July 2021 – Sophia Drewry Portfolio

Week #8: 7/26/2021

My final week has been a bittersweet one. My duties were remained as usual, rotating between COPA and COCOVID and working on the CDCD literature review during my free time. To spare my loyal readers, I will not provide another recap of my work with COPA and COCOVID but instead, focus my last blog post on what I learned during my 9 weeks here.

In Georgia, I am constrained by our state’s own privilege when it comes to understanding Arboviruses on a macro level, being that Georgia does not have the need for a large-scale arboviral surveillance network. While my professors spent time trying to find case studies and teaching about zoonotic disease, I was learning about the tree of knowledge when I could be eating the fruit. In Puerto Rico, I was given the opportunity to see how a country handles endemic diseases like dengue, Zika and Chikungunya. While I worked with the CDC on this project, the real public health work is done by the citizens of Puerto Rico. Mosquito control can and has become political in ideal conditions, and to understand how a government-run program can work, you have to inadvertently learn about the political history between a government and its citizens; something I did not expect to be studying.

In summary, this is only the beginning of my scholarly arboviral career with various Spanish-speaking nations. When studying arboviral prevention, surveillance, and treatment, I learned just how important the government’s role plays in overall effectiveness. This variable alone will always be accounted for wherever I end up working with whatever country I work with. You can study the most effective treatments and solutions, but if there is no money, will, or government sentiment, all it is just an idea at the end of the day. Luckily this was not the case in Puerto Rico as at the end of the day it operates under the US public health network. This summer alone was the second annual release of Wolbachia released mosquitos. But other countries do not have this same will or luxury. Once again the word sobering comes to mind when realizing all the forces that come to play with successful mosquito control. I must reemphasize, sobering in this case will result in a more mindful future epidemiologist with hope for what can be working within what is.

Well that’s all folks! I have attached a couple of photos below for your viewing pleasure.

Week #7: 7/19/21

This week marked a transition towards the end of my internship. I have continued my usual duties with COCOVID and COPA. I have also been putting more effort into the analytical portion of my internship working on a literature review and thinking critically about the difference between a passive and sentinel surveillance system. In a way, I include cohort studies such as COPA as an interesting variable in the mix of case identification. It could be said that the cohort studies, while spall, yield the clearest picture of arboviral infection in Ponce. Since so many cases are presented as asymptomatic, a large portion of passive and Sentinal surveillance do not pick up such infections.

My humble exploring of Puerto Rico has also shed light on the ongoing fight against mosquito breeding. Post-hurricane Maria, many buildings are still abandoned which leaves plenty of time and room for mosquitos to grow. Trash disposal is an issue on the island, and I have seen firsthand large areas where used tires are dumped, the perfect breeding ground for mosquitos. The amount of wild dogs and cats also makes me wonder from a veterinary perspective the rates of animal to human transmission of various diseases.

Week #6: 7/12/21

By this point in my internship, I have become familiar with all the programs and can somewhat expect a routine. This week I evenly balanced doing all three programs. In COPA, there was a push for recruitment of participants in neighborhoods where there was a significant loss to follow-up. In COCOVID there was the usual pick up and drop off of samples, although being able to go out into town never gets old. In SEDSS, I am still dressing up with full PPE to go to the ER, interestingly there are still a handful of COVID patients that often have overlapping symptoms with the dengue symptoms we look for. In other exciting news for this week, I will start to work on a lit review looking at symptomatic dengue cases picked up by surveillance systems. I am interested to see if the inclusion criteria is the same as the one used in the SEDSS program I work with.

While not much new has been happening this week here in Puerto Rico, I cant help compare the almost 66.5% vaccination rate and end of strict regulation to the state in which Cuba is in. Though both islands are in the Caribbean, they could not be any different. It has really given me time to reflect on how important government structure is to successful public health practice.

Week #5: 7/5/2021

After taking a relaxing week off with friends and exploring the island, I started the week off strong helping with a busy week in COCOVID. Because of the holiday, the pickup and drop-off schedule was a bit muddled and it was all hands on deck collecting and picking up samples. This week was pickup shift after pickup shift and I really got to learn the intricacies of participant management. We had to juggle giving out incentives with schedules and coordination with the main cohort study, COPA. This week I also got my CDC laptop up and working and continued to do file conversion for CDC headquarters in San Juan.

Since I am looking at the data as it is collected and the questions used in the survey, I have been thinking about possible research questions to ask. The art of finding an interesting research question is often rushed and given a deadline. With this long-term project, I am able to marinate about what data is collected and involve current events, such as the Denguevaxia rollout and Covid into the situation. Pictured below are the other interns I am working with.