Kaci Ginn is this week’s guest. She’s currently an undergrad public health student at the University of Iowa College of Public Health who is also working at a county public health department helping to navigate the COVID-19 pandemic.

Steve Sonnier:

Hello, everyone. Welcome back to From the Front Row, brought to you by the University of Iowa College of Public Health. My name is Steve Sonnier and if this is your first time with us, welcome. We’re a student run podcast that talks about the major issues in public health and how they are relevant to anyone, both in and out of the field of public health. Today, we are delighted to talk with the University of Iowa CPH student, Kaci Ginn, who is working towards her Bachelor of Arts in Public Health. Kaci, welcome to the show.

Kaci Ginn:

Hi, Steve. Thanks so much for having me today.

Steve Sonnier:

Can you tell us a little bit about what you do? What’s your current experience like and how has it being a student and everything along those lines?

Kaci Ginn:

Absolutely. Hi, everyone. My name is Kaci Ginn. I am a third-year undergrad student on the BA track like Steve mentioned. I also am serving right now as the Preparedness Specialist with Jones County Public Health, which is a semi-rural county in Eastern Iowa, halfway between Dubuque and Cedar Rapids. I actually just got an unofficial acceptance to the undergrad-to-grad program at the University of Iowa, as well. So, I’m excited to be continuing on my education at the university. I definitely found myself in a unique situation with this pandemic. I had actually been an intern with Jones County Public Health on and off since about my senior year of high school, going back for summer break and winter breaks and all those fun things.

Kaci Ginn:

And, I remember, it was March about 15th, 2020. I got a text from Jenna who was the director and she said, “Hey, you’ve done some of our social media stuff in the past. Would you be interested in even just some part-time work helping us to kind of manage communications and making sure that our Facebook page is staying up to date with all the rapidly changing information?” And I said, “Yeah, absolutely. I think I can handle about 5 to 10 hours of work a week and I would love to help you guys out.”

Kaci Ginn:

It’s a really special opportunity to be able to work in the community where I grew up. I actually graduated from Anamosa High School and my parents still live on their small farm in Olin. My mom loves it that I worked there because I see her every once in a while around town. That, I guess, internship opportunity from high school really blossomed into now, I’m a part-time employee of the county. I’ve transitioned from just being PRN as needed to a standing fixture of the department. So that is, has been a great opportunity with a very steep learning curve.

Steve Sonnier:

It sounds like it, I mean, being trusted it from this position of being a bachelor student through your bachelor’s side of things and coming in with that experience, what did that look like? You talk about, obviously, having roots within the community as a whole and understanding how things operate. But when you’re coming up against this novel pandemic, what really was your day to day when you were first starting out with it? What did that look like?

Kaci Ginn:

I would say, going back to March, I actually had a Snapchat memory from a couple maybe last week, and it was a picture of me sitting in front of my personal computer and my work computer listening to an IDPH webinar about when those first isolation and quarantine guidance documents were emerging. And, just trying to keep up with how things were changing so we could keep the public informed because, I mean, we were getting calls from the Chamber of Commerce, from the local bakery down the street, all of the schools, daycares. So many people wanted so much information that we really didn’t have. So it was, I think, the best way I’ve heard it summed up is drinking from a fire hose, which is how the pandemic was evolving. And then, that was also amplified, even more being … Still, I think, I was taking 16 credit hours coupled with the pandemic, experiencing it as a person, experiencing it as a student and experiencing it as an emerging professional was very much this perfect storm of could have gone a lot of different ways, but it, somehow, worked out.

Steve Sonnier:

When I’m thinking about it, there’s so many different ways that public health leads folks in so many different areas. And for you, what made you stick out and say, “Jones County Public Health, this is where it’s at. I really want to see what I can do to help out my community.”

Kaci Ginn:

You mentioned earlier, having roots in the community and that social capital, which is a research area that I’m really interested in. It’s been such a help, I think, for the department as a whole. I mean, if I get quoted in the newspaper, that’s the same newspaper that was writing articles about me when I was playing softball in high school. My parents have lived in that community for 30 plus years. So, having those names to faces, I think, for community members, also helped out an extra degree of humanity to it, especially when there’s like, “Oh, public health said we have to do this.”

Kaci Ginn:

We had a business where there was an outbreak and I had a personal relationship with the owner of that business outside of my role in public health. So, I feel like, again, adding that humanity to those conversations of saying, “Hey, we don’t want to shut down your business, but we need you to take a hard look at how you’re doing things.” First of all, because we couldn’t shut down a business, even if we wanted to. But, again, having that humanity being approachable, I think, was really the crux of being able to do good work in Jones County. And then, also just the opportunity I had the relationship with the department chair. The supervisors walking into those meetings are like, “Oh! Hi, Kaci.” They’re like, “Oh, I didn’t know if it was the Kaci from Jones County or someone who maybe happened to have the same name.” And, I also think that helped maybe soothe some nerves of, “Oh! We’re bringing on this other person.”

Kaci Ginn:

When I already had that institutional knowledge of how the department ran, how do you keep track of our time? It’s just those little things that I didn’t necessarily have to be trained on because I had already been trained on them before. I knew how to change things on the website. I knew how to get into the Facebook page. That, I think, again, it was just a perfect storm of being in the right place at the right time with the right skillset.

Kaci Ginn:

I, actually, last spring, took the fundamentals in public health, emergency preparedness and response. So, that also contributes. So, I was taking like the ICS 17 and 300 classes. So, I knew what an EOC was. I knew what emergency operation center was. I knew what things could look like especially with in such a small county, there’s some idiosyncrasies that go on where we do things this way here because it works for us. So, having that humility of coming from the academic, the bubble, we all can pretty much see that there’s very large distinctions between theory and practice that worked together really well. But again, having that humility of saying, “Okay, well, maybe because it was presented to us like this in class doesn’t necessarily mean it’s going to work this way, but having those two kind of perspectives to inform each other, I think, was really helpful for me.

Steve Sonnier:

When you’re looking at the coursework [inaudible 00:08:12] mentioned, the academic bumble side of things a little bit. When you’re looking at the coursework that you were able to do, were there other things that you were able to gain in your public health education that you took into this drinking from a faucet situation?

Kaci Ginn:

Absolutely. A really big course that comes into my head is, I believe, it’s called public health science. It’s the very first Biostat class that you take. Dr. Chorazy was teaching it when I was a first or second year, I think, still. So, those are not values. That meant, honestly, nothing to me when I was a student learning about it. But then, when you’re seeing like infectivity rates in the news, you’re like, “Oh my gosh! I know that I know what that is.” And, having the words, having that academic background to explain it to a stakeholder, to explain it to a local politician, I feel like it really helped me internalize it. So I was able to then present it to the world in a way that they were ready to gear because something that has really stuck with me is people aren’t used to maybe seeing science in such a public way.

Kaci Ginn:

So, when things are changing, when guidance is changing, there’s always this moment of one, ‘Oh my goodness. I have to change all of those documents that I’ve been producing and all my social media graphics.” But then, two, you have to present the change in a way that this is a good thing. This isn’t changing because we necessarily made a mistake. It’s changing because we now know more and we understand better so we can do better.

Steve Sonnier:

I really liked that idea of change is not a mistake. I think, that’s very hard for folks to understand, it is. And I’ve loved that idea of you’re seeing science actively happening. And for us, in the academic bubble or in the practice bubble side of things, there’s this certain transparency now with public health where we’re right out in the media. We’re always talking about here’s this thing changing and it is inundating for the average viewer. For folks in our side of the field, obviously, it’s like, “We did this on a daily basis. I’m so used to it.” But for the person who’s processing all this stuff, it’s a lot of change.

Steve Sonnier:

When you’re looking at the communication side of things, was there something that you had either difficulty communicating or was there something that the people that you were communicating to had difficulty understanding during the pandemic, especially when we’ve seen so many things evolve over the course of these months?

Kaci Ginn:

Yeah. I think, the thing that really sticks out to me is when the CDC changed the isolation and quarantine guidance to … We went from that straight 14-day quarantine with close contact or 10 days for isolation, if you’re ill or you’ve tested positive, or you’re presumed positive, those kinds of things. But when it went from, you can do a straight 14 days, that’s the gold standard, or in order to improve adherence, we’re going to back it down to 10 days without a test seven days with a negative test within the last 48 hours. When you’re doing disease investigations, people are stressed. People are like, “Oh my gosh. I just tested positive for this.” “I don’t know how this is going to turn out.” “I could have long haul symptoms with a mild case.” “I could end up in a hospital [inaudible 00:11:39].” “I could infect my grandma that lives down the street that I was with two days ago, that I didn’t know I had COVID and I was just doing the best I could with the information that I had.”

Kaci Ginn:

So, that was really challenging. And even still, I think about, I don’t do many case investigations anymore, but it’s very overwhelming to think about the people, especially nurses, who are doing case investigations as their primary job function. I commend them so much. I just have immense gratitude for people who are still doing those disease investigation, because there was definitely a shift, especially after those new guidance documents came out. I feel like people were, as the pandemic wore on, they were very much burnt out from all of the information. And I think that they just weren’t receptive to it, which I think if I hadn’t been bathing in it 24/7, I think, I probably would have gotten there, as well. So, you can’t fault people for wanting a normal life. You can’t fault people for … At the beginning we were thinking realistically, a vaccine is three to five years out.

Kaci Ginn:

And I think, a missed opportunity for public health with messaging was, we went straight at the public with like, “Stay home. Don’t do this, don’t do that. Don’t do the other.” People aren’t very receptive to that. I mean, even as someone working in public health, there’s this dissonance. I really like going grocery shopping. I don’t know why. That’s just something that I enjoy. So, there was very much this distance of like, “Oh gosh. I really want to go to the grocery store and pick out my [produce 00:13:30] and all those fun things.” But then, you’re sitting at home doing your grocery pickup because you know it’s the right thing to do. And, people get tired of that really fast.

Kaci Ginn:

So, I think if we had taken more of a harm reduction model, we need you to know that you’re assuming some sort of risk going about these activities and that’s a decision that you have to make. I very much appreciate how public health 3.0 is trying to take that personal responsibility out of things, because we have to acknowledge that 80% of our health is based on the systems that we exist in and about 20% is that personal responsibility, that self-motivated behavior. But, I think, there are things that could have been done differently. And, I wish, I would have recognized that sooner because I think, we could have prevented some issues.

Steve Sonnier:

I think, that’s a very common theme. Now, there’s a little bit of hindsight is 2020. What could we have done better? But, I think that it will be important to dwell and study those things for when the next pandemic happens or for when something similar happens in another epidemic or whatever have you. I’m wondering about what Jones County Public Health looks like right now. Obviously, we’re in the middle of dealing with the vaccination rollout. You talked a little about the expectation of three to five years and it’s miraculous. It’s been one year and we have efficacious vaccines that can prevent death and hospitalization in long COVID. When you’re looking at the vaccination rollout in Jones County and other public health departments in Iowa, what do you think that looks like? Are folks receptive to this? Because you’re dealing a lot with the social media interactions, which can be varied tremendously. Where do you think the public sits with that? And where do you think that we could move the needle closer to say here’s some more evidence about why you should consider getting vaccinated?

Kaci Ginn:

I guess, just to delve a little bit into our maybe strategy, I’ll call it. Jones County is pretty rural. So, there’s four clinics that are currently open and operational. There’s a fifth that’s a satellite clinic, but that hasn’t been open since last April, which leads a really big part of our county a really long ways from the doctor’s office. With the percent of the population that we have, our vaccine allocation weekly is extremely low. I think, you’re going to hear that from anyone and everyone that they want more vaccine. I mean, public health, we train and we train and we train to be able to do these mass situations, these large community clinics. There’s that dissonance of we want more vaccine so we can do these large deployments of like, “let’s open up the community center and get 500 people vaccinated in one day.”

Kaci Ginn:

But then at the same time, the vaccine supply is like this trickle, drip out of the faucet. The consistency that we’ve had has been helpful for planning, but we know it’s going to go up at some point. So, it’s just like sitting with bated breath. When is this going to go up so we can move on? But, initially, we distributed an interest form online. We actually did some website updates. So, a Jones County resident or someone that works in John’s county, really anyone, because there’s no residency requirement on these vaccines. They go to that website or they call. We have a warm line that people can call, especially those older individuals who aren’t as technically literate as maybe younger people are. We have them submit that interest form because that helps us with planning. And we know we still have X amount of people in our county that want vaccine. So, we’re going to plan out vaccine clinics for the X number of weeks.

Kaci Ginn:

Once the state opened up availability to that 65 plus population, we started allocating vaccine to our primary healthcare clinics so they could focus on their patient population in that 65 plus category, which actually the average age of Jones County, I think, is around 40. So, we definitely have a robust 65 plus population. So, being able to kind of funnel them through those clinics was nice because, then they got to see someone from their healthcare provider. They knew where they were going. They didn’t necessarily have to drive out of town. And then, for those like that 1A population with the healthcare providers and with 1B, and now as it’s opening up to people with pre-existing conditions, we’re doing community-based clinics bi-weekly. So, we’re flirting with the concept of mass vaccination, but, I wouldn’t quantify it as mass because we’re doing two or three or 400, I should say two or 300 prime doses. And then we’re doing two, 200, 250 boost doses in one day.

Kaci Ginn:

But, that federal pharmacy partnership that opened up maybe a couple of weeks ago, a month ago has kind of left some of us rural counties out in the cold, because we don’t have any pharmacies which fall into that Hy-Vee or that CPS categorization. So, the only vaccine that’s coming into John’s county is what IDPH is allocating to us. We’re hopeful that within the next couple of weeks, we’ll get some more channels. I know we’re hopeful that some other corporate chains are going to get vaccine very soon, but it’s leaving a lot of our people with early on 165 plus was eligible. People were going to Waterloo. That’s two hours one way. There was a couple who went to Waterloo, but their appointments were on separate days. So, they had to drive two hours both ways, two days in a row, three weeks apart because they wanted to get vaccinated that bad. And, it makes my heart sing that people want to get vaccinated so badly. And, it really frustrates me that we can’t do better for them.

Steve Sonnier:

I’ve heard that anecdotally from other folks, too, of driving to Bettendorf or driving to other places and say, “I want to get vaccinated. I can’t find any appointments here and I’m going to drive over an hour maybe to find a vaccine. And I will just do that a different day.” And, it’s strenuous, and, I wonder, are there other health equity implications too in Jones County? One of the concerns we’ve seen during the pandemic is racial disparities, especially with the allocations for vaccinations and uptake for individuals. Folks in Jones County face those kinds of similar issues too, as well.

Kaci Ginn:

I think, our biggest challenge is vaccine hesitancy with the makeup of our population. Even right away, when we were getting that first large infusion of vaccine in late December, we had a really hard time with uptake. I mean, I heard of one county saying, “Our two large hospitals are having 98% uptake rate.” And I was like, “How? I want that.” I want that problem because there was a lot of mistrust in our community about the vaccine and a lot of concern about side effects. I don’t know if anyone remembers in early November, Jones County made national headlines, maybe even international headlines, I’ve heard. Our positivity rate was, I think, it got up to 50%. That was really hard. You know, you’re coming down with finals, you’re coming down with … There’s a state penitentiary in the county where seemingly 400 individuals tested positive overnight. We had media inquiries from everything, from CNN to NPR. So, managing that and managing the pandemic at the same time was definitely a challenge for local public health.

Kaci Ginn:

And then, seemingly two months later, “Boom! Here’s the vaccine take it.” So, there was a lot of eyebrows raised like, “How did this happen so fast?” And, you’re having some of these conversations with people. I was talking to a gentleman and he was just grilling me. He’s like, “How did this happen so fast? How is this safe? How is this effective when it’s just all of a sudden?” It seems like they started talking about vaccine in August and then, boom. In December, here it is. And, having to walk through while really this virus emerged before it emerged in the United States. So, that genetic sequencing was there.

Kaci Ginn:

People got to work on developing a vaccine right away, helping people kind of zoom out of Jones County, Iowa, and see all the players. The federal government heavily investing, private businesses heavily investing and being invested in the development of this. I mean, I feel like in some ways the entire science community went to bat for this vaccine so we could, I don’t even want to say, move on with our lives, but get back to a sense of community that we were really missing with the isolation that had to happen in order to keep those vulnerable populations safe.

Kaci Ginn:

I really hesitate to say return to normal because, I think, this is also an opportunity for a cultural shift, whether everyone is ready for that shift, I don’t know. But, I also see public health as a catalyst for change in that cultural shift. It’s a heavy thing to think about all of the work that needs to be done, especially since we’ve been … I lovingly referred to this pandemic as the public health Super Bowl. We’ve been playing in the Super Bowl since early March of last year, a full year at this point, and it is heavy. And, I worry a lot about the public health professionals that are working day in, day out, usually to some degree, seven days a week to get this done. So, I think, yes, there’s a lot of work to be done and we need the whole community, need everyone to lean in instead of lean on public health.

Steve Sonnier:

I think, that’s a very eloquently well put. It’s the idea of community support, especially now. And, [inaudible 00:24:28] that’s what this pandemic is about. I think, it’s been a really sharpening of a lot of folks focus about where we ground ourselves during difficult times, what we can do as a community to come together. And then, ultimately, recognizing the value of public health. We’ve been not armchair quarterback for a while because we were doing a bunch of other different things across the field of public health to borrow your analogy. But really, we’re seeing it front and center right now and everything that folks are doing to protect their communities is evident. And so, I’d want to thank you for being part of that and being part of that response in Iowa, to protect our communities and make them a better place to live. So, I want to thank you for your time for coming on today and chatting with us. And it’s wonderful to hear about your experiences. Fantastic. Congratulations on moving on to the next steps in your career. I know you’re going to excel on that area.

Steve Sonnier:

Big thanks to Kaci Ginn for coming on today. This episode was hosted, written, edited, and produced by Steve Sonnier. You can find more about the University of Iowa College of Public Health on Facebook. Our podcast is available on Spotify, apple podcasts, and SoundCloud as the University of Iowa College of Public Health. If you enjoyed this episode, please share it with your colleagues. Our team can be reached at cph-gradambassador@uiowa.edu. This episode was brought to you by the University of Iowa College of Public Health. Keep on keeping on out there.