui Laird and Baffour Otchere — joined Guest for a virtual discussion to reflect on their experiences over the past year. The students all earned master of public health degrees from Rollins in May and shared how their work during the pandemic has impacted the trajectory of their future careers in public health.

Q: What has it been like to travel the state with the ORT?

A: “Our team has spent many weekends and nights talking about and providing vaccinations in Atlanta and other areas of the state, with a total of 36 pop-up testing and vaccination sites in the past 12 months,” Guest says.

The group often returned to the same locations to strengthen relationships within the communities they served.

“It builds trust,” says Holton. “When they see us out there over and over again, we see some folks eventually go ahead and get vaccinated just based on that — and based on the experience that other folks have had with us. So, just building that trust in the community [through] the repeat visits has been really important.”

The team particularly enjoyed connecting with community members in Downtown Atlanta’s Woodruff Park. “We've referred to it at times as our home away from home, since we've been there several times,” says Grill. 

They also expanded their reach beyond metro Atlanta, trekking north to communities in Hall County and south to areas including Fort Valley, Georgia. Altogether, the group spoke to thousands of individuals across the state.

“We set a marker of success for every event we went to as being a conversation,” Guest explains. “If we had a conversation with one person, even if they didn't find a way to vaccination that particular time, we found that to be our marker of success that we wanted to strive for, and I think it's really important to recognize. I think at some events we were talking on average to 25 people to every one person we vaccinated, so this is a lot of communication and conversations that we've had every time we go out there.”

Q: What role did community partners play in the work of the ORT?

A volunteer administers a vaccine at an outdoor ORT event

Clinical team partners, including members of the Emory School of Medicine Physician Assistant Program, helped administer vaccines at many of the ORT events.

A: The team collaborated with partners from within Emory and the broader Atlanta community. For example, members of the Physician Assistant Program at Emory University School of Medicine often served as the clinical team for vaccination events hosted by the ORT.

“It is so great to be able to bring in another part of Emory and see their training work with what we’re doing to be able to deliver those vaccinations,” Grill says.

Grill served as a liaison between the ORT and collaborators including the Atlanta mayor’s office, SafeHouse Outreach, HEALing Community Center and Fair Count.  

“All of these organizations help us make the events happen, and it's really amazing because it allows us to go more places than we could if we were just trying to make it happen on our own,” she says.

“I think one of the reasons our community partners have been so incredibly important is that it's not just us coming and joining an area of a community or corner of a neighborhood, but it's really us getting the value of folks who are already there and saying that they know us and that they trust us,” Guest adds. “And then that really affords some additional trust in the community as they learn who we are and why we might be there.”

Q: How has the ORT changed the way you have conversations related to COVID-19 and vaccinations?

A: “What I learned from a biostatistics professor was that great research comes with great humility, and I think that applies to public health service as well, most definitely,” Holton says.

“The first thing I would say is to humble yourself; when you're entering into some of these conversations, you have to show that you care,” he continues. “They don't really care that much what you know, and you can't just act humble, and this isn't a performance; you really have to feel it and show it, because we don't have all the answers. Even the most foremost infectious disease experts — we're going into year three of this thing [and] there are still some unknowns out there and some uncertainty. And we have to carry that with us into these conversations and know that what's right for somebody else may not be right for me, and vice versa.”

“The second thing I would say is simply just to listen,” Holton says. “And by listening, I mean active listening, not just waiting to talk. We don't get paid commission for getting people vaccinated. We're out here, we're just having conversations, and you never know where that conversation may lead, so listening is key. Those are a couple of things that have been reinforced for me through the ORT.”

Q: What does it mean to use a “layered approach” in these conversations? 

A: “Essentially, it's referring to the idea that we're meeting people where they are with their attitudes and feelings towards COVID-19 testing and vaccines,” Laird explains. “People are on a spectrum with how comfortable they feel with receiving the vaccine.”

“A lot of people were — and still are — super hesitant to receive the vaccine,” she continues. “They might not receive it after the initial conversation we have with them, just kind of talking about COVID-19 in general. And we're not really going into these conversations as only an epidemiologist, but first and foremost as a human recognizing another human, their experiences and their concerns. So, the layered approach really just goes back to emphasizing the importance of returning back to the same testing and vaccine sites to build trust and a consistent rapport with the community.”

Q: How did working with the ORT enhance your understanding of public health outreach? 

A: “This experience actually highlighted the need for diversity in public health,” Otchere says. “During our different visits to Woodruff Park, there were several instances where people [would] only interact with me because I’m the Black man in the group, and they felt like I could understand the reasons why they are vaccine hesitant. And these reactions are very valid, and I understood because of the dark history pertaining to some public health interventions leading to general mistrust.”

“So, I think it's imperative that for our programs to thrive going forward and for our initiatives to be more effective, we must build public health capacity, and more importantly, encourage diversity in different levels of public health,” he says.

Q: How did you keep up with the latest information related to COVID-19?

A: The group stayed informed with the help of weekly meetings led by Guest. At these meetings, it was a team effort to share the latest data from across the state and country related to COVID-19, and to seek out additional information when needed.

“When we were confused by information, our team was willing to contact state and local health department folks and ask specific questions and bring it back so that we were always all learning together,” Guest says. “That team effort made it easier for all of us to stay on top of all of it.”

“[Having] each other as a resource to be able to not only keep up to date on the latest headlines, but really talk through things and digest and try and apply what we've learned in the classroom to what the latest recommendations mean, and how we can communicate that to the people that we’re going to be going out to serve, I think was probably the most helpful thing,” Grill adds. “And conversations that I had with my family — all of a sudden they were looking to me as a public health expert, and I said, ‘I'm pretty new to this, but I'll tell you how I best understand it, and let's have a conversation about it so that we can hopefully both reach a better understanding.’” 

For Otchere, expert opinions on social media also proved to be a useful resource.

“Personally, discovering ‘epi Twitter’ was a game changer for me,” he says. “It gave me additional reliable information and varying perspectives from public health experts from around the world who are working on different levels of pandemic response.”

Group photo of the Outbreak Response Team

Members of the ORT traveled to communities throughout Georgia to help administer COVID-19 vaccines.

Q: How has your ORT experience influenced your future career in public health?

A: “I only came to the School of Public Health because of the pandemic, and I envisioned more of a research role, but the past couple years and specifically my experience in the ORT has led me to incorporate service more in terms of my personal mission statement and my personal attitude towards my future career,” Holton says. “Right now, I’m hoping to be a servant to the state of Georgia, and specifically the metro Atlanta area, in terms of the COVID-19 response.”

“It's one thing to go watch the news or read headlines about the number of people who've gotten sick or number of people who have passed away from this disease, but actually engaging with people who do have a fear of the virus and potentially had someone who they love pass away from it just kind of makes you realize that what we're doing is with people and for people,” Laird says. “It's not just sitting at the desk doing some data analysis, so that's what I have really appreciated from this experience.”

“I came in thinking I wanted to be behind a computer all the time, getting deep into some data, doing lots of analysis — and I like that, and I'd love to be able to continue doing parts of that, but I think what I was really missing and what I found in the Outbreak Response Team was the ability to engage with the community and really understand why we're doing what we're doing,” Grill adds. “We talk about [humility] a lot in our classes, but I think you really don't get it until you talk to somebody and really see that there's statistics and then there's a million different personal reasons that people have for making their decisions, and what we can do to help guide them towards good public health decisions.”

“It highlighted the importance of partnerships, both within the School of Public Health and outside of it, and in the community as well,” Otchere says. “And it's shown the importance of showing up multiple times, because we have different encounters where at one event somebody was saying no [to vaccination]; subsequently, after having had one or two conversations, if we went back there they were [willing to] get vaccinated or they were vaccinated elsewhere, and I think that's key, because at the end of the day we're adding value to people to make better health better choices.”

“I think we came in as strangers who were trying to get our MPH degrees, and we’re leaving as friends and colleagues who are ready to make a difference, and I’m grateful for every step of this journey,” Otchere adds.

“We have learned from the people we've spoken with in the community and our community partners just as much as we've been able to try to bring good information and answer questions appropriately,” Guest says. “I know I have learned constantly from [the students of the ORT] and from the people we've spoken with and our community partners, and so I think that, to me, is also an incredibly important part of what we've done. Every single conversation we've had has helped shape me and the way I think about engaging in community work.”

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