Rasika welcomes guest Mariah Gesink, a hospital epidemiologist, to discuss the upcoming cold and flu season and steps you can take to lessen the chances of getting sick.

Rasika Mukkamala:

Hello everyone and welcome back to From the Front Row. Today we are delighted to have Mariah Gesink on our show. She’s currently an infection control epidemiologist at Lakeside Hospital in Omaha, Nebraska. She received her master’s in public health in epidemiology from the University of Nebraska Medical Center. I’m Rasika Mukkamala, and if it’s your first time with us, welcome. We’re a student run podcast that talks about major issues in public health and how they’re relevant to anyone, both in and outside the classroom. Welcome to the show, Mariah.

Would you be able to start out by talking about your background and how you got into hospital epidemiology?

Mariah Gesink:

So my background is in microbiology and that’s what I got my undergrad in. So biology and chemistry. And then I was pretty set on going into medical school of course, because what else do you do with a biology and chemistry degree in your undergrad? And it wasn’t until my senior year that I had a professor who was like, “Hey, look into epidemiology. I think you would be a great fit for that. I think that’s exactly what you’re looking for.” And it’s kind of how I wound up finding a master’s of public health and epidemiology. And I got my master’s in 2016 from University of Nebraska Medical Center.

And it was really cool, because while I was there, they had the Ebola patients. And so that really kind of concreted my love of infectious disease epidemiology. And then after I graduated, I worked at a health department for a hot second, like four months, and I knew that was not going to be for me. And while I was in my master’s program, I had done one of my research projects in Tanzania, which is in East Africa. And I just fell in love, in a hospital, and I fell in love with being in the hospital and conducting epidemiology. And so when an opportunity arose, I chose infection prevention as a hospital epidemiology in Omaha, Nebraska, so it was perfect.

Rasika Mukkamala:

That’s so great. A lot of people know what epidemiology is post-pandemic, but definitely pre-pandemic, I feel like it was lesser known about what was being done behind the scenes, but now it’s kind of prevalent and in the news.

Mariah Gesink:

Yes. Before the pandemic, we’d go to dinner parties and people you’d ask like, “Oh, what do you do?” And I’d say, “Oh, I’m a hospital epidemiologist.” And they’re like, “So you skin, like epi?” And I’m like, “Nope, not like epidermis. Nope. It’s infectious disease.” And then they’re like, “Oh, okay.” I’m like, “Like an epidemic.” And then it was so funny, after the pandemic, everyone knew what an epidemiologist is, so they knew exactly what my job was. Which is kind of nice, because I don’t have to explain it, but then everyone thinks that they’re an epidemiologist based on reading some Google articles.

Rasika Mukkamala:

You’re like, “I’m actually trained in this.”

Mariah Gesink:

You’re like, “Funny, I didn’t go to Google College. I have an actual degree.”

Rasika Mukkamala:

I know you generally don’t have a typical day, but can you tell us a little bit about what your responsibilities are and what average week looks like for you?

Mariah Gesink:

Yes, that’s great. Okay. So infection prevention, because the kind of umbrella that I fall under. So basically the whole aim of infection prevention is patient safety and we’re aimed at preventing healthcare associated infections. So I will just refer to them as HAIs, healthcare associated infections. And so by doing that, there’s a lot of ways to tackle that problem or thing. One of them is I do daily ICU rounds in the intensive care unit, and that is just going along, it’s a multidisciplinary team, so we have our critical care docs, we have our critical care nurse practitioners, maybe some residents and fellows. We have the charge nurse of the unit, we have the nurse taking care of that individual patient. We have the respiratory therapist, the pharmacist, PT, OT, all these different people. And we round from patient to patient to patient just to update the plan of care.

And I go, because there are some things that make people more prone to infections in the hospital. One is antibiotics, long-term antibiotics, because it can cause something called C. difficile infection, which is a terrible diarrheal disease. You do not want that. Other things, a central line is basically an IV that ends in the great vessels of your heart. And if you have a central line, you can have a complication of a bloodstream associated infection via your central line. So it’s called a CLABSI, a central line associated bloodstream infection. So I like to round with these providers and nurses to say, “Hey, does this patient really need the central line anymore? Let’s get it out.” Because you can’t get infected from something you don’t have. That’s my philosophy. And so I’m a big advocate of getting things out that you don’t need. Meanwhile, which is kind of funny, before I came to the hospital, most infection preventionists are nurses.

And so nurses like to sympathize with other nurses and they’re like, if the nurse taking care of that patient’s like, “Well, I just really like it because I don’t have to poke the patient as many times and it just makes my job easier.” Well, then they’re like, “Oh yeah, I completely understand.” And they would leave it in. And then here comes big bad Mariah coming in and I’m like, “Well, I don’t see the need, so it needs to come out.” And so I kind of use my nursing ignorance, but I have been well versed nowadays. The other one is a Foley catheter, so that’s something like a tube insert into your bladder to drain your bladder when you can’t move, maybe on a ventilator, sedated, all that kind of stuff, or maybe you have urinary retention. There’s lots of reasons why you would have a catheter.

One of them is to track critical iNO. So input and output of fluids. And so a lot of times, and Foley catheters are great because if you have a patient with a Foley, you don’t have to get them up to go to the bathroom every hour or track, it’s just kind of easy. It’s very passive. And people can get a urinary catheter associated UTI, a urinary tract infection. And so I’m a huge proponent of getting those catheters out so people don’t get infections. So that’s the ICU rounds. Oh gosh, that’s just one thing. So then we could do, there’s daily huddles and then there’s different quality improvement projects that I’m always working on to reduce HAIs. And then there’s surveillance. As the hospital epidemiologist, I put eyes on every single urine culture, blood culture, sputum culture, wound culture, positive influenza, positive COVID, RSV, all the different respiratory viruses.

And then just think of all the different types of testing. You can have HIV testing, syphilis testing, gonorrhea, anything that has to do with microbiology, viruses, bacteria. I look at them every single day. So any patient that comes into the emergency room or is just an inpatient in my hospital, I’m continuing to look at those different microbiology reports and doing surveillance just to make sure that I don’t see any issues or something weird, funky pop up. And that leads into COVID, RSV, influenza. It’s that time of year where the CDC publishes lots of information about how many people are hospitalized, what the influenza rates are, all that kind of stuff. Well, I’m the person behind the scenes that is collecting that for our individual hospital. So during the COVID, I was tracking every single patient that came into the hospital that had COVID, so then I could report out those numbers to our local and state health department and CDC.

And then the same thing goes with influenza, we have to report out those numbers.

Rasika Mukkamala:

Do you report RSV as well?

Mariah Gesink:

I do not. Well, so it’s passive. So there’s different things that are reportable labs that have to get sent to the health department, and RSV is probably one of them. But actual tracking RSV patients in the hospital, no. It’s always historically been influenza and then since COVID came onto the scene, now it’s also COVID.

Rasika Mukkamala:

Okay, that makes sense.

Mariah Gesink:

And then of course, meetings, because what job is not complete without meetings? And then doing education for healthcare workers, patients, the community. I love teaching. And so I love providing education. And then there’s lots of auditing on compliance. How are we doing with our hand hygiene? How are we doing with our urinary catheter care? How are we doing on our central line care? How are we doing with our antibiotic usage? There’s all these different things that we audit. How are we on wearing our PPE going into isolation rooms? All those things.

And then that leads to data analysis, figuring out where we are and reporting out those numbers. God forbid we have an outbreak of something, because then I will be doing an outbreak investigation. When I was a beginning hospital epidemiologist, those things are like, oh, that sounds so fun because it’s all new. And now as a seasoned… I always joke, I’m like a 60-year-old and a 30-year-old body. I’m like, “Please, no one’s spread anything. I don’t want to do all the work to do an outbreak investigation.” So it’s kind of funny how my mind has changed on that. Yeah, we had a patient who, fun fact, fun little storyteller and Rasika knows I love to tell stories.

So this is not even a month into my job. I’m like a brand new MPH grad, not even a year out of school. I’ve only worked at a health department, that’s it, and then I have no nursing, no healthcare experience other than when I was in Tanzania. I get a phone call from our infectious disease doctor, and I’m at a high school cross country race because my husband’s a high school cross country coach, and I have my, not even 1-year-old with me in a stroller and I get a call from my ID doc and he’s like, “Hey, I’m going to rule out one of our patients for rabies.” And I’m like, “Come again. Did you say rabies?” He’s like, “Yeah, it’s rabies.” And I’m like, I mean, if you know anything about rabies, very, very dangerous. Most people die of rabies. And we had had this patient that had come in and he was unresponsive, encephalitis, just weird things.

He was a firefighter, but he also volunteered at the zoo and could come into exposure with bats. And so just like we were ruling everything out, we had no idea. And the last thing on the list was rabies, so we have to do our due diligence. So I literally push my stroller with my child to some parent I had barely known and was like, “Make sure he gets to his dad.” And I take off running and I go to the hospital. We’re on the phone with our state health department and the CDC, and we’re getting ready to transfer the patient to UNMC for the Biocontainment Unit. It’s like this whole thing. I had to go through and find every single person that took care of this patient because God forbid he actually does have rabies and he had any saliva or anything on a healthcare worker, they have to get vaccinated for rabies, it’s a whole thing.

And while he was there, he had aspirated a bunch of times, vomited. So it could have been very possible. So we’re doing all this work up until midnight. And finally we get the specimens sent off to CDC, and our doc just was like one Hail Mary pass. He’s like, “You know what? I think I’m going to test him for West Nile one more time.” Because had gotten tested when he came in, but he was negative along with all these other encephalitis causing pathogens. So logically the next test was rabies. So we sent them off to UNMC. Thank God the rabies was negative. And it turned out that West Nile was positive. It took longer to turn positive. We had tested too early, but by golly, I was a month into my job and I had to do an entire outbreak investigation for rabies. We still joke about it.

Rasika Mukkamala:

Oh my gosh, that’s so funny.

Mariah Gesink:

So after that, anything’s a walk in the park. COVID, meh.

Rasika Mukkamala:

So to all of our listeners who have to do outbreak investigations in your classes, know that it is real and you can be in charge of it one month after graduation.

Mariah Gesink:

Yes, yes. Pay attention.

Rasika Mukkamala:

Yes. So I know in Iowa City, it’s getting really cold outside and I know that means that a lot of people get sick in the wintertime. Can you tell us a little bit about the influenza, COVID, and RSV vaccines and kind of things that the CDC has put out about them?

Mariah Gesink:

Yes. Yeah, same in Omaha, Nebraska. It’s getting cold. I actually have the sniffles right now thanks to my three little boys. They bring all the stuff home from school and daycare. Okay, so let’s talk about influenza first. Everyone get your influenza shot. A lot of people are like, “But every time I get my influenza vaccine, I get influenza.” Or, “I’ve never gotten influenza. I don’t need the vaccine.” Regardless, I always joke, you don’t want to be that person who shows up to Thanksgiving or Christmas and you were supposed to bring a side of mashed potatoes, but guess what? You served everyone influenza instead. That’s the worst.

So get your darn flu shot. I feel like there’s not much has changed in our influenza. Usually it’s a quad valent vaccine. So it vaccinates for two strains of influenza and two strains for influenza A and two strains for influenza B. And they look back the last… It’s not perfect because as we know, I feel like more people are kind of understanding that vaccines mutate. That was the one blessing with COVID is everyone is seeing in real time how much viruses mutate and how difficult it is to come up with a new vaccine every year. I think people didn’t realize that with influenza, they’re like, “How hard could it be to get the right vaccine?” And you’re like, “Actually, a little bit more difficult than you would imagine.” So don’t be a critic. But anyways, it’ll still offer protection. Even if you do get it, it’s not going to be as severe.

I joke one year I got my flu shot, I’ve always gotten my flu shot and my sister did not, and I got it. And again, it was just the annoying sniffles, crappy sleep, one to two days and you’re done. Meanwhile, my sister was face down in the bathroom, thought she was dying, and I was like, “And this is why we get our influenza vaccine.” She’s like, “I’ve learned my lesson.” Okay, so that’s influenza. The second one, let’s talk about RSV. So huge gains in RSV in the last year. So now we have two new vaccines aimed to protect older people. So I think it’s like, and don’t quote me on this, 55 years or 65 years, I can’t remember which one is the age range of when you should get it. We’ll just say older adults. And again, this is the traditional platform. It’s very similar to your influenza shot.

It’s not like the new technology of mRNA that our COVID vaccines have. So I mean, the technology has been around forever. We introduce an inactivated RSV protein into your body, then your immune system, your host cells stimulate your immune system. And then that way we can recognize the actual RSV virus when it does enter your body, when your immune system encounters it, and so then you, voila, have some immunity to it. And then the overall efficacy for these is pretty dang good. I think one vaccine is upper 80s and then against severe infection it’s like 95% effective.

Rasika Mukkamala:

Oh wow.

Mariah Gesink:

Which is great.

Rasika Mukkamala:

That’s pretty good.

Mariah Gesink:

Yep. And then they looked at, I think for two seasons it’s like 67% effective. So maybe you would only have to get this every other year. They don’t know if it’s going to be an annual shot. The second cool thing with RSV is, I know you said vaccines, but I’m going to throw in my monoclonal antibodies, is this new thing, monoclonal antibodies for children under the age of two. So this is pretty awesome. It gives them immunity for nine months. So baby born, maybe it’s their first coming, maybe you just had a baby right now, it’s November. You could theoretically get monoclonal antibodies for your child and it would protect them through this RSV season. So that’s pretty cool. The CDC recommendations right now, just because there’s not enough for everyone is babies that are preterm or have other, what do I want to call it?

Rasika Mukkamala:

Preexisting conditions?

Mariah Gesink:

Yeah, preexisting conditions or that kind of stuff.

Rasika Mukkamala:

Okay, that’s cool.

Mariah Gesink:

But that is a huge, that’s amazing. And the last one is a vaccine targeted for pregnant women, which provides them with antibodies that they could pass along to their baby. And so when their baby’s born, the newborn has protection from birth to six months from severe RSV. So it’s kind of like pertussis and pregnant women where like pregnant women get vaccinated during pregnancy between, I think it’s like week, oh gosh, I should know this, 27 and 33. And that prevents babies, it’s not because the mom needs protection, but it actually is just so the mom can pass the antibodies to the unborn baby. And so then the baby is born with protection from pertussis because pertussis is a very severe, awful whooping cough for infants. So that’s another cool thing with RSV.

Rasika Mukkamala:

Wow. The more you know. That’s cool.

Mariah Gesink:

I know. So tell your pregnant friends, maybe you guys don’t have lots of pregnant friends though. Tell pregnant family members. Tell anyone that’s pregnant. So those, and then lastly is COVID. So you probably have seen in the news there’s this, they don’t call it a booster anymore. It’s the updated vaccine and it’s monovalent with the latest, gosh, Omicron. I’m going to butcher it, you guys, because I haven’t even stayed up on all the versions, but even though the, what’s it called? I’m going to draw a blank. The variant has mutated and is something new right now, the updated vaccine, everything that is circulating right now has come from that strain. So they’re all descendants of it. So it will still offer protection and it will still protect from severe infection.

Rasika Mukkamala:

Are there a lot of people that are getting the vaccines this year? Is it recommended by the CDC? Is it highly suggested? What can you tell us about what the CDC is recommending?

Mariah Gesink:

Yep. So the CDC recommends everyone get it. I don’t know how much vaccine uptake has actually happened in the United States and just in our area, because I just don’t think people talk about that as much as it did when the first vaccines came out. And usually same with influenza. It usually takes towards the end of the season, we get numbers of how many people were vaccinated that season for influenza. So I think it’s so new, we just don’t know yet. But yeah, highly recommended by CDC to get it. It should have six months of protection, all that kind of stuff. I think the big thing people are talking right now about is, do you get your RSV, influenza, and COVID all at the same time? Do you spread it out? All that kind of stuff.

For me, I personally would spread them out because I don’t think a lot of tests have, or research has gone into your immune response if you get vaccinated to all three. And I would rather be on the safer side and be like, okay, well, I’m going to get my RSV vaccine now and then a couple of weeks later I’m going to get my influenza shot and then I’ll get my COVID shot. But again, that’s three different office visits or you know what I mean? So a lot of times that’s not feasible for people. So a lot of people are just going to get all three of them because it’s better than nothing.

Rasika Mukkamala:

Yeah, and I think too, it really depends on if you’ve had a previous reaction, also. I know for me, when I get the COVID shot, I get really sick. So I personally want to separate them so I know for certain that it’s the COVID shot that’s making me have an immune response so that next year I can track it in a sense. It’s good to know which ones are giving you these reactions and making sure that your body is working. It’s sometimes nice to separate them so you know what your reaction is to each of them.

Mariah Gesink:

Yeah, yeah.

Rasika Mukkamala:

So as people are getting sick and people around them are getting sick, what are some good practices people can follow to try to stay healthy or get better quicker?

Mariah Gesink:

Yes, okay. So obviously infection prevention. I always joke at my hospital, it’s like, wash your bloody hands season. So washing your hands is the first step. Practicing good etiquette when you are sick, staying home. I have the sniffles right now, so I have a tissue and every time I wipe my nose and then I go somewhere, I’m hand sanitizing the crap out of my hands, coughing into your elbow, all that kind of stuff. And then as far as just be smart when you are out and about, try to avoid touching your eyes and avoid touching your mouth and all that kind of stuff. And then people are going to be getting together for Thanksgiving. Thanksgiving it is in three weeks. I am like, in shock.

Rasika Mukkamala:

Which is crazy.

Mariah Gesink:

Yeah. So that’s a huge, it’s gathering time for people. So just make sure that you’re washing your hands and if you’re not feeling good, keep distance from your loved ones that are older. My grandparents are in their late eighties, so we’re very mindful if the kids have sniffles to keep them away from their grandparents.

Rasika Mukkamala:

It’s easy sometimes to forget all of those things that we learned during the pandemic now that we’re kind of in the post pandemic era when those were all the rules that everyone followed right after. It was like, make sure you test before you come to Thanksgiving, things like that. And now a couple years after, it’s almost like we need to go back to the basics of what we followed. So it is good to hear about the advice that you have for our listeners and for their families during the holiday season.

Mariah Gesink:

I know, I think the one thing that has made me the most frustrated coming out of the COVID Pandemic is we saw how easy it was to have these at-home tests for COVID. I’m like, by golly, why can’t we have these at the supermarket for influenza and RSV? Like a quick nasal swab at-home test. Oh, I have COVID. Okay, now I know I should go to my doctor’s and be seen and then they can prescribe me some antiviral medication or whatnot. And I’m like, it’s so doable. I’m like, why don’t we do it? And I feel like there’s a market because by golly, we saw how many people were obsessed with getting tested for COVID. I would probably be one of those people who would be always testing my kids for RSV and influenza.

Rasika Mukkamala:

Yeah, I know. I remember in undergrad when they had the randomized testing and we would get an email on Monday and you would have to go by Friday. And I do think it gives some sort of peace of mind, especially when there are so many asymptomatic patients. But it’s definitely interesting to think about that was so unique to COVID and now it’s not necessarily happening anymore. So it is, it is hard.

Mariah Gesink:

Yeah, and right now there are so many other respiratory viruses and crap out there that is not influenza and it’s not COVID and it’s not RSV. And it’s so weird. We’re seeing these patients come to the hospital and they’re testing negative for all this other stuff. Rhino-enterovirus is really popular right now. And then so is I’m seeing a lot of Metapneumovirus. So those are the two viruses that are circulating. Not much COVID, which is kind of interesting.

Rasika Mukkamala:

Yeah, that is interesting. Hopefully it stays that way.

Mariah Gesink:

Yeah, you know what? I would totally be okay. Everyone keeps saying the sky is falling, the sky is falling, that we’re going to have this huge uproar in COVID and it just hasn’t happened. So I don’t know if the old girl just doesn’t have it in her anymore and she’s just going to… We know influenza and RSV do it.

Rasika Mukkamala:

Yeah.

Mariah Gesink:

They were like, hold my beer for a couple years and now they’re back at it.

Rasika Mukkamala:

Now they’re back with a vengeance.

Mariah Gesink:

They are. They’re like, “You forgot about us. You shouldn’t have forgotten about us.”

Rasika Mukkamala:

So during your career, what is one thing that has surprised you about being in hospital epidemiology?

Mariah Gesink:

I guess I thought, I don’t even know. At this point, I feel like I’ve had an entire career warped into seven years. I mean, a lot of other IPs, I’m one of the youngest one in our CHI Health region or even hospital system, there we go. And most of them are in their late forties, fifties, and some of them are about ready to retire, and they’re like, “You have seen stuff that we have gone our entire career…” You know what I mean? It’s just so crazy. So I joked that nothing would surprise me anymore after dealing with monkeypox, almost Ebola, Marburg, all the things. Nothing literally will surprise me. But one of your questions was, what was it?

Rasika Mukkamala:

Oh, what is one thing you thought you knew, but we’re later wrong about?

Mariah Gesink:

Yes. So with that question, I will say with COVID, I definitely thought we were going to have a more overrun hospital system with COVID, kind of like what we saw out in New York City kind of stuff. So I was really preaching the doom and gloom. “You guys buckle up, it’s going to be bad.” And it was bad, it was so bad, but it wasn’t as bad as I thought it could have been.

Rasika Mukkamala:

Yeah.

Mariah Gesink:

Does that make sense?

Rasika Mukkamala:

Yeah, like-

Mariah Gesink:

It was still terrible.

Rasika Mukkamala:

You kind of was looking at other places and were seeing how bad it was there and you were thinking it would be as catastrophic almost. And it’s still was like-

Mariah Gesink:

It wasn’t catastrophic. It was horrific.

Rasika Mukkamala:

It was bad.

Mariah Gesink:

It wasn’t catastrophic, yes.

Rasika Mukkamala:

Yeah, no, that makes sense to me. I understand.

Mariah Gesink:

I thought we would have ICU patients in our surgical suites needing ventilators. You know what I mean? We would turn our ORs into ICU rooms. We did not have to do that, thank goodness, our hospital was at capacity completely and all that stuff, but we didn’t have as much of the critical. Which was really interesting. Nebraska’s population over the age of 55 is like 22% of the population of Nebraska’s over the age of 20, or over the age of 55, which is very similar to New York. I think New York’s is like 24, 25, 26%. So I really did think that was going to happen here, looking at the numbers when I was running my projections and all that kind of stuff to get the CHI Health leadership to understand the severity of what could very well happen, like truck trailers out at hospitals, [inaudible 00:28:00], I was like, this could be us.

But something very different that the Nebraska governor did was when they had COVID cases happen in nursing care units or nursing homes, they removed those patients and put them in designated areas to isolate. So we had one hospital in the Omaha Metro that took this offload of patients and then one hospital in Lincoln, Nebraska.

Rasika Mukkamala:

Oh, wow.

Mariah Gesink:

And I really think this was the reason why that didn’t happen was because nursing homes had a place to, A, put these very sick patients and so they didn’t spread it to everyone else. And then hospitals are a little bit better equipped to handle isolation practices than say, a nursing home where the ratio is one nurse or one tech to 15, 20 patients. And so this happened throughout the entire pandemic, and I think it’s a huge reason why we didn’t have that huge death toll in our elderly population that would’ve overrun the hospital systems.

Rasika Mukkamala:

Yeah. No, that’s great.

Mariah Gesink:

And then, let’s see, yeah, I don’t know anything that would surprise me.

Rasika Mukkamala:

I think it’s good that you’ve experienced so much in your career, because now you can teach everyone and the next generation of future hospital epidemiologists what you’ve seen and what you’ve learned, because I think that’s really valuable is making sure that the information gets passed down so that the mistakes that maybe you saw during the COVID pandemic and during monkeypox and all of that, that it doesn’t get repeated later. So making sure that it’s taught, even if something didn’t go right, it’s important to know that it didn’t work because that’s how we improve. So I think it is good that you’ve experienced all this, because now you’ll be able to adapt that in the rest of your career.

Mariah Gesink:

Yeah, okay. So that’s a great segue. Something that surprised me would be that I didn’t think I would fall in love with teaching so much, being in this role and teaching is a huge aspect of infection prevention and hospital epidemiology. And that was something that surprised me. And yes, what you’re saying is passing down those stories and passing down the learnings that we’ve learned is one of my huge passions right now, hence why I’m going back to school, which most times I regret. But anyway, yes. And that’s another thing, I’m so surprised that we don’t have a dedicated career track where we educate for this profession. And I definitely see in the next maybe even five, 10, 15 years that that’s going to change, where people will go to school to become hospital epidemiologists, go to school to become infection preventionists, because as we can… There’s this huge population of, because it used to be called infection control practitioners or infection control nurses, and we moved away from controlling something to preventing it in the first place.

So a lot of the big movement in infection control happened in the 1980s into the nineties. And all those nurses that started this career are retiring and they’re leaving. So when I first started, the projections with infection prevention were three out of every five infection preventionists will be retired by 2025. And I think the COVID pandemic, A, sped that up because people are like, “I don’t need this. I’m about to retire. I’m just going to leave.” And so there’s this huge gap going to come up. And now we’re seeing a lot more masters of public health like myself come into it.

But again, it’s like drinking from a fire hose if you have never been exposed to anything like this. So I definitely think that’s something, even if it was like a, I don’t even know, a sub-field under epidemiology where you focus-

Rasika Mukkamala:

Like a specialty or something.

Mariah Gesink:

Yeah, a specialty where you take classes and you learn about things in clinical stuff, you learn about different surgeries. I just remember being a brand new infection prevention, and they basically treated me like a nursing student slash medical student. They’re like, “Okay, you’re going to go observe all of these surgeries.” Because I didn’t even know like, “What area of the body are you cutting into?” And so there’s so much knowledge that you need to have. And so I definitely think that would be something amazing to have.

Rasika Mukkamala:

I agree. I think it’s really important to keep the lineage going, and especially we don’t know what we have in store for us in the next few and beyond years. So we just need to be prepared. And the best way to be prepared is to tell people what we experienced. I appreciate you coming on the podcast and sharing with everyone about your experience and telling us a little bit about the vaccines that are recommended for this winter. And to our listeners, if you liked this podcast, feel free to like and subscribe on Apple Podcasts and Spotify and listen to next week’s episode. Thank you so much for joining us, Mariah.

Mariah Gesink:

Of course.

Rasika Mukkamala:

Anytime.

Lauren Lavin:

That’s all for our episode this week big thank you to Rasika for hosting Mariah on the podcast today. This episode was hosted and written by Rasika Mukkamala and edited and produced by Lauren Lavin. You can learn more about the University of Iowa College of Public Health on Facebook. Our podcast is available on Spotify, Apple Podcast, and SoundCloud. If you enjoyed this episode and would like to help support the podcast, please share it with your colleagues, friends, or anyone interested in public health. Have a suggestion for our team? You can reach us at cph-gradambassador@uiowa.edu. This episode is brought to you by the University of Iowa College of Public Health. Until next week, stay healthy, stay curious, and take care.