A Critical Role
Community members who contract or are exposed to COVID-19 may find themselves talking on the phone with Rebecca Nyangufi, one of about 45 University of Iowa College of Public Health students who are working part-time as contact tracers at Johnson County Public Health in Iowa City. These students have the unique experience of helping the local public health department and wider community handle the coronavirus pandemic, all while gaining valuable skills.
For Nyangufi, a senior majoring in public health, the experience has solidified her choice to pursue public health. “Before, it was really hard to explain to my friends and my family what public health was.” Now, she says, with public health professionals leading the battle against a pandemic that has upended daily life, people are beginning to understand the critical role public health professionals play, often behind the scenes, to prevent disease and promote health.
She also has a new appreciation for local public health and how different public health professionals work together to manage the pandemic. “They do a lot to keep the community safe and keep everyone healthy,” she says.
Contact Tracing Lessons and Opportunities
In leading the local coronavirus response, the Johnson County Public Health Department receives information from labs and doctors’ offices about positive cases in Johnson County. Contact tracers call the people who test positive and work to figure out who else they may have infected, and follow-up with those potential cases to encourage staying home, social distancing, and watching for symptoms. The tracers also enter detailed data on each case and communicate with employers to help prevent the potential spread of the disease in the workplace.
Collected information is also revealing health disparities due to the pandemic — multiple analyses of available federal, state, and local data show that people of color are experiencing a disproportionate burden of COVID-19 cases and death. Callie Ferring, a senior majoring in public health and Spanish at the College of Public Health, has seen these inequities in her work as a contact tracer in Johnson County. In one case, she talked with a family of 10, of three different generations living in a single household. “It just wasn’t possible for them to isolate from one another,” she says, “It definitely opened my eyes to disparities in Johnson County.”
Both Nyangufi and Ferring have an interest in working in global public health and had the opportunity to gain experience abroad before the pandemic hit, in South Africa and Costa Rica, respectively. While international job opportunities are in limbo, the students have seized the opportunity to work in frontline public health roles in their home state of Iowa.
“It is very difficult to have a normal internship or job [right now],” Nyangufi says, “I’m not happy about the pandemic, but it has given us real things to learn from with what we’re experiencing. I would have never anticipated as a freshman, three years ago, that I would be doing public health work during a pandemic.”
Public Health Classes Spark Passion
The student contact tracers are navigating all of this as both students and young professionals, using their body of knowledge from coursework and training and applying it to the current moment. All students majoring in public health at the University of Iowa learn about the spread of disease during their core courses, and many dive deep into studying pandemics in a class called “Finding Patient Zero,” taught by Matthew Nonnenman, assistant professor of occupational and environmental health. Students also have the opportunity to learn about public health emergencies in the class “Public Health Emergency Preparedness,” a course created by adjunct instructors Laurie Walkner and Bonnie Rubin.
“Finding Patient Zero is all about infectious diseases and how public health goes about finding the cause, treating it, and preventing it,” says Carly O’Connor, a second-year undergraduate student at the College of Public Health who is also working as a contact tracer. “We learned about different disease outbreaks, and it’s astounding to say we’re living in one now. They’ll probably teach about it in that class in the future.”
O’Connor, a Bachelor of Science student, is drawn to the quantitative aspects of public health — think disease modeling, rates of infection, and infectious periods — that are key to understanding the pandemic. She isn’t sure if contact tracing will lead her to find her calling in public health, but she knew that it was an opportunity she didn’t want to pass up. “I’m only 19 years old, and I’m already working for a public health department in the real world in our community and that is so cool to me,” she says.
Sam Jarvis, Community Health Manager for Johnson County Public Health, leads a team that supervises the contact tracers. He has also taught “Public Health Emergency Preparedness” at the College of Public Health. Jarvis says the students already have a desire to serve, the education, and diverse experiences that prepare them for the job. “It’s a wonderful opportunity to immerse students in local government public health, provide real-world experience, and support local public health’s mission of disease prevention. We’re hopeful that we’re instilling a strong desire to work at the local governmental public health level in the future,” he says.
For Madison Snitker, a Master of Public Health student, that desire is there. With her graduation on the horizon, she wants to continue on her current path in a local public health setting with a job in health communications or emergency response.
As an undergraduate public health student, she was largely influenced by the class “Public Health Emergency Preparedness,” which focuses on how public health responses are shaped in times of crisis.
“It was my absolute favorite undergraduate class. We learned so much about disasters, whether that be natural disasters, outbreaks, or bioterrorism,” she says.
Now that she has experience as a contact tracer, she feels more prepared for a job in local public health. “It has opened my eyes to the importance of county health work, whether that be here in Johnson County or a rural area like where I’m from in Allamakee County, and it’s helped me focus on where I want to end up being,” she said.
The Power of Communication
Contact tracers need strong communication skills, including sensitive and interpersonal skills, cultural sensitivity, and interviewing skills that allow them to build and maintain trust with community members.
Ferring recognizes the importance of her Spanish language skills in her public-facing role. While Johnson County Public Health uses an interpreter service, she says her knowledge helps minimize miscommunications.
The students acknowledge that it can be difficult talking to people who may be misinformed about the virus, or struggling to handle the news that they could be sick.
“You deal with different personalities every day and some people are really outspoken. Some people feel like you are invading their privacy,” Nyangufi says. Her response is professional — she communicates that this is a way of helping prevent further spread in the community.
Snitker emphasizes how much she has learned to communicate with people in difficult situations. “This is a very heightened time of fear and anxiety of just not knowing things,” she says. “Being able to communicate and help them through those tough feelings and experiences regarding COVID-19 has definitely been a learning experience that I will take with me through the rest of my career.”
While the future of the pandemic may be unclear, one thing is apparent — these young public health professionals are ready to take the lessons from today into their future and continue to work towards a healthier community.
Story, video, and photos by Katy Stites
This story also appeared in the fall 2020 issue of InSight magazine.