From the COVID-19 Frontlines, A Career in Public Health


From the COVID-19 Frontlines, A Career in Public Health

"It is a very unprecedented time, and there are a lot of eyes on my field right now. In my work before COVID-19, I would have difficulty getting people’s interest enough to even pick up a phone call. Now, I find myself being directly messaged by friends, family, and former colleagues to understand the details of the COVID-19 virus."

Elgin Yalin is working on the frontlines of the COVID-19 pandemic with the Centers for Disease Control (CDC). As part of a CDC field services team, Yalin served as a liaison to the medical team. She was managing the data for field services operations, taking calls coming in from the field, preparing for future field visits from the medical team, and drafting protocols for documentation. “Adaptation and flexibility were necessary,” she says. Now sheltered in place at home, she's had time to reflect on her scientific path.

Yalin is an alumna of the Amgen Scholars Program, a program sponsored by the Amgen Foundation to give summer research experiences to undergraduate students worldwide. She participated in the program in 2016 at the National Institutes of Health (NIH).

ABE spoke with Yalin about her experiences on the response team, her early interest in science, her path to the CDC, and her work with communities to help prevent transmission or improve outcomes for individuals living with an infectious disease.

First, how has your morale been?

I have been absolutely exhausted, but, at the same time, thankful that I was doing something useful and had a sense of purpose. The room was always bustling, and aside from minor frustrations, everyone stayed pretty upbeat. My coworkers and I used humor to get us through.

What has it been like to be in public health right now during the COVID-19 pandemic?

It is a very unprecedented time, and there are a lot of eyes on my field right now. In my work before COVID-19, I would have difficulty getting people’s interest enough to even pick up a phone call. Now, I find myself being directly messaged by friends, family, and former colleagues to understand the details of COVID-19 virus. I feel a sense of indirect pressure to step into a public health advocacy and education role within my social network, and I think many other health professionals can relate to this. Unfortunately, it is a novel virus, and there is still a lot that is unknown, as robust, peer-reviewed research studies take time to validate findings. I cannot provide any new information other than urging people to alter their daily behaviors and stay at home. All levels of public health—be it federal, state, or local—are working nonstop to respond and contain the spread of COVID-19.

How did you get into public health in the first place?

I have always been a curious person, and science helped to feed that curiosity. My parents would tell me how annoying all my “but why?” questions were when I was a child. I looked forward to my science classes in school because there was an underlying drive to explain and understand the natural world. I loved the objectivity of the scientific field and the ability to predict outcomes with current knowledge at hand, which has been built upon by generations before me.

As I was going through my undergraduate education, I felt an internal conflict between my passions for the social and hard sciences. I wanted to make a difference in the health sciences, but I became frustrated with the fact that there are structural barriers to quality healthcare. There may be the knowledge and tools to address a particular chronic or infectious disease, but it requires economic means and self-advocacy to receive those benefits. I began to grapple with who will have access to these resources and how this pattern originated in the United States. I was also struck by the fact that pathogens themselves do not discriminate in who gets infected, but despite this fact, certain populations are predominantly affected. 

With all my knowledge about health disparities, I could not imagine myself doing anything else than working to improve health outcomes for vulnerable populations. Public health is the marriage of hard and social science knowledge being actioned to increase health equity. I finally had insight where I realized my passion for public health and started looking for more public health classes and opportunities.

What was your early science education like?

I grew up in Elon, North Carolina, and I went to Western Alamance High School. It is a fairly small town, and from my personal experience, there were not many opportunities to learn about how a science degree would be utilized in the real world. However, I was extremely lucky to have incredible science teachers in middle school and high school. There are memorization tools they taught me that still come to mind as I was reviewing some material while studying for the MCAT exam. They were passionate, creative, and fun to be around, which ultimately influenced me to pursue science in college.

In the summers throughout high school, I worked as a teaching assistant at a free science camp where curriculum was provided to elementary-level children at my local public library. Most of the children were homeschooled, so for some of them, it was their first time doing interactive science experiments. It was an impactful experience to see the gears working in young minds and how excited they were while extracting a strawberry’s DNA.

Looking back, I wish I had more opportunities and female role models in science. I did not have much guidance in applying to colleges, and I declared a biology major honestly thinking I would change it later. It was not until I went to UNC Chapel Hill that I felt like I belonged in my science major. The majority of my graduating biology class were female, and though it was a large school, I was able to make connections with my professors. One of them told me about the Amgen Scholars NIH Program.

Can you describe, in brief, your path from Amgen Scholars and undergrad to the CDC?

I was part of the Amgen Scholars program the summer before my senior year of college at UNC Chapel Hill in 2016. At that time, I really did not know what I was going to do once I graduated from my university. I wanted to get more experience before I determined what kind of graduate degree I was going to pursue. I applied to a variety of positions, some in infectious disease research labs, others in public health nonprofits and local governments. I ran into a common problem of needing experience to get experience. I started researching entry-level jobs at large federal organizations when I came across the Centers for Disease Control (CDC) Public Health Associate Program (PHAP).

PHAP is a salaried two-year public health training program that is geared towards recent graduates. The program places you anywhere across the United States to work with a local health department or nonprofit organization who is in need of support. I was placed in San Francisco, CA working with the San Francisco Department of Public Health (SFDPH) Tuberculosis (TB) Prevention and Control.

What did you do in that position?

During my time there, I served as a disease control investigator where I would interview active cases of tuberculosis to identify all of their close contacts to contain the spread of the disease. I ensured that all the contacts were evaluated and treated. Sometimes, this involves going to their homes and drawing blood, whereas in other instances I would set up massive screenings at work places, hospitals, homeless shelters, etc. I was also responsible for providing daily observed therapy and collecting specimens from cases. I have been able to work on outbreaks at the state level, and I also organized multiple community outreach events around World TB Day. After the program ended, PHAP graduates are able to interview for a number of positions that are not open to the public. I joined the CDC Division of HIV/AIDS Prevention this way, and the position I obtained was newly created through the Ending the HIV Epidemic (EHE) Initiative.

What has been the most exciting thing coming out of your current work?

My current work involves HIV cluster detection and response. It is exciting to be working toward ending the HIV epidemic. What I love about my investigative work is that you never know what information you will get when you speak to someone on the phone or in person. Everyone has a story to tell, and it is amazing how much people open up when you ask how you can help. It has been quite sobering to see all the ways that someone can slip through the cracks of even the best healthcare system. Some common examples are lack of insurance, clinic wait times, unreliable transportation to the clinic, or miscommunication about payment options. A lot of individuals I work with are quite jaded with both healthcare and the government. So, it is very fulfilling when my actions can demonstrate otherwise and how these systems can work to their benefit.

What is the driving force behind your work?

My overarching goal is to address health disparities, but ultimately the driving force behind my work always circles back to the connections I make with people. It is their story, voice, kindness, and resilience that keeps me going. If I can help them in any small way, then I know a hard day has been worthwhile. I always think about the close bonds I created with my work as a TB investigator. I was with these individuals day to day throughout the beginning of their treatment, which is always a difficult transition. I would visit them in the hospital, their homes, and sometimes their workplaces. There are multiple patients that have really stayed with me throughout my career, and they have taught me so much.

What advice do you have for students who might be interested in public health?

It would be great for high school students interested in public health to become active in their communities. The building blocks of public health are the efforts that happen locally. This could be helping at a community garden, volunteering at a nursing home, organizing a 5K race, or anything that improves community health. They could also look online to see if their local health departments have internship opportunities. I think it’s also really important to become comfortable working with individuals very different from yourself. Creating effective public health programs requires teamwork from a wide range of expertise as well as input from the target population. If they can get any experiences involving teamwork or building rapport with people different from themselves, this will really demonstrate skill sets needed in public health.

This article was prepared with Elgin Yalin in her personal capacity. The opinions expressed in this article are the author's own and do not reflect the view of the CDC or the United States government.

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