These days, the people fighting COVID-19 are usually easy to spot. They are wearing full-body personal protective equipment surrounded by beds, charts and machines. But many of the people integral to the fight are not as obvious – often working long hours in home offices and at kitchen tables, behind the scenes of public presentations and news reports. Among those behind the scenes at Upstate Medical University are members of the Department of Public Health and Preventive Medicine.

“As the department within the College of Medicine that serves as the home for our academic public health expertise, we recognized a looming crisis right away, and what we needed to prepare,” said Department Chair Christopher P. Morley, PhD.

The department consists of epidemiologists, biostatisticians, data analysts, coordinators, as well as community health and social scientists, to name a few of the skill sets represented. When it became apparent that the virus that causes COVID-19 was present in New York state, Morley organized a departmental COVID-19 response team to prepare for the wide-ranging needs that would likely present themselves during a public health crisis. Those included monitoring the needs of students, faculty and staff as learning and work was shifted off-campus, as well as preparing to respond to the needs of Upstate’s Incident Command team, and later, Upstate’s Recovery and Resilience Team.

One member of the response team is Telisa Stewart, DrPH, MPH, associate professor of public health and preventive medicine and assistant director of Upstate’s Master of Public Health program. Stewart and the team have been tracking, interpreting, mapping and communicating data about the virus and COVID patients for two months.

Their responsibilities are broad and varied but also intricately linked to one another. Team members describe long days compiling, analyzing and interpreting data about the virus, how and where it’s spreading and the status of COVID-positive patients at Upstate. For weeks they have worked like this, coming together several times a week to share information and collaborate on ideas. Several contributed regularly to Incident Command, which consists of hospital and university leadership coordinating Upstate’s COVID-19 response, and have continued on to serve in roles with the Recovery and Resilience Team.

Their work focuses on surveillance, modeling, communication and preparedness as well as developing evidence-based policies and procedures for future use. Team members are working with many Upstate departments including the emergency department and laboratories, and particularly with infectious disease physicians and physician/epidemiologists, among others. Their results have been shared with the New York State Governor’s Office, Onondaga County, the city of Syracuse, economic and manufacturing groups, SUNY officials and local news outlets, Morley said.

Upstate has also helped local officials better interpret information from Unacast, which is using cell phone data to track people’s movements in the area. Upstate has created several working models of the coronavirus to help predict a timeline for its spread, growth and eventual decline. Members of this team are also helping Upstate create a playbook for future use that will document what can be learned now for future waves or another pandemic.

“I was building systems to support the institution in making informed decisions,” said Stewart, who before coming to Upstate in 2011, worked at Dartmouth-Hitchcock Medical Center and the Vermont Department of Health running public health initiatives.

“I think the messages to the community remain the same,” she said. “People are scared. They are afraid of COVID. They want to have information on what that means to them, how do they protect their family, what do we think is going to happen. For Upstate, the institution wants to know how we make the most informed decision about resources to protect and serve the population. Those messages, whether it’s COVID, or HIV infection or H1N1, are all real conversations that happen in public health and I think they are just heightened right now because of the fear of COVID. But these are skill sets that we’ve used time and time again.”

In addition to daily tasks associated with tracking the disease, nearly all of the members of the response team are also professors at Upstate, which means they are actively teaching students while working through a pandemic. 

Martha Wojtowycz, PhD, is director of the Upstate Master in Public Health Program and vice chair for education. In addition to helping craft the pandemic playbook, Wojtowycz has also led efforts to move the entire program online for students. The students, she said, have been resilient and dedicated to their work in a field that is rapidly gaining attention. 

“Students will have lived through this and will be able to apply the concepts that we’re teaching in this class having gone through a pandemic,” she said. “I think this has definitely increased awareness of the field of public health and the public has a new appreciation for how broad the field is.” 

Several members of the response team likened public health to a wheel with many spokes – similar to medicine with a variety of specialties. Public health involves gathering and interpreting data, building partnerships, communicating information and educating the public as well as creating systems or plans for how to deal with future crises. Public health experts rely on a variety of expertise areas in the same way doctors do – referring to a biostatistician in the same way you might refer a patient to a neurosurgeon; their specialties contribute to a larger picture of health. Several members of the team said the pandemic is bolstering people’s respect for the field.

“For decades, public health has not been at the forefront of combined initiatives between medicine and public health, however, we need to be,” Stewart said. “I think with COVID, people have recognized that we need to be at the forefront and they need us there.”

Stewart said she hopes that as people rely on graphic presentations of data – like the curve charts, the bar graphs and the mapping models that have become familiar during this pandemic – people also appreciate the work that goes into them.

“People see a model, they see an image, they see a projection, they see a surveillance system – they get data out of it and they say, ‘great,’ “ Stewart said. “But I don’t think they realize the amount of time and effort it takes to produce those. These things take an enormous amount of time to create and validate, and entire teams to make sure they’re accurate.”

Team members said that while the skills they are using today are familiar, none of lived through a public health crisis of this magnitude. Despite its grueling requirements, all said they are eager to tackle such an important project for Upstate and for the community.

“For some of us this becomes a 24/7 thing. There are a very few breaks,” Morley said.

“This has truly been an all-hands-on-deck event,” he said. “On Incident Command, Dr. Dongliang Wang and I worked with Dr. Katie Anderson and Dr. Jana Shaw on projecting models of how COVID-19 will impact our community and hospitals over the coming months, while Dr. Stewart, with Drs. Gary Brooks, Margaret Formica and Don Cibula tackled work related to daily surveillance of the virus in real-time. Other team members have taken on additional work, like Dr. Wojtowyz and Dr. Michaele Webb, who kept the fires burning under our distanced MPH program. We had a great post-doctoral associate, Dr. Hsin Li, and amazing coordinators and administrators like Laura Schad, MPH and Alyssa Indelicato, who helped oversee surveys and ancillary projects, while keeping core departmental functions running. There are too many people to list, but we kept our machine running, and supported vital needs in the fight against COVID-19. I’m proud of our team.”

Caption: Christopher P. Morley, PhD and Telisa Stewart, DrPH, MPH.