ASPPH COVID-19 Storytelling Project: How Schools and Programs Made an Impact During the Pandemic

The pandemic was felt similarly on Arcadia University’s campus as it was worldwide – from cautious optimism at the beginning of the pandemic, to realizing the need for a significant shift in priorities. Dr. Suzanne Redington, assistant professor, who provided vital support to Department Chair Dr. Margaret Longacre, and the broader university response, shares: “Once we all moved past the realization that COVID was happening, there was a continued hope that it would be temporary and be over in a few months at most. The university’s global presence required their swift attention to the rapidly unfolding public health concern in the early months of 2020. Our efforts for the remainder of that semester centered around two main things: (1) supporting our students and (2) supporting each other. We found it important to talk to each other and assist each other as we learned how to teach and work from home during a pandemic, often while having increased caregiving responsibilities or other strains. It was a daunting task for all involved and not without its challenges.” 

Arcadia’s programs met logistical challenges head on and collaborated to overcome them. “We realized there was no perfect decision in this scenario,” Longacre says. “The programs within our College of Health Sciences worked collaboratively to know what each program was doing over the summer of 2020 in response, including a guiding document that was regularly updated. This allowed for learning from each other during an experience that was new to all of us.” 

Among the academic challenges was the issue of burnout. Redington explains, “The burnout experienced by our students and employees was, and is, incredibly challenging to address. This ebbs and flows, and the experience is different for everyone. Having to constantly adapt and make decisions based on ever-changing information due to the progressing pandemic takes its toll. Mental health resources have been made available to students and employees. We have talked to each other, shared resources, provided opportunities for social engagement (virtual and in-person) and established a culture that values mental health care. But this is the long haul, and we still experience times of burnout. Thus, we consistently go back to some of those previous approaches that have worked. We also continue to learn to prioritize our efforts and ask for help from others.” 

“One of the biggest lessons we learned was the importance of adaptability and flexibility. COVID pushed all of us to adapt in ways we never expected. Sometimes this pushed us to accomplish things sooner than we intended, like integrating more variety into how we engage students in our classroom. Sometimes this required us to accomplish tasks differently, like participating in Zoom meetings or teaching while at home with children in quarantine or learning from home themselves,” Longacre says. 

Redington summarizes that “Arcadia decided early in the pandemic that they would prioritize the health and safety of the university’s global community. This held true even if an action or response was not the ideal business decision. That doesn’t mean that the university paid no mind to the financial aspects of its response to COVID. They made a conscious effort to put their community’s well-being first and had confidence that they had the wherewithal to accomplish this while addressing any potential financial impact. This created a culture of valuing data and other scientific evidence in the decision-making process. Expectedly, there was never a time when everyone at the university was happy with a decision related to the COVID response, but the university was always clear about its values.” 

“Rather than one clear moment, the growing threat of the pandemic occurred in small stages, addressing increasing student needs while responding to multiple requests from local and state public health agencies,” says Director of Communications and Marketing Rob Schroeder at the University of Illinois at Chicago School of Public Health. “Our approach was to remain flexible to meet student concerns and academic needs, while adapting to the latest public health guidance.” 

Adds Dean Wayne Giles, “It became clear to us as a school that in a moment of global crisis, this was public health’s moment to lead and shape a response that recognized social, economic and political determinants of health.” 

When the COVID response started in March 2020, the School was receiving requests for support from multiple health departments including the Illinois Department of Public Health, Cook County, Chicago, as well as a number of community-based organizations, businesses, and faculty and staff at UIC. They found that many of the requests were getting lost and faculty were overburdened by the pleas for help. Schroeder says, “We created an incident command structure with one email address to handle all requests. The email address was monitored 24/7 and we made sure that we responded to all requests in a timely manner. Members of the incident command structure included faculty and staff across all academic departments and the administration. There was initially an incident command meeting twice weekly which as the pandemic evolved went to weekly and then monthly meetings.” 

Along with civic organizations and city leaders, UIC co-led the launch of ChiTracing, a corps of Chicago-based contact tracers composed of community members new to the field of public health. Along with developing training for the crucial task of contact tracing, they also focused on developing citizen scientist and research skills among contact tracers to bolster public health capacity in Chicago communities. They also led the development and implementation of the UIC COVID-19 Contact Tracing and Epidemiology program, providing contact tracing and resources for quarantine and isolation to the 45,000 members of the University of Illinois Chicago campus community. 

Schroeder mentions that “the COVID pandemic exacerbated systemic disparities by income, education, occupation and race, which are caused by poverty, residential segregation and racism. It was imperative that we addressed, and continue to address, these structural barriers to health to ensure that all have an equal opportunity to obtain their optimal health.” 

He points to the Center of Excellence in Maternal and Child Health, which recognized a need early in the pandemic to ensure pregnant people headed to a hospital to give birth were equipped with adequate PPE. “The Center brought together maternal and child health advocates and volunteers from around the state to create homemade masks, to protect pregnant moms and health care workers alike. This effort came at an early stage in the pandemic, before masks were universally adopted and readily available.” 

He says there are still lessons to be learned. “1. The value and importance of timely hyperlocal data to identify communities at greatest risk and target interventions to those communities most in need; 2. The need to have a community-engaged approach that includes community health workers to implement interventions. Our researchers have stressed that public health interventions only go as far as public buy-in allows. We see a key need to develop and strengthen citizen scientists to assist in future public health endeavors and build community support for such efforts.” 

“The New York University School of Global Public Health (GPH) is a young school, located in what quickly became the global epicenter of the COVID-19 pandemic,” Julia Cartwright, the senior associate dean of communications explains. “The pandemic was both an enormous challenge and a remarkable opportunity for our faculty, staff and students.” 

She continues, “In early 2020, along with the rest of the world, we watched in horror and trepidation as Wuhan locked down. We had several students there in China, and we watched along with the world, seeing people in quarantine in their apartments, waving from their windows, with the streets and highways oddly silent as traffic completely ceased. It was surreal and we knew it was only a matter of time before cases began to show up in the US. Then-Commissioner of Health for the State of New York Dr. Howard Zucker, who serves on the NYU GPH Advisory Board, was invited to speak on campus on February 29, 2020, with a panel of our faculty experts to follow. The commissioner was called to Albany to meet with the governor, so this prescient event quickly switched to having him speak from the state capitol, and our panel was in-person on campus at NYU. It was one of our most attended events, as people were just starting to realize the inevitability that the virus was already in the city and starting to spread. Understanding COVID-19 became the first of numerous hybrid and online events we would host as the city and our school galvanized for the coming pandemic.” 

She says, “The rapid spread of cases became fully evident late in February and March 2020. On March 11, 2020, the World Health Organization declared the virus a global pandemic. Then on Friday, March 13, 2020, our faculty, staff and students were advised to begin teleworking. We locked up our office doors that evening, thinking we might be back in a few weeks. We had no idea that we would remain teleworking for two years. The experience of the GPH community could be felt despite the distance.”  

Cartwright says, “Our classes shifted online and we began to recognize how resilient and nimble our faculty, staff and students could be — but it came at great cost. Family members lost their lives to COVID, and everyone felt great anxiety but the obvious need to soldier on.” 

For GPH, the lessons learned during the pandemic will be with them for a long time. “We learned about the resilience of the human spirit and despite the obvious challenges, the unexpected ways people can rise to nearly insurmountable challenges. Over the course of the worst months and years of the pandemic, the nation lost over 1 million Americans to the virus. Globally, over 6.5 million lost their lives,” Cartwright says. 

Important public health leaders spoke at the GPH: “Dr. Fauci and Dr. Walensky both graciously agreed to be our graduation keynote speakers in 2021,” Cartwright recalls. “And, in what has been dubbed ‘The Fauci Effect,’ despite all the hardships and sacrifices, prospective students are answering the call in record numbers to enter the field of public health.” 

“Here at GPH, our student body has doubled in size, and we have great optimism that along with graduates from our sister schools in public health nationwide, we will together rise to this challenge.” 

While many would identify early March as the key month for the start of the COVID pandemic, the faculty at the University of Florida College of Public Health and Health Professions were well aware of the looming threat from COVID-19 in January 2020. At that point, faculty began considering strategies to prevent disease spread and to develop an evidence base that would allow for the most effective policies. According to Dean Beth Virnig, “In March 2020, it was absolutely clear that COVID-19 was a direct threat to student safety when college leadership learned that students with patient care responsibilities had been exposed to an individual who tested positive for COVID-19.” 

The college quickly communicated a variety of steps to protect students, faculty and staff, patients and research participants. Strategies were based on the college’s deep understanding of control of contagious respiratory diseases and emphasized sanitation, distancing and use of PPE. The college also adapted to a fully online course delivery within a week and avoided the confusion, inefficiencies and major hurdles faced by some others. “We had the benefit of early attention to the potential challenges and a curriculum that was overwhelmingly in a blended format. Because courses were already blended, the content for the entire semester (videos, online activities, digital reading materials and presentations) had been produced and made available through the learning management system. Face-to-face activities were easily transitioned to synchronous Zoom sessions and online assessment proctoring since the faculty were already very proficient with educational technologies used in their blended courses,” says Dean Virnig. 

Because of existing expertise and infrastructure, faculty, staff and students were able to mobilize quickly on several fronts. As an example, Florida needed testing and contact tracing capacity. Key to this was widescale COVID testing. Four years prior to the pandemic, PHHP Professor Dr. John Lednicky, a virologist who has studied coronaviruses for decades, had developed a coronavirus test that he found was a good match for SARS-CoV-2. His test was used to test thousands of people in Gainesville and central Florida in the early stages of the pandemic. In addition, faculty, staff and students in the department of environmental and global health built a high throughput testing lab in just 10 days to meet the massive demand for local testing, including for residents of The Villages, Florida’s largest retirement community. 

In addition, members of the department of environmental and global health developed a wastewater surveillance system to serve a nearby island community, the city of Gainesville and the UF campus. UF is unique in that it has its own wastewater treatment facility, which allowed faculty to narrow testing results to specific student residential buildings. When increased virus levels were detected in a building, residents received targeted text messages advising them to get tested. The wastewater surveillance team has now partnered with other UF teams to use the technology to detect bacteria and chemical markers of health, such as pesticides and illegal substances, in wastewater. 

Using innovative sampling techniques, Dr. John Lednicky and colleagues in the UF College of Engineering published results in summer 2020 that provided some of the first evidence to the international public health community that SARS-CoV-2 can be spread through aerosol transmission, not just respiratory droplets. News outlets such as The New York Times called this the “missing piece of evidence that infectious virus can be found in the air.” 

As a member of the World Health Organization Solidarity Trial expert group, professor Dr. Ira Longini has helped lead the design and analysis of clinical trials testing COVID-19 treatments and vaccines. The Solidarity Trial is a first-of-its-kind international clinical trial enrolling tens of thousands of participants across dozens of countries. 

Several faculty members in the college generously shared their time conducting numerous interviews with news media to help educate the public and dispel misinformation. Their efforts included video news releases, informational Q&As, Facebook live interviews, standing interviews on an international radio station and opinion pieces in national mainstream media. These stories generated more than 13,000 media hits. 

The greatest challenge, though, was managing the uncertainty associated with the virus. Says Dean Virnig, “The transmission models were being developed in real time and were, initially, quite inaccurate. Every policy involved evaluating tradeoffs. No one expected that COVID-related disruption would be as long lasting as it was. There were few policies or guidelines about managing risk to students, staff and faculty. We had to develop a comprehensive plan to ensure educational, research and service programs could be continued at the highest levels possible while protecting the health of our students, employees, patients and research participants; to assist the state and county with their requests for public health workforce and consultation assistance; and to support workplace flexibility for employees who needed to care for children or other family members at home.” 

There were lessons to be learned. Says Dean Virnig, “The pandemic showcased students’ and employees’ capacity for flexibility and resiliency in a way we have never seen before. The pandemic, along with other events over the past two years, also highlighted the interconnectedness of environmental, social and racial justice and the role public health must play in addressing injustices. Beyond improving US public health infrastructure, such as better personnel training and faster deployment of interventions, a lesson learned for the next pandemic is the importance of basing public health decisions on scientific findings rather than political influence. The more we can educate the public about the science of disease prevention and simultaneously engender a sense of social responsibility, the better able we will be in managing future outbreaks of infectious diseases.” 

She adds, “While the pandemic created many challenges, it also led to several surprises, particularly in our educational mission. For example, in the Doctor of Physical Therapy program, which requires a face-to-face component to meet accreditation standards, students were organized into small teams of five or six students who remained together for the entire semester for all course activities. The program also partitioned the classroom into three segments that fit a limited number of groups, in order to limit COVID-19 exposures. Unexpectedly, instructors and students alike preferred the small group design. It promoted greater learning and more accountability from students. Similar silver linings arose in the communication sciences master’s program when students were not able to complete scheduled clinical placements in spring and summer 2020. A faculty member stepped up to offer an online practicum and online clinical case series featuring experts from across the state who covered a large array of health conditions. Students felt they received greater exposure to clinical issues than they may have otherwise, and it filled an important need until students could get back in the clinic. Master of Public Health (MPH) students were given tremendous opportunities to respond to a public health crisis in real time, especially the dozens who were employed as disease investigators with Screen, Test & Protect. For one MPH student in particular, Screen, Test & Protect offered her a job with relevant experience after she was furloughed from a restaurant server position. She not only gained new confidence in her abilities; she identified a career interest in hospital infection prevention. Following graduation, she accepted a position as an infection preventionist at a Florida medical center.” 

For faculty and staff at the University of Nevada, Las Vegas School of Public Health, the moment of realization that COVID-19 would become a dire threat was when they started seeing cases among their own school community, and the numbers started to climb quickly. Says Dean Shawn Gerstenberger, “We knew that we needed to respond. Immediately, we began to assemble our own experts and reach out to community partners to figure out what our response would be. Collaboration with the state health department and Southern Nevada Health District in order to come up with a plan on how to address this issue with students was critical.” They continue, “Being located in Las Vegas, one of our unique assets at the UNLV School of Public Health is the fact that we live in one of the most diverse communities in the nation, and we have a diverse student body. Therefore, we were thinking about how we could use this to our advantage to inform people, protect them and provide credible information.” And they did. 

The UNLV School of Public Health helped the university develop an incident management team and had their own epidemiologist and disease expert Dr. Brian Labus take the lead. According to Dean Gerstenberger, “We pulled people in from different parts of campus including housing, student health and wellness, classrooms, online education, communications, public affairs and more. We put chains of command processes in place and also coordinated with the Nevada System of Higher Education to ensure everything was consistent with other institutions across the state.” 

They continue, “The goal was for us to best communicate a plan for how things would look at UNLV not just weeks from the start of the pandemic, but years. Based on what we know about infectious disease, we knew this would affect us for at least two years – which no one else initially believed when we predicted this. Once the incident management team was put together, our school helped them create and craft information for the university to address the many questions people had. The university ultimately created a COVID-19 website where faculty, staff, students and community members can go for the latest information, news, announcements and resources. We filmed Q&A videos and even held a special webinar featuring our faculty and experts at the health district to answer our community’s biggest questions about the virus while also encouraging public health practices on how to prevent COVID-19.” 

UNLV School of Public Health also received $5.1 million in grant funding from the State of Nevada to partner with the Southern Nevada Health District and employ university students to assist in reaching out to individuals who may have been exposed to COVID-19. Says Dean Gerstenberger, “What started out as a volunteer team of only a handful of students led by Dr. Brian Labus eventually expanded to nearly 240 paid contact tracers who spoke 29 different languages. More than 1,100 students initially answered the call to become a contact tracer. Once selected, those hired underwent comprehensive training, which included learning the contact tracing system and spending time making calls under supervision at UNLV. These students were all trained and led by a group of 15 experienced UNLV graduate students. This team helped investigate more than 38,000 cases, accounting for 1 in 6 COVID-19 cases investigated in Southern Nevada.  

Reaching out to the community’s most vulnerable and minority populations was also critical. In spring 2020, the Nevada Minority Health & Equity Coalition (NMHEC) within the School took on this challenge and created the One Community OneResponse initiative. NMHEC brought together community partners and helped to create specific COVID-19 toolkits and resources for people in seven target populations: African American/Black, Native American, Hispanic, Asian, Pacific Islander, LGBTQ+, and Deaf or Hard of Hearing. As part of this effort, an “Amplifying Equity” webinar series was also created. With more than 25 webinars since summer of 2020, NMHEC and the School of Public Health featured experts to talk about COVID-19 from the perspective of these different communities in order to better reach out to them and help them navigate the questions and concerns they had during the pandemic. 

They note that communication overall was tough, especially the full process of figuring out how to effectively communicate some of the changing rules of things like quarantine process and how to make people understand these decisions. “The reality was that the more we found out about the virus, the more knowledge we now had. So, while things seemed contradictory, they weren’t,” says Dean Gerstenberger. “We as public health professionals had to learn as we go, just like everyone else in the community and around the world.” 

The Dean says that “the biggest lesson these two years have taught us is how we are far behind on public health preparedness, which is unfortunately one of the first things that gets cut in terms of funding. Especially in the state of Nevada, we have had a chronic underinvestment in public health infrastructure. This is crucial for public health response and helping to fund more qualified workers, laboratory, communication and more. We have a little brighter light on our field now because more people know what public health is because of COVID-19. However, we still don’t have the proper investment because people don’t hear about us for the most part if we’re doing our job. We overall need to do a better job of communicating public health, both when things are good and bad.” 

Gersetenberger adds that “COVID-19 demonstrated how a public health crisis — something we were unable to manage very quickly — impacts every part of a community. Public health is everywhere. In Las Vegas, it impacted tourism, gaming, economy, food, supply chain and more. This pandemic shut down a city of 3 million people and even closed down casinos – something we’ve never seen before. It really showed how important public health is.”

Faculty and staff at the University of Nebraska Medical Center College of Public Health undertook a number of important initiatives to respond to COVID-19. One of these was aimed at protecting food and commercial essential workers. During the COVID-19 pandemic, an estimated 30 to 50 million people had jobs that were deemed essential. These people were required to consistently and physically be present at their workplace because their jobs were critical to public safety, national security and societal function. The United Food and Commercial Workers (UFCW) International Union represents more than 1 million of these essential workers. To better understand their members’ workplace conditions, experiences and attitudes during this critical period, UFCW leadership partnered with researchers at the University of Nebraska Medical Center (UNMC) Colleges of Medicine and Public Health in the spring of 2021 to create the UFCW Essential Worker Health Survey (EWHS). The goal of this survey was to collect reliable pandemic information and encourage employers to implement stronger workplace safety measures to protect their workers. 

During surveys conducted from July 2021 to May 2022, new monthly COVID infection rates rose from 2% to 15% among UFCW member respondents. These rates of infection were 10 times higher than U.S. incidence rates during the same period. Six percent of respondents who contracted COVID needed to be hospitalized, which is a significantly higher rate than the nationwide 2% rate of hospitalization. These results highlight the great sacrifice America’s essential workers made during this pandemic to keep their communities running and inform future strategies to protect essential workers exposed to infectious diseases at work.  

“This UNMC study makes clear that COVID-19 has — and continues to have — a serious and significant impact on America’s essential workers,” said Marc Perrone, UFCW International president. “These essential workers paid a hefty price for continuing to do their jobs, which kept food on American families’ tables and our economy moving throughout the pandemic.” 

“Policies to protect these essential workers are critical to weathering the current surge of COVID cases nationwide and being ready for the next pandemic,” said Ali S. Khan MD, dean of the College of Public Health, UNMC. 

The UNMC College of Public Health has been particularly focused on meat processing (meatpacking) facilities, as over half of the meatpacking plants in the U.S. are located in the Midwest. Meatpacking is an important industry to the state of Nebraska — producing millions of dollars of economic impact and directly employing nearly 30,000 residents. Much of the meatpacking workforce consists of immigrants, refugees, racially/ethnically diverse workers, veterans and people with justice system involvement. For these vulnerable workers, COVID-19 exacerbated their already precarious circumstances. It intensified the stability of work itself, as employment became increasingly insecure, unstable and uncertain for many people, with limited protections and control over their working conditions.  

Early in the pandemic, a UNMC team developed a tailored playbook for the meat processing industry with best practices to control transmission of the virus (released prior to CDC guidance for employers). The team conducted 14 site visits to facilities across the state to assist facilities in controlling infection risks. In May 2020, a survey¹ of 585 Midwestern meatpacking workers was conducted to understand how the work environment had responded to the COVID-19 threat. Recommendations from this study, such as paid sick leave, physical distancing of line workers and culturally and linguistically tailored education were promoted by state legislators to enhance pandemic protections for workers.  

In 2021, an exposure assessment study was conducted to explore SARS-CoV-2 transmission risks. As part of this study, the team collected air samples and assessed ventilation and air flow throughout three meatpacking facilities. The team also interviewed 50 workers to learn about their experiences as an essential worker during the pandemic. Workers described the plants to be places that consistently prioritized production over people: “I do not consider the plant where I work safe,” one of the workers explained. “They only care about filling their production, and they do not care about the health of their workers or the risks of it.” The study resulted in several recommendations, including reducing density of workers and modernizing heating, ventilation and air conditioning (HVAC) systems (e.g., balancing air flow, using higher efficiency filters). It also highlighted the need to focus attention and interventions on crowded common spaces and demonstrated that the design of buildings reflects a prioritization of food safety and production over human health.  

Further, when hospitals throughout the U.S. faced a critical N95 respirator mask shortage, UNMC and Nebraska Medicine experts decided to tackle the problem. A team was set up, led by John Lowe, UNMC assistant vice chancellor for Inter-professional Health Security Training and Education in collaboration with Nebraska Medicine infectious diseases experts, like Mark Rupp, MD.  

“The shortage of PPE is a nationwide issue — each and every one of these items is increasingly precious,” Dr. Rupp says. “Although we were well prepared, our supplies are beginning to dwindle. We had to find a way to keep our providers and patients safe.” 

This team decided to use the ultraviolet (UV) light tower usually found in the Nebraska Biocontainment Unit and used to decontaminate rooms after patients leave. The ultraviolet light disrupts the coronavirus’ genetic material, deactivating it, making masks reusable for their original owners. This innovative solution was attractive to hospitals as this technology was already available to most of them and the process of decontamination was fast. 

Although this solution is only recommended in emergency situations, it helped expand the availability of masks, which were becoming a scarce resource, and responded to the crisis the country was facing.

1[1] Ramos, A.K., Lowe, A., Herstein, J.J., Trinidad, N., Carvajal-Suarez, M., Quintero, S.A., Molina, D., Schwedhelm, S., & Lowe, J.J. (2021). A rapid-response survey of essential workers in Midwestern meatpacking plants: Perspectives on COVID-19 response in the workplace. Journal of Environmental Health, 84(1), 16-25. 

There were various points at which there was a growing awareness of the potential threat that COVID-19 posed to the globe, the U.S. and more specifically Utah, University of Utah Public Health Program, and its campus. According to Kimberley Shoaf, DrPH, professor in the program, “Early in January, many of us in the program expressed our concerns with the growing threat and discussed where we thought it would go and how it might impact us. Utah had an early case from the Crown Princess, which served as a very stark threat to the state. Many of us fielded calls from colleagues and friends around the country as to what they should do personally, for their businesses and families.” 

Working quickly, the group put together a survey of faculty expertise in the Division of Public Health and the other divisions within the Department of Family and Preventive Medicine to share with the university health communications team. Faculty offered their expertise in infectious disease epidemiology, environmental health and emergency public health with the university. Much of that expertise was not initially utilized as many saw the growing pandemic as more of a medical problem and not a public health issue. Within the division itself, administration and faculty members began to discuss pivoting to online classes and a work-from-home setup.  

As the pandemic grew in scope and severity, the State of Utah, Salt Lake County and the University of Utah realized the potential magnitude of the problem. Utah was the first state to cancel classes and invoke public health orders to close non-essential services after Rudy Gobert of the Utah Jazz tested positive for COVID and the NBA cancelled not only the upcoming game but the entire slate of NBA games for four months. This occurred on March 11, 2020, which coincided with the beginning of spring break at the University of Utah. The return to classes after the break was cancelled and the university pivoted to online instruction and work-from-home for the remainder of the spring semester.  

Despite the monumental shift in their usual working conditions and responsibilities, faculty in the division reached out to public health partners in Salt Lake County, the Utah Department of Health (now the Department of Health and Human Services) and the other local health jurisdictions to offer assistance with contact tracing, ICS, hotlines and other services. The division has a history of providing students, with faculty guidance, assistance with emergency response operations, having previously done it during the measles outbreak of 2015. On the first day of COVID response in Salt Lake County, a number of Utah students were deployed to the poison control center, which had been repurposed as a COVID hotline.   

Of this effort, Dr. Shoaf says, “We were fortunate to count on a great deal of expertise within the Division of Public Health that was relevant to responding to this public health emergency. Within our faculty we have a former EIS Officer who specialized in infectious disease epidemiology, an infectious disease MD/environmental engineer, an environmental engineer with specialty in infectious disease, a specialist in emergency public health and a former UDOH employee who directed the state’s PHEP program. Further, three of these individuals were in leadership roles in the Division at the beginning of the pandemic. This allowed the Division to make decisions for our faculty, staff and students as well as provide expertise to the University based on the best available evidence.”  

Shortly after the initial wave of cases in Utah, the Utah Department of Health requested that the Division of Public Health stand up a cadre of contact tracers to function as surge capacity for UDOH and the local health departments. Sharon Talboys, PhD, and Dr. Shoaf led those efforts. Under contract from UDOH, more than 700 individuals were screened, hired, trained and functioned as surge capacity for the state for a period of time stretching over 24 months. At the peak, the program provided 250 contact tracers to the effort each week. The contract shifted to an on-call contract in May of 2022, making it possible to surge a much smaller cadre of contact tracers with a two-week notice when cases surged beyond the capacity of the state and local public health departments.   

Amid the successes of their contact tracing effort, the division encountered significant challenges during the pandemic. “The first [challenge] was the struggle to maintain the normal academic responsibilities for those faculty who were functioning as public health practitioners on behalf of both our public health practice partners and the university,” says Dr. Shoaf. “For the team that functioned as part of the university incident management team, those roles, particularly in the first year, often exceeded 50 hours/week. In the meantime, those faculty were also teaching classes, attempting to conduct research and advise students. The second challenge was a result of attempting to implement best public health practices at a state institution in a state with a legislature that declared the pandemic over and ending the ability to issue mask mandates in April 2021 and requiring in-person classes and no mask requirements in fall 2021. While university leadership wanted to do what was right to protect the faculty, students and staff, their hands were often tied by the legal and political climate. However, in spite of these hurdles, the university throughout the last two years had higher vaccination rates, lower positivity, better compliance with quarantine and isolation, and overall better health than the surrounding community.”  

While the challenges they faced were significant, the pandemic nevertheless provided opportunities for learning and growth. Of lessons learned through the pandemic, Dr. Shoaf says, “The change that will have the greatest impact on our ability to respond to future public health emergencies is to raise awareness of the incredible unwavering dedication of public health practitioners and academicians to the health of their communities. If politicians and the general public truly understood the dedication of these heroes, we would not have seen some public figures dismiss their (our) value in responding to this catastrophe. The lack of understanding of what public health does was often discussed prior to the pandemic. Little did we understand the impact that lack of understanding would have on our ability to respond. The second lesson that needs to be re-learned is that all public health is local. The CDC provides guidance and, ideally, trusts and collaborates with academic public health to do the science necessary to develop that guidance. But it is the state and local practitioners who need to take the lead for their community. Often during this pandemic, CDC would change the guidance and announce it through the media. Practitioners on the ground were left scrambling to change their policies and procedures, while their communities and elected officials were challenging them that they weren’t in compliance with the CDC.”  

“The United States spent much of the early 21st century planning for this event that has been occurring over the last 30 months,” Dr. Shoaf concludes. “Funding to state, territorial, local and tribal public health for public health emergency preparedness has been declining since 2008. There was an academic program funding schools of public health to work with those public health agencies to provide training, exercises and technical assistance and conduct research into the best way to protect the health of the population during public health emergencies. We need those systems funded today.”

In late February 2020, it became clear that COVID-19 was going to have a significant impact on the campus community and beyond. The news of European countries enforcing lockdowns was looming large as the U.S. braced for the growing threat. Says Lee Pearson, associate dean of operations and accreditation at the University of South Carolina Arnold School of Public Health, “My personal moment of realization came when I e-mailed our then director of student health services, Dr. Debbie Beck, prior to spring break and offered my assistance if needed. She and I had worked together on our campus pandemic plan back in 2009 during the swine flu outbreak, and I thought it would be helpful to reconnect given the growing concerns over COVID. She had a simple response: ‘Send me your cell phone number.’ That one e-mail began an intensive partnership of daily interactions that continued for more than a year as we worked with an array of campus and community partners to navigate the challenges of the pandemic.” 

UofSC was quickly mobilized to confront the threat of COVID-19. The president at the time, Bob Caslen, was a former army general who developed an immediate “battle plan” to focus the resources of the campus and begin to manage the impact of the virus. Like other colleges and universities, UofSC shifted suddenly to a virtual learning environment, but the President’s focus was on the future — particularly the fall semester and the question of how to safely resume in-person learning.  

Thus, UofSC’s campus was mobilized under the banner of the Future Planning Group with numerous teams addressing key aspects of campus operations. Team #1 was public health, including 24 individuals from across the university’s health sciences and health services as well as vital community partners from the state health department and the regional health system. While each team in the future planning group worked collaboratively to implement campus mitigation protocols and to plan effectively for returning to campus in the fall, it was the public health team that was asked to inform decision-making every step of the way. 

But the most important action within the Arnold School was to structure the public health team to include an effective mix of scientists and practitioners who were able to translate the evolving information on COVID-19 into workable mitigation strategies. The most effective campus initiatives included establishing a strong partnership with the City of Columbia — essential for an urban campus — and fostering the committed engagement of student leaders.  

There were challenges, says Associate Dean Pearson, in staying ahead of the information and effectively communicating their actions. “When you are surrounded by a campus of researchers and scholars, they are always bringing new information to light. It was essential to keep pace with that and to communicate frequently with our audiences of faculty, staff, students, parents and community partners. Over-communicating was the intent, when possible, but it was often quite challenging to keep up that effort amid the daily (and hourly) tasks at hand.” 

Pearson points to lessons learned: “Focused leadership is absolutely vital in a crisis. Having a solid, decisive voice at the helm gave clarity to our purpose and efficiency to our charge. The second lesson is that communication is essential. Both internal and external communication efforts were vital in setting and managing expectations, allaying fears and ensuring collaborative problem-solving. Consistent communication was also a key ingredient in our successful return to campus in the fall of 2020.  

Pearson continues, “To improve pandemic response in the future, there are several necessities: 1) Adequate funding is needed for the public health system at the local, state and national levels; 2) A robust professional workforce is needed to sustain public health into the future, and there is essential training needed to enhance overall capacity in public health preparedness; 3) And public health systems must be enabled to operate free of undue political influence in order to implement sound decisions and right actions informed by the science and available data.”  

Pearson adds, “Public health is vital, but it is often least visible when it is working well. We need to find ways to make public health more visible outside of a crisis. Our field will thrive best when people know its value in their daily lives. We must champion our value!”

“As a former CDC scientist for almost 20 years, I have dealt with pandemics before,” says University of Pittsburgh School of Public Health Dean, Jonas Salk Professor in Population Health, Professor in Environmental and Occupational Health, Maureen Lichtveld. “What was and continues to be most surprising is that we are inadequately utilizing our knowledge of and experience with pandemics to counter COVID-19.” She stresses that our response to the pandemic lacked three fundamental components: 1) public health leadership and thus a systems-driven approach; 2) sustained investment in the floor of our public health home: the infrastructure that includes people, health departments and surveillance systems; and 3) the golden principle of crisis communication: be first, be right, be credible.”   

Dean Lichtveld joined the University of Pittsburgh School of Public Health in January of 2021, when a new wave of COVID-19 cases gripped the nation and morbidity and mortality rates were spiking again. While most of the university was working remotely according to pandemic guidelines, she decided to be in the office every day to serve as a beacon in the sea of uncertainty. She adds, “As a collaborative leader in a new deanship, I exercised this critical aspect of leadership almost exclusively in the virtual space. Daily meetings with our executive team and all-hands introductory meetings signaled the start of a new era at Pitt Public Health and facilitated us moving forward.”      

At the start of the pandemic, the school successfully switched to offer remote classes and other programming. This included celebrating them through virtual graduation ceremonies when they couldn’t safely meet in person. 

In addition, led by their Senior Vice Chancellor of the Health Sciences Dr. Anantha Shekhar, the University of Pittsburgh instituted a health care advisory group to support and guide the medical response office. This group provided 24/7 advice and aided in communicating public health safety measures university-wide. Two of Pitt Public Health’s department chairs are members of the group — contributing their pandemic and infectious disease expertise to the university’s response and giving them firsthand information. “Having familiar faces fulfilling these important roles was very comforting to us all,” she says. 

She notes that it was important to not delay in introducing her vision for the school, which included four strategic imperatives: precision public health; climate and health; diversity, equity and inclusion; and developing the new Bachelor of Science in Public Health program. She says that “the latter has already been accomplished! Each of these imperatives relates directly to the pandemic and our mission: tailoring our responses to any health threat to the most vulnerable communities (precision public health); dealing with an even greater and more persistent threat often resulting in a cumulative health burden (climate change); targeting our actions to those who need it most (DEI); and growing a diverse cadre of emerging public health leaders (BSPH).”

At Tulane University School of Public Health and Tropical Medicine (SPHTM), COVID-19 was an obvious opportunity to live out its mission of acting as stewards of the first school of public health in the United States.  

“We encouraged our faculty and students alike to be innovative and independent thinkers, mobilizing a gift from a generous donor to support immediate, grassroots efforts to help the Greater New Orleans community. This funding helped older Vietnamese Americans in an underserved neighborhood get information (in both English and Vietnamese) and provided mitigation tools like masks and hand sanitizer. Funding also helped a local community health center address the mental health of patients in light of the pandemic while separately assisting the center to switch to telehealth,” says Senior Director of Communications Dee Boling.  

“Tulane in general and SPHTM specifically played a direct role with state and city government, providing guidance to address the COVID-19 pandemic. Faculty, staff and students were on the front lines volunteering at mobile testing sites.”  

Adds Dean Dr. Thomas LaVeist, “Centers and programs of the school distributed masks to community members. Faculty participated in city and state responses and even consulted with some corporate and nonprofit entities on their responses.” 

Boling says that they knew as early as January 2020 that COVID-19 (before it was even called that) was emerging as a potential global threat. “School officials began meeting regularly to discuss the school and local response to what was shaping up to become a pandemic. New Orleans, however, was an early entrant to the American caseload for COVID-19, so the discussions quickly went from theoretical to practical. How to protect students, staff and faculty. How the school could assist the university and local government. Everything happened quickly. We went from thinking, ‘How could we inform the public about this threat?’ to closing our physical offices and working from home. As a school, we had already been using Zoom for online classes and meetings with groups far from New Orleans, so we really had a leg up in shifting to the virtual world, but that doesn’t mean it wasn’t without bumps. We had to mobilize to get access to some students who didn’t have internet or maybe didn’t even have a reliable laptop. Several of our deans spent countless hours assisting students and faculty to adjust to a virtual-only format for classes.” 

Faculty mobilized on the research front as well, conducting serology research, assessing the experiences of low-income patients, testing wastewater, addressing the health of women and children in Latin America, assessing college student well-being and testing prophylactic response. A number of faculty were involved in highlighting the needs of the incarcerated, writing an open letter calling for the reduction in the Orleans Parish Justice Center population in the interest of health to avoid widespread infection. 

In addition, Dean LaVeist co-chaired the Louisiana COVID-19 Health Equity Task Force, an initiative that looked at immediate ways to reduce or eliminate disparities in the communities impacted by COVID-19. While in many Southern states, communities of color experienced lower vaccination rates than their white counterparts, in Louisiana, those statistics were reversed. The dean was also instrumental in getting the National Academy of Medicine along with corporate partners to promote the vaccine, especially to people of color who might be vaccine hesitant.  

They also established a regular newsletter specific to COVID-19, put together by a former U.S. intelligence officer who had done a similar newsletter in response to the spread of past infectious diseases, including H1N1 and Ebola. The newsletter was initially shared five days a week, and later twice a week, with reports from news sources all over the world. The response was tremendous and the Tulane Outbreak, as it was called, developed a very loyal following. The audience loved being kept informed on the day-to-day and week-to-week changes on COVID, covering topics such as scientific publications, surveillance, official reporting, misinformation and the psychological impact. Each newsletter even included something on the lighter side. 

A “daily briefing” email was also instituted as part of a plan to be as transparent as possible to the school community. The briefings included ways to get help with online classes, changes to practicum requirements due to the virus, where the community could physically go for help if needed, where testing was available, updates to research protocols impacted by the pandemic and ways the community could get involved to help. School leadership was meeting regularly, and those meetings informed the briefings, which were a lifeline for many. The briefings have been so successful that they are a regular part of Tulane’s emergency planning now. 

Boling points to lessons learned. “One lesson we’ve tried to highlight throughout the pandemic has been around recognizing who is most impacted by infectious diseases like COVID-19. All populations were affected, but in the U.S., workers who could not easily isolate and work from home, people who live in denser populations with others and people who work in service industries — these communities were all more significantly impacted. Often these are people of color who already experience health inequity and something like COVID-19 only exacerbated the situation. We collectively need to address this situation so that Black and Brown Americans are not automatically more significantly impacted any time we have an outbreak or health crisis.” 

Boling continues, “We have also learned that words and communication matter. The national response started out flat-footed by sending out the message that masks were not needed, then reversed that advice. Project Warp Speed suggested that corners were being cut in the interest of speed to develop a vaccine. Messaging has been unclear and unnecessarily complex. To help the most people, messaging needs to be clear and unambiguous, and helpful to the largest number of people. Unfortunately, that mixed messaging left room for misinformation and use of the pandemic for political purposes.”

The gravity of the COVID-19 pandemic really hit home at the University of Arizona’s Mel and Enid Zuckerman College of Public Health when colleagues in regional hospitals began reporting that they were overwhelmed and out of beds and then that people were dying. The need emerged to support not just health services colleagues, but everyone in the broader community.  

First, the UArizona shut down in-person work and classes, and within two weeks, courses went remote on Zoom. “It was an amazingly quick response, and it did not always go smoothly, but it happened and saved many from early infection with COVID,” says Dean Iman Hakim.  

Second, once it was clear that masking was a very effective way to prevent transmission, all the regional leadership at the university, City of Tucson, and Pima County promoted wearing masks to stop the spread. Soon people in the region also began turning to the university for answers — how to prevent infection and what to do if someone in the family was infected. Public health faculty worked closely with the Pima County Health Department, the City of Tucson and the leadership at the University of Arizona to answer the community’s questions with the best available answers from the limited data at the time and to communicate that information widely, clearly and effectively. Leadership and organizations mobilized rapidly, especially when it came to health care, promoting social distancing, hand hygiene, and soon masking both internally at UArizona and externally in the community.  

Faculty and students jumped into action to respond to the COVID threat and their efforts were often successful. In particular, the Mobile Health Unit (MHU) teams, one based in Phoenix and the other in Tucson, both went to work as soon as the pandemic hit. First, they used their contact lists to call clients and provide accurate information to people in Spanish-speaking communities where misinformation was common. They also promoted the facts on their established and trusted social media channels. Then, once the vaccine was available, the MHUs took the vaccine to underserved communities that did not have access. So far, they’ve delivered more than 70,000 vaccines.  

However, it was challenging to convince some people to modify behaviors based on underlying knowledge about how to stop the spread of COVID. In many ways, misinformation became the most dangerous foe, and it was spread rapidly through social media. It was essentially a communications challenge for the UArizona, says Dean Hakim. “How do we change minds when people have their mind made up already due to ideological affiliation? First, people refused to wear masks. Then, when, amazingly, the vaccines became available, it was a logistical challenge to distribute the vaccine to millions. But it was a challenge we were able to meet in collaboration with regional and state governments,” she says. “The bigger challenge was that some people did not trust the vaccine and refused to take it, which meant that they were at risk, and so were their friends, family members and co-workers.”  

“Science can give us answers and develop vaccines at astonishing speed, but it can’t change minds. We know how to stop the spread of a disease like COVID, but we have to convince people to shift behaviors in order to implement prevention measures. In a society that lacks trust in public health experts and leaders, there is no easy answer to fighting infectious disease. Ultimately, to improve pandemic response, health care providers and civic leaders need to build trust in their communities so that effective prevention measures will be adopted, followed and respected,” says Hakim. “So many talented individuals have dedicated their lives to public health, and yet we face information and communication challenges that we have never seen before as misinformation and disinformation is spread rapidly through social media channels, almost always due to underlying financial motives. The path to winning back public trust and countering disinformation with facts will require all of our intelligence and expertise.”

“One of the first discussions held about this new respiratory illness in China that was making the news was in the hallway of my department (epidemiology and biostatistics),” says Texas A&M School of Public Health Instructional Associate Professor Angela Clendenin. “Infectious Disease Epidemiologist Dr. Rebecca Fischer and I were talking about the news and the upcoming flu season. We commented that we needed to remind the students about the flu and now was the time to take extra precautions like getting a flu shot, eating healthy, getting plenty of rest and washing hands, etc. As SARS-CoV-2 began to appear in the United States, I was asked to represent the School of Public Health at a community leaders emergency planning meeting. Our local health department, the Brazos County Health District, was leading the meeting and it was clear that with only one epidemiologist on staff, they would need support. I began working with our administration to see what it would take to perhaps have student volunteers help to man phones, etc. But very quickly, things changed. Dr. Fischer and I both offered to volunteer our services in support of case investigation and contact tracing beginning March 13, 2020. In the weeks before we began that service, we realized this was going to be something big. I often said this is going to be like the Olympics for public health practitioners, the thing we train our entire lives for. That being said, we knew something was coming, we knew it was going to be bigger than what our community was prepared to handle, and we knew we were uniquely qualified in emergency management and public health to provide support.” 

It was decided on March 13, 2020, to extend the spring break at Texas A&M University, thereby keeping over 70,000 students away from campus. This was a significant first part of the response because these students would have been returning to Bryan/College Station, TX, with unknown exposures and unknown disease status, as well as a likely extensive travel history. As the decision was made to bring students back in the fall of 2020 to a hybrid educational experience (some face-to-face with online options), the School of Public Health recognized Texas A&M was going to contribute to a very large spike in cases in the community that potentially could impact an already overburdened health care system. 

“Dr. Fischer and I had already begun to volunteer at the health department with case investigations and contact tracing. As cases grew and an increasing number of Spanish speakers were impacted by the virus, we added another faculty member, Dr. Maria Perez-Patron, to our cadre at the health department,” Professor Clendenin says. “The numbers continued to grow, so we advocated to bring on eight high-performing graduate students to help with the increasing case investigation load. These students worked under our supervision as faculty members. What made this so special is that prior to this pandemic, we had not had many students engaged with our health department. There were limited internships and interactions. This represented a very positive shift in the relationship between our school and our local health department. Although ambivalent about bringing student volunteers in at first, the health department agreed since Dr. Fischer and I vouched for their maturity and abilities. Needless to say, the health department team was amazed at the caliber of students we brought in and what they were able to accomplish.”  

Clendenin continues, “Dr. Fischer and I came up with a plan to build a cooperative arrangement where we would take on the bulk of the case investigation and contact tracing for Texas A&M University students and then any other groups the health department needed us to cover. From this initial conversation, the Texas A&M Covid Operations Center (the CoOp) was developed. A new partner, the Texas Workforce Commission through the local Workforce Solutions program, provided funding to hire people who were displaced from employment due to COVID to serve as contact tracers and case investigators at the CoOp. We also received some additional funds from Texas A&M to retain the students we brought on in the beginning and to hire additional support. The Texas A&M Health Science Center provided space and computers for the operation, and the ‘long hallway’ between Texas A&M University and the Brazos County Health District was formed.” 

Right around the time the idea of the CoOp was being presented and forming, the School of Public Health hired Dr. Shawn Gibbs as the new Dean for the School of Public Health. He provided a wealth of expertise and his support to the CoOp plan. Dr. Fischer, Dr. Gibbs and Clendenin served on the newly formed contingency council at Texas A&M, consisting of university administrators to provide guidance and reporting on the status of COVID at the university to support decision-making. Out of this contingency council came the apparent need to make testing more accessible as students returned to campus. Working again with volunteers from the School of Public Health (faculty, staff and students), as well as across the university, pop-up testing locations, including a drive-through testing operation, were planned and scheduled on multiple dates. 

Clendenin adds, “It is often said in the world of emergency management that meeting response partners in the field during a response is not the best time to meet partners. In between disasters is when partnerships should be formed, communication channels opened and collaborative training occur. If we invest in public health now and invest in regular, multidisciplinary training and conversations, we will build a much stronger foundation from which to respond the next time, which will help us all get out in front of the problem instead of just reacting to it. ‘Teamwork makes the dream work’ seems like such a cliché, but in this case, it doesn’t just make the dream work, it has the potential to save lives, and I can think of no more important thing in which to invest time, people and funding.”

For St. George’s University Department of Public Health and Preventive Medicine staff and faculty, there were many signs that COVID-19 would become a major threat to the world’s health: from the announcement of increasing cases, to the declaration by the World Health Organization of a pandemic, to the closing of port entries.  

They reacted by reading and obtaining information from credible sources (e.g., WHO, CDC) and following their guidance on mask-wearing, sanitation and distancing, and getting vaccinated (and convincing others to do so). At a departmental level, it involved collaborative initiatives like COVID-19 communication advisory committees and a KAP COVID-19 study.   

One of the biggest challenges, they say, was ensuring, obtaining and reporting accurate information, especially in the early days of the pandemic when much was still unknown and many were starting to promote interventions that lacked clear evidence of their efficacy. Says Professor and Track Director Martin Forde, “Dealing with the sheer quantity of misinformation and conspiracies this pandemic generated and trying to debunk them, especially such misinformation that came from colleagues and personal family members, [was a major challenge].”   

But there were lessons to be learned. Professor Forde notes, “The more things change, the more they stay the same. …The traditional hygiene and sanitation measures are tested and proven strategies which, no matter how advanced and developed we get, the basics will always be applicable in promoting health and preventing diseases.” Further, Forde says, “COVID-19 illuminated the gaps and deficiencies in the public health system. The lack of priority toward public health was apparent and I expect that to unfortunately remain the case. We will no doubt be challenged with what will, not may, be the next disease outbreak and even a pandemic, but the reprioritization of public health and strengthening of health systems to manage disparities and inequities will persist.”

When COVID-19 emerged as a threat at San Diego State University School of Public Health, they got to work right away. According to Director Eyal Oren, “We listened to our community advisory boards, identified gaps and opportunities to help and started modifying resources to be of service to our community. Right away we partnered with our County HHSA to develop a culturally appropriate and linguistically concordant community health worker-led contact tracing program for four marginalized San Diego County Communities. This >$5M two-year partnership was enormously successful and led to several NIH and HRSA funded grants to address COVID inequities in testing, tracing and vaccination. In addition, we partnered with numerous collaborators on modeling efforts, surveys and behavioral interventions.” 

They also met with the Cancer Health Equity Collaborative and queried members about their experiences trying to meet community needs. They then identified gaps and developed potential solutions together, including leveraging existing resources to address community needs and getting the word out through community partners. Then, they met with county colleagues to discuss the likely inequities that would result from the coming pandemic. From there, they developed community health worker (CHW)-led contact tracing to try to prevent some of these inequities. Communities Fighting COVID was developed at the Institute for Public Health, the practice arm of the SPH. The school and their community advisory board developed recruitment and hiring plans, created training and onboarding materials, developed protocols and procedures that were separate from but dovetailed with existing county policies. CHWs were on the ground within six weeks of contract execution.  

Director Oren notes there have been challenges: “People want accurate, trusted information. They can handle nuance. And it should be delivered through trusted messengers, often individuals from affected communities. We need better data infrastructure, including timely collection, management, reporting and communication of information.”

At the St. Louis University College for Public Health and Social Justice, staff realized early on that COVID-19 was not going to be the same as the first SARS CoV. Says Special Assistant to the President and Professor of Epidemiology in the College for Public Health and Social Justice, Dr. Terri Rebmann, “My initial reaction was to plan for this on a local and national basis through my work as a researcher, educator and member of the Association for Professionals in Infection Control and Epidemiology (APIC). It was only about a month or two later that I became involved in pandemic planning and response for my university after being brought to the leadership planning meetings by my Dean.” 

From the beginning, SLU used a multidisciplinary approach to decision-making that involved leaders, faculty, staff and students. Says Rebmann, “We aimed to make decisions that were evidence-based, mission-centered and values-driven. We put together multiple working groups to discuss the best approach for each decision we needed to make, to ensure we involved the right group of stakeholders for each discussion. We were completely transparent in our plans and protocols and held open fora to allow community members to get their questions answered.” 

They created their own internal contact tracing team, led by their public health faculty and staff, co-managed by two MPH student leaders and team members consisting of MPH students. Rebmann says, “We were able to conduct case investigations in less than 24 hours after notification that someone had tested positive. The team monitored the data closely and responded quickly when a trend or cluster was identified. This allowed us to conduct cluster testing and respond rapidly to unusual disease spread on campus.” 

They collaborated with local public health officials to develop and implement a modified quarantine protocol that allowed them to take mask use into account when determining if someone was a close contact who required quarantine. “We did this systematically for the entirety of the spring 2021 semester and determined that it did not result in increased disease transmission. We found that this protocol greatly reduced the number of students and faculty who required quarantine, which enabled more individuals to safely teach and attend classes without disruption. It also reduced the burden on our isolation and quarantine housing that we provided to our on-campus students.” 

They faced two periods of intense challenge during the pandemic: fall 2020, when a very large number of cases on campus almost forced them to move online, and emergence of the Omicron variant that almost forced them to begin the spring 2022 semester online or late.  

According to Rebmann, “We successfully opened on time and stayed in-person for the entirety of the fall 2020, spring 2021, fall 2021 and spring 2022 semesters. We were able to succeed due to our robust response team, evidence-based protocols, mission-centered approach and community members who graciously supported our efforts by following our policies. The other major challenge we faced on campus related to our COVID-19 vaccination requirement policy. In spring 2021, we faced the question of whether to require our employees and students to be vaccinated against COVID-19 for the fall 2021 semester. We used a multidisciplinary approach to determine our vaccination policy. Our university president put together a representative, multidisciplinary working group of 13 faculty, staff and students to assess whether we should require COVID-19 vaccinations or adopt other COVID-19 vaccine policies. That group met on multiple occasions to review the pandemic epidemiology, science behind vaccine safety and effectiveness, and input from our community members that had been collected via a survey sent to all employees, students and parents. After many discussions about the advantages and disadvantages to implementing a vaccination requirement policy and weighing the competing issues of personal autonomy versus expressing our care for one another by being vaccinated so that we could be together safely, free from isolation and anxiety, our working group opted to recommend to our president that we require all students, staff and faculty be fully vaccinated against COVID-19. Our president agreed with our working group’s recommendation to require vaccination and implemented that policy. This decision was met with mixed reactions by our community members. Many were elated by the decision, but others were opposed to the policy. Implementing this policy required our COVID-19 response team to develop protocols for tracking compliance and increase the vaccination clinics we offered on campus. As our president stated in his message to our community about this decision: ‘I close by asking that you remind yourself of all that we were able to accomplish together throughout the 2020-2021 academic year. It involved many sacrifices of our students, faculty and staff. It required us to not give in to anxieties and fears, and instead follow the best scientific knowledge as it became available. One would be hard pressed to find any university anywhere that did it better than we did. Let’s do what needs to be done to be able to say the same at this time next year. It begins with getting vaccinated.’” 

Rebmann points to lessons learned: “One of the most important lessons we have learned through this pandemic is that it is critical to follow consensus science, be inclusive in including our stakeholders in decision-making, communicate our protocols to our community members and the evidence behind them, and stay mission-centered in order to gain the support and trust from our community members. We have received a lot of positive feedback from community members regarding our multidisciplinary, evidence-based, transparent and inclusive approach. We will take these lessons forward into our response to other public health challenges we face as a campus, including our preparations for monkeypox virus on our campus.” 

Rebmann continues, “The second most important lesson we learned was the critical need for better coordination across the city of St. Louis in terms of higher education’s response to the pandemic. Very early on we set up a weekly meeting between local health department officials and COVID-19 leaders from universities across the greater St. Louis region. This weekly coordination meeting allowed (and still allows, since this is ongoing) collaboration and sharing of best practices and protocols across the city. It improved the communication between SLU and local public health officials, as well as creating a support network for COVID-19 leaders. This collaboration also aided local public health officials who often used our protocols as the basis for their recommendations for local K-12 schools. Our relationship with local public health officials strengthens not only our COVID-19 response by resulting in faster response during times when the university had clusters or other issues on campus, but also has aided the university when we had to quickly develop a protocol for MPV for the fall 2022 semester.”

When COVID first emerged as a dire threat at the Michigan State University MPH Program, the school aimed to ensure it was ready to respond. Because their primary mission is under the umbrella of education and training, they recognized early on that they had potential volunteers in students and faculty. The path was clear, and they knew they could impact the people providing medical care and the general public to help increase vaccine uptake.  

In the early stages of COVID, activities to enhance the public’s response began with seeking and training volunteers for contact tracing. As the pandemic went on, courses were developed for medical students to understand the whole issue of pandemics. For the public, a free course was launched to inform the public about COVID-19 and pandemics with the goal of helping one another be safe. To date, nearly 300 users have enrolled in the course.  

According to the Director of the Master of Public Health Program Wayne McCullough, the most significant challenges were understanding the virus, effectively communicating about it and how it was transmitted, and ensuring the community stayed safe. “The initial take was to wash and sanitize everything that came into your house because so much early research suggested that the virus could live on contact surfaces. Tension was high. People were locked down, locked up and locked away. Because of the school’s wraparound services model for the online program, they were well-prepared to deal with most of the issues and concerns students had. They focused on ensuring that they stepped back and listened more closely to students’ issues and challenges. From a workplace perspective, many of our students were now working remotely or on the frontlines of the pandemic response. The Program needed to be sensitive to how they protected themselves and their families. And as COVID continued, they had to step back and understand the impact of individuals who had lost family members to COVID and students who had come down with COVID. There was a heightened sense of how to address these issues and increased flexibility.”  

The number one lesson, Director McCullough says, is to listen. “The small signals can have significant meaning. It can be like a student saying, ‘I’m having trouble or difficulty doing this.’ But that may be a signal to a more significant underlying issue. For example, a few students wanted more points of connection with peers. As a result, we asked several instructors to have more synchronous discussions around topic areas. And while not everyone can participate, it’s opened up a higher level of understanding, communication and camaraderie with their peers.”  

Secondly, he emphasizes the ability to respond to change. “While we are an asynchronous program, by and large, we’ve pivoted and are including synchronous discussions in most courses, which allows for much greater contact, awareness and understanding. It also allows us to start to address some of the difficult conversations around diversity, equity and inclusion, and those conversations are best had synchronously. This allows for broader in-person discussions on why COVID-19 does not have an equal impact across all populations. Why did its impact have a more significant effect on the most vulnerable? And so, stepping back has allowed us to get deeper into that space of addressing public health in vulnerable populations.”  

Finally, the Program learned to have a better relationship with community partners. “We’ve been able to say to Flint in particular that we have developed our free course, and it’s open to you. It helps to improve community health. We also created our workforce development efforts and brought some tools in a webinar format that allowed communities to increase their impact.”

At the end of every quarter, Loma Linda University School of Public Health (LLUSPH) hosts a poster presentation for graduating students that allows them to showcase their practicum projects to staff, fellow classmates and community partners. It’s a milestone for many students and one that everyone looks forward to. Practicum presentations for winter 2020 were scheduled for Friday, March 20th. On March 12, the county reported its first case of the coronavirus. According to Interim Dean Dwight Barrett, “We knew we needed to set an example as a public health institution and made the decision to make the event virtual on Wednesday to protect the health of our students, staff and community partners, and their families. The next day brought the official shelter-in-place order from the governor’s office.” 

At LLUSPH, going completely virtual overnight was a bit of a challenge considering it was the final week of the quarter and faculty had approximately a week to wrap up the quarter and be prepared to teach the entire spring quarter in a virtual setting. Says Interim Dean Barrett, “University leadership looked to the School of Public Health to organize risk communication concerning the pandemic for the entire university.” In efforts to keep university students, staff and faculty updated on the COVID response, LLUSPH created a risk communication team that developed a COVID-specific text and email strategy to keep everyone informed concerning best practices, case rates and other important information. In addition, the school partnered with the LLUH Institute for Community Partnerships to organize a COVID Care Corp that designed informational content for local community partners and members. This included COVID care information, resources, information on related government policies and other local community specific concerns. 

As with any other educational institution, there were challenges — particularly with the overnight transition to virtual learning. “We were especially invested in our students that were getting ready to graduate and had various practicum requirements at places that were also in emergency mode,” Barrett says. “Looking back now, this was one of our greatest blessings because it allowed us to move many of our programs 100% online and allowed us to offer public health education to those who may not have found it accessible before.” 

Lessons were learned though. Notes Barrett, “First we learned or rather saw the incredibleness of the public health community in times of crisis. We learned that we CAN pivot to keep educating and serving regardless of the circumstances. Secondly, we saw the importance of communication and relationships. We were able to partner within the university and among our community to effectively practice and promote public health. Having those relationships and prior lines of communication made us more effective in times of crisis.” 

He adds, “People have a better understanding of public health post-pandemic, but unfortunately that has come with a mistrust in public health. It is up to us to curate our messaging, partnerships and relationships to promote trust and be a reliable source for relatable information and resources.” 

Among the unique experiences captured by those in the Emory University Rollins School of Public Health community during the early days of the pandemic are those of Dr. Jodie Guest, who was leading logistics of the famed Iditarod International Sled Dog Race when the first cases occurred. Guest was asked to discuss the realities of continuing the race across Alaska and was forced to consider how to stop 70 mushers, more than 1,000 dogs, and move more than 200 volunteers out of remote villages and back home as Canada closed its borders and flights out of Alaska became scarce.  

“In the village I was in, we were told to fill our small bush planes with fuel and fly as soon as the weather was good as the airport and town were shutting down,” Dr. Guest recalls. “If we were not gone within 48 hours, we would not be able to file a flight plan and would be residents of the village until at least end of April, when the town council assumed the airport would begin flying again.” Guest made it out on the last plane to Anchorage and then got on the last plane out of Anchorage back to the lower U.S. to find her family quarantining, stockpiling toilet paper and cleaning mail and groceries in the garage where they stayed for 72 hours before coming into the house. She later designed and implemented the COVID-19 prevention plan for the race in 2021 and 2022 and the upcoming 2023 race.  

Among the various Rollins-led response efforts in the early days of the pandemic included assisting health systems in Hall County, Georgia, which were experiencing COVID-19 outbreaks in poultry plants and seeking epidemiologic support. Dr. Jodie Guest quickly mobilized to assist the county — proceeding to visit the county more than 52 times in less than four months. Within a week of being contacted by the county, Guest assembled a student team (Emory’s COVID-19 Outbreak Response Team), trained them in proper PPE usage and nasopharyngeal COVID testing via Zoom, and traveled with the team to Hall County to perform their first testing site where they tested 1,000 people in three hours (causing a traffic jam across Gainesville).  

It quickly became clear to Guest and members of the team that access to testing was key, with the initial event showing a 35% positivity rate. They began working directly with poultry plants and provided testing onsite. Guest and her team also worked with plant managers and operators to allow for sick leave (so that no one was out of work if a test was positive given that workplaces were asking people to test). They joined the Latino business organizations to garner support for testing sites and overcome barriers to testing by creating pop-up testing sites where people could find them.  

Guest and Emory ORT also joined two local school districts in the county to work on science communication. As schools were closed for students, the school districts used their bus routes to provide breakfast and lunches to students. Members of Emory ORT rode these buses and handed out masks and science education materials they developed for the students. They had COVID bingo cards and engaged at every stop with the kids and parents to provide culturally sensitive and age-appropriate information. They also created videos for best practices for cafeteria workers and bus drivers.  

During this time, the team was also approached by the Mexican Consulate in Atlanta to provide testing onsite as well as by mayors’ offices in other parts of the state where testing was hard to find or where testing sites were requiring documentation of insurance or resident status. They spent 45 weekends (86%) of the first year traveling to provide their pop-up testing sites across Georgia. They also became a testing site for five testing modalities to provide data for FDA approval, including the first FDA-approved saliva test. Much of the planning was organic and responsive, though they learned to quickly pivot their style for different communities. The team’s priorities were to work in communities with inequitable access to testing, inequitable risk for COVID-19, and where they could partner with trusted community members and groups. They had clear boundaries about who could engage and be present at their testing events so that they could earn and maintain community trust.  

As vaccinations became available, the group set up the first Latino-specific vaccination event in Georgia at the Mexican Consulate and vaccinated 500 people in the first two clinics. This was a combined effort between the Emory ORT, Emory School of Medicine clinical students and faculty, Fulton County Health Department, the Latino Community Fund, and the Mexican Consulate. They also partnered with the Atlanta Mayor’s Office to provide vaccinations at pop-up sites in areas where people experiencing homelessness spend time.  

Forming the Emory ORT was both swift and life-changing for those involved and those impacted by its work each week. Dr. Jodie Guest recalls, “To be able to be in the community, work with a team of incredibly talented and compassionate students and offer needed services — (appropriate age-wise, language-wise, culturally wise) education, testing, vaccinations — in a way that created deep community connections and saved lives changed the way I talk about science information, engage with communities and work with students outside of the classroom.”  

Another major response effort from Rollins was initiating a weekly (sometimes more frequently) video series featuring Drs. Jodie Guest and Carlos del Rio that enabled the university to share the most up-to-date information on their ever-changing knowledge about the pandemic. This effort, paired with national media placements and consultations with businesses, health departments, public officials, hospitals, churches, industries and community groups about COVID-19, have allowed Rollins experts the opportunity to provide synthesized and targeted information about COVID prevention, vaccination and stigma during the first years of the pandemic.  

As Dr. Guest recalls in reference to the Emory ORT, the biggest challenges were finding time to sleep, fighting misinformation and earning trust. “We could have done this work in 20 places every day for the first year,” she recalls. “Keeping track of requests and deciding where we could work best was challenging. We also worked hard to earn the trust of the communities we worked in by canvassing the areas in advance, partnering with trusted leaders (whose trust we also had to earn!) and continually showing up.”

One other impactful initiative undertaken by the Emory COVID-19 Response Collaborative (ECRC), led by Dr. Allison Chamberlain, was the Rollins COVID-19 Epidemiology Fellows Program funded by the Robert W. Woodruff Foundation. Launched in August 2020 to recruit and place early-career MPH-level epidemiologists across Georgia’s 18 health districts, the first cohort of fellows started in November 2020. The fellows hit the ground running, working as entry-level epidemiologists to conduct case investigations, manage contact tracers, and to liaise with external stakeholders like schools and long-term care facilities. Fellows embraced their assignments and started doing things like leading the production of weekly COVID-19 epidemiology reports, doing on-camera interviews with local news stations and participating in on-air COVID-19 vaccine Q&A sessions with Spanish-speaking radio stations. Since the program started, Emory has hired 37 fellows across three cohorts, placing them within 16 health districts throughout Georgia and at the state health department. Five fellows have been offered full-time positions with their health districts and four have transitioned to full-time roles thus far. 

“The week of March 9^th, 2020, was a blur,” says Dr. Krissy Simeonsson, associate professor of pediatrics with joint appointment in public health, epidemiology concentration at the East Carolina University MPH Program. “I remember being concerned about the pandemic potential of COVID-19 since February when cases were skyrocketing in Washington and was wondering why the World Health Organization hadn’t declared a pandemic in February or early March. It seemed as though all of the pandemic prerequisites had been met. I distinctly remember things got very real on Wednesday March 11th when Adam Silver, the commissioner of the NBA, announced they were canceling games for the foreseeable future. The pandemic declaration that followed the next day from the WHO seemed almost irrelevant. By the end of the week, things were really ramping up and everyone was asking the big questions. … Are schools going to close? Are hospitals and clinics going to be able to handle a surge of patients? Are we going to cancel other big events like concerts, conferences, conventions? With twin daughters in their senior year of high school, Friday March 13th for our family marked the last day of in-person school and the last high school soccer game of a season that barely started. So, you can imagine I didn’t pay much attention to an email sent on March 13th from the associate dean of academic affairs at our medical school asking if some of us had interest in teaching an online class to medical students who were scheduled to start their 4^th-year clinical rotations. I didn’t respond to the email, thinking one of the other faculty members included in the email would take charge. Apparently, I was mistaken.”  

Dr. Simeonsson continues, “Early the next week, I received a text from my friend and colleague in student affairs who asked me if I had time to chat; by the end of our conversation, I had agreed to teach an online course for 88 medical students displaced from their clinical rotations. When I look back now on the experience, it’s hard to really understand how we pulled it off. And when I say WE, this was a group effort like none I had ever experienced before.” 

They had less than two weeks to pull together learning objectives, course content, evaluation methods, online delivery methods and faculty expertise. The course, entitled “pandemic crisis management”, was set up to be scalable; each module ran for two weeks with the option to run for 12 weeks total (six modules if needed). The 88 students were divided into pre-existing small groups from their pre-clinical years; each small group had one to two faculty leaders from several departments in the medical school: public health, pediatrics, family medicine and pharmacology. Chief residents and senior residents in pediatrics also helped faculty lead small groups and design some of the course content. They relied heavily on the small groups as a way to keep students engaged with learning and with others. While the majority of course content focused on public health principles, respiratory viruses, prevention and control of infectious diseases, and crisis management, there was also an emphasis on building community and connections within small groups and on wellness. Students were assigned wellness activities every week to complete and small groups engaged in activities such as going on virtual field trips together and creating pandemic playlists that student affairs loaded into Spotify that everyone could listen to! The online class became a way for many people at the medical school to stay engaged during a very unnerving and isolating time.  

Dr. Simeonsson concludes, “When I think back on my career as a medical school faculty member, my role and participation in the “pandemic crisis management” in spring 2022 will be one of the most memorable and rewarding things I have been a part of.”

At the Drexel University Dornsife School of Public Health, the pandemic and initial shutdown in March of 2020 coincided with the tail end of their spring term (and when their second-year MPH students finish up). It required some quick cancelling of celebratory events and responding to the concerns and questions from the school and university community while trying to figure out what was going on. In addition to engaging with the university, they also immediately joined with the health department to assist.  

Esther Chernak, MD, MPH, FACP, associate professor of environmental and occupational health, director, Center for Public Health Readiness and Communication at Dornsife, and her team assisted in the planning and implementing of Philadelphia’s first COVID-19 drive-thru testing facility at Citizens Bank Park in the first weeks of the pandemic. The site was open for two months and was created to provide testing to potentially more vulnerable individuals over the age of 50. Additional DSPH faculty and students also volunteered at the site. 

Says Associate Dean for Public Health Practice and External Affairs Jennifer Kolker, “Our mobilization was both internal and external. The university quickly created a scientific advisory group to advise on the university’s COVID-19 response and drew heavily from faculty and leadership of the School of Public Health. Externally, our Dean and several faculty members sit on Philadelphia’s Board of Health and so engaged immediately in the citywide response. They have also continued to develop strategies to respond and protect the health of residents with the Philadelphia Department of Public Health (PDPH) and Health Commissioner.  On a more individual level, we had to reassure our students, parents, faculty and staff and create a sense of community and resiliency during incredibly challenging times.” 

Associate Dean Kolker continues: “We immediately saw our role as a school of public health to try and disseminate newly evolving information and highlight the issues of health equity that COVID-19 so clearly demonstrated. We immediately launched a webinar series, Emerging Issues in the Coronavirus Pandemic, with 31 webinars to date, with 4,500 live viewers via Zoom and over 4,000 additional views on YouTube. Topics ranged from racial disparities in COVID-19, population mental health and COVID-19, COVID-19 and cities, first responders, clinical trials and treatments. In keeping with our role in dissemination and education, over 25 of our faculty were regularly quoted in the media, helping to disseminate research, explain and comment on local, state and federal COVID policy, and provide an additional voice to COVID messaging. We had over 365 media clips from local, national and global publications.” 

On the programmatic side, the university partnered with the Big Cities Health Coalition (BCHC) to release a “COVID-19 Health Inequities in Cities Dashboard” — a powerful data tool that enables visualizations of COVID-19-related outcomes and inequities over time and across BCHC cities. The dashboard includes information on COVID-19 incidence, mortality, testing, test positivity and hospitalizations in BCHC cities. Additionally, the dashboard allows users to characterize, compare and track inequities at three levels: across individuals within cities, across neighborhoods within cities and across cities. Interactive visualizations allow users to explore data on COVID-19-related outcomes and outcome inequities for BCHC cities, including options for users to select specific variables or cities and tools to assist in interpretations. The project was supported by the Robert Wood Johnson Foundation and the de Beaumont Foundation. 

Kolker adds, “The COVID-19 pandemic has highlighted the multiple ways that structural factors such as racism and economic inequality drive health inequities. Inequities in COVID-19 outcomes (testing, incidence, hospitalizations and mortality) emerged early in the pandemic. A first step in addressing these inequities is to describe and quantify their magnitude in order to create public awareness and identify the factors and policies that may be most effective in eliminating them. Comparing inequities across different cities can be especially valuable in understanding drivers, targeting resources and identifying effective policies.” 

But there were enormous challenges, Kolker says, in putting courses online and continuing to provide a high-level academic experience for students. “We discovered that we were nimbler and more flexible than we thought and have learned through those challenges.” She adds that “the other great challenge has been maintaining a sense of community and collaboration as we also strive to make the workplace safe and flexible. Managing varying levels of risk (even within a public health community), personal and family circumstances, desire to be in-person and learn in-person, has been a challenge that we continue to work through with students, faculty, staff and the university at large.” 

She points to lessons learned though: “We have learned that we are more resilient and flexible than we realized. In the past, we’d say we needed weeks to put on a webinar or months to put a class online; COVID-19 taught us we can move quickly when we need to. At the same time, we’ve learned that our competencies and what we teach may need to move more quickly to better respond to the public health needs of our students and the field.”

Three of the faculty (Raskob, Bratzler, Wendelboe) of the University of Oklahoma Health Science Center Hudson College of Public Health were appointed to the health sciences center’s Special Pathogens and Preparedness Operations Team (SPPOT). The team first met in mid-January 2020 after the initial reports of the SARS-like outbreak in the Wuhan province of China. According to Interim Dean Dale Bratzler, “Several team members were well-informed of the worldwide outbreak of SARS in 2003, so we were immediately concerned about the possibility of worldwide spread of the new disease. After deliberation, we recommended the University president suspend all international travel (students, guest faculty and staff) in the third week of January 2020 (prior to President Trump’s lockdown of travel to China). Of course, the initial identification of a case in Washington state confirmed our fears. The SPPOT started meeting 2-3 days a week and have continued to meet as needed up until now.” 

Initially, the most important actions were to close the campuses, move to virtual learning and mandate masks in all University facilities. The Hudson College of Public Health worked closely with the operations vice president to implement cleaning protocols in all facilities, work with all air handling units to increase air exchanges with outdoor air and install high-efficiency filters. 

In December 2020, the College began deploying vaccination clinics. Dr. Bratzler developed an educational program to train all first- and second-year medical students, PA students and dental students to administer vaccines. Says Interim Dean Bratzler, “Working with our interprofessional faculty from across campus, we had our students (public health, medicine, nursing, pharmacy, allied health and dentistry) coordinate community vaccine clinics that delivered approximately 50,000 doses of COVID-19 vaccine from January through April 2021 to Oklahoma citizens, students, staff and faculty. The student teams also worked with our health center staff on the large undergraduate/graduate Norman campus to deliver more than 3,000 doses of vaccine to students in a single day. With faculty supervision, our interprofessional student teams (the ‘Unity Clinic’) continued to deliver the vaccine for months to come in multiple sites — such as churches and schools.” 

Dr. Bratzler continues, “Not surprisingly, there was considerable pushback about the significance of COVID-19 and lots of vaccine hesitancy to address. For example, decisions to mandate masks in all University facilities or to move to virtual learning were not always popular with students and parents. We had to identify isolation housing on our main campus to accommodate students in residential living settings who tested positive. Early in the pandemic, we struggled with supplies of personal protective equipment. The subsequent legislative action limited our ability to require masks in classrooms.” 

He also points to lessons learned: “I think we were surprised by the substantial pushback to the pandemic response. The rapid dissemination of invalid information about the disease and vaccines through social media inhibited some of our responses to the pandemic. As a result, our state performed quite poorly during the pandemic (as was profiled in the Commonwealth report on the pandemic response). On the positive side, we pulled together the resources from across our comprehensive health sciences center campus. We also engaged the teams of students that we had developed as a part of our interprofessional education training on campus. Clearly, there is a tremendous need for more training in public health. A large proportion of the public health workforce in our state has no formal training in public health. Second, public health has systematically been underfunded, which became apparent at the pandemic’s peak. With this in mind, substantial investments must be made in the public health workforce and pandemic preparedness for the future.”

The University of North Texas Health Science Center School of Public Health was quick to respond to COVID-19. Faculty were involved with local and state public health agencies in the early months of 2020 as alerts and planning began taking shape, and the school was among the first in the Dallas-Fort Worth metroplex to respond to the call for help from the local public health department. Their students were immediately hired to conduct contact tracing at the Tarrant County Public Health Department. Not only did these professionals-in-training play an important role in community response, they also gained real-world leadership experience in meeting a major public health threat like COVID-19 head on. 

Mobilization began in March 2020, first through volunteerism and then as students took on temporary, paid positions with the Tarrant County Public Health Department through federal Coronavirus, Aid, Relief and Economic Security (CARES) Act funding. Classes in their residential cohort programs were quickly and successfully moved online, enabling students to arrange their public health department training and work schedules around their academic responsibilities. The spring and summer semesters of 2022 were challenging, but they welcomed the opportunity to serve the community during its time of greatest need.  

According to Sally Crocker, associate director, academic communications, “Our school also recognized the need to support the students themselves, who were feeling the same emotions, fears and anxieties as all the community and the nation. Our student food pantry was open, counseling was available, and our student services division offered a host of other resources. Our university also collaborated in March 2020 with community partners to open a COVID-19 testing site for first responders, which then expanded to include health professionals, transit employees and sanitation workers. Our School of Public Health faculty, particularly Dr. Diana Cervantes and Dr. Rajesh Nandy, were front and center in fielding media inquiries, providing television, print, radio and online news interviews that shared science-based guidance for the public and analyzing data that was recognized and relied on by the Texas Governor’s Office.” 

But their most important impact was made through the quick response and support they provided to the Tarrant County Public Health Department — where emergency response resources were very limited. The viral outbreak revealed the many gaps and weaknesses in the local and regional public health systems. 

There were challenges though: As an academic institution, the biggest challenge was the immediate pivot to online education and sole reliance on video conferencing for communication, planning and execution of the university’s mission. The School of Public Health responded well and came to find that there were many advantages to operating in a virtual environment. In teaching, research and service, several indicators of productivity and effectiveness increased. The lessons learned from the pandemic have changed how the school works in positive ways. 

The HSC School of Public Health cites lessons learned. Lesson one: Trust affects how people behave and the effectiveness of public health initiatives. A lack of trust will undermine public confidence in necessary public health measures. We must work alongside our communities to build trust – an authentic community engagement approach is critical. Lesson two: We live in an era of misinformation, and social media magnifies its spread. We need to find better ways to educate people on how to spot misinformation and critically analyze new health information.

When they first became aware of the dire threat of COVID-19 at the University of Memphis School of Public Health, and even before there was a case in Tennessee, Dean Ashish Joshi contacted the university president to offer the school’s services in pandemic planning and response. Immediately, the dean became part of the president’s COVID response leadership team. Their faculty served on various committees, contributing expertise to the university’s COVID policies and communication related to masking, social distancing, physical plant cleaning procedures, transition to online instruction, return to campus, case reporting, modified freshman orientation, campus vaccine distribution — even guidelines for the marching band’s practice. 

In addition, the School of Public Health collaborated with the metropolitan (Shelby County) health department to measure compliance with Memphis’ city-wide facial mask ordinance and the Shelby County Health Directive. Their research used two methods of direct observation to examine pre-post trends of mask usage: direct observation of mask usage in retail settings and review of videotapes captured by city cameras of outdoor public areas. With oversight by two faculty, four MPH students counted the number of individuals wearing masks correctly (covering mouth and nose) in 20 heavily trafficked large retail locations (e.g., groceries, home improvement stores) across the county. Site locations were randomly selected by the Shelby County Health Department, with 10 sites being in zip codes with high COVID-19 transmission and 10 in zip codes with low rates of COVID-19 transmission. Results were provided to the mayor’s COVID-19 Joint Task Force to guide their continued COVID response. Additionally, the public health graduate students reviewed a total of 44 hours of video tapes of public areas provided by the Memphis Police Department to examine mask compliance.  

Overall, they say they learned the importance of promoting the school’s expertise and value to a variety of stakeholders and the need to be nimble and politically astute. Future changes would include enhanced, more timely communication and partnership with logistics experts who can provide strategic advice on distribution tactics.  

Dean Joshi notes, “I think I would just add that a coping, adaptability, resilience and empathy (CARE) curriculum is an important learning for the public health workforce and the next-generation public health leaders.”

According to University of Massachusetts Amherst School of Public Health and Health Sciences Dean Anna Maria Siega-Riz, when the COVID-19 pandemic began, “We were in shock and had no concept of how long our shutdown would go on for. Our first response was to ensure the degree progression of our students and support high-quality teaching through remote technology.” 

The focus on health and safety of the campus community ramped up as they started planning for a return to campus for a select groups of students and courses that had to be delivered face to face in 2020–21. During this planning process, the school contributed in expertise and time to developing protocols and procedures for the reopening of the campus, including masking-campaign ads, contact tracing efforts, development of a COVID dashboard and serving on campus advisory boards. 

Aimee Gilbert Loinaz, SPHHS assistant director for internships and employer engagement and UMass Amherst’s manager of student contact tracing programs, led student contact tracing teams to help prevent the spread of coronavirus in their communities. The contact tracing effort involved over 100 student volunteers, who also used social media messaging to promote health and COVID-19 safety. Says Dean Seiga-Riz, contributions to the university’s asymptomatic testing and contact tracing efforts helped turn the UMass Amherst Public Health Promotion Center into “one of the largest and most efficient COVID detection and prevention programs in the state.”

She adds, “We developed a very strong and comprehensive public health response that not only served our campus, but also the surrounding communities. We are using this model as an example of how local public health agencies can work together. In addition, key leaders on campus are now working together to promote the health and well-being of students, faculty and staff. We are taking steps to join the Okanagan Charter to be a health-promoting university.”

At the University of Maryland School of Public Health, when the pandemic hit, they knew their role was to act quickly. Assistant Dean of Communications Kelly Blake says, “When COVID-19 first emerged, we knew that we had to mobilize as a School of Public Health. It was clear that this threat was like nothing we had seen in our lifetime. We immediately leaned on our dean’s rich leadership expertise in pandemic preparedness and response, as well as deep commitment to prioritizing the health and well-being of our school, campus and local community.” 

The structure of leadership among the dean’s office at the University of Maryland was critical. “Based on his experience serving as the acting surgeon general during the Ebola outbreak in the Office of the Surgeon General and a USPHS Commissioned Corps officer, SPH Dean Boris Lushniak organized an ‘incident command system’ for the dean’s office leadership team so that we could respond quickly and appropriately to new information and communicate with the SPH community and our university and community colleagues and stakeholders,” Blake explains.  

“Preparing our students, faculty and staff was paramount, as well as creating an open dialogue (via Zoom) with our community partners, Community Advisory Council and Dean’s Council. SPH leaders and faculty members played key roles chairing and/or serving on advisory committees both at the campus and community levels. We also formalized and led a standing Campus, County, State COVID-19 response team that met regularly to discuss current and future risks and concerns. This team of leaders continues to meet to this day.” 

Blake adds that the “Stop COVID Study,” launched by the school’s Public Health Aerobiology Laboratory and led by Dr. Don Milton in the spring of 2020, has “been informing efforts to address indoor air quality to prevent the spread of COVID, flu and other viruses.” 

“Our Center for Health Literacy and students with the UMD Public Health Beyond Borders organization created materials to help kids and young adults better understand risk and how to make decisions about mask wearing and activities that involved being around other people. Our Department of Family Science created materials for families, including age-appropriate information to support mental health.  

Blake describes another national initiative to increase vaccination uptake in communities of color: “Our Center for Health Equity, which already partnered with Black-owned barbershops and hair salons for health promotion initiatives, expanded its reach through a partnership with the Black Coalition Against COVID and the Biden administration that aimed to train barbers and stylists to dispel misinformation and provide reliable sources of information about the COVID vaccine, and in many cases, also serve as vaccine clinic sites.” 

There were also challenges. “We also have had to address the effect of the pandemic on the health and well-being of our local and national public health leaders and incorporate skills and services for our SPH members in their public health roles. As a school with heavy involvement with community partners in all aspects, these modifications required careful attention to personal, professional, university and societal needs,” says Erin McClure, chief of staff and diversity officer. 

“Witnessing that the policymaking decisions were often not being driven by the recommendations of public health science was another challenge. This was the case nationally and even at the university level. Our researchers and SPH leaders were included in the committees that were making decisions and advising students, faculty, staff and the public about how to stay safe using plain language and the latest and best scientific understanding, however, public health-informed actions were not always incorporated. We often navigated tough decisions of when, how and with whom to push back on if we felt that policy decisions did not adequately reflect the current scientific evidence.” 

Two lessons stand out for the University of Maryland, according to Blake. One, “Require training in plain language and risk communication for all working in public health,” and two, “Invest in formal community-academic-government partnerships.”  

“This investment will also be critical in addressing health equity. The COVID-19 pandemic and co-pandemic of racism highlighted issues of unequal access and outcomes for underserved and underrepresented populations, particularly Black and Brown communities, and the resulting health disparities,” Blake concludes.

The University of Louisville School of Public Health and Information Sciences was on high alert after learning that a person who tested positive for COVID-19 had traveled by plane to Louisville during the first week of March 2020. Says Professor and Associate Dean Dr. William P. McKinney, “Some of our personnel were transiting the airport when the case was likely present, so there was immediate concern.” Dr. McKinney explained that concern increased further when it was learned that many persons were exposed, and several were infected, at a major fundraising event at an art museum on the UofL campus that same weekend. They learned that persons exposed or affected included a number of local VIPs as well as nationally recognized politicians.  

The school’s immediate response was confirming that those exposed were going to quarantine according to CDC recommendations and getting reliable information out to the health and public health communities. The implications for classroom-based teaching were also a top priority. Very shortly after these events, a major COVID-19 outbreak was noted at a large retirement facility in Louisville. An employee who knew she was sick came to work anyway, needing a paycheck, and not truly understanding the true implications of her actions. She was the person who dispensed medications to all the residents on the second floor of the building, where the weakest and most vulnerable residents were living. As a result, a massive relocation of residents was required, and 17 persons died out of the approximately 30 exposed. Dr. McKinney added, “It was very clear at this point what we were up against.”  

UofL SPHIS mobilized several informational events. Even before the outbreak affected Louisville directly, they were tracking its impact internationally and nationally through an emerging infectious diseases course. They presented an online tabletop exercise with the University of Texas/Rio Grande Valley simulating the impact of SARS-CoV2 there and participated in a regional informational webinar through their Public Health Training Center (PHTC) during the first week of March. A statewide webinar and follow-up national webinar, both held in conjunction with the PHTC, followed. SPHIS faculty had numerous interactions with local media to provide updates and worked to offer contact tracing training for interested persons.  

Volunteers from UofL SPHIS made important contributions to contact tracing through the local health department and campus health. The Louisville Metro Department of Public Health & Wellness (LMPHW) and UofL SPHIS worked to increase local capacity for contact tracing. A total of 18 students and four alumni were trained to serve as case investigators and case callers with the LMPHW’s COVID-19 Epidemiology Group. Teams were organized for regular meetings with UofL’s associate vice president for research and innovation, the director of the NIH-sponsored level 3 emerging pathogens research lab, and the division of infectious diseases. Research groups were set up to monitor outcomes of community patients and health care workers infected with SARS CoV-2. 

A team of UofL SPHIS researchers projected trends in COVID-19 cases for regions and counties in Kentucky using a model of epidemic dynamics called the susceptible-exposed-infectious-recovered (SEIR) model, which allowed the team to measure the efficacy of public health policy interventions created to contain COVID-19. Initial results showed the positive effect of social distancing measures in Metro Louisville. Further work by the same team explored the impact of weather conditions on the risk of disease and documented the degree of adherence to mask mandates and advisories in the community. UofL SPHIS is maintaining a website to make these data available to the public. 

As the pandemic progressed, other faculty became involved with efforts to follow activity of the virus through wastewater monitoring. Well before the confirmation that vaccines would be available, teams from UofL SPHIS and LMPHW planned how to set up an accessible site for rapid distribution of vaccines on a large scale and included public health students in a drive-through influenza vaccination clinic as a precursor of larger events to follow. A faculty member serving as liaison member of the CDC’s Advisory Committee on Immunization Practices (ACIP) helped to ensure that key local personnel were kept informed of emerging guidance and vaccine-related information. Ultra-low temperature freezers from the university were located to store vaccines once that need was announced. Students, faculty and staff were trained and participated in the mass vaccination events that followed. Faculty helped structure and maintain a database of UofL students, staff and faculty who had received the vaccine. Outreach efforts were made repeatedly to reduce vaccine hesitancy that was based on inaccurate information. Faculty studied groups of special concern, including racial minorities and the LGBTQ+ community. Throughout the pandemic, faculty participated in meetings with university administrators, the health department, the mayor’s office and local hospitals to ensure that accurate and up-to-date information was being shared and that vaccine was offered equitably to historically underserved communities. At present, a team is working on the assessment of vaccine availability and use of oral antiviral agents for the treatment of COVID-19 infection.  

Dr. McKinney explains that the school’s efforts were not without challenges: “There was resistance locally to the idea of a shutdown of businesses and churches that was difficult to deal with. When it became clear that masks were helpful in controlling transmission, monitoring mask usage despite resistance was the next hurdle. Later in the pandemic, helping to counter misinformation about vaccines and false claims about pharmaceuticals became our focus. Within UofL SPHIS, the greatest challenges were making a smooth transition to online instruction in the Spring of 2020 and in supporting effective faculty interaction while working remotely.”  

Dr. McKinney concludes, “The critical question that has not received enough attention is: How can future outbreaks similar to that of the original SARS (2003) and SARS CoV-2, whether they involve SARS CoV-3, a pandemic influenza strain or another pathogen entirely, be prevented? We need to address the risk associated with large-scale, live animal markets, where species of the same kind from different regions, or many different animal species, are brought together in tight quarters together with humans. These have proven to be favorable incubators for novel viruses with enormous potential for causing disease and death across continents. We cannot continue with business as usual and expect that the same catastrophic events will not happen again soon. By changing our approach, the hope is that we will be better prepared and well-equipped to respond to future public health threats.”

A moment at the beginning of the pandemic stands out for Director of Communications and External Relations Dan McMillan at the University of Iowa College of Public Health: “For me, the moment of realization came on an evening in February 2020. We had worked for several weeks to stage a community event in which a group of our faculty and students used a new (to us) presentation style called Pecha Kucha to share stories about public health with an audience who knew little about our field. It was a wonderful evening with great energy, new connections and hopes for future gatherings. But throughout the evening there were also worried side conversations about the newly emerging coronavirus and what it meant for us. As we departed, someone said casually: ‘Take care everyone. It might be a while before we see each other again.’ Little did we know how long that would be.” 

Strong strategy guided the University of Iowa’s pandemic response: “At the outset of the COVID-19 pandemic, College of Public Health faculty stepped up to support the University of Iowa’s Critical Incident Management Team, helping to develop COVID-19 response strategies including preparation of safety protocols, technical expertise on proper building ventilation, guidance on PPE usage, planning for safe return to campus and effective health messaging to students, faculty, staff and the public,” says Edith Parker, dean of the University of Iowa College of Public Health. 

As health providers nationwide struggled to overcome a critical shortage of PPE for frontline health care workers, there was a desperate need for alternative materials and innovative methods to prolong the life of safety equipment. Iowa experts like Patrick O’Shaughnessy, professor of occupational and environmental health, played a leading part in evaluating the safety of PPE that had been manufactured from novel components, decontaminated using new technologies or produced by volunteers.  

A team of UI faculty, led by Joseph Cavanaugh, professor and head of biostatistics, worked with the Iowa Department of Public Health to analyze data and develop predictive models to help Iowa respond to the COVID pandemic. The team also developed an interactive tool to model the effects social distancing and face masks/shields could have on the future course of the disease in Iowa. 

Early on and continuing throughout the pandemic, College of Public Health students used their student-produced podcast, “From the Front Row,” to share information with fellow students and promote wider awareness about the public health response to COVID. The students interviewed infectious disease researchers, emergency response coordinators, health communications experts and many others to explore multiple dimensions of the pandemic.  

In spring 2020, doctoral student Anne Abbott led an innovative collaboration with local parks and recreation departments to produce materials that built awareness of social distancing etiquette while using outdoor public spaces during the COVID-19 pandemic. These materials, free and available for anyone to download, promoted behavioral uptake of COVID mitigation strategies in the community. 

Two important actions stood out from the university’s response: 

Safe reopening strategies: “College of Public Health faculty provided exceptional leadership in the production and dissemination of rapid research pertaining to workplace safety. In particular, these efforts were key to the University of Iowa’s plans to safely reopen the UI College of Dentistry’s clinics in the face of numerous COVID challenges. CPH faculty, led by Professor of Occupational and Environmental Health Renee Anthony, collaborated with campus colleagues to understand how to control aerosols and particles emitted during dental procedures. Their findings and recommendations helped UI safely reopen dental clinics, and this expert guidance was shared with other colleges of dentistry across the country.” 

Contact tracing: “During the COVID pandemic, public health students applied their training and gained invaluable firsthand experience in pandemic response through community-based internships and special projects. UI College of Public Health students helped lead the local coronavirus response while working as contact tracers at Johnson County Public Health. The students gathered information about positive cases from labs and clinics, called people who tested positive to work out who else may have been infected, then followed up with those potential cases to encourage staying home, social distancing and watching for COVID symptoms. The tracers also entered detailed data on each case and communicated with area employers to help prevent disease spread in the workplace.” 

One of the most significant lessons learned was about trust. “The severe breakdown in trust — particularly the distrust of scientists, health officials and other leaders at the local, state and national levels — may stand out as one of the most serious problems emerging from the COVID-19 pandemic. We need to restore the social connections and sense of shared purpose that have long been the underpinnings of our profession. These human connections have provided the impetus for the greatest public health achievements of the past, and they are essential for rising to the health challenges that lie ahead: a warming climate, rapidly aging populations and growing chronic conditions and yes, the next pandemic,” Parker concludes.

In January of 2020, when it became clear that COVID-19 was spreading beyond the borders of Wuhan, China, University of Georgia College of Public Health faculty began speaking with community groups and local media to put the outbreak in context but also warn of the virus’ potential to reach the US. The tone of the discussion began to shift in late February when cases were reported in Georgia. By March of 2020, with University of Georgia (UGA) students away on their spring break, it had become clear that COVID-19 cases were rising dramatically in Georgia and across the US. The governor and board of regents were likely to close schools statewide.  

Says Dean Marsha Davis, “The moment was, dare I say, unprecedented, and we weren’t sure what the next days or weeks would look like, but together, when our college leadership asked, ‘What can we do?’ the answer was clear: We could leverage the passion and knowledge of our faculty, staff and students to help educate and guide the public through these next few weeks.” 

In the two weeks that UGA closed, before resuming virtual classes, the college hosted a 48-hour COVID-19 virtual hackathon, recruiting over 90 public health students to research and develop public health messaging, from infographics and data visualizations to policy briefs, and even TikToks — all in aid of supporting communities with useful, evidence-based information on COVID-19. The projects addressed issues like how to talk to kids about the coronavirus, how to tell the difference between allergies and COVID-19 symptoms, and the possible impact of shelter-in-place policies on homelessness and domestic violence. Some students created COVID-19 lesson plans for middle schoolers; some tackled data visualization projects to help the general public make sense of the changing case numbers. The resources were made available to the public for free and were widely accessed by nonprofits, local government and faith organizations in the early weeks of the pandemic.  

Dean Davis says, “As a college, we felt called to provide leadership and information to guide policymaking that is grounded in scientific evidence. The hackathon was the natural first step to act collectively as a college, while individual faculty and students were pivoting their research and service activities to contribute to the COVID-19 response.”  

In addition to faculty making themselves available to local municipal leaders and the news media to offer expert guidance on the pandemic as it evolved, there are two efforts that were especially meaningful, notes Davis. “A team of faculty and students partnered with health care systems in northeast Georgia, where Athens is based, and in rural South Georgia to predict COVID-19 cases and hospitalizations to help health care providers prepare for surges. Community and hospital leaders say these reports helped to provide some certainty in uncertain times and served as tools to underline the need for community safety protocols. In addition, faculty and students from our department of environmental health science launched and continue to lead a wastewater surveillance project to track SARS-CoV-2 in sewage samples. The data is generated and uploaded weekly to a publicly accessible database. The wastewater surveillance work has proven to be a timelier predictor of community surges than official case counts, especially as at-home testing has become more common. Local leaders now depend on this work to make community safety decisions that impact Athens-Clarke County residents, the health district and the thousands of tourists who visit Athens each year.” 

There were challenges though as Georgia and UGA felt the consequences of the spread of misinformation about COVID-19 and COVID-19 vaccines. Says Davis, “Some state political leaders felt motivated to act as if the pandemic was over and that basic community safety protocols were unnecessary when the evidence suggested otherwise. This led to unfortunate clashes in the political arenas that spilled over onto campus and into the classroom. I’m sorry to say that much of the research our faculty conducted became less welcome to report as continuing to address the pandemic beyond the spring of 2021 became a somewhat controversial act. This experience continues to weigh on our college community as it seems that across our field, trust in science and scientists is eroding.”  

Davis says she’s learned several lessons from the pandemic, personally and professionally. “One lesson is that even on my most despairing days, all I had to do was look to my faculty, staff or students to feel inspired by their resilience, their creativity, their fight to continue the work of public health. I’m truly hopeful for the next generation of public health professionals who will take this drive and these lessons into their careers and create a healthier world for all that our college envisions.” She continues, “I shouldn’t take for granted the public or communities we serve. Engagement, especially with vulnerable and marginalized communities, revealed deep wells of misunderstanding and mistrust that we helped to build because we just didn’t engage frequently or meaningfully outside of moments of crisis. Trust in public health work is built day-by-day, in the days between acute crises. That said, we’re a college with 60 faculty. Our state health districts and public health workforce has been woefully underfunded in Georgia for decades. This is the challenge going forward: How can we convince policymakers to fund adequate public health services that not only have the capacity to respond to the next pandemic, but address the ongoing and persistent concerns like high maternal mortality, high rates of cardiovascular disease and diabetes, HIV, opioids and so on? What needs to change is that the public health community comes off the sidelines to advocate for our field and our work.”  

She adds: “I want to emphasize the incredible dedication of our faculty and staff to not only contribute to COVID-19 response and research, but to continue to teach and mentor our students in very difficult, and often times, frustrating circumstances. Similarly, I’m inspired by how eager our students were to contribute to the local COVID-19 response and how creative they were. We as academic public health leaders need to do all we can to listen and engage with them to support their passions into careers that will benefit us all.”

“Since my personal area of expertise is public health emergency preparedness, I had the opportunity to work as part of the public health response to SARS in 2003, avian influenza (2005), novel influenza A (H1N1), Zika and other outbreaks globally and locally. I was actually teaching methods in field epidemiology (outbreak investigation) in the spring of 2020 and in the first few weeks of class we were viewing the epidemic curve for COVID-19 during each class session. I remember thinking that we would probably continue to do this for the entire semester and try to stay up to date with the news about COVID-19,” says University of Delaware MPH Program Professor and Founding Director Jennifer Horney. “At the time, I thought this could be the outbreak that would hit the sweet spot that we avoided with avian flu in 2005 and swine flu in 2009 — both easily transmitted person to person AND a severe disease with relatively high mortality rates — and that there may be pretty severe impacts on the public that could last 6-18 months. I obviously never anticipated the scope and scale of the COVID-19 pandemic.” 

But since the University does not have a medical school and the epidemiology program was relatively new, Professor Horney offered her expertise to the University-level committees that were forming to deal with the pandemic. “I ended up serving on both the policy-focused and the operations-focused committees. I think it was important to have epidemiology at the table, particularly as testing became more widely available, as we needed to work more closely in coordination with the state’s Division of Public Health on contact tracing, and as we needed to develop policies to safely reopen our clinical programs and other essential elements of the University.” 

For their small program, they needed to keep pushing forward. Says Professor Horney, “Our first cohort of MPH students had just started their second semester of their first year when we went home for an early spring break and did not return to face-to-face instruction. A majority of our students were already working in governmental public health roles, and they were suddenly facing tremendous demands at work while being enrolled in a graduate program that suddenly shifted to an online format. We continued to focus, not only on growing the program, but on providing very intensive supports to our current students.” 

There were other challenges. Horney says that because the program was so new, “I think we had to convince decision-makers at the University of the value of having public health students working in roles both on campus — such as contact tracing and as health ambassadors — and in the Division of Public Health as part of their full-time jobs or even in practicums and internships. We also had to appreciate the constraints from our public health practice partners to move new initiatives forward and to engage our students.” 

She cites lessons learned in the process: “I think we forgot — or no longer had the capacity to effectively apply — a lot of the basic lessons learned from 9/11 and other public health emergency responses once we stopped investing in academic programs to assist with both workforce development and public health emergency preparedness research. With turnover, retirements and public health workforce shortages more generally, that work wasn’t nearly finished when those programs ended. Going forward, we should all think about the evidence base that has been created as part of this response — what worked, what didn’t — and how the response to COVID-19, although unique, is relevant to many other types of public health emergencies and disasters.” 

She continues, “I think universities in general are focusing too much on the ‘return to normal,’ without putting much strategic thinking into what the new normal should be. As any of us who study disasters know, that won’t increase our resilience to future emergencies, which are more likely than ever. There isn’t nearly enough ‘outside-the-box’ thinking to re-envision what public health training and education should look like, what skills and abilities our future public health leaders need, and how we finally overcome the data and other technology deficits that marred nearly every aspect of the public health response to COVID.”

When COVID first emerged as a dire threat at the University of Cincinnati College of Medicine MPH Program, students were alerted via text and email that the school and many Cincinnati-based businesses would be shutting down. The university community quickly transitioned to virtual learning and telework, following guidelines imposed by the College of Medicine, the university, the State of Ohio and the CDC. In addition, the university put into place stay-at-home orders, along with handwashing, masking and physical distancing signage.  

While staff say it was a relatively easy transition, with everyone stepping up to do their part — whether it be simply remaining vigilant or volunteering as contact tracers — they point to the inability to come together as a community in offices and classrooms as a challenge.  

They note that there are major lessons to be learned about how to communicate appropriate messaging during a pandemic, calling the statements from all levels “sporadic, often incorrect or misleading and quite frankly appalling in some cases.”  

Program Director and Professor Charles Doarn says there is still more to learn about ensuring that all viewpoints are brought to the table during a crisis, pointing to the way telemedicine and telehealth —programs previously rejected by policymakers — became essential during the pandemic. “No idea is bad,” staff say. “Get out of your comfort zone.”

In February 2020, the University of California, Berkeley School of Public Health was the first Bay Area institution to hold an event on the novel coronavirus, now called COVID-19. Art Reingold, infectious disease expert and professor, spoke with the San Francisco Chronicle’s Erin Allday and the Tang Center’s Dr. Anna Harte on the escalating outbreak. “The situation is evolving rapidly,” said Reingold. “It’s pointing out enormous gaps in the global capacity to prepare for, predict and respond to such infections. The world has a lot of work to do.”  

So did the UC-Berkeley School of Public Health. That came in the form of reporting on the unimpeded spread of COVID-19 in California prisons and how better policies can prevent the same from happening in future pandemics and development of a mathematical model by Professor Maya Petersen that helped guide the city of San Francisco’s response to the pandemic. As a result, May 18, 2021, was named “Maya Petersen Day” in San Francisco.  

At the same time, UC-Berkeley’s Assistant Professor of Environmental Health Sciences Laura (Layla) H. Kwong was an integral part of the largest randomized controlled trial to date testing the effectiveness of mask-wearing. Her research showed that masks do work to prevent community transmission of COVID-19, and that surgical masks are the most effective. And Colette “Coco” Auerswald, professor of community health sciences, addressed the needs of marginalized and unhoused youth in San Francisco during the pandemic through her “Ending Youth Homelessness” Catalyst Group. As a result, the City of San Francisco teamed with Larkin Street Youth Services to create a temporary Shelter-in-Place (SiP) hotel available for up to 55 young people aged 18-30 who are at higher risk for COVID-19 due to homelessness and being medically vulnerable to the virus.

As New York City became an epicenter of the disease early in 2020, students and staff at the University at Albany School of Public Health (UAlbany) began to recognize the global impact of the outbreak and knew that life as normal was about to change. There was much uncertainty, but close ties to the community at UAlbany enabled them to work hard as a school to help understand, fight and track the novel coronavirus outbreak. 

UAlbany’s work with the New York State Department of Health (NYSDOH) was absolutely critical for the generation of timely scientific knowledge, including the first comprehensive epidemiological report on the emergence of COVID-19 from a U.S. state in a peer-reviewed publication. The school provided information on how many people were infected, diagnosed, hospitalized, and more. This work essentially gave a “snapshot” look at the pandemic, answering questions that were unknown at the time. Early on, UAlbany also worked with NYSDOH colleagues to analyze the effectiveness of hydroxychloroquine and azithromycin to determine whether these drugs made a difference in treatment. The study added critical information to the evidence base, as benefits were not observed for hydroxychloroquine treatment, with or without azithromycin, in the critically ill patients who were studied. This enabled medical practitioners to make more informed decisions for hospitalized patients. The School of Public Health also contributed to a landmark study of multisystem inflammatory syndrome in children in relation to COVID-19, which helped healthcare professionals across the US diagnose this condition. Maternal and child health experts from the school were also tapped to support the state’s COVID-19 Maternity Task Force by helping to review the impact of COVID-19 on pregnancy. These are just a few examples of the many research papers and reports UAlbany faculty and students have published on Covid-19.

UAlbany Students, who represent several countries and US states, quickly began assisting health departments and public health nonprofit organizations, many of which struggled with a lack of resources and personnel alongside a significant increase in their workload. This meant that the students truly were learning “on the ground,” often completing work that would have in previous years been assigned to full-time employees. Their willingness to learn and their eagerness to help certainly made a remarkable difference for the public health workforce as they responded to COVID-19. 

Aside from impactful work with the local community, UAlbany worked to navigate the pandemic on campus. An operational challenge the school faced was continuing to deliver high-quality education and hands-on learning opportunities when their usual methods were not possible. With a very short turnaround time, UAlbany faculty and mentors rose to the occasion and pivoting their courses and guidance to online formats. Now that they have returned to in-person learning, some faculty still utilize digital technologies to enhance the learning experience — for example, Zoom has allowed professors to more easily bring in nationally and internationally recognized guest speakers who provide invaluable insight and networking opportunities for our students. 

Among the many different hardworking individuals at UAlbany, one student stands out. Lou Rotkowitz, a former MPH student, worked full-time as an emergency room physician in New York City while working toward his degree. In March 2020 he contracted the virus after intubating a COVID-19 patient and became severely ill, struggling with debilitating symptoms. Lou felt even more motivated to finish his MPH degree because of this experience so that he could better help his patients, showing passion and dedication on the frontline that is exactly what is needed in the public health field. 

Over the course of the pandemic, UAlbany was reminded of the importance of health communication. It’s critical to send the right message, at the right time, to the right people, through the right medium. They say that going forward, public health professionals must have better systems and checks in place to ensure that messaging is applicable and understandable and that actions people need to take are clearly explained in layman’s terms. 

The school has also seen clearly throughout the pandemic why efforts must focus on eliminating health disparities, especially on determining where and how disparities emerge. Examining optimal points of intervention, for COVID-19 and other public health concerns, can enhance service delivery and fine tune policy — ultimately improving the health of so many. As public health educators, it’s critical to provide the next generation of public health professionals with the tools to be able to understand and address health disparities in all of the work that they do.

Dean Emerita Barbara Rimer at University of North Carolina Gillings School of Global Public Health recalls, “In January 2020, I received an email from Gillings virologist Dr. Ralph Baric, alerting me to a new strain of SARS virus, subsequently named SARS-CoV-2, that was found in Wuhan, China. He said he thought it could be the big one, a concern also voiced by Dr. David Weber, a Gillings epidemiologist. I was immediately on high attention. Just 18 months before, in April 2018, we had held a symposium entitled “Going Viral” to commemorate and learn from the 1918 influenza epidemic that had killed about 50 million people around the world. Because of preparation for that event, many of us had immersed ourselves in that outbreak, what had been learned from it and what could happen if another such tragedy occurred. At that symposium’s closing session, Dr. Baric predicted that another pandemic was likely to occur, that it was likely to come from a coronavirus, and that, because of environmental and other reasons, it could start in China.” 

Dean Rimer continues, “From the beginning, we were aligned closely with others in the university, including our infectious disease colleagues in the School of Medicine, those in the Eshelman School of Pharmacy and the provost, who was former dean of UNC’s School of Pharmacy. We began discussing the potential for a global pandemic and assessing what we might need to do if we had to close the university to students and staff and how we could continue to keep essential research laboratories functioning on campus. On January 31st, I heard from the Baric Lab that their work on remdesivir looked very promising. People were paying attention. On February 1, 2020, we sent the following to university officials regarding the work of the Baric Lab: ‘We have the opportunity to contribute to eliminating a global threat — good for the world, Ralph and his team, the Gillings School and the department of epidemiology. I hope we can work together to be sure he and his lab can do the work.’”   

On the morning of February 25, 2020, Dr. Nancy Messonnier, spoke frankly at a press briefing, warning reporters of a new respiratory virus originating in China and threatening an inevitable spread to the US. 

“It’s not a question of if this will happen, but when this will happen, and how many people in this country will have severe illnesses,” said Messonnier, then director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control (CDC). “Disruptions to everyday life may be severe, but people might want to start thinking about that now.” 

Messonnier is now the dean of the Gillings School, as of September 1, 2022, replacing Barbara Rimer who stepped down as dean after 17 years in the position. 

By March 9, it was looking increasingly likely that the country would shut down, and that would include the university. Rimer added, “We stepped up conversations in the school and university about what could be done and what our role should be in addressing the pandemic. We operated on many fronts. Our epidemiology faculty members became partners with the NC Department of Health and Human Services, tracking the virus in North Carolina and projecting hospitalizations. We provided advice to university officials about how to proceed, and we worked with our faculty over spring break in March 2020 to prepare to transition to teaching fully online. There were weekly calls with university leaders to discuss and reach conclusions about appropriate actions, including tracking campus cases. We organized and delivered regular online COVID conversations (monthly at the height of the pandemic), a highly interactive Zoom forum in which Gillings COVID experts met with the Gillings and university communities, explained what was happening and helped us all collectively take necessary actions. We read papers and followed CDC advice. We made some missteps too. I wish I’d encouraged masking earlier but followed CDC guidance on the issue. CDC experts themselves were hampered by a White House that resisted acknowledging the full force of the epidemic. Ralph Baric and I participated as part of a National Academy of Medicine committee that mounted a series of webinars on the pandemic. Gillings leadership also offered a series of webinars — “Emergency Preparedness, Ethics and Equity” — to elevate visibility and action on the systems of racism and COVID. We met with state legislators from both parties who provided support to investigators at UNC, including our school, to address questions urgent for North Carolina.”  

There were lessons learned, she says. “As in other threats, communication was critical. We did a good job of reaching out to our various constituencies, but we could have been even more aggressive about it.” 

Ralph Baric said, “The rapid response in terms of therapeutic antibodies, vaccines and drugs against COVID-19 is sort of an unparalleled scientific achievement in biology and microbiology and medicine. That entire infrastructure of collaboration and interaction at the public-private interface paid off. It paid off for the American people. Having said that, we can do better. We learned that we need to reinvest in public health. We need to speak with a single voice in a pandemic. And we need to figure out how to deal with misinformation on social media which we have not been able to deal with effectively.”

At the Tufts University School of Medicine, Public Health Program, Dr. Susan Koch-Weser served on the Milton, MA, “Return to School” Task Force from May-August 2020. The Task Force advised the superintendent of schools on a comprehensive plan to relaunch in-person learning and programs. Planning was guided by up-to-date scientific research and guidelines and sought to: 

• Optimize safety and security for all MPS students, staff and families. 
• Reinforce principles of equity throughout the district. 
• Communicate progress to the MPS community and beyond, so that schools could continue to provide engaging, high-quality education and related services for all.

For the University of Hong Kong MPH Program, the start of the pandemic took place close to home – prompting a quick response from the school. Professor Keiji Fukuda, former director of the School of Public Health at HKU, says, “I was on a family Christmas holiday in Japan in late 2019 when colleagues from WHO alerted me about cases of an unexplained illness in China. From my previous experience working on events such as the emergence of avian and pandemic influenza, SARS and MERS, I knew that the situation could remain limited or quickly escalate.” 

“Given the faculty and School’s deep and relatively unique experience with previous emerging infectious diseases, and Hong Kong’s close proximity and relations with Mainland China, I knew if the situation escalated, the School would be busy. Once the Hong Kong Government informed the public about cases in early January 2020, it was clear that further spread was highly likely and that many of us would be deeply involved in the response,” Fukuda recalls.  

Two concerns drove their response: “The first was how to manage and balance the safety of School students and staff while maintaining continuity of teaching and other work. The second concern was making sure that the School staff contributed to local and global responses as much as possible. Many of the School faculty members are laboratory scientists, epidemiologists and clinicians with extensive experience working on previous emerging infectious disease outbreaks and pathogens.” 

“As a result, School of Public Health staff conducted, and participated in, many of the world’s earliest and most critical scientific studies related to COVID-19. For example, by mid-January 2020, we had developed a protocol for detecting COVID-19, which was one of the earliest diagnostic methods shared on the WHO website. Reagents and methods were shared with over 70 countries and territories. One of our studies modelled and forecast the spread of infection across Mainland China and the world through a mathematical dispersion model. The projections, produced in late January 2020, were in many ways materialised.” 

Research from the University of Hong Kong shaped pandemic response. Fukuda says, “Our research published in April 2020 also confirmed that face masks could help limit the transmission of pre-COVID-19 respiratory viruses from symptomatic people. The finding attracted significant coverage from social media and mainstream news outlets around the world.” 

One observation made at the school was about the key players in COVID-19 responses. “Unlike most outbreaks, COVID-19 was managed at the level of Heads of State, rather than at the level of Ministries of Health. This occurred because countries generally were unprepared, and the impact of COVID-19 was so profound, similar to a war or a severe economic depression. Many countries approached COVID-19 as an individual national or local issue rather than as a collective global challenge. If countries want to avoid another COVID-19-like situation, they need to make the domestic political, bureaucratic and financial commitment to make sure their capacities are adequately prepared for another major pandemic and to adopt the political position that pandemics are global rather than national events,” Fukuda says. 

The school also observed a need for better global networks. “On a global level, the biggest challenge with COVID-19 is the disconnect among policymakers, practitioners and scientists. The global scientific community has collectively risen to the challenge of COVID-19 by innovating and deploying in real time a wide range of collaborative tools and platforms to facilitate epidemic nowcasting. In contrast, ineffective leadership, lack of coordination and inconsistent risk communication have seriously undermined epidemic nowcasting (and, more broadly, pandemic response). This disconnect must be remedied in order to align evidence synthesis with public health operations and policies, with political implementation for the ongoing COVID-19 pandemic as well as future emergencies,” Fukuda adds. 

Dean Amy Fairchild of The Ohio State University College of Public Health recalls the beginning of the pandemic. “In the midst of spring break, informed by both public health and medical leaders at the university, Ohio State’s president made the decision to have students stay home and shift to all virtual learning to end the semester. That started a late spring and summer scramble to set up a group of experts charged with evaluating the science around indoor masking, testing, classroom and office distancing, resident hall density and developing recommendations for fall 2020 so that the university could make a decision about whether to have a limited face-to-face experience or conduct the semester entirely remotely.” 

Priorities needed to be set as the university moved into a response. Fairchild says, “More broadly, I was thinking about what we knew about major global threats historically and how immense the response and resources would have to be if things were as bad as they seemed. I knew that I wanted to offer to be part of the university’s response, help answer questions the public was asking and support all the experts within our college in their efforts to partner with local and state public health and inform the public about the science, even if that science was a moving target. And I wanted to ensure that while we relied on the best science available, we were transparent about the values that necessarily guide decision-making in the face of uncertain and rapidly evolving evidence. Above all, I was worried about the most vulnerable among us and knew that the obstacles to good health and access to protections would be inconsistent for different populations.” 

“The real mobilization started with the Comprehensive Monitoring Team or CMT. That group was supplemented by representatives from our office of student life and, on occasion, academic affairs, so that as we create a complex monitoring system that brought together nearly 60 data sources to make recommendations about testing cadence, masking, gatherings and communications, we understood the practical constraints that shaped the decisions leaders had to make. The key to that group being effective was early buy-in from the provost and president,” Fairchild explains. 

The school’s efforts quickly expanded. Fairchild says “At a university our size, situated within a major city, what started out as a small group of volunteers using Excel to track cases and close contacts evolved to a team of 100+ staff during high volume periods. Our initial staff heavily relied on redeployed Ohio State staff, student employees and public health graduates wanting to apply their previous experiences to assist with managing and tracing COVID-19 case volume and transmission. As the pandemic progressed, creating contact tracing automations based on current policy became an essential component of our work.” 

“The pandemic also created the opportunity to align data analytics resources. We stood up the Ohio State/Infectious Diseases Institute (IDI) COVID-19 Modeling Response Team, which had been an informal and loosely organized interdisciplinary group that included mathematicians, statisticians, epidemiologists, infectious disease physicians, geographers and environmental health risk modelers. The group stepped up to lead analytical efforts for Ohio State’s Comprehensive Monitoring Team and contributed to modeling and monitoring efforts at the Ohio Department of Health,” Fairchild says. 

When facing a pandemic with so much uncertainty, mobilizing change was a serious challenge. “From early on in the pandemic, it was clear that even in key relationships where public health’s expertise was valued and respected, that we’d have to be tenacious, patient and at times insistent if we were going to influence policy in ways that would best protect and inform the public, especially those at greatest risk of the worst outcomes. But we also had to be pragmatic. From the very outset, we framed our work in terms of fundamental tradeoffs in a context of uncertainty.” 

She continues: “The risks of widespread community transmission were a matter of urgency. As we cleared the initial epidemic surge, we began to address the many layers of disease, economic and social risks simultaneously. Although many questions were unanswered, social distancing measures blunted the epidemic surge, creating an opportunity to increase the capacity for surveillance and contact tracing on the part of state and local health authorities. The capacity for viral and antibody testing changed the landscape for us as a university by Fall 2020.”  

At the same time, as a city and state we had experienced nine weeks of stay-at-home orders that amplified collateral viral harms. These included: a battered economy; an increase in mental illness due to lockdown trauma and related stresses; reduced educational, clinical, performance and athletic opportunities; impediments to career development and recruitment; disruptions to social interactions, networking and the university experience; research obstacles; restraints on the university’s role as a resource and special partner in the community; and reduced tuition, state funding and other revenue.  

Each of these harms, in addition to disease, impacted students, staff and faculty, and hindered the university’s ability to fulfill its educational and community missions. Each person was both a victim (in terms of COVID-19 infection or other harm caused by isolation orders) and a vector (someone able to transmit COVID-19), the latter of which was potentially complicated by the significant rate of asymptomatic or mildly symptomatic infections. Moving forward with measured and carefully crafted re-opening plans — while taking into account a broader view of risks and harms — was essential to protecting the health and welfare of our community. But there were loud voices at both extremes in the community. There were some who would accept only zero risk, which could not ever be promised. There were some who did not accept that the risks were serious and resisted sound public health measures, from masking to vaccination.  

“Navigating that terrain — which was both political and touched on values related to community, responsibility and accountability — required effective translation of evidence, transparency about what we knew and did not know about the risks and benefits of different options with clear explanations for why we favored one over another, and explicit discussion of the ethics and values that guided our recommendations to decision-makers,” Fairchild says.

At the George Washington University Milken Institute School of Public Health, Dean Lynn Goldman saw the warning signs early on. “I actually realized this in January 2020, as reports were coming out of China. I had experienced (at another university) the response to SARS and recognized that at my university, we were woefully underprepared for any threat of that magnitude. I at first expected this to be much like SARS, meaning that, as a university in a large metropolitan area with many international travelers, we were at risk. I called on our head of emergency management and the two of us set up a public health committee that had its first meeting in February 2020.”  

“Like most universities, the George Washington University (GW) switched to online instruction during spring break (March 2020),” Goldman says. “We also knew that we had to move quickly to protect health care workers who were on the frontlines of the evolving crisis. First, here at Milken Institute SPH (a project led by Dr. Cindy Liu), we launched a pilot study aimed at shielding health care workers and then we transformed that to a larger project, one that would ultimately become a large-scale testing protocol for the entire campus. Our public health infectious disease experts (especially Dr. Chris Mores) reached out to the GW Hospital to help them establish PCR COVID testing when none was available from DC health and prior to commercial availability of test kits and test orders.”  

Two important efforts taken at the Milken Institute were surveillance and risk mitigation. Goldman says, “Mandatory periodic (weekly) COVID-19 virus testing as well as daily symptom monitoring for all on-campus students, faculty and staff took place. We worked in concert not only with GW’s emergency response team but with virtually every office across campus to devise and implement other safety measures like communications and messaging, mask-wearing, social distancing, systems to verify testing and (eventually) vaccine strategy, new staff and faculty policies and training, and many more.”  

“The end result? GW was able to stay one step ahead of the virus and prevent its spread. We were fortunate to also have schools of medicine and nursing but also experts in building ventilation and health communications to participate,” Goldman says.  

One of the biggest challenges, Goldman says, was reacting to an emergency so unprecedented. “Our university, like all of US society, was not prepared in the first place. At GW, none of our systems were designed to support pandemic care, communications and operations. Our data systems, both for the university and student health, needed tons of work in summer 2020 so that we could manage the health of our population.”  

“All had to pull together in the same direction and much time and effort was required to coordinate across a community that included a multitude of offices that were not used to working together. This level of cooperation was facilitated by an excellent on campus EOC and I am proud of our role as a member of that team. On top of that we had to manage relationships with a community that was fearful that members of our student body (in particular) were spreading COVID,” Goldman explains.  

The response to the pandemic has implications for the state of public health in the US as a whole. Goldman says, “First, public health is chronically underfunded and underprepared. A short-term infusion of money and people will not fix it. We need to see a much longer-term commitment to public health capacity at local, state and national levels. Federal authorities need to be strengthened to allow for clearer and more consistent direction when we have a national public health emergency. Public health research needs to be much stronger and the role of our schools and programs better understood not only by policymakers, but by the agencies themselves. The gaps in our research and how slow we were to apply the public health science we already know (such as around spread and control of aerosols, vaccine hesitancy, and issues around chronic disease and health disparities risks) highlighted the lack of understanding by policymakers of public health science and research and the need for more support.”

“In January 2020, I returned from the Philippines,” remembers Texas Tech University Health Sciences Center School of Population and Public Health Department Chair Theresa Byrd. “We had taken a group of nursing and public health students there for a global learning experience. We heard then that a coronavirus was spreading. My original thought was, ‘Oh just another coronavirus — probably not a big deal.” Next, I was at a Mardi Gras party in February, and one of our bench scientists from the graduate school was sharing that she thought this virus was going to go wild. That it could be a big deal. I trust her science, so I thought, hmmm, maybe we ought to be concerned. By March 17^th, we were all working from home. I realized this really was a global pandemic. My reaction was a little bit of fear and a lot of public health energy! I started right then and there learning all I could, following the news, internet and scientific reports and sharing what I was learning with others.”  

“Our institution was a bit slow to mobilize,” Professor Byrd continues. “We did have everyone work from home. Students all went online overnight. We were well prepared to do this since we already have a completely online MPH. We learned to use Zoom for classes. A COVID-19 task force was formed — at first no one from public health was on it. When my dean told me he was going to a COVID-19 task force meeting and asked what message I had from public health, my answer was, ’Tell them they need to put someone from public health on the committee.’ After that, I was added.” 

She says they planned ways to keep students, faculty and staff engaged while working from home, how to deal with overfilled hospitals and ERs, and how to get as many people as possible vaccinated. Byrd adds that “of course, here in Texas, our governor stepped in to let us know we could not mandate vaccines or masks, so that was an issue. We worked with the local Health Department to develop messaging and to study vaccine hesitancy. We surveyed our faculty and staff about their intentions to be vaccinated and helped to develop appropriate messaging. There was a LOT of hard work!” 

But there were challenges — particularly political ones. “And we really couldn’t overcome them,” says Byrd. “As the pandemic became a political issue. The issue was framed as ‘freedom’ instead of as a public health emergency. In our region, many people did not (and still don’t) believe that COVID-19 was an emergency. Our vaccination rate is only 49%, and only 18% are boosted. The Centers for Disease Control and Prevention (CDC) also challenged us as they continued to change policies, sometimes not necessarily for scientific reasons.” 

She points to lessons learned. “It is so important not to politicize public health issues and to let the experts be in charge! And the US needs to update its method of ensuring that equipment and PPE is always abundant and available (and not expired!).”  

She adds that “I think that this (still ongoing) pandemic has changed all of us. I know that life expectancy has decreased in the US and that mental health issues abound. In my mind, most of us are not yet ‘ok.’ I had no idea how long-term separation from colleagues and friends would affect my mental health and change me in so many ways. I think most of my colleagues feel the same. I guess it gives us insight into how the world felt in 1918.”

According to University of South Florida College of Public Health Dean Donna Petersen, “I had crafted a communication for our relatively new president to send to the university community in late February 2020, as we had been watching [the COVID-19 outbreak] evolve from the initial reports out of Wuhan to the first cases on U.S. soil. We literally said, once we had sent it out, ‘Well, now we just wait for the first case in this area,’ and that very weekend, the first case in the Tampa Bay region was reported. Monday morning, we were summoned to a meeting by our president, a task force was created and I was named its chair.” 

With the task force established, the university set to work to first gather any information that was available. They were data-driven from the very beginning. Says Dean Petersen, “Having an academic health center on our campus and long-standing excellent relationships with our colleagues in the Florida Department of Health, the Florida Division of Emergency Management, County Government (we have a footprint in four counties) and elected officials allowed us to draw upon expertise and be a resource at the same time. We started making those connections immediately. We also committed to transparency at the outset and immediately set up webpages, email inboxes and a data dashboard to track case activity on our campuses. I spoke to any group who would have me — we held virtual town halls with staff, faculty, students, parents. We made ourselves available to our local colleagues, the media and to myriad organizations in the community.” 

She continues, “On campus, there was already a high degree of credibility and trust with our emergency management division because of our rather frequent hurricanes. People seemed to, without hesitation, reach out to ask us questions, share ideas and offer to help. The task force was slightly modified to encompass additional parties than just those who would normally engage in emergency response, and that group met regularly and worked at a very high level. There was a high degree of trust in the group, and we were able to encourage and then capitalize on the creativity of our colleagues. People ransacked every closet on campus looking for stashed PPE.” 

She notes that “one of our basic scientists designed a nasal swab that could be quickly 3D printed. Millions of these have been distributed around the world. Another designed a pooled-testing protocol that allowed us to do our own testing (we don’t have a CLIA certified lab so we could not do individual testing on campus). Our IT people came up with creative solutions, not only how to manage remote learning and remote services, but how to expand our database capability, design a ‘return to campus’ survey that allowed us to draw random samples for testing and allow everyone to complete a daily symptom checker. Our facilities team mapped out spaces, rearranged furniture, upgraded air handlers, placed signage, wrapped up drinking fountains, and distributed face masks and hand sanitizers. We sent over 150 public health students to serve as contact tracers and extended the local public health workforce by deputizing them to do contact tracing on our campuses. On and on — all the while, managing cases, guiding anxious people, supporting families, eventually linking to testing and ultimately to vaccinations. We had great scientists feeding us information so that we could anticipate the impacts of the virus; when we didn’t, we were in a position to react swiftly, and we did.”  

But there were challenges. According to Dean Petersen, “Early on, [there was a] challenge of some individuals professing their rights to autonomy versus our policies that were designed to protect the greater good. I could usually effect some kind of compromise with these individuals, but not always. We had built in consequences for failure to follow these policies but at the end of the day, university leadership didn’t feel that it could actually enforce them. The bigger challenge was politics. We had spent months designing a really elegant vaccine reporting system only to have the Florida legislature in the waning hours of the 2021 legislative session pass a law that prohibited us from asking. As a state university, we must follow the direction of State Board of Governors, who oversee the university system, and the governor who determines our budget. We did our best to work within these constraints, but it was challenging when the data conflicted with the guidance we were receiving. In the end, we achieved the best record in the state system; we had the fewest reported cases by far, and as far as we know, the fewest deaths.” 

She points to lessons to be learned: “We are terrible at communicating a message people hear the way we intend it. We were completely ill-equipped to cut through the noise of all the social media channels. We were too slow to respond — pretty much every time, as things kept changing — and we were not good at countering all the misinformation out there. I wish I knew how to do this, but somehow, we have to restore the idea that we are interdependent on each other, that there are reasons we set aside our individual desires to act on behalf of the greater good. That it is the right thing to do, to make sacrifices for others. I met some great people along the way who understood this and worked hard to advocate but these messages were lost or scoffed at. Very sad.”

When COVID first emerged as a dire threat at the University of Texas Medical Branch School of Public and Population Health, Dean, ad interim, Kristen Peek noted there were a lot of questions: “First, how do we keep our faculty, staff and students safe? How are we going to teach everyone and continue to do our jobs with this threat? How long is this going to last? How do we keep members of our community safe? And of course — how can we help? At that point, we were an accredited public health program within a school of medicine department, so for ‘jurisdiction’ purposes, we were reaching out to our local health authority, the county health district and our president to see what we could do to help with volunteering (if safe), testing, tracing, etc.” 

With that, they put together command task force meetings with all leadership present to deal with clinical, educational, research and public health issues arising in the university and in the surrounding communities. Dean Peek notes, “So we planned through those meetings and our program supported the university’s initiatives where they could through contact tracing and volunteering and communicating with the public (e.g., school systems). Education-wise, we participated in planning of online platforms and constantly checked on our students.”   

Many of their faculty quickly shifted research energy to investigating the impact of COVID-19 on mental, physical and financial health, especially among underrepresented minority populations. They had two large-scale cohort studies on older adults of Mexican descent, and both Principal Investigators immediately focused on the impact of COVID-19 in those studies. Peek adds, “I like to think we had an impact on stabilization in our communities through communication and volunteering.” 

But Peek points to fear and lack of resources as major challenges. “Fear because no one knew where this was going and how long it was going to last — and everyone was afraid. So, it was important to provide straightforward leadership, comfort and action-oriented goals to help everyone stay focused. Then, all resources got locked down. How are we to survive and thrive under such circumstances? — that was one of the biggest challenges that we faced.” 

She notes lessons learned. “It did hit home that communication and trust were so incredibly important in responding to a pandemic. In addition, politics played a much more important role than I thought. Even with lives at stake. It was quite shocking to me. Getting out in front of the issues, clear communication and fostering trust are very important in public health responses.”

In the spring of 2020, St. Ambrose University, Master of Public Health Program held a meeting to make a decision about closing the dorms and shifting online. This was before they had a single case, locally, but the situation in the larger cities was already serious. The MPH program became a key member of the COVID response team and produced a number of short videos to unpack concepts like “flattening the curve” and other newly emerging terms and concepts that are standard in PH/epidemiology that other faculty, students and members of the University’s leadership team valued and circulated widely. Additionally, they prepared weekly information on the virus for leadership/cabinet and for the community. These were mini-lit reviews and county-specific data summaries titled “COVID situational reports.” The data and information provided by the MPH program informed policies and decision-making for the University. The program’s focus was to share the latest data that tempered the massive “mis-” and disinformation that was emerging during the first year and beyond.  

Says Program Director/Professor Melissa Sharer, “We intentionally started our MPH program in 2018 as an online program, this was linked to our values of social justice and access. Many of our students were on the frontlines of the pandemic and felt the need for more information to help them understand how to sort/sift through mis-/disinformation and how to best live and work and support others during COVID. In response to COVID-19 we adapted by preparing informational videos, lunch-and-learns, weekly situation reports for the university that we also shared with the broader community and informal sharing of the COVID-19 experiences ‘at home’ via MPH family emails.” 

Professor Sharer explains, “For us, the biggest challenge was navigating the political considerations for a university situated at the border between two states. Our university is within the state of Iowa, but many of our faculty, staff and students live in Illinois. We were navigating the political and safety concerns of our bi-state positioning as the COVID-19 pandemic was emerging. In the early days of the pandemic, the governor of Illinois declared a lockdown before there was a single case of COVID-19 in our local area. In contrast, the governor of Iowa shut down the monitoring systems well before the pandemic was over.” Sharer continues, “Locally, one of the greatest challenges was the deviation in state-level policy and public health recommendations in Iowa versus Illinois. In Iowa, state regulations limited policies universities could take, including specific legislation limiting mask mandates and vaccination requirements, on penalty of withdrawal of state funds for student grants.” 

“We as a nation and a world need to continue to strengthen the PH infrastructure to be able to be nimble and efficient in any PH crisis. We also need to prepare students to combat mis-/disinformation in a way that inspires change collectively in our community and world.” Sharer adds that “the examples of systemic racism that came out at the time of COVID-19 are inextricably part of our national COVID-19 story and should be linked and taught and help us continue to work to combat inequity that is linked to racism and privilege.”

For the Brown University School of Public Health, the community has been at the core of their pandemic response since the start. Interim Dean Ronald Aubert says, “Since the onset of the COVID-19 pandemic, Brown has focused on protecting our community’s health while delivering exceptional education and impactful research and remaining a valued neighbor in our city, state and region. Transparent and consistent communication with the internal and local community has been at the heart of the Brown response.” 

Aubert recalls the response on campus: “Faculty and staff realized the potential for immediate disruptions to our mission. So how do we teach and conduct research and service commitments remotely? Our educational team and information technology team worked collaboratively to mobilize technological solutions such as Zoom, Google Meet, Canvas and Banner to continue the work of educating the next generation of public health leaders.” 

Two efforts stood out. “The School’s faculty went to work as outspoken advocates in the media and with the nation’s key decision-makers to help shape policy, public health infrastructure and emergency preparedness to combat mis- and dis-information on a local, national and global level. For example, Dean Ashish Jha, now on temporary assignment at the White House, has been at the frontlines of the COVID-19 response, leading national and international analysis of key issues and advising state and federal policymakers,” says Aubert. 

“Secondly, the school took immediate action to help our community partners at the Rhode Island Department of Health,” he says. “SPH faculty built and maintained dashboards to support the governor and the Rhode Island Department of Health, allowing the response team to identify and act on trends and patterns of critical metrics such as infections, hospitalizations, deaths and test positivity across the state.” 

To accommodate the scale of the work, Brown expanded. “Understanding the dire need to expand this work, the School recruited new leaders with national and global expertise in these areas. For example, Jennifer Nuzzo, DrPH, leads a new effort on pandemic preparedness and response at SPH to address the urgent issues exposed in this pandemic and intrinsic to every pandemic: to alleviate human suffering and economic loss. In addition, Claire Wardel and Stefanie Friedhoff have launched the Information Futures Lab, which investigates the harms of misinformation, data deficits, outdated communications practices and other barriers to meeting the health information needs of communities,” Aubert says. 

Over the course of the pandemic, the school learned a few lessons. First, Aubert says “the disproportionate burden of disease from COVID-19 carried by minority and low-income communities has been a stark reminder that, as public health professionals, we need to do more. We need to prioritize the most vulnerable among us through culturally appropriate education and community-informed interventions. In addition, we must continue to support a diverse pipeline of future public health professionals so that the leadership ranks reflect the communities where the work of public health is done.” 

Second, Aubert says “the US must invest in critical public health infrastructure to prepare for the next pandemic. While it is said that this country has the best science and medical care in the world, our normal process of public health evaluation and approvals could delay the innovation needed to address a pandemic.”

The Rutgers School of Public Health has long recognized that we live in an interconnected global society prone to pandemics such as COVID-19. As such, the school immediately realized that COVID-19 was a global threat that would require coordinated action.  

Early on, the Rutgers School of Public Health recognized that to address COVID-19, they needed to partner with local, state and federal entities, as well as community organizations and the press, to offer their resources and expertise. The school partnered with the New Jersey Department of Health and the Office of the Governor on several key initiatives, including contact tracing. The school’s faculty, staff and students were also quick to pivot their work to address the social, psychological, biological and financial implications of the pandemic, offering their unique expertise and skills. But the safety of Rutgers’ faculty, staff and students was of utmost importance. They were one of the first units to pivot to remote education and work within the university. Faculty also assisted with the university’s COVID-19 planning and response, including the decision to mandate vaccines for all university personnel and students, becoming the first major university in the country to do so.  

The Rutgers School of Public Health launched New Jersey’s Community Contact Tracing Corps Program, a key step toward slowing the community spread of COVID-19, as the state began to ease its initial social distancing guidelines. Working closely with the New Jersey Department of Health, the school trained a diverse contact tracing workforce that included people from across the state and students studying public health, social work and related fields at Rutgers and other universities and colleges. The school trained over 1,000 contact tracers using materials and tools developed by Rutgers School of Public Health faculty and staff. The Community Contact Tracing Corps assisted local health departments, who regularly undertake contact tracing for infectious diseases like hepatitis A and HIV, along with the influx of COVID-19 cases, by providing much needed support in the form of in-depth interviews with those infected and any close contacts.  

In addition, the Rutgers School of Public Health has always been committed to disseminating accurate, timely and clear communication and data to where various people and populations — including those at their own university — get information. The school began working with journalists early in the pandemic, hosting a press conference in March of 2020 with various public health experts, clinicians and elected officials. They briefed media outlets on the virus and ensured accurate information from a diverse group of experts reached many audiences. Rutgers School of Public Health experts became the go-to and trusted voices for COVID-19 information in New Jersey and beyond. Experts lent their voices to TV, radio and print publications and were featured on CNN, Bloomberg and publications like The New York Times, Washington Post and in all New Jersey outlets.  

The field of public health has always faced challenges, with the COVID-19 pandemic exacerbating poorly funded and supported public health systems. Early on, Rutgers School of Public Health faculty, staff and students found that it was challenging for many to accept that the pandemic was much more than a biological phenomenon. The pandemic, which is still disproportionately burdening many marginalized people and populations, has social, psychological and financial effects that all impact overall health and well-being of people.  

According to Dean Perry N. Halkitis, there will be other pandemics and we have to learn from the past. “Relying solely on biomedical models, which are based on the notion that people are rationale operators, is failing us. We must work together as health professionals to break the barriers that exist and prevent us from learning the past.” Moreover, “stigmatizing illnesses and people who have them aids in their proliferation. It delays testing and treatment and increases burdens on various disproportionately impacted groups. … Our job as a leading school of public health is to continue training agile public health practitioners who will lead us in developing equitable solutions to new public health challenges. We must also support research and researchers who are committed to achieving social justice and health equity through their work and partner with community organizations to have a true impact. Finally, public health must be recognized as an equal partner to medicine in the management and prevention of pandemics.”

“I was following the development of SARS since fall 2002 [when there were reports] of a mysterious new contagious and lethal disease that emerged in South China. When it started to spread outside China, I followed the news and statistics daily until the pandemic ended,” says Professor and Director Chunhuei Chi of the Center for Global Health, College of Public Health and Human Sciences in Oregon State University. “This unique experience made me (and most public health professionals in Taiwan, Vietnam and Singapore, three nations that were hit the hardest in 2003 SARS) ultra-sensitive [to] any news of a new contagious disease in China.” 

Professor Chi’s attention to the current pandemic began in the latter part of December 2019 when Taiwan’s news began to report mysterious infections that were going around in the Wuhan area. “I was alerted but was hopeful that this should not be a repeat of 2003 SARS when China initially tried to hide it from the international community for several months. By early January 2020, it became obvious, unfortunately, [that this was] a repeat of the 2003 SARS [in] that China was not initially willing to disclose the nature of the new disease — several Chinese researchers’ publications in leading medical journals proved that the Chinese authority knew about the contagious nature of COVID-19 as early as November 2019. At that time, I realized that here we go again! These early attentions would become my strong and primary foundational knowledge about COVID-19, the pandemic of the century.” 

On January 21, 2020, Chunhuei received his first media interview from the Wall Street Journal Beijing Bureau on the nature of this new disease. “Because I was one of the few public health researchers who was prepared to address this emerging and highly contagious disease, I decided early on it would be my responsibility to communicate and inform the public on the nature of this disease and methods of prevention and control. Media interviews are an important venue for ‘translative science,’ which is gathering and synthesizing information, statistics and research evidence, and communicating with the public via an easily accessible message.” 

Chunhuei continues, “My active engagement with the media also provided many other channels of communication, ranging from regional, national and international webinar talks (such as Carnegie Endowment for International Peace and Rotary Club of Summerset, England). I had other opportunities to communicate with different communities. Likewise, I was invited to participate in numerous committees addressing COVID-19 safety (such as the PAC-12 Health and Safety Committee). I saw these engagements as both a public health intellectual’s social responsibility and an opportunity for an academician to have a direct impact on communities.” 

But there were challenges. “The biggest challenge of media interviews is the evolving knowledge and constant new discoveries of the COVID-19 disease and the SARS-CoV-2 virus. As is typically the case in science, most knowledge is accurate in a timeframe and can potentially be proven wrong. COVID-19 knowledge is constantly being revised, and some earlier research, including that published in the world’s top journals, was proven wrong later. As a public health scholar, I have to keep up to date on all relevant knowledge. Each media interview is like an oral exam to me, which is what I told my students. What I [say] will become a permanent public record. The toughest interview [I gave] was on the COVID-19 vaccine, and the target audience was physicians and medical researchers. That interview took me 12 hours of study and preparation, in addition to the knowledge I already acquired prior to the interview. The first one-and-half years of remote teaching and working [could] be depressing, as we were isolated from our relatives, friends, colleagues and students without knowing when this [would] end. It was the notion that I can contribute to public safety and the early ending of this pandemic that motivated me in my work and life during the pandemic.”

At the National Taiwan University College of Public Health, they realized the threat of COVID-19 very early on because of the close interaction between Taiwan and China and the 2003 SARS outbreak. According to Dean Shou-Hsia Cheng, “We had been very cautious about emerging infectious diseases from China as well as other neighboring countries.” 

In the face of the unknown and new virus, their first mission was to disseminate updated information and science to public health professionals in a timely manner. To this end, they worked with the Taiwan Public Health Association to organize physical and online workshops and provide the most updated information. They also organized frequent press conferences to translate and interpret to the general public important international information on the development of the pandemic. At the same time, their infectious disease experts started to work with central and local public health officials to provide consultation and analyze epidemic data on a timely basis.  

According to Dean Cheng, one of the most important initiatives was expanding their infectious disease expertise by recruiting more faculty members from this field. “This was proven to be critical later because our newly recruited staff interacted and worked closely with Taiwan CDC during the later waves of the pandemics.” 

But there were challenges. Says Dean Cheng, “The biggest challenge is the evolving situation of the outbreak on the daily basis and the need for the administration team to react and adjust to maintain the key functions of the college.” 

Cheng adds, “We (both people and the system) have to be flexible during an emergency. This pandemic challenged our ways of planning and doing things. To prepare for future public health emergencies, it is time for us to look back and restructure our organization based on what we learned in the past two years. One lesson is the funding mechanism and the finance system need to be more flexible during an emergent public health issue so that our researchers could have enough resources to respond to and answer important and time-sensitive questions. The second lesson is that there should be a stronger linkage between academia and policymakers. It is possible that the speed of knowledge generation from academia was behind the timeline of policymaking for such a crisis, and the government officials had to make critical decisions in the absence of strong evidence. Nonetheless, examples from other countries have suggested that there are better ways to do science-and evidence-based policymaking. It is also the time for both academia and policymakers to reflect on what happened in the last two years and jointly discuss ways forward.”

At the Louisiana State University Health Sciences Center School of Public Health, faculty and staff knew COVID-19 had become a dire threat when the US reported its first confirmed case on January 30, 2020. The intense period of Mardi Gras parades was just beginning, and the last two weeks of February 2020 would be the peak, ending on Mardi Gras. Dean Dean Smith says, “We were very concerned that this would be a potentially catastrophic event, which has been confirmed to have been associated with as many as 50,000 cases. We were thinking about how we convince people not to act in the usual crazy manner and realized that the city was not prepared to change.” 

As a school and campus, they responded by meeting to review their continuity of operations plans. Being in a hurricane-prone area, they have up-to-date plans and were able to implement remote work and learning, practice and research, and to subsequently launch a tracking and tracing program using their Epidemiology Data Center platform.  

Dean Smith says, “We explored many phone-based applications and did not find any that appeared to be worthwhile. We also launched communications from the School epidemiologists. That included key messages like, ‘There is unfortunately a lot of poor messaging out there now, so we need to be careful consumers of the daily deluge of information,’ and ‘threats from infectious diseases will never go away and this is why many of us are in public health and epidemiology.’” 

There were challenges though. According to Dean Smith, “Misinformation provided innocently as well as deliberately [was a challenge]. A good story or lie spreads just as quickly as the truth. [A second challenge was] individual and organizational resistance to constraints on freedoms. We don’t care about each other as much as we might say that we do.” 

And there were lessons to learn. “The pandemic highlighted how social and economic vulnerability impact health. We need to work on social and economic measures to address a multitude of public health issues,” Dean Smith adds. “Second, the COVID-19 pandemic has made the public more aware of public health and the role its professionals play in addressing the pandemic. Schools and programs in public health have a new opportunity to recruit, train and sustain the public health workforce.” 

“We had been thinking about the threat of a pandemic long before any of us had heard of COVID-19,” Dean Ellen J. MacKenzie of the Johns Hopkins Bloomberg School of Public Health says. “One of my first official functions as dean of the Bloomberg School — back in the fall of 2017 — was to preside over a symposium that reflected on lessons learned from the 1918 flu. Our keynote speaker was none other than Anthony Fauci, and the event’s official title was: ‘The Pandemic: Are We Prepared?’ The answer, according to the panelists, was a resounding no,” MacKenzie says. 

“When the COVID-19 pandemic hit the US we were faced with two overwhelming challenges: One, we had to keep our school community both safe and functioning, and two, we had to leverage our expertise to help the world understand and combat COVID,” MacKenzie recalls. “The Bloomberg School moved very quickly to share the knowledge of our experts, launch new research and projects to learn about the virus and to reduce its risks to the public, and of course we had to make an unprecedented fast pivot to online learning.” 

“Drawing on all our strengths — research, practice, policy, advocacy, teaching, communication — we led rapid responses on all fronts, from the laboratory to the community. Our contributions to the early global response were swift and significant. Our Center for Health Security had prepared for this. In partnership with the World Economic Forum and the Bill & Melinda Gates Foundation, they had hosted a tabletop exercise on global pandemic preparedness just months before — they anticipated the difficult decisions that would arise. And when the reality was upon us, they provided quick-turnaround policy reports, advised governments around the world and galvanized the public. Our faculty collaborated on the Johns Hopkins University Coronavirus Resource Center and map dashboard, which became the global go-to source for COVID-19 statistics. And seeing the need for reliable guidance in their home countries, our students created COVIDEO-19, a series of educational videos about the coronavirus in 35 languages,” MacKenzie says. 

Balancing a constant flow of new information and a steady stream of misinformation was a challenge. MacKenzie says, “We launched a COVID-19 Expert Insights site as a hub for the School’s knowledge with original articles, videos, a searchable FAQ database and more. Our COVID-19 — now Expert Insights — newsletter quickly amassed 80,000+ subscribers, and our Global Health NOW newsletter grew to 52,000+ subscribers. Our Center for Health Security was a leading voice and resource from the early days of the pandemic.” 

The Bloomberg School also worked on cutting-edge solutions that directly approached the crisis from every angle, as MacKenzie explains: “Our faculty, with students at their side, studied every aspect of the virus and found ways to reduce harm. In line with our commitment to forge meaningful connections between our School and the city, we collaborated with public health leaders in our home community of Baltimore on projects to provide much-needed services and resources to the local residents. And as always, the work of the Bloomberg School extended around the globe, with our network of researchers and practitioners addressing each new challenge.” 

During challenges faced both on and off campus, MacKenzie recalls the role of leadership in pushing through: “These challenges often felt overwhelming, but again and again we found a way to move forward. I have always believed in collaborative leadership, and I have never valued it more than during this pandemic. Our actions were not the result of just one or two people making decisions, but a team of people representing all facets of the School.” 

“Together, not only did we weather the storm unleashed by the coronavirus, we created a more vibrant culture of collaboration and problem-solving that will further strengthen us for the years ahead and the new challenges we know will come,” she says. 

Two lessons stand out for the School: “Good science isn’t good enough. We learned the hard way that proven medical and nonmedical interventions will not help control a pandemic if governments and communities are reluctant to follow the science. We need to engage with politics — not flee from it. We must foster closer partnerships among scientists who develop the vaccines and medicines, social scientists and communications experts adept at motivating the public to make use of best practices and lifesaving technologies.” 

And finally: “Get to the source of health inequities. We have always known that disparities in housing, education, employment, and other social drivers produce inequities in health, but the pandemic cast a bright spotlight on this reality. We have seen yet again how unevenly the best health outcomes are spread across races and ethnicities and between the haves and have-nots. If we are to advance health in this country, we must advance equity and social justice.”

For Dean Stuart Tedders of the Georgia Southern University Jiann-Ping Hsu College of Public Health, the moment of realization that COVID had emerged as dire was when communities around the world began shutting down. “For me this was monumental because I had never experienced a global reaction like this to any health problem.” 

Dean Tedders continues, “As public health practitioners, our first reaction was to lean on the pillars of public health: disease prevention and health promotion. We were proactive in messaging the importance of hygiene and other basic safety measures related to control of infectious disease. In many ways, this really brought us together as a community.” 

At Georgia Southern, they poured resources into both the organization and implementation of closed vaccination PODs to serve the institutional community. “We were at the forefront of creating a marketing campaign for the university to use to message hygiene and basic safety measures. Later, when we knew the vaccine would become available, our college team were leaders in the messaging aspects to combat vaccine hesitancy within the university population.” 

But there were challenges, says Tedders. “From an academic standpoint, our major challenge was to implement protocols to ensure continuity of education to our students. For online courses, this was not much of an issue, at least from the faculty perspective. However, courses designed and delivered in a face-to-face format were a bit of a challenge. Balancing this redesign in such a rapid fashion was daunting.” 

Assistant Professor Jessica Schwind, PhD, who has a passion for emergency preparedness, rose to the occasion as a leader in advising institutional leadership about how to design, implement and evaluate a closed POD at the university. “Her intellectual curiosity, attention to detail, boundless energy, commitment to making a difference and problem-solving skills were vital to the success of these PODs.” 

Tedders points to lessons learned: “From a personal and professional perspective, I had never considered mass fear as a significant barrier to effective public health practice. The sheer panic that was pervasive in a diverse community was overwhelming to me, and I’m still unsure how it should have, or could have, been mitigated. On a positive note, though, the COVID pandemic forced us to use the technology at our disposal to its fullest extent. Whether it is from a pedagogical perspective, participating in an institutional meeting or engaging with the community, it is clear we harnessed the power of technology to make a difference.” 

He concludes, “As public health practitioners, it is important we spend time reflecting on our experiences in the last two years. In many ways, I argue the public health community, while doing an outstanding job, was caught flat-footed. It is evident there needs to be more investment in public health infrastructure. Further, mistakes were made regardless of what side of the political aisle you align yourself with. If we do not pause and reflect on lessons learned, we are bound to repeat some of the same mistakes when this happens again.”

For members of the Upstate Medical University Public Health Program, located in Syracuse, NY, the threat posed by COVID-19 emerged gradually. It was easy to dismiss at first, since potential pandemics like SARS 1, MERS and H1N1 were serious, but regionally and/or temporally contained. However, the arrival of SARS-COV2 in Italy, with devastating impact, demonstrated how it could travel and what it could do; by February 2020, physicians in Seattle were treating the first patients in the US, and their descriptions rang an alarm bell. It would take a month before it would arrive in New York State, home to Upstate Medical University. But by then, the institution was already institutionally in an incident command posture, awaiting the inevitable identification of the first cases in the region, which would arrive in March 2020. 

Parallel to the institution-wide response, the Department of Public Health & Preventive Medicine (which houses the Upstate Public Health Program) pulled together its own response team, both to prepare its own programs and operations for the oncoming wave, as well as to respond as needed to broader institutional or regional requirements. Before long, members of the department were pulled into the incident command structure. Incident command was focused largely on protecting the hospital from being overrun by patients; the department had its own graduate program, teaching, research operations and service projects, which all had to pivot to remote work and online instruction. 

While figuring out how the collective talents of the department could contribute to the incident command, departmental and programmatic leadership also foresaw that the “two-week pause” on in-person work and instruction would likely not be even close to enough, and they immediately made the decision to move the program to remote instruction for the remainder of the semester and for department members to be set up to work from home for a long period of time. That quick action served the school well, as the quick pivot was successful, and they stayed remote for more than a year and still do much of their work and a fair portion of instruction remotely. According to Department Chair Chris Morley, PhD, “My first thoughts, almost simultaneously, were: We are public health, we need to be fully engaged in this response; and we need to keep our students, our faculty and staff, our institution, our families and our community as safe as possible.”  

The departmental team ended up contributing in a variety of ways. They helped lead local modeling and prediction efforts for several incident commands, organized information sharing, surveillance systems and dashboards in collaboration with other teams and brought health behavior theories to the table as well. The roles expanded as members of the department eventually started consulting with educational institutions, public agencies (including fire and police), critical access hospitals and manufacturers on mitigation, testing strategies, health communication and more generally explaining the pandemic.  

Says Dr. Morley, “Our two most important actions were to immediately recognize the long-term nature of what we were facing, and shift into it; and then commit our expertise, training, bodies and souls to the fight, and be ready to serve. That may sound overly dramatic and insubstantial, but I believe that adopting these stances is what allowed us to operate effectively and to do the substantive things we were able to achieve and provide.” 

Of course, there were challenges. At first, a lot of groups, constituencies, departments and professions were newly thrown together. Morley says, “We certainly felt misunderstood as public health in a medical institution, but it was more widespread than that. To deal with the chaotic, volatile and sometimes contentious environment, we all had to go back to that mindset of service and to remind ourselves and one another what we KNEW and what we brought to the fight.”  

“Once our institution settled into a routine, I ended up tremendously proud not just of our public health department, but of the entire Upstate Medical University. We banded together, achieved things and provided both care and sound advice to the entire region and state. The next fight, of course, would be against the politicization of the pandemic. I wish we could say we all overcame that (it still exists); what I will say is that we, as individuals and as a department, learned a whole new set of skills and applications in dealing with the public, with different constituencies and with toxic criticism hoisted by politically charged COVID deniers, along with the more generally (and understandably) pandemic-fatigued among us.”  

There are still lessons to be learned, he says. “Public health needs to find ways to communicate what it does. That is first and foremost. We lost a lot of time needing to prove that our skillsets were not only useful, but necessary. In doing so, I also think that we need to communicate the distinction between what is medical and what is public health. We are already seeing the mindset shift away from communally stopping viral spread because we have reasonable vaccines, reasonable therapeutic approaches and a lot of fatigue. The concept that now, hospitals won’t get overwhelmed and most people won’t die is seen as reason enough to ‘live with the virus’ (and return to pre-pandemic life). This posture RELIES upon faith specifically in medical intervention, as opposed to primary prevention and population-level action. It also leaves behind those at greater risk for serious outcomes. I think our perspective needs to be better communicated.”  

“Finally, we MUST find ways to communicate messages in succinct, clear and direct ways. We still can’t tell people how to test, when to mask, etc. without stumbling into arguments. Our public agencies appear to be hamstrung by an aversion to controversy and extreme political pressure. This has led to nearly useless proclamations and policies that are often internally contradictory or watered down and easily questioned.”

At West Virginia University, the Dean of the School of Public Health Jeff Coben explains that their pandemic response started at home. “As a land-grant institution, we are committed to supporting the health and well-being of West Virginians — it’s one of our top priorities,” Dr. Coben explains. “Our first action was to meet with our governor, his team and others across the state to determine how we could help and how we could support the statewide response. Shortly thereafter, the governor identified Clay Marsh, MD, who leads the academic health sciences center of West Virginia University as chancellor and executive dean, as West Virginia’s COVID-19/Coronavirus Czar — a role that required a significant commitment of time and effort. To help address Dr. Marsh’s responsibilities on the WVU Health Sciences campus, individuals across our campus and throughout the University pitched in as a team to provide support while he fulfilled his duties as Coronavirus Czar.” 

Contact tracing was one of the first initiatives launched at West Virginia University. Coben says, “We were one of the first universities in the country to launch a contact tracing training program. We knew the state would need to scale up those efforts quickly, so in order to do that, our team — along with colleagues from WVU, the West Virginia National Guard and Johns Hopkins University — stood up an online training program to enable individuals to learn about contact tracing and obtain certification. We trained over 200 people across the state, exceeding West Virginia’s anticipated need for contact tracers.” 

“Other COVID-19 tracking efforts within the School of Public Health involved mapping, modeling and monitoring — collective efforts that yielded important results and valuable insights to both our university and statewide communities. For instance, our Department of Epidemiology and Biostatistics used geographic data to identify health disparities related to risk and access to care, revealing a shortage of COVID-19 testing among communities of color and increased rates of testing and positivity in areas of food insecurity within West Virginia.  

Additional efforts spanned from leading N95 mask-fit testing for the campus and health care communities to collaborating on the development of alternative personal protective equipment during mask shortages. In partnership with others, they also took the lead in standing up data dashboards that ultimately increased access to critical information, such as testing site and vaccine clinic locations and infection rates. 

An important part of leading a strong response is listening. Coben shares, “Being a part of a larger effort means you must first seek to understand and then seek to be understood. I spent a lot of time listening and gaining an understanding of other leaders’ concerns. It was important for me to express what the best practices were from a public health and medical perspective, but it was equally important for me to first understand other points of view and the concerns of their respective constituents. Rather than taking a dogmatic approach — one that, potentially, others might have ‘closed the door on’ — it was better for me to have a seat at the table and continue to try to work with people, while continuing to express what I felt was the best approach from a public health perspective and recognizing that there were many different ‘pulls and pushes’ on people and the stakeholders they represented as we responded to the pandemic as an institution. Had I been overly dogmatic and not stayed at the table, things may have gone in a different direction and not as well as they did, despite the ever-evolving challenges.” 

And throughout it all, Coben says, “Collaboration is key. We can’t do this alone; we have to collaborate not just with traditional partners but nontraditional partners, too. As we address public health concerns, traditional partners have typically included local and state health departments, health care providers, nurses, social workers, etc. Non-traditional partners that we need to think more about are communications professionals, including those working in social media, health educators and people in the community, among others. Collaboration is key to improving our outreach and meeting people where they are.” 

Reflecting on the pandemic so far, Coben says, “Regarding change, I think one of the things that the COVID-19 pandemic has revealed is that over the years, across the nation, there has been a weakening of the public health system and infrastructure. Public health is something that people tend to forget about when COVID-19 — and other issues like it — is no longer an issue. It’s easy to cut budgets when you’re not at the top of somebody’s thought processes. And when budgets get cut, then people get cut. And when people get cut, services get cut, ultimately leading to a situation where you have very small local health departments that serve the entire population of the county, and that doesn’t work. We need sustained infrastructure development and to develop the public health workforce at the local, state and national levels. An ongoing, significant level of investment in public health is necessary in order to keep all of us safe and healthy for the future.”

At the Yale School of Public Health (YSPH), there were many signs that COVID had become a dire threat. Nathan “Nate” Grubaugh was active on Twitter very early on, warning that what was happening in Wuhan looked ominous. YSPH faculty realized relatively quickly that this was another “SARS,” but one that was less lethal per infection. The fact that SARS CoV-2 appeared to be infectious prior to the onset of symptoms was a surprise as this was not the case with SARS. This, combined with high infectiousness and the lack of immunity in the population, created a strong sense of urgency for a vigorous response.   

Experienced pandemic responder Professor Albert Ko had gone through Zika virus in Brazil and had responded to dengue and leptospirosis outbreaks. In April, Dr. Ko accepted a temporary assignment with the state government to co-chair the ReOpen Connecticut Advisory Group for the governor, alongside Ms. Indra Nooyi, board co-chair of AdvanceCT, and former CEO of PepsiCo. Professor Linda Niccolai and her Emerging Infections Program colleagues mobilized volunteer teams for contact tracing on behalf of New Haven and the state. Meanwhile, a YSPH team joined economists from the Yale School of Management to publish a mask study suggesting the benefits of cloth masks in the absence of KN-95 or surgical masks in late March of 2020. Their team of Anne Wyllie and Nathan Grubaugh developed a saliva-based PCR by May 2020 — Saliva Direct™ — that became a low-cost backbone for labs around the world without any patent claims from Yale when it received emergency use authorization from the U.S. Food and Drug Administration in August 2020.  

Yale’s top vaccine researchers included Saad Omer and Jason Schwartz, who became consultants in 2020 to the WHO, the National Academies of Sciences, Engineering, and Medicine, the State of Connecticut, and others. By April 2020, Professors Krystal Pollitt and Sten Vermund began intensive engagement of schools, arts, and health care organizations in CT, NY, RI, KY and CA for risk mitigation and safe reopening.  

Their public health modeling teams worked tirelessly on estimating transmission dynamics, forecasting how transmission would spread or contract with time and interventions, guiding schools and universities as to best practices to keep them open and safe, costing out interventions and other vital roles. The university made the decision to move all classes online in early/mid-March. Prior to the pandemic, the vast majority of teaching was in-person. The office of academic affairs quickly came up with plans to train and support the faculty for remote learning and to triage technical issues. It is estimated that half of the 152 faculty in YSPH pivoted part or most of their efforts toward COVID-19 in 2020-2022. 

There were challenges, though. Says Anna M.R. Lauder Professor of Public Health Sten Vermund. “Vaccine hesitancy and misinformation loomed large in January 2021. Fortunately, experts like Professors Saad Omer and Jason Schwartz had worked in the field and even in 2020 had started working on this challenge. Connecticut benefited enormously from their initiatives and consultations; it is plausible that Connecticut rates of vaccination, among the highest in the nation, were nurtured by the preemptive counsel from Professors Omer, Schwartz and colleagues.” 

Professor Vermund continues, “Uncertainty as to where viral transmission was going and how to stop it was right in the wheelhouse of our modelers. Professors Ted Cohen, Alison Galvani, Gregg Gonsalves, David Paltiel, Virginia Pitzer, Jeff Townsend, Dan Weinberger and members of their teams all contributed.” A number of these papers were highly influential to policymakers and won “impact” awards from several journals. 

There were multiple stressors that affected all members in the community in different ways. Members of the community lost loved ones and there was a good deal of anxiety and uncertainty. Many of YSPH’s international students faced visa and travel issues, and there were students who could no longer afford to study.   

Vermund points to lessons learned. “Schools of Public Health are too valuable to the commonwealth to only be schools. They should be linked to local and state health departments for emergency response, whether mitigating weather events, pandemic threats or toxic exposures. Existing legal obstacles should be addressed, work contracts established, and emergency authorization and credentials should be in place and able to be activated on short notice. Hospitals affiliated with medical schools serve such roles as a matter of course and this should be generalized to academic public health. This will take new understandings from universities and state and local governments alike. Health communications are inadequate to meet the public’s needs. Vaccine and mask hesitancy, wild rumors about viral origin and spread, and hostility toward public health officials are all widespread. We must do better in educating the public and our policymakers about the importance of public health, well before crises kick in.”

Founding Dean and Professor Paul Halverson of the Indiana University Richard M. Fairbanks School of Public Health – Indianapolis first heard from colleagues about the severity of the pandemic. “I realized that after talking with colleagues at ASTHO and at CDC that COVID-19 was spreading faster and was making people much sicker than what we originally thought to be the case,” Halverson shares. 

“About a week later, I was contacted by the president of our largest health system in the state and was asked to help support them with technical advice and disease modeling and forecasting. Having been at CDC during 9-11 and anthrax, I began to have that familiar but uncomfortable feeling that we had yet to see the worst of these symptoms. Also, having been at CDC prior to H1N1, I know we had developed deliberate plans for state and local response. It was heartbreaking to know that so much of that work had been long forgotten and not maintained for years,” he says. “The budgets for state and local preparedness had been substantially reduced and preparedness planning, training and the careful communication and public awareness campaigns were but a distant memory. I had that sinking feeling that this would again be a crisis that we would not be prepared to address.” 

“In my new role as dean, I recognized that our focus must change to doing all that we could to support our state and local public health departments. We had good people in these roles and this would be a time when our commitment to public health practice would be tested. Our school was created for times like this and our value as a school would be demonstrated by how we responded,” Halverson says. “The first thing we did was to mobilize our school leadership team and describe what our priorities would be over the next several weeks. We needed to help support our faculty, staff and students but we also would do whatever it took to help support our partners.” 

“We mobilized our faculty to support the epidemiological modeling and forecasting for our hospital partners, the state health department and our local public health department in Marion County,” Halverson recalls. “We developed guidance, investigated testing and developed mitigation strategies.” 

He continues, “For the state health department, we helped with developing dashboards, forecasting tools and assisted in communication with the local health departments. Ultimately, we worked with the governor’s office and the state health officer to lead a statewide random testing strategy and worked with the local health department and religious leaders in minority churches to arrange for targeted testing. In addition, we agreed to take on the task of hiring, training and conducting contact tracing for our local health department. Ultimately, we would hire over 200 people and would be available for technical consultation 24×7 to write guidance, emergency regulations and conduct trainings, host forums and help to keep the wheels moving for our public health system.” 

The Fairbanks School conducted integral, early research, he says. “Our school led the first and most comprehensive statewide prevalence study in the United States. We conducted a scientific study to measure the spread of COVID-19 throughout the state. The closely monitored study included random sample testing for SARS-CoV-2 — the novel coronavirus that causes COVID-19 — viral infections and antibodies in Hoosiers. This study led to state and national policy changes and established the 40% asymptomatic rate for positive cases and identified the loss of taste and smell as symptoms of COVID-19,” Halverson says.  

Halverson says two lessons stand out from the Fairbanks School’s experience during the pandemic so far. First, “There is no substitute for a strong well-trained public health staff at the state and local levels with robust infrastructure especially in epidemiology and informatics.” And, second: “We must make sure that our students are well versed in emergency preparedness and our faculty need to know how they can be most helpful during a public health crisis.”

Georgia State University School of Public Health Dean and Professor Rodney Lyn became ill with COVID-19 two days before the nationwide shutdown in March 2020. He says, “The moment of realization for us occurred during this week, though even at that time we could not have imagined that almost 6.5 million people worldwide and over 1 million people in the U.S. (and counting) would die from COVID-19. Our first response was in concert with our university, to protect faculty, staff and students. The university closed. The scale of impact was hard to come to grips with. It was jarring.” 

After moving class to 100% remote for the rest of the 2019-2020 academic year, Georgia State began to invest energy in supporting the university community and the state in responding to the pandemic. According to Dean Lyn, “We worked closely with the Georgia Department of Public Health, and they desperately needed individuals to serve as contact tracers. We put a call out to our students and sent 50 of them over to the state to be hired as contact tracers and case investigators. Our Prevention Research Center leveraged its community connections to share information about COVID precautions and, after vaccines became available, launched a project to increase vaccination uptake. To reach an even wider audience, SPH faculty launched the COVID-19 Forecasting Center, with daily forecasts for states and countries around the globe.”  

He continues, “I was asked to co-lead the campus response, together with the university medical director and chief legal counsel/chief of staff. It was an intense period. Time was of the essence and there was no support outside of the university — we were on our own, much like the health departments, hospitals, etc. Everyone needed to be rescued, but help was slow to come. We had to make our way alone using our internal/institutional resources in those early days.” 

They implemented several initiatives: 

• COVID-19 testing for athletes and those in on-campus housing that leveraged faculty expertise and on-campus labs.  

• A self-reporting system for faculty, staff and students to report COVID-19 symptoms and cases to a case-investigation unit.  
• Development of a data system to daily track and report on-campus COVID-19 tests and cases identified through testing and from self-reporting.  
• Since the university could not mandate testing, SPH faculty developed a sampling method based on COVID-19 testing among students in campus housing to determine the positivity rate and potential spread. They utilized external vendors to expand testing to all faculty, staff and students and provided testing sites across campus.  
• Vaccination clinics and sites for the campus community. 

Dean Lyn adds, “Our biostatistics and epidemiology faculty contributed their time and expertise to develop a sampling plan for COVID-19 testing in the campus residence halls. In reality, they developed a plan for campus-wide testing, but this was scaled back to focus solely on residence hall students. This plan served as the foundation for the university’s testing and data monitoring among on-campus students.”  

“Systems are inadequate. … public health systems, health care systems and government systems,” Dean Lyn says. “There was a need to mobilize quickly, and this was not possible because the systems did not allow for it. Public health and health care needed to work together better, but there was no history or plan to do this well. The government needed to mobilize the private sector, but this was slow to occur because systems and plans were not in place. Data systems and interoperability are critical. We need more professionals with deep expertise in these areas. We need to teach our students to recognize urgent moments. I saw too much slow-walking, as if there was not a crisis with life and death implications. How do we teach this?”

For Senior Associate Dean for Academic Affairs Bob Weiler at George Mason University College of Public Health, the moment of realization that COVID-19 had become a dire threat was January 31, 2020, when the U.S. declared COVID-19 a public health emergency, followed by March 12, 2020, when Virginia declared a state of emergency. “Because of the rapidity of transmission across the U.S. and around the globe, I had this dreadful feeling that COVID was not going to go away anytime soon. At the time, I had so many thoughts running through my head. My elderly father and aging in-laws. How will the country respond? Do we have the public health and health system to launch an effective response — which we later learned that we didn’t. What was Mason going to do? What did Mason need to do to protect the health and well-being of our students, staff and faculty? My thoughts quickly turned to what we needed to do to maintain the instructional continuity for our degree programs to ensure academic progression and success.” 

As it happens, the Emergency Management Executive Committee at Mason responded quickly by forming the Mason Continuity Coordination Team and some 22 working groups charged with developing various plans, policies and programs, including the COVID Safety Plan. These efforts were directed under the leadership of the associate vice-president for safety, emergency, and enterprise risk management who served and currently services as the university’s COVID coordinator. 

Throughout the response process, various members of the college served on a variety of committees and made substantial contributions to the implementation of the COVID Safety Plan. For example, Associate Dean Weiler served as a member of the Instructional Continuity Working Group, which was charged with essentially addressing all matters pertaining to academics and educational instruction.   

Faculty and staff engaged in a number of initiatives to combat COVID. Dr. Amira led a team to create and launch the nation’s first online COVID-19 symptom and exposure tracker — Mason COVID Health Check. They created a vaccination clinic, which delivered thousands of vaccines to the students, staff and faculty of the university as well as members of the Northern Virginia community. And for Weiler, “On a personal level, my most important efforts were (1) creating a distinct undergraduate COVID-19 response internship and graduate COVID-19 practicum that provide experiential learning opportunities for students interested in working in the Mason COVID-19 vaccination clinic; (2) working on the Instructional Continuity Working Group; and (3) volunteering in the vaccination clinic. 

But there were challenges, says Weiler. “From my perspective, I think the biggest challenges had to do with communication and with ensuring that we were doing all that we could to ensure the delivery of our teaching and research mission while protecting the health and well-being of the students, faculty and staff and their families.  We asked a lot of our faculty and staff and they delivered at every turn. Yet I was always concerned about their overall well-being. It was a stressful time. Also, keeping everyone informed in a timely manner was often a challenge given the complexity of the density of the information that was being conveyed.”    

He cites lessons learned: “(1) Do not take for granted the public’s level of health and science literacy and (2) you can’t divorce politics from public health (a lesson that was reinforced). And to improve pandemic response: (1) Expand the public health infrastructure at the national, state and local level; (2) improve the public’s health and science literacy; (3) improve how public health professionals communicate with the public from diverse backgrounds living in communities across the US — urban, suburban and rural; and (4) improve the public’s perceptions of public health.” 

Before the lockdown in March 2020, the CUNY Graduate School of Public Health & Health Policy was mainly focused on getting in front of the communication effort to inform communities — especially vulnerable and underserved communities in New York City such as in Harlem where the school is based — about the virus and community spread. In the weeks approaching the lockdown and during the lockdown itself, the school then expanded its attention to 1) how to seamlessly transition to remote learning; 2) how to continue the fundamental operations of the school and provide cloud-based or remote/virtual means for organizational administration; and 3) work with the city to help provide training to the contact-tracing workforce and to keep the public informed about the virus and measures to protect against infection and misinformation.   

With respect to education, their goal was to ensure that all faculty were well equipped to deliver and manage their courses on the learning management system. Many training sessions were scheduled to ensure that faculty and students knew how to navigate cloud systems, the learning management system, web-based conferences and other systems. The IT unit innovated their service by providing a chat-based system to make it easier for students, staff and faculty to access services throughout the transition. The school ensured that faculty, staff and students had appropriate equipment such as laptops, headsets and internet services to be able to work and learn remotely. The school also secured emergency funding for students demonstrating need, expanded mental health and counseling services as students dealt with isolation and financial stresses, and provided a flexible grading option for students who struggled academically.   

“We were constantly thinking about learning outcomes, the health of our students, keeping students on track to complete their degrees, and any potential financial loss and harm,” CUNY SPH Dean Ayman El-Mohandes says. “To that end, various school committees, the school leadership and work groups collected data to measure how well we were doing supporting various communities and our organization. Our results showed that we did very well to ensure that operations and people were well supported.”   

Researchers and educators convened a task force during the first weeks of March 2020 to discuss potential roles for confronting the pandemic. By considering what the school could produce quickly and consistently with the expertise and resources at hand, the CUNY SPH Covid-19 Tracking Survey (CUNY CoTS) was launched on March 13, 2020. The resulting reports provided vital information that was made available quickly and distributed to news outlets, to public health officials and to policymakers to aid in informing the pandemic response. This 16-week project led to various similar surveys over the past two years, largely from the same team at CUNY SPH. A series of three quarterly surveys (September 2021, November 2021, January 2022) tracked food and housing security across the city and monitored willingness to accept a vaccine prior to authorization and widespread rollout. Then revisiting some of the same issues, they fielded a survey in January 2022 to compare one year of data collection. This included an oversample in Harlem to zoom in on neighborhood-level sentiments and resource needs. The team produced a data report and a recorded presentation to distribute to community partners and local elected officials. 

The CUNY SPH Covid-19 Tracking Survey also paved the way for a series of annual global surveys aimed at tracking public attitudes on the government’s pandemic response, vaccine sentiments and acceptance, and personal risk assessment. These global surveys have led to multiple publications and now a third round of data collection in July 2022. The NYC-level data was quickly synthesized into a report to provide access to information on current attitudes and behaviors across the city with local news outlets picking up key data points. These ongoing survey projects demonstrate CUNY SPH’s commitment to collecting timely data as a foremost research institution, but also the school’s commitment to providing information to empower actions and response at the community level. 

In June 2020, CUNY SPH partnered with NYC Health + Hospitals and the Mayor’s Office of Housing Recovery Operations to help hire and train resource navigators and supervisors to connect those infected or exposed to COVID-19 with free critical economic, social and physical health resources and programs including food delivery, help accessing health insurance, links to a primary care provider and mental health support, help with domestic violence, connections to social services and housing resources, and a “take care” package with enough personal protective equipment for a household to quarantine. This project continues today. CUNY SPH has a cadre of 80 navigators and supervisors who are connecting New Yorkers living with long COVID to services. 

Despite tremendous global efforts to achieve high vaccine coverage and community immunity against COVID-19, widespread vaccine hesitancy has become a major hurdle, Dean El-Mohandes says. “Addressing the barriers to, and facilitators of, vaccine acceptance is crucial in implementing effective and tailored interventions to attain maximum vaccine coverage,” he adds. 

Another major obstacle that has emerged during the COVID-19 pandemic is the increasing amount of false content circulating on social media platforms.  

“Before a vaccine was approved for public use, rumors of safety scares and conspiracy theories swirled, leading to social media outlets taking active measures to limit misinformation,” says Dean El-Mohandes. “These measures, although important, have not prevented a saturated information system nor blocked harmful misinformation from undermining science-backed sources. These features of the media environment and the way people engage with the news call for a revision of the risk communication guidance during a public health crisis.”  

He continues, “As faculty and staff, we were very concerned about the mental health of everyone — but particularly our students. Many of our students come from underrepresented and chronically under-resourced communities. The City University of New York is nationally known to be a powerful driver of social and economic mobility. Education is at the heart of this driving force, and we were collectively concerned about the implications of the isolation and stresses of the lockdown on the ability of our students to succeed in their educational endeavors. As we slowly return to normal, we know that some of our students still suffer from the stress of this pandemic. We intend to keep an eye on the well-being of our students. 

Dean El-Mohandes points to lessons learned: “The importance of clear, concise public health communications from trusted sources has never been more apparent. It is critical that health communicators worldwide are more proactive in tackling risk communication challenges related to COVID-19 and other public health emergencies. Social service, health care, public health and financial systems must work in concert on the federal, state, local and institutional levels, sharing data and aligning their messaging to avoid disseminating conflicting information. Most importantly, marginalized communities and those most impacted by public health crises must be included in the conversation.” 

On December 15, 2019, W. Ian Lipkin, MD, the John Snow Professor and director of the Center for Infection and Immunity (CII) at Columbia University Mailman School of Public Health, was informed of an outbreak of an unexplained respiratory disease. By December 31st, 2019, the Wuhan Municipal Health Commission, China, reported a cluster of cases of pneumonia in Wuhan, Hubei Province. That very same evening, Colombia’s Center for Infection and Immunity Director Dr. Lipkin received confirmation that the causative agent was a novel coronavirus. That Dr. Lipkin was contacted in the early stages by his Chinese colleagues is a testament to his longstanding relationship with the Chinese scientists, having collaborated with them in 2003 to identify and control the SARS coronavirus outbreak.  

One of the foremost authorities on infectious agents, Lipkin has hopscotched the globe helping tamp down outbreaks over three decades. In late January, as concern was increasing across the world about this unknown pathogen, Dr. Lipkin traveled to Guangzhou and Beijing to consult with Chinese scientists and public health officials and serve as an intermediary with the NIH and the CDC. After returning from China, Lipkin made television appearances to sound the alarm. His advice for the United States was prescient: promoting isolation of patients, testing and contact tracing, among other critical containment measures he had seen in China. His first-hand knowledge was valued by colleagues at Columbia Mailman and the University as reports continued to emerge during January and February.  

Says Dean Linda Fried, “As the urgency of the situation became more clear, we were concerned about the impact on our community of students, faculty, staff – and the community in which we work, which was already vulnerable to health inequities. Our first actions were taken out of an abundance of caution, which turned out to be just the beginning of the steps needed to confront the crisis.”  

Informed by Dr. Lipkin’s first-hand experience in China, Columbia University formed in February 2020 the President’s Advisory Task Force on COVID-19, which by early March was meeting on a daily basis—often two times a day. From its inception, the task force included Columbia Mailman School Dean Linda Fried and faculty member Wafaa El-Sadr, University Professor Dr. Mathilde Krim-amfAR Chair of Global Health and founding director of ICAP. The group also included Mailman School alumnae Melanie Bernitz, senior vice president of Columbia Health, and Donna Lynne, senior vice president and chief operating officer of Columbia University Irving Medical Center, as well as leaders from across the University who were responsible for academics, housing, operations and more to steer every action of the University in response to the crisis. Under their leadership, the University developed protocols for moving classes online, students out of campus housing and non-essential staff to remote work, as well as developing a COVID testing program, including everything from the actual mechanics of where they would analyze the test to the operation of the centers and the scheduling system, and a contract tracing program. The testing and the tracing programs, which helped to rapidly break chains of infection, made a significant difference as Columbia’s numbers fell well below New York City’s as well as those in the surrounding areas.  

The School worked at the forefront of developing the science to understand and identify the virus, modeling to inform policy decisions, and programming and communications to prevent the spread. A sampling of the work and recognitions of the School’s faculty includes:  

• When the sequence of SARS-CoV-2 was released on January 11, 2020, Dr. Lipkin and the Center for Infection and Immunity (CII) team, including Nischay Mishra, Ph.D., an assistant professor in epidemiology, working in CII’s high-security, pressurized biosafety level 3 laboratory, developed an antibody test for SARS-CoV-2 as well as a PCR assay that can simultaneously detect influenza A, influenza B, and SARS-CoV-2 viruses. It was employed by the Los Angeles Unified School District and Santa Clara County in California and Rockefeller University.  
• Dr. Lipkin also consulted for the Democratic National Convention in 2020 and the Oscars in 2021 and, together with Larry Brilliant, developed the biosafety protocols used by the film industry.  
• Prior to the crisis, Jeffrey Shaman, professor of environmental health sciences, had conducted a groundbreaking study that examined how disease is transmitted, even by seemingly healthy people. Tapping into those findings and applying them to the current situation, Shaman and his team concluded by late February 2020 that “stealth transmission” by asymptomatic yet unidentified carriers was driving the spread of SARS-CoV-2, a headline-making turning point in understanding the virus. They determined that in China, a stunning 86% of early infections were not documented. Shaman and his team, including Sen Pei, Ph.D., associate research scientist in environmental health sciences, then built models projecting the disease’s spread in the United States using data provided by The New York Times. The calculations laid bare the destructive potential of the virus and exposed the fact that had mitigation measures been used just one week earlier, 36,000 lives could have been saved.  
• From early 2020, Wan Yang, assistant professor of epidemiology, worked with academic and NYC DOHMH colleagues to model the spread of COVID-19 in New York City and assess its health risks, demands on the health care system and the effectiveness of various public health interventions. Late last year, the New York City Department of Health and Mental Hygiene (NYCDOHMH) honored her team of researchers for their disease modeling and epidemiology work on COVID-19 that helped inform city policy with the Community Partner Award for Excellence in Response.  
• In September 2021, the New York City Economic Development Corporation (NYCEDC), and New York City Department of Health and Mental Hygiene (DOHMH) announced their selection of Columbia University to launch and operate the Pandemic Response Institute (PRI) in partnership with the City University of New York (CUNY) Graduate School of Public Health and Health Policy (CUNY SPH). The $20 million grant is “dedicated to preparing New York City for future health emergencies and epidemics in a more effective and equitable manner while positioning the city as a global leader to serve as a model for public health response.”  

Still, there were numerous challenges, from training faculty to providing an education to students now situated all over the world to continuing research that required in-person interaction. From a public health perspective, two of the biggest challenges were the rampant misinformation in the public sphere and witnessing the glaring inequity of how COVID impacted communities. To help combat the issue of misinformation, the School partnered with several stars of the movie Contagion, including Matt Damon, Lawrence Fishburne and Kate Winslet, to produce a series of evidence-based PSAs to explain what individuals can do to protect themselves from COVID-19. The videos were produced by Contagion director and screenwriter Steven Soderbergh and Scott Burns, along with the movie’s scientific advisor, Dr. Lipkin.  

Dean Fried notes we have lessons to learn: “After more than a million deaths in the United States alone, it is clear that this country’s disinvestment in its public health system left it insufficiently able to provide the essential public health expertise and leadership needed during this pandemic. The longstanding pandemic control methods were inadequate to meet the needs of our 21st-century demography of an aging population; the prevalence of chronic disease and health disparities; community health realities and inequities; and changing global threats.”  

She continues, “At the Mailman School of Public Health, we believe that the time is ripe for an insightful conversation on the question — or urgency — of reframing public health as a vital public good necessary for the successful function of societies. If the country is to be prepared for the next inevitable pandemic, the public health system’s mission, capabilities and responses must be reimagined and reinvested in, creating an updated system with modernized infrastructure integrated across federal, state, and local levels of government. The investment would include rebuilding a depleted public health workforce that is fully trained in the expertise needed to conduct surveillance and develop rapid responses, and to further protect the vulnerable in ways that mitigate infection. In sum, the United States must value public health as a public good and invest in it as such.”

When the first few COVID-19 cases were reported in Colorado, the Colorado School of Public Health directed those who could work from home to leave campus. Says Dr. Lee Newman, distinguished university professor and interim chair for the department of environmental and occupational health, “I received a call from a local TV reporter on March 16th who wanted to interview me to help explain to the public the concept of ‘exponential growth.’ Honestly, I wasn’t sure if I was being too alarmist or not. We knew so little. The modeling was in its infancy. But I told him to bring his camera crew to my house and to pick up a large desk calendar and a few big bags of M&Ms. In my living room, they recorded as I placed the first M&Ms on the calendar to represent the first SARS-CoV-2 cases in the state. Two cases, then eight, then a few dozen. … I then started pouring large bags full onto the calendar, spilling over the days. Could this really be happening? It hit me — and my audience — what this really meant and that for starters they needed social distancing and to follow public health guidance. P.S., [the reporter] and his cameraman were the last two people other than immediate family members in my ‘bubble’ to enter our house for the next 18 months.” 

At first, the center was directly involved in messaging about what the virus was and how to protect oneself. Once the vaccine was available, the work shifted to conducting interviews, focus groups and surveys to better understand how to reduce vaccine hesitancy and increase vaccine uptake, especially among residents of rural communities. They then delivered interventions based on needs assessments such as a health messaging chatbot, care kits and trainings for health care workers and community leaders in motivational interviewing methods to increase vaccine uptake. 

Says Clinical Professor May Chu, “I was fortunate to have been able to pull together a consortium of academic high-containment virology labs (to handle the infectious virus experiments), PPE regulatory testing labs (to test the integrity of the PPE in accordance to the regulations), the materials engineer experts (to test the protective effects of the PPE), the PPE standards experts (to ensure compliance to PPE was followed), statisticians, epidemiologists and innovators (a new way to decontaminate PPE that is safe and cheap). This was the DeMaND consortium, we were by then, four virus labs, two materials labs, two registered testing labs, a coalition of over 52 persons, over six countries and two continents. I was also, through my previous work contacts, engaged with a philanthropy organization looking for ways to help and received generous funding. So together, we were able to demonstrate that two cheap and easy methods worked well to inactivate any live SARS-CoV-2 virus on the surface of the masks and N95 respirators: using dry heat for short periods of time and another method, even more intriguing with potential for other applications, use of methylene blue (MB). Our DeMaND work was rewarded with good results coming from so many parties. Further, the WHO picked this up and we explored and developed MB on its application to inactivate Ebola, Lassa, Rift Valley fever, norovirus and other pathogens of public health threat. This work continues to be a successful application of MB to monkeypox.” 

According to Dean and Professor Jon Samet, “The pandemic itself posed the most significant challenge, following its own course as evermore transmissible variants caused successive waves of infection. Colorado, like other states, faced pandemic politics, but at the local level. Colorado’s Governor Polis sought evidence-based guidance in shaping strategies for pandemic control — with the goal of avoiding exceedance of hospital capacity. As a school, our internal challenges were undoubtedly those faced by our colleagues — maintaining operations and high-quality education and a sense of community.” 

Professor Jenn Leiferman points to lessons learned: “We need to increase resources and enhance the infrastructure of our local public health agencies to better prepare for future public health crisis.” 

Dean Samet concludes, “The imprint of the pandemic on the Colorado School of Public Health will be lasting and the school’s practice mission has been redefined. We intend to be a strategic partner as public health is rebuilt in Colorado and the Rocky Mountain Region.” 

At Temple University College of Public Health, Interim Dean Jennifer Ibrahim recalls dealing with COVID-19 rapidly spreading through Philadelphia’s communities, misinformation on the spread and potential “cures,” and an economic infrastructure that would not support a nation in lockdown.  

Interim Dean Ibrahim says, “Drawing from our knowledge of social determinants of health, many of us knew early on that the pandemic would disproportionately impact our communities, and we had to be prepared to do more than just address the virus. The pandemic highlighted structural and social issues that have long plagued our nation but never came to a boiling point where we had no choice but to address them.”  

Ibrahim notes that “the breadth of our disciplines allowed us to mobilize quickly and begin working to address disparities in our local communities with vulnerable populations. We began working first to educate local residents on the importance of masking and social distancing and set up a contact tracing certificate program in partnership with the Commonwealth of Pennsylvania.”  

One of the first things several departments within the college did was donate PPE and equipment to Temple University Hospital, including a ventilator, gloves and masks. And while a vaccine was in development, they worked with the City of Philadelphia to lobby the state government for the language pertaining to the use of emergency powers to be modified to include several of their disciplines so that they could enlist students from programs other than nursing — including physical therapy, occupational therapy and athletic training, as well as students from Temple’s School of Pharmacy — to help in the wake of healthcare workforce shortages.  

Later, once vaccines became available, Temple created a vaccination program called RapidVax. With a $1.2M grant from the City of Philadelphia, they vaccinated and boosted thousands of local residents — including hosting clinics in communities with vulnerable populations as well as on-campus clinics for students, faculty and staff. This program also included significant efforts to educate residents on the importance and safety of vaccination to fight vaccine hesitancy.  

Ibrahim recalls, “In fact, some of our nursing students and faculty were among the first to administer vaccinations when doses became available in December of 2020. Soon thereafter, we began hosting vaccine clinics on campus staffed by College of Public Health volunteers.”  

But there were difficulties, says Ibrahim. “Building trust in our local communities was a challenge. Fighting vaccine hesitancy in neighborhoods heavily populated by ethnic groups who historically have had reasons not to trust the government required a concerted educational public relations campaign, led in large part by faculty in our Department of Social and Behavioral Sciences. We faced challenges regarding getting our early vaccine clinics on campus up and running, with the complexity of coordinating with the university, our hospital system and city officials on short notice. We also encountered the standard issues of obtaining and paying for PPE for our students and faculty — which was significant as a school of public health with multiple clinical disciplines. We also had to deal with issues related to required clinical hours for our clinical programs. We didn’t want to see students wind up with delayed graduation, so in the summer of 2020, we piloted a summer lab session blending stay-home online lectures with safe in-person instruction for students whose programs require this.”  

She points to the insight gained. “The pandemic forced us to do several things that were long overdue. While we talk about the need for interprofessional education and practice, it had largely been in an academic context until COVID hit. The urgency of an effective and coordinated response forced us to think beyond the traditional healthcare providers — doctors and nurses — and to a broader health care workforce that included athletic trainers, physical therapists and occupational therapists. It made us think about the social determinants of health and the roles that public health practitioners and social workers had to support our communities. COVID-19 was a major catalyst for our interprofessional practice and research. Necessity drove our innovation, and now there is no looking back.”  

She continues, “The second lesson was about the way we approached our teaching. For several years before COVID, we had several fully online degree programs, but they were restricted to just those online programs. As part of our mission, we strive to provide students with access to high-quality education. However, we had not fully grasped the different ways of meeting our students where they are — and the associated benefits — until the pandemic forced us to pivot to be fully online. COVID showed us that flexibility in learning opens up more educational possibilities for our students. For example, a working student could not have participated in a lunch-and-learn from their desk at work when we only offered these events in person. Offering these online creates opportunities for more people. Similarly, a student who has to care for a sick child can still participate in class when it’s offered remotely — and not have to choose between school and family.”

In January 2020, University of Michigan School of Public Health epidemiologists began responding to media requests on COVID-19, communicating with reporters and the public on what they knew about the novel virus. Says Dean F. DuBois Bowman, “As the world watched the virus advance globally throughout February, it became clear that the spread spanned far beyond any particular country or region. The changing landscape of our understanding of the breadth of the virus’ impact evolved rapidly as we watched shutdowns cascade across the Asian continent to Europe and into North America. As we witnessed the devastation unfold in coastal cities like Seattle and New York City, it was clear that COVID-19 had already established a significant foothold in North America.”

Like many campuses, the University of Michigan quickly moved to cease all in-person activity in mid-March 2020. With other university leaders, Dean Bowman grappled with the unprecedented question of “how do we fulfill our academic and research mission while keeping our faculty, staff and students safe?” He says, “We knew we needed to shut down in-person activities, but how long would it last? When and how could we resume some in-person activity safely? How can we support our community through this? Developing responses to these questions required broad teamwork and innovative solutions from many on our campus and in the public health community. Our school worked with numerous groups from across campus and the Washtenaw County Health Department to determine how to move forward. To do this work effectively, we had to be well-coordinated with critical stakeholders.”  

He continues, “As a biostatistician, my first reaction is to examine the data to understand a problem. As I think back to early 2020, there was still a lot of uncertainty about what the coronavirus was, how transmissible it was, how it spread and how severe its health impacts could be. Cases began to pop up globally at an alarming rate, and legal restrictions on movement were imposed in many places hit early by the pandemic. In Michigan, cases were rising faster than in many other states in the Midwest.”  

In collaboration with the Michigan Department of Health and Human Services and Governor Gretchen Whitmer’s office, Michigan Public Health faculty began using data to model projected case counts in the state. Says Bowman, “Our team shared data, modeled projections and outlined the potential devastation of COVID-19 if we did not take quick action. State policymakers considered the guidance from our school and ultimately decided to take proactive measures to mitigate the spread of the virus.”  

In late March, Governor Whitmer issued an executive order called “Stay Home, Stay Safe,” which outlined protective measures for businesses and activities across the state. Bowman says, “We continued to track and analyze COVID-19 cases across the state after the order was in place. The measures led to a steady decrease in cases, ultimately helping to save lives and mitigate the spread throughout Michigan.”  

The natural next question became, “When and how can we begin to safely reopen businesses and the economy?” To answer this, Michigan Public Health began working with a group of business leaders and colleagues from the Michigan Department of Labor and Economic Opportunity. Bowman explains, “The economy could not simply be turned back on like a light switch. Our approach had to be more like a gradual turning of a faucet. We supported the state in establishing which data points we would need to reach to move to each subsequent step toward more in-person activity. Our framework became known as the Michigan Safe Start Plan, which helped our state gradually and safely reopen the economy and resume in-person activity.”  
 
Meanwhile, Michigan Public Health Associate Professor of Epidemiology Dr. Marisa Eisenberg led a project to develop a dashboard that showed Michigan COVID-19 cases and hospitalizations by race, ethnicity and gender. The dashboard provided more data to Michigan residents and enabled experts to identify trends early and make informed decisions about public health measures.  

Bowman says that although this was clear to those in public health, imposing significant restrictions on in-person activity in any community is not a decision that can be made lightly. “Few Americans had ever lived through a pandemic, much less restrictions on movement and government-mandated shut-downs due to a virus. We knew we needed data to convince people that these measures were critical for the public’s health and to buy time for us to learn more about how to mitigate the impact of this novel virus. We used the data available to model a variety of estimates and projections about the trajectory of the virus’s spread. We worked to pull all the data we could find from numerous sources — some gathered by us but other data that came from local, state and national efforts. It was immediately apparent that we could not easily predict what would happen because we were working with imperfect and incomplete data. We knew that time was of the essence — we needed to act fast or there would be serious and fatal consequences.”  

Another Michigan Public Health faculty member who has made a significant impact throughout the pandemic is Dr. Arnold Monto, professor of epidemiology. Since 2020, Monto has chaired the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC), which reviews the safety, effectiveness and appropriate use of vaccines and advises the FDA. Says Bowman, “His expertise and leadership in this space have been critical to ushering in the prompt approval of safe, effective vaccines. But this is just one example of Dr. Monto’s impact. He is passionate about combating misinformation and informing the public about the safety and efficacy of COVID-19 vaccination, participating in countless media interviews and other public engagement activities.” 

Bowman notes that “COVID-19 will not be our last pandemic. We live in a global society where the ease of travel enables viruses to spread quickly and easily. Additionally, as our climate continues to grow unstable due to warming, the mass migration of animals will increase, thereby escalating the chance of a viral jump to humans. We can see the devastation of climate change already happening around the world, and most recently, with the shocking flooding in Pakistan. We can also anticipate major human migrations as parts of our planet become uninhabitable for humans. The human density refugee centers and increases in population in urban areas will only make the need to be prepared to mitigate and protect from viral outbreaks all the more critical. It is imperative that the public health community prepare for this future by identifying effective methods to establish community trust in order to deploy protective measures quickly and efficiently. This is a rapidly approaching reality for which the field of public health cannot afford to fail.” 

Some of the first COVID-19 cases in the U.S. were detected in Northern California and were treated at the University of California, Davis MPH Program. Says Chairman and Distinguished Professor Brad Pollock, “One of my friends and colleagues is a pulmonologist and took care of the first infected patient in our ICU. This happened in February 2020, and with the rumors about contagion spreading to other parts of the globe, I realized that we might be looking at a significant epidemic. My thinking was to let my university leaders know that we were available to step in to help.” 

When multiple cases started appearing in the hospital and occupying ICU beds, Professor Pollock looked for some models to help estimate the number of expected new cases over time. “I also called six other large academic medical centers and spoke with the person or persons in charge of modeling bed capacity to determine what they were using as models to estimate increasing cases that were being admitted. In mid-March, I participated in a call with public health, infectious disease and disaster preparedness experts within the University of California (UC) to discuss the best advice for making the UC campuses as safe as possible. Later that evening, I decided to accept an invitation to chair a new UC Systemwide COVID-19 Work Group. This Work Group was charged with developing guidance for each of the 10 campuses of the UC System and operated for over two years.” 

But there were challenges, he says, such as, “Scrambling to move our entire education program from in-person to remote in a matter of a few weeks. Keeping our students and faculty moving forward in the face of a complete change in lifestyle and threat of becoming ill or dying. Recruiting in faculty and staff in the middle of a pandemic.” 

He points to lessons learned: “A key to our success in reducing the occurrence of COVID-19 in the Davis, California, community was the various public-public and public-private partnerships that were either strengthened or newly established. Providing the technical components such as universal PCR testing distribution of PPE and free vaccines was insufficient. Combining these epidemiologic infectious disease control measures with health behavior change interventions was key to our program’s success.” 

When COVID-19 first emerged as a dire threat, the Washington University in St. Louis Brown School Public Health Programs’ Dr. Jason Purnell, associate professor and the director of Health Equity Works, a research-based initiative housed in the Brown School, led a response team of over 40 St. Louis-area nonprofits, social service agencies and government programs to deal with the coronavirus pandemic. New research from Brown School faculty provided guidance to local policymakers on how they might contain the spread of the virus that causes COVID until vaccination ramped up to levels high enough to provide widespread protection.  

In addition, Dr. Matthew Kreuter, the Kahn Family Professor of Public Health, received a one-year $1.4 million grant from the National Institutes of Health’s Community Engagement Alliance (CEAL) Against COVID-19 Disparities. Funding was supported by the American Rescue Plan. To help address the global impacts on social, economic and public health, the McDonnell International Scholars Academy awarded $250,000 in seed grants to kick-start research projects led by Washington University faculty members and their international collaborators.  

Under the leadership of Dr. Lora Iannotti, professor and institute faculty scholar, and Sherlie Jean-Louis Dulience in Haiti, several faculty members, students and staff from Washington University designed and co-instructed public health courses with Haitian counterparts. Research collaborations have also emerged in public health nutrition, environmental sustainability, air quality and engineering, enteric disease, child development and radiology.  

Associate Dean for External Affairs Gary Parker mentions, “The COVID-19 pandemic created challenges that spanned the boundaries of public health, social needs and communication while magnifying already-existing health disparities in St. Louis and across the nation.” The Brown School-based Health Communication Research Laboratory has taken quick action on all those fronts, partnering with local organizations to secure millions of dollars in federal grants to address immediate issues like vaccination and community impact, while conducting longer-term research that can make a difference when the next pandemic hits.  

In March of 2020, the Office of the Dean at Boston University School of Public Health hosted a public health conversation to provide information to the public on the newly emerging threat of COVID-19, when that term was still novel to most. As the world transitioned to remote work and learning, the school shifted to using Zoom in place of classrooms and began planning for remote work for the community. In the dean’s office, they quickly prepared a page on their website dedicated to COVID-19 updates, as they realized clear and frequent communication was what the community needed. They were honest with the community about what they did not know and aimed to be responsive to the data that was rapidly changing. 

“The school leadership was required to be nimble in adjusting to the pandemic, beginning with moving traditional in-person courses to virtual,” says writer/editor at SPH School News, Mallory Bersi. “Our education team compiled resources and provided trainings for our instructors on teaching remotely to help with the quick transition. The administration also worked to provide clarity on remote work and provided resources to employees to help support this transition. We also began to host frequent ‘Community Conversations,’ open to all staff, faculty and students, to meet with the school leadership and ask questions.  

But there were challenges, says Meredith Brown, director, strategy and planning. “The biggest challenge was that there were strong differences of opinion about how to handle the pandemic, and while that was certainly true for universities everywhere, it was particularly true in schools of public health. In the fall of 2020, there was a strong push to be fully remote, but it was important for us to implement a hybrid model because a lot of our students could not engage in an exclusively remote learning environment. This decision resulted in over a year of community debate, with many passionate members of the community making arguments for equity on both sides of the conversation. Another significant challenge throughout the pandemic has been continuing to look forward, when there is so much happening in the present. We often use the framework of balancing the urgent with the important. Much of the COVID response was urgent; we needed to prioritize adjusting to the pandemic, keeping our community safe and connected, but we could not abandon ‘the important’ during this time, as would have been easy to do. The school celebrated its 45th anniversary in 2021, an important milestone to be recognized as a community, and we are now preparing for our 50th anniversary, thinking about ways that the school can continue to be the best community and the best place to be. Our community has done a tremendous job in continuing to look to the future with optimism. On a personal level, one of our biggest challenges in the dean’s office was the steep learning curve to hosting remote programs and remote community gatherings. We had just days to pivot all our external and internal programming to virtual, with no prior experience.” 

She concludes, “The pandemic made it clear that the fundamentals of leadership are 1) clarity of vision, 2) executing that vision and 3) communicate, communicate, communicate. In a time of immense uncertainty, never was it more clear that communities need leadership to act on these three fundamentals to get through difficult times with the opportunity to emerge stronger.”