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.