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.”