00:00:00Q: Today is Friday, May 20, 2022. This is Mary Hilpertshauser for the COVID-19
Oral History and Memory Archive Project. I’m in Atlanta, Georgia, and I will be
talking with Jonathan Bryant-Genevier who is also in Atlanta, Georgia. We are
recording through Zoom. We have had one pre-interview before this. Hello, Jonathan.
BRYANT-GENEVIER: Hi, Mary.
Q: Do I have your permission to interview you and record this session?
BRYANT-GENEVIER: Yes, you do.
Q: Thank you. Thank you for being here with me today and being part of this
project. For the record, can I ask you to say my name is and then state your
full name and tell me what your current position is at CDC [Centers for Disease
Control and Prevention]?
BRYANT-GENEVIER: My name is Jonathan Bryant-Genevier, and I am currently a
health scientist in the Division of Cancer Prevention and Control here at CDC.
Q: Great, and before we delve into those details of your path to CDC and
COVID-19 [Coronavirus Disease 2019], could you tell me a little bit about your
family background and the community that you grew up in?
BRYANT-GENEVIER: Right. I was born in the UK [United Kingdom]. My father’s
American, and my mother’s French, and at the time, my father was a scientist
working as a postdoc there, and we moved around a bit for the first few years of
my life. From the UK, we went to New York, a few different places in New York,
and then most of my childhood was spent after we moved to DC [District of
Columbia], I was probably about four or five years old, yes, and so I grew up
mostly in the northwestern suburbs of DC in a town called Montgomery Village, Maryland.
Q: What did your parents do at that time?
BRYANT-GENEVIER: Right, so when we were in Maryland, my father worked as a
scientist, a PI [principal investigator] for NIH’s [National Institutes of
Health] National Center for Biotechnology Information or NCBI, and my mother
stayed home. She had been a physician in France but couldn’t practice medicine
in the States, so for when we were really little, she stayed home and watched my
sister and I. When we got to middle school, she went back into the workforce and
ultimately landed at FDA [Food and Drug Administration] and working on a variety
of different projects, it was mostly in vaccine review and post-market review of
vaccines and medical devices.
Q: Okay. Can you tell me a little bit about your schooling?
BRYANT-GENEVIER: Yes, so I mostly attended the public schools in the area—in
Montgomery Village. I’m a dual citizen, a French and American citizen, so for a
few years, my sister and I attended a French school in DC. They have that there,
so we learned to speak French and instructed in the French grade school
curriculum—I think I was, I don’t know, maybe fourth and fifth grade, sixth
grade maybe, so when I was really little. Yes, I went to middle school and high
school at the local high—at the local public schools in my town, and, yes, I
ultimately went into college at the University of Maryland, Baltimore County to
study chemistry and English.
Q: Chemistry, what made you want to go in that direction?
BRYANT-GENEVIER: I had done well in my science classes in high school,
chemistry, biology, and physics, and chemistry had been the thing that made the
most sense to me, or I was just—maybe I did better in that than I did in the
other courses. It was, to me, a fairly simple problem, right, there wasn’t as
many things to remember, I was never very good at remembering all of the things
that I needed to know to do well in biology classes, the pathways and all that.
I didn’t do as well in those classes and so when I got to college, I actually
didn’t really want to study—I was good at chemistry, so I figured you know what,
I’ll do this because I’m good at it. I wanted to be an engineer, I wanted to
make things, to build things, I was a tinkerer, I loved taking things apart,
putting them back together, fixing things, understanding how they worked. But
then when I got to college and I realized, okay, the engineering curriculum was
so regimented, there was never going to be a pause to do anything outside of
engineering courses, and you wouldn’t have time to learn another language, you
wouldn’t have time to—I wanted to take writing courses, and I wanted to study
abroad, I wanted to do all the other things that kids like to do when they’re in
college, and if I went down the engineering path, I wouldn’t—it would have a lot harder.
I showed up as an engineer, dropped out of the engineering program and then
focused on chemistry. I floated a little bit between biology and biochemistry
and chemistry, worked in a couple of different labs, and tried to find my, kind
of, little home there, but I kept coming back, and chemistry made the most
sense. That’s how I ended up there may be.
Q: Okay, so during our pre-interview, we had—you had talked a little bit about
when you’re growing on the Chesapeake [Bay], which is—the Chesapeake is a—?
BRYANT-GENEVIER: A body of water, yes. Yes, I guess zooming back, so I grew up
in Montgomery Village Maryland, but my family spent summers—my dad had this
little sailboat that he’d kept on the Chesapeake. He had gone to graduate school
at [Johns] Hopkins [University] and so had—so we had— our family had been in the
Maryland area for a while. My grandparents, my father’s parents lived in
Virginia relatively nearby and so the family would get together and sail
together on the Chesapeake. I spent my summers as a kid growing up there, and
that was probably a bit of the impetus to go into the sciences or—I—the
Chesapeake Bay is a—was at the time and perhaps less so now, it was a polluted
area. Growing up as a kid in that area, you saw front-hand pollution and—you saw
the natural environment, you saw the pollution, you saw the mix of those two. I
think that bothered me a little bit, so I wanted to—so I think my interest in
science was a little bit about how to—and that was 2000. I graduated in high
school 2004, climate change, global warming, those were things that were
happening then. They didn’t feel as—quite as pervasive as they do now, though
certainly they were, and so I think a lot of those pieces were instrumental in
pushing me towards a career in how to use science to solve some of the bigger
problems. That was my interest.
Q: You had also spoke about boat conservation, which is also—when you conserve
anything, it’s all about chemistry. I thought that was interesting and kind of a
nod to history and keeping it going.
BRYANT-GENEVIER: Yes, yes, that I think came together later. Early on, it was
just boating was a family hobby and something I did. When I was in college, I
sailed on the sailing team at the University of Maryland, Baltimore County,
rowed fairly competitively. I was involved in that as—it’s a weird sport where
you make a fairly slow thing go really quick. It was a lot of fun and being
involved in that community early on was important to me, yes.
Q: It must be hard for you living in Atlanta, which is a land—
BRYANT-GENEVIER: No, although after I left Maryland, I mean the road was long,
but I did graduate work in Michigan, and I moved to the frozen wilderness. I did
some time in the Midwest and then Upstate New York and so, yes, I’ve been—I’ve
lived away from the water for a long time. Atlanta didn’t—yes, this was some—one
of the—that’s okay.
Q: Right, yes. So, after you were—you were at the University of Maryland,
Baltimore County, what happened after that?
BRYANT-GENEVIER: Right. I was graduating with a degree in chemistry, I had a
minor in English, writing, I had a lot of different ideas of what I wanted to
do. At my last year of the university, I had taken classes in a bunch of
different things, in environmental science and in other spaces and so I’d ended
college on a note of, well, I don’t really know exactly what I want to do next
and it’s—I was still unsure. I graduated in 2008. I got a job working in a small
organic synthesis lab, so it was basically a start-up company, a couple of
employees, I think I was employee number three. The company was called Aurora
Analytics [LLC], and this company mostly did custom organic synthesis, so that’s
making small batches of chemical substances for other companies, usually
pharmaceutical start-ups that want to test a particular chemical structure and
so my job there was mostly to just do the synthesis. I was a chemist, I had—I
knew how to do the—follow the recipe, so to speak, and then synthesize and
purify whatever it was that the lab needed to make that week or whatever. So
that was my first job.
Q: I love the honesty of your comments of not really knowing what you wanted to
do after you’ve gone through your four years of college. I think a lot of people
get there, and they think they go straight into a job, and sometimes that’s not
always clear. I appreciate your honesty there. You had mentioned or we had
talked about your interest in EIS [Epidemic Intelligence Service] in 2017.
There’s some time there, you were at Aurora Analytics for some time and then how
did you—?
BRYANT-GENEVIER: Yes, so we’re sort of jumping around. I started this job in
2008, so this is—we’re still like nine years before I figure out that EIS is a
thing. We’ve got a long—we’re—
Q: Okay, and so [crosstalk]—
BRYANT-GENEVIER: I don’t pick it up that quick.
Q: You were at Aurora Analytics, and you’re in bench chemistry, probably not
what you thought would be the real world. So, you return to get a PhD [Doctor of
Philosophy], am I right?
BRYANT-GENEVIER: Yes, so the impetus there was I haven’t really decided what I
want to do, and so the crystallizing moment was I was working in organic
synthesis and I was mixing stuff in a jar and then it hit me one day that some
of the stuff that we were—was—we were disposing of in a very rigid way, was
going into the waste and this sort of thing. Then other things were sort of
like, oh, that’s not really all that bad, we can rinse that out as we rinse the
glassware. I remember this crystallizing moment for me was realizing, well, how
do I know which one of these things is bad or not bad, and is it bad for me, is
it bad for the fish, is it bad for the bird? It hit me in this practical sense
of like am I polluting stuff, how is this—? The lab was following the
regulations, but at the time, it hit me that I realized I’ve been through four
years of chemistry and never really learned that much about what was bad, the
toxicology of substances, right? I’ve learned how to mix things, I’ve learned
how to make things, I learned why they behave the way to do, but I never really
understood the interface between the chemical substances and their impact on
human health. That was the moment when I realized, okay, that’s what I want to
do, that’s where I’m going to go spend my PhD time doing.
So, I applied to programs in environmental health, and that’s—was my plan. I
worked for about a year, in that time, I applied to graduate school and then I
got into the program at the University of Michigan, their School of Public
Health in their environmental health program, so I moved to Ann Arbor, Michigan,
in late 2009 to start my studies, I guess.
Q: Yes. You still have the thought of environment and doing good for the world
on your mind while you’re doing this?
BRYANT-GENEVIER: It seemed like a way to make use of my knowledge of chemistry,
right. At that point, I had studied something, I knew a little bit, I was like
how am I going to use this? A lot of the guys I had studied chemistry or people
I studied chemistry with went on to work for pharmaceutical companies or other
things. It wasn’t that I thought that there’s anything wrong with that, it just
wasn’t exactly speaking to me, it wasn’t what I wanted to do.
I go to Michigan, and this is 2009, there had been the market crash, funding for
academic—the academic funding in general was a little tight. My experience with
starting in academia was not what do I want to study and me writing proposals,
it was like what money can be had and how do you fund a degree. I mean I make it
sound bad, but I think in the—there was a lot of academic space that may operate
on some level to that in that way. I joined a research group that was primarily
focused on developing instrumentation for exposure assessment. This is exposures
like how to—measuring how much of a chemical a person is exposed to, and we use
this in the occupational setting to understand like is this worker exposed to a
dangerous level of whatever substance that they’re working with or— and the
ambient environment are people who live in their homes or schools or whatever,
are they exposed to dangerous levels of some hazard? My group was focused on
chemical hazards so that’s—as opposed to particulate matter or radiation or
noise, all of these are exposures of concern. In the environmental exposure
assessment field, we focused on the chemical exposures.
Q: I see. So why public health though? You went into the school of public
health, why not— why not do chemical engineering or— why that?
BRYANT-GENEVIER: Yes, that’s a good question. My family had been public health
practitioners, right, so in some way or other, my parents had been involved in
the health sciences and so I think that was part of it.
I think the objective to the culture in public health schools was about
improving health period and it wasn’t—so I can enjoyed ecology, right, so
the—how do you study just the environment in general, not human health, but
there was a little bit more—in public health, there felt like there was an
action responsibility, right? You have a responsibility to then take action on
what you’ve identified as a risk or a hazard and try to improve it. I think that
culture, yes, lured me in maybe?
Q: The culture that you grew up with your parents. Did somebody else have some
influence on you regarding improving health and responsibility for this—the
public’s health essentially?
BRYANT-GENEVIER: I had never taken a public health class at all before coming to
Michigan to do my PhD. I had never taken an epidemiology class— I had never
taken a—so my exposure to it through other mentors outside of just the network
of who—where I had grown up hadn’t exposed me to that. In a lot of ways, I
didn’t know what I was getting into when I joined the public health school. I
have a couple of aunts who were—and uncles who are physicians and a lot of
different family members in the extended family have worked in public health in
some way or another and so it just felt like a pathway that I might fit in. I
had a hunch is basically the—it’s best I can share—
Q: It’s subtly baked into your DNA?
BRYANT-GENEVIER: Maybe, maybe, yes.
Q: Okay. Can you describe what you were working on at the University of Michigan
in the School of Public Health, in environmental health sciences?
BRYANT-GENEVIER: Yes, so my doctoral research was mostly on developing tools
on—instrumentation so we—that could be used to do exposure assessment. The idea
being that measuring very low levels of chemical exposures is a job that
typically requires quite a sophisticated piece of laboratory bench equipment.
So, a large instrument that sits on a tabletop, and you can’t really bring it
with you very easily, and you can’t really bring it to the place where, say, a
worker is doing his job. The field has developed a lot of ways to basically
collect a sample and—on a tube or in a bag or in a canister and then you bring
that sample to a lab and analyze it and then later—so six weeks or two weeks
after the—you take—collect the sample, you figure out the number, like how much,
he was exposed to X quantity of a substance. But there’s this Holy Grail in the
field of being able to get that answer in the moment, real-time detection of
these chemical exposures.
The lab was basically—that I worked in was half an engineering lab and then half
a public health lab. We were partnering with colleagues in the engineering
school, and the idea being how do you shrink the size of that tool, simplify it
enough, that you can get a reliable measurement, an accurate measurement of
individual things, individual substances that are present in the work
environment and have that guy wear that tool on his belt that worker, whoever is
being exposed can wear. It’s an engineering objective— it’s a public health
objective. A lot of the work was the mix of engineering and public health. I
think that’s why I fit because I joined—I think I was one of the few chemists
who came in in my PhD class. I was a tinkerer, again I enjoyed taking things
apart, I’d worked with a lot of instrumentation before in—when I worked in the
organic lab, so I just fit with the team. At the time the—yes, the group had
funding and so I joined and it had worked out for me.
Q: You were actually building machine-type things, instruments—?
BRYANT-GENEVIER: Yes.
Q: When you say you’re—you are—you’re working on instrumentation, I’m like,
okay, and you’re tinkering, so that tells me that you’re actually building
things like—
BRYANT-GENEVIER: Designing, building—
Q: —prototypes, that type of thing?
BRYANT-GENEVIER: Yes, prototyping instrumentation.
Q: Yes, you’re —you’re sawing down tiny, little instrument, is that really what
you’re doing?
BRYANT-GENEVIER: Right. The components we used in the machines were manufactured
using the same processes big companies use to make computer chips. They were
etched of silicon wafers, so the individual components of the machine were
incredibly tiny, you could put them on a penny, or a quarter is how we would—you know?
When we were writing a paper, we wanted a big splash picture, we would take a
picture of the component on a—on the face—make—look—Lincoln’s face huge look
huge on it. But, yes, so they were very small components, we put them together
into machines that were relatively small at the time, and so, yes, it was
prototyping, it was instrumentation development, and it gave me a really
hands-on understanding of how to build from scratch these chemical sensors basically.
Q: Wow, so that really is hands-on.
BRYANT-GENEVIER: Yes, it was kind of an engineering training, but I wasn’t an
engineer, so I didn’t get a PhD in engineering, I got a PhD in public health,
but then when public health looked at what I did, they were like, “Wait, but you
don’t do population statistics.” I’m like, “No, no, I’m an engineer.” For me, it
was a great exposure, it was this interesting mix of things I was interested in.
Q: Sure.
BRYANT-GENEVIER: But down the pipeline, why—what did you really learn how to do.
It was hard to pitch that to other people.
Q: I just never thought of engineering labs actually doing that type of thing.
All right, so tell me more about what you—besides your building and tinkering,
were you—I know if you were—if you’re getting your PhD, you’re probably teaching
a little.
BRYANT-GENEVIER: Yes, so I taught, I was a graduate student teaching assistant
for a couple of years, and I taught an environment sampling class for master’s
students in the environmental health and industrial hygiene tracks at the school
of public health. They needed to know how to go collect these samples in the
field, right, whether it was a particulate matter sample or whether it was a
wastewater sample, whether it was any sort of chemical. And a lot of it was
biological detection too, so whatever they were interested in sampling for, if
you’re going to do environment sampling, this was the class, the field class,
the lab class that taught those techniques. My job as the teaching assistant was
to make sure that all the equipment was working, and everything was packed up
and we had all the specimen collection tools and all that stuff. It was really a
hands-on lab course, and it took a ton of time, so it was—
Q: Yes, it sounds like you really liked teaching?
BRYANT-GENEVIER: The teaching part was a lot of fun. There was a little bit of
fieldwork— it got me outside. Sometimes when we would go do some lab activities,
it got you thinking about the practical end a little bit of why are we
collecting these things, why does it matter. We’d do these labs on pesticide
exposure, and you would have the students put on coveralls, like the—a
body-protective suit. It wasn’t anything dangerous, it was just—and then we had
like a fluorescent dye, something that you can only see with the black light and
then they would pretend that they were applying a pesticide to a plant or
pruning plants or something and then, yes, after the exercise is over, you’d
look with the black light how much of this color dye did you get on your suit to
understand how does like thermal contact exposure happen in that setting. There
was a lot of these little pieces that was interesting to think about. The
students usually really liked the class. I think there was a lot of art to the
teaching that I really liked.
Q: Yes, and so there you are, you had your PhD and you’re at that crossroads, do
you want to stay or should—do you want to stay in academia, or shall you branch
out into the great, unknown world?
BRYANT-GENEVIER: Yes. After that, I had a hard time as a graduate student. My
advisor and I didn’t really get along very well. I didn’t have a good working
relationship with him and then we collaborated with some groups, but actually,
he had a relatively not-great working relationship with other groups and so our
collaborations didn’t pan out super well a lot of the times. I started looking
for postdocs when I knew the end of time, but there wasn’t a lot of
opportunities to places to go. Like I mentioned, I was in this weird niche. I
didn’t do traditional environmental health research, so if they were—if someone
was looking for an environmental health postdoc, I was on the fringe of the
value. They’d have to want something really specific to choose me, and then at
the same time in an engineering space, then I wasn’t a trained engineer. I
didn’t have the background that engineer—a PhD in engineering would have, so I
wasn’t really valuable there. I remember looking for postdocs for, I don’t know,
maybe three, four, five months and not having any luck finding anything. When it
came time, like defended, I needed a job, so I had thought about staying on and
being an academic, but I—the process of writing grants basically and finding a
home, I had just not enjoyed my time as a graduate student enough to pursue that.
My also feeling was that there—I saw some of my colleagues who were really
impressive folks struggling to succeed in that career path also, and I was like,
well, these guys are way better than I’m going to be. This isn’t going to pan
out, I need to find another way to be useful because if I—yes, it’s not going to
go well for me. I basically started looking for jobs just like out of the blue,
and I—like cold calling places and trying to find something to do.
Q: Oh, that’s hard.
BRYANT-GENEVIER: Yes, yes, it was. I mean it was a bit scary. I think I started
the PhD expecting, oh, when you’re done, they’ll come to you, you’ll be all set,
everything will be golden, you’re on a smooth walk—smooth sailing from there on
out. I was disappointed a lot in—yes, this. I think just I hadn’t figured out
how to use my training yet. I hadn’t figured a way to link what I knew how to do
with what I wanted to do and so that took a few more years to figure out.
Q: Yes, that’s honest and very much a real thing.
BRYANT-GENEVIER: Yes. I land a job at a company called INFICON, and INFICON is
an instrumentation manufacturing company, so they make chemical sensors. I knew
a lot about chemical sensors, right? This was a company, they sold chemical
sensors for a bunch of different applications, most of which were semiconductor
fab, which is not important. But it’s basically like when you make a computer
chip, they need a sensor to monitor the chamber that that computer chip or that
OLED [organic light-emitting diode] screen or that whatever is being
manufactured inside of. They make sensor for that, and the company just makes
that sensor and then puts it into the giant machine and then that helps them
manufacture chips more efficiently, and that was the bulk of his company’s
market. But they had also adapted a tool or an instrument for environmental
detection, right, which is basically a backpack-sized GC-MS or gas
chromatograph-mass spectrometer, which is basically the type of equipment that I
had learned how to use pretty well and learned how to design reasonably well.
They had a backpack one that they sold primarily for—to military groups looking
to detect chemical weapons or to environmental groups looking detect trace
levels of pollutants.
But they didn’t have anyone on the team who could talk to the scientists who
worked with these, who bought these tools, and help them run trainings or help
them adapt the tool or other stuff, so I ended up joining their marketing
department to be the scientist on the marketing team that—yes. I was basically
the subject matter expert on using the tool and the problem. I understood why
you are worried about—at this point I knew a fair bit about which chemicals are
bad for you and why and how much is bad and how much is less bad and that kind
of thing, so, or how to answer those questions, yes.
Q: A marketing SME [subject matter expert].
BRYANT-GENEVIER: Yes, yes, it was a very weird role. It was the first job I got
out of my PhD. I remember I showed up, my first day, it was about seven days
after I defended. Anyone who’s done a defense, your brain is so focused on the
thing and then you show up in this totally different building, in this totally
different—I had moved, so we’d move to Upstate New York, so I had left Michigan.
My whole life had been in Michigan for six years and then in a weekend, you up
and move, you pack, and you find a new apartment and then boom, you show up in
this office building, I don’t know, and you’re meeting with Susan in HR [Human
Resources]. It was a very surreal experience because I—they’re like, “Oh, you
must be Dr. Bryant?” I’m like, “Yes, I guess, so,” “Cool,” so it’s a very weird
space. Anyway, so I worked there, and I—my job is mostly to run trainings for
customers who buy the equipment to apply—to adapt, help design the
next-generation equipment, and then to basically be the scientist support for
anyone who—in the department who needed it. I did a lot of sales support, I did
a lot of marketing support, and a lot of manufacturing support. The
manufacturing facility was downstairs and so I would float between all of those places.
Q: Well, you’re using all of the stuff that you learned, including teaching.
BRYANT-GENEVIER: Yes, it was jack-of-all-trades kind of space. I immediately
disliked the corporate space. I immediately felt like we weren’t really doing
science, we weren’t really at all interested in people be exposed to chemicals,
we were interested in selling a tool that helps them answer that question and so
immediately I felt like, oh, this isn’t for me.
My girlfriend at the time moved up, she was living in DC, she moved up to join
me in Upstate New York, like frozen. We lived in Syracuse, New York, there in
Syracuse, New York. She moved in February—
Q: That is cold.
BRYANT-GENEVIER: Yes, don’t move in—don’t move to Syracuse, New York, in
February. She moved up, and I remember she had just moved, she’d left her life
in DC, and we were moving in together there in Syracuse, and it was like, oh
man, I—we moved, and now I’m here working at this job that I don’t like how—?
Even the first six months we were in Syracuse that are—we were like, how do we
get out of Syracuse? It’s not that we didn’t like the town, it was—nothing to do
with that, but it was just I knew it wasn’t for me, I knew it wasn’t what I was
going to love to do, so—
Q: So, what did you do? There was not enough—hmm, what we would we say—public
service in your life, you needed something a little bit more for your soul?
BRYANT-GENEVIER: Yes, so I basically tried to get creative, and that’s when I
started to realize, okay. Then I really started thinking how do I do it? I had a
paycheck, I could pay my bills, I was paying off my debt, I felt good, the job
is helping me do something and so then I started thinking a little bit more. I
volunteered a fair bit with the local industrial hygiene chapter to help man,
run a conference a couple of times.
Q: What is industrial hygiene?
BRYANT-GENEVIER: Right. So industrial hygiene is the field—occupational health
and safety is the—probably the more common term that people would know. It’s
about making safe workplaces, and industrial hygiene is specifically concerned
not with safety so much as the protection against illness and disease from
exposure. The field, if you ask an industrial hygienist, do I wear a helmet in
this setting that that industrial hygienist will be very— “Oh, that’s not my
department.” They’ll be like, “We’re more concerned with the chemical
exposures.” At the end of the day, it’s all— is the workplace safe? So it’s kind
of a little bit of the same thing, but the industrial hygienist concerned with
the, yes, hazardous exposures.
Q: Okay, so chemical-related thing rather than have—being in a place with that
giant I beam over your head?
BRYANT-GENEVIER: Right, that’s exactly right, so that would be—you know? Anyway,
it’s a small, minute point, but when you say industrial hygiene, that’s kind of
that—oh, I guess that’s I’m pointing—an obvious oversimplification—
Q: Oh sorry. Sorry.
BRYANT-GENEVIER: Yes.
Q: Okay, because when you say industrial hygiene, it just makes me feel like a
bunch of guys in a factory washing their hands, so—
BRYANT-GENEVIER: Right, or a big, giant toothbrush or something, yes, so it’s—
Q: Something like that, yes, anything—because hygiene is like that. So, it’s a
little bit different, it’s more chemical related, and what you’re exposed to in
the workplace?
BRYANT-GENEVIER: Right, exactly, yes, yes.
Q: Got it. All right, so then what did you do? You were saying you’re here in
Upstate New York, you are kind of cold—
BRYANT-GENEVIER: Kind of cold and—
Q: —you’re searching for something more fulfilling.
BRYANT-GENEVIER: Right, so I mean I—we—I get married, we—my girlfriend and I get—
Q: Oh, wait a minute, how’d you get married? You were already just—what happened there?
BRYANT-GENEVIER: Well, so my girlfriend had moved up. We’d been in Syracuse for
a couple of years, we’re there. We end up being in Syracuse for about four years
and so we’re up there. Our life moves on, like some of my career stuff doesn’t
pan out the way I’d like it to, but we just continue. But it’s during that time,
maybe after about two years in Syracuse as I’m working with other space that I
hear about the EIS program. This is the first time, so this is like 2016,
probably 2017, I’m realizing, oh, there’s this thing where the—I try to imagine
what would you like to do if you can picture anything? I was like, well, I’d
love to investigate a new thing. Like when a new outbreak of occupational
illness happens and we don’t know what’s causing it, I’d love to be the person
they call to go investigate what that is, to figure out that mystery, that
sounded fascinating too. I’ve met a few people, I’d done a training for a NIOSH
[National Institute of Occupational Safety & Health] team, so it’s a CDC team,
while I was at INFICON.
Q: NIOSH is, what does that stand for?
BRYANT-GENEVIER: The National Institute of Occupational Safety & Health. All the
industrial hygienists at CDC are mostly there. I’d done a training for a team of
CDC industrial hygienists at one point and so that had pointed the way a little
bit, oh, there—that is a job that exists and then doing more and more research,
I just ended up finding the EIS program reading about it on my own. I don’t
remember anyone pointing to it, but it just came on to my radar. Once I read
about the EIS program, it’s like this sounds like a great place to be, this is
exactly what I want to do, going to be a disease detective. I was like maybe I’m
qualified for this, right, like maybe I can do that job, so I applied and
eventually get into the program, yes.
Q: Wow. That’s not an easy thing to do, so congratulations. You and I had a talk
beforehand in the pre-interview, you got your invitation to be a part of EIS, is
this true, the day before your wedding?
BRYANT-GENEVIER: Yes, right, yes, yes, I forgot about this. Anyone who has been
through the EIS process knows that it’s a bit—the application is a bit grueling,
right? So, you apply, you fly to—or well you did—you flew to Atlanta, and they
interviewed, and you went to this gamut of steps, and then eventually after this
long process, they’d call you on the phone and they say you’re in, right? If you
didn’t get in—the first time I applied, I didn’t get in—so you don’t get the
call, and you’re bummed out. You get an email way later that says no, but if you
get in, you get a phone call. The day before my wedding, I get a phone call from
one of the program folks, a guy named Wences [Arvelo]. So, I’m getting married
that week, this was the day before I’m getting married, I’m in the grocery store
up at—we get married in Lake Placid, New York, which is up in the Adirondacks
[Mountains], like really pretty remote space and down at the grocery store start
picking up, I don’t know, some sort of wedding-related item. I can’t remember
what it was, soda or booze or—I can’t remember.
Anyway, I’m in the grocery store, I’m running through, I’m late, I’m doing
something else, and Wences is like telling me, “You’re in the program,” and I’m
like, “Great, great, great, great, that’s huge news,” and he’s like, “You don’t
seem excited.” I can remember telling him like, “Oh, no, I’m super thrilled but
I’m just—I’m a little distracted, I’m getting married tomorrow, I’m trying to
find—” whatever it was I was trying to look for,” and I was like, “Can I call
you on Monday?” I think it was a Friday afternoon or something he called me.
Anyway, so yes, that was my EIS phone call story, yes.
Q: Wow. So, you got to fly down here, you did interview, and then what happens
after that? Usually, they’ll tell you in what month, like October or something
like that.
BRYANT-GENEVIER: Yes, you find out in October and then you attend the conference
in May. I was the class of 2019, so we had a conference in May of—our first, our
sort of inaugural conference—May of 2019, so I—or April or something. I fly down
to Atlanta, and I attend the EIS conference, and it’s a big, giant zoo. I’d
never attended EIS conference before, a lot of people have been to the
conference, so they know what to expect, I was completely—completely no idea.
But it’s a big conference, you get to see a lot of presentations from the
existing officers, and then the main objective for you as an incoming officer is
to interview and—with all the available programs and then match with a position.
You’re basically running around the conference trying to talk to all the
supervisors in this division and that division, and it’s a really great
experience I think. I really enjoyed it, you learn so much, you see—basically,
you get a snapshot of what the agency looks like in a way that I think most
people who come to CDC don’t get that view. You see like all—how do all the
different groups here operate, and you get to figure that about four days, so
it’s pretty fun.
Q: Yes, it’s pretty intense and then there are other past EIS officers that are
there too—because everybody comes back too, sometimes. I mean your interview,
that’s like the process of, what they call it, matching?
BRYANT-GENEVIER: Right. You’d talk with people, then you list which programs
you’re “interested in,” and then you interview them in a slightly more formal
process on the last day, and then everybody ranks each other. You rank the
positions, they rank you, and then—there’s the algorithm, and everyone has their
story on how this works. But basically at the end of the day, you get paired
with a position with the idea being that everyone’s happy. I end up matching in
the Division of Global Health Protection, which is in the Center for Global
Health, and that position is all about infectious disease and global health
work. Again, we have just been talking about it, I was a chemist who knew how to
tinker with things. I had never worked in infectious disease, I’d never worked
in global health, but they tell you, use EIS to learn some new stuff, step out
of your comfort zone, so I volunteered. The only thing I had going for me was I
spoke French, right, because I’m a French, so I thought maybe that would help,
maybe that would help.
Q: Did it?
BRYANT-GENEVIER: I think so yes, I think it did help. I don’t know if it helped
them match with me, I think mostly it just helped do my job when I got there but
yes. EIS was this great opportunity that enables you to left turn in a career,
and I had just spent so much of my career figuring out how am I going to change
direction even slightly.
Because I was always kind of where I wanted to be but not quite and then EIS
just throws you this unimaginable opportunity, just go somewhere and do
something different that you wouldn’t have gotten the opportunity to do, which
is great.
Q: Your class is the last class to actually train in person together and
establish some sort of rapport.
BRYANT-GENEVIER: I mean hopefully not the last one, but yes, there’s been a
pause, yes.
Q: Yes, yours was the last. Now, they’re starting to—this one that’s coming in
is now starting to do that so that’s—yes. Anyhow, so you’re in DGHP, which is
what, the Division of Global Health Protection is.
BRYANT-GENEVIER: Yes.
Q: How many people are in that division and what does their—I mean it’s global,
so it’s everywhere in the world kind of thing?
BRYANT-GENEVIER: Right.
Q: Tell me more about DGHP —
BRYANT-GENEVIER: So DGHP, okay, I can’t tell you how the people in the division,
that’s a great question, I should have the answer to that. It’s a fairly large
division because it houses a lot of the country offices that CDC funds. The
Global Health Protection team is mostly interested in the Global Health Security
Agenda, which is basically a long-standing kind of strategy on how to do
capacity-building work overseas and—yes, that’s the main tagline, but that
basically no specific pathogens are housed in that group. It’s a division where
you’re focused on building work-building capacity whether it’s work, so some of
the—one of the branches focus on workplace development, the FETP program, which
is the, oh man, Field Epi [Epidemiology] Training Programs, CDC helps countries
establish and so it’s about building partnerships. It’s about capacity building,
it’s about building partnerships, it’s about working with country offices and
country ministries to help them address their priorities and connect them with
other areas of CDC where we have an expert that might be able to assist on that.
So it’s really this middle-ground player, and the reason I went to that group
and the reason I think what I learned about—really learned a lot is because they
sort of—how do you manage these big partnerships where the priorities aren’t—I
mean not already established, it’s not, does not as—is not always clean and
specific. So you’re building those partnerships, right? It’s a lot of
communication, a lot of diplomacy, a lot of, yes, working together.
Q: That’s what capacity building is?
BRYANT-GENEVIER: Exactly, yes.
Q: Right. So, you start EIS program July first usually, so you start with this
group and they—this is very typical of EIS, they instantly send you out on a
deployment—to a place that you’re unfamiliar with, with a task that is not in
your usual abilities.
BRYANT-GENEVIER: Yes.
Q: Can you describe your first deployment?
BRYANT-GENEVIER: Yes. So, my first project in the division is to do a
surveillance evaluation project, and it’s to evaluate the meningitis
surveillance system in Senegal. The team had prepped this project for me, they’d
set up the collaborators and primed everyone, and so. But within a few weeks of
arriving in the team, I fly out to Dakar, and I have one guy from the branch
with me and then we meet other partner members at the CDC country office in
Senegal. We meet with the ministry of health partners, and so. But the basic
objective is to figure out how well meningitis surveillance works in Senegal.
Meningitis in CDC is housed in the Division of Bacterial Diseases, so my—I’m
learning about what is meningitis, oh, it’s caused by a bacteria, oh, oh, right.
I don’t know any of this and so I’m learning not exactly on the plane but pretty
close to on the plane. And then we arrive in country, and pretty much everything
is in French, and I speak French, but as I mentioned I think the last time I
used it regularly was about sixth or seventh grade, so I—my French isn’t great,
and it certainly doesn’t include medical terminology, things like that, so, or
epidemiology terminology, so I’m trying to update my vocabulary accordingly. I’m
in country about three weeks, and the first week we’re in Dakar, basically
working with the planning group to plan the field activities.
It’s building interview questionnaires, it’s building the tools, who we’re going
to interview, what we’re going to ask them, what types of data are we going to
try to collect, that type of thing, all the planning stuff. Because I had never
worked on a surveillance system before, this was pretty new to me, I really had
no idea what I was doing. In basically the second week, the guy I’m with, he’s
like, “Okay, I’m going to go back to Atlanta, you’re going to go into the field
with your counterpart here from the country office and then—who’s a Senegalese
guy who’d worked at the ministry for a long time, and so you guys are going to
do the field interviews. You’re going to drive around to some different parts of
Senegal, outside of Dakar, go interview some folks, and then try to answer these
questions.” So that’s we do.
He flies back to Atlanta, I get in the car, and we drive out into Senegal. We
interview, we stop by the hospitals, surveillance offices at the district and
regional level, the laboratories, the local health clinics. We basically
interview providers, we’re interviewing surveillance officers, we’re
interviewing laboratorians, we’re interviewing all these different people. We
have these different questionnaires that we’re sort of following, but they’re
unstructured, and just trying—getting—gathering qualitative data. Every once in
a while, we get a—we look at some of the quantitative data for meningitis
surveillance, how many CSF [cerebrospinal fluid] samples or cerebrospinal fluid
samples were collected, which is the process. If you think you have a case, a
suspected case, you take a CSF sample and then this is all for children. We’re
looking at that, we’re looking at the flow of where do the lab samples go, how
do they move their—you know? It’s all very kind of standard surveillance
evaluation work in the field.
I had never done this type of work before, and I was doing it all in French
trying to conduct these interviews, and of course, you feel—you’re the CDC
representative from Atlanta and so it was—I had been with CDC like six weeks and
so I feel like, oh yes, I guess so, but—yes. So anyway, you really get thrown
it. It was a great experience— I learned a ton. In the last week, I present all
the findings to the head honchos, all come from big ministry departments and so
we have the coordination meeting in Dakar and then we—I give a talk, which I
felt super embarrassed about. I was like I don’t want to give a talk, but they
had me give me a talk, so I gave a talk to partners. I think it went pretty
well. I think we’d highlighted some things that worked well, some things that
didn’t work well, and some ways to make it work better. In theory, we
accomplished the goal, yes.
Q: You helped their capacity building?
BRYANT-GENEVIER: Yes, I think they recognized also that it’s a training
exercise, right? The country office knew when they were getting some help that
they were going to be getting trainees, so everyone knows a little bit, and
you’re there to ask questions too. There were a lot of things I didn’t know how
to do, so then you ask, like, “I don’t know how to do this, what do we mean by
this?” and then you start the conversation. So, EIS is set up to put you in
uncomfortable situations and then expect you to ask questions to figure out how
to resolve. They pick people, I think, who they think have the potential to
solve those problems even if they don’t already have those skills, right? You’re
there to learn those skills and so, yes, so anyway. I think it worked out, it
was a good experience, I really learned a ton, and that was my first trip out.
Q: In the span of six weeks, you had moved from northern New York to Atlanta,
and went straight into the field?
BRYANT-GENEVIER: Yes. Well, we had late summer course, but it’s an epi training
I mean—
Q: Sure.
BRYANT-GENEVIER: —yes, and then I’m back on a plane, yes, so it was a lot.
Q: Yes, there’s the two-week summer course.
BRYANT-GENEVIER: It was kind of a wild ride.
Q: Yes, there’s that two-week summer course where they give you the basics of
what epidemiology? I don’t know what the—you tell me what they do. Well, you—
BRYANT-GENEVIER: My PhD was in public health, so all the coursework you do for a
PhD is epidemiology principles, right, so I—we do all the stuff, so it was
basically recapping that. I started EIS in 2009 or excuse me, I started EIS in
2019, I started my PhD in 2009, so it had been ten years since I—someone said,
“Hey, make a two-by-two table.” I was like, “Oh yes, a two-by-two table.” You
had to go back and remember a little bit, but, yes, so it was good. There’s
obviously more to it than two-by-two tables, but the summer course covers a lot
of investigating outbreaks, right, and create some mock scenarios for you to
pretend you’re doing that. It’s great exercise. I remembered I tutored some high
school kids when I lived in Syracuse on disease detective science competition, I
don’t know, that’s the thing, I—anyway. I had a friend who taught at the
local—he was a science teacher at the local high school, and he’d asked me to—he
knew —I don’t know, I don’t know how we made this up, but he knew that I was
interested in that kind of thing and so he had pulled me in tutor some kids. I
was going through, and I tutored some high school kids on how to do these
basically exact same scenarios for a high school competition.
So, then you show up at EIS—to the EIS program, and you’re doing their summer
course, then you’re going—it’s like, hey, I think I remember this from we did
with the high school kids. It’s obviously not the exact same thing but it’s—it
gives you a bit of a flavor.
Q: Yes. Do they also give you media training?
BRYANT-GENEVIER: Why, am I doing bad?
Q: No, I think because when you’re out in the field and especially now during
COVID, a lot of people are—I mean media has become almost another player. Part
of your outbreak investigations, you have to report, you have to be able to talk
in front of a camera, that type of thing, and it’s become even more prevalent
especially during COVID and how media has become this other thing that you need
to manage. Did they give you any?
BRYANT-GENEVIER: They do, and they really tried to do—to include that, but the
summer course is short, there’s not a lot of time. I remember doing the media
training, you learn like if you’re—basically there are people whose job it is to
communicate to media, yes. If you can, pull them in, right, pull them in to help
you. It was my takeaway from the training that we got. Nothing that we did in
2009 was at all geared towards the type of media we were going to—we were soon
to encounter, right? None of us, no one attends a—there’s not much media in
general in public health. The pandemic has totally changed that but—
Q: Yes, and we’ll get to that later. Because that is a big part of this whole experience.
BRYANT-GENEVIER: Yes.
Q: All right, so then you come back home, do they throw you back out in the
field again, what happens after that? Because we’re now in, let’s see, July of
2019, you were there three weeks, so you really — June, July?
BRYANT-GENEVIER: I get to Senegal more in the August, September, I think I’m
there from like August, September. July is summer course, I start with the group
in August, I think it’s near the end of August, beginning of September that I go
to Senegal, so I get back from Senegal in September. I have some projects at—in
the branch that I’m working on, data analysis projects that are—and prepping for
manuscripts and stuff like that, so I had some non-fieldwork that I’d do. In
October, I go to—I do fact training, which is this required thing for a lot of
people in the Center for Global Health or anyone who works overseas. It’s this
foreign affairs counterterrorism training— it’s this weeklong thing where you—
Yes. It’s a required thing, and so I had other stuff basically happening in the
fall of 2019.
Q: Do you do a health check too before you are deployed by the way?
BRYANT-GENEVIER: You do, and it—so they have like a basic one if you’re going to
be gone for some—less than thirty days at a time, I think. It’s not a big deal.
They have a state department one that’s a little bit more involved, that
basically if you’re going to live overseas, you need to have done, so, yes,
there’s a couple of different layers of that. You have to go do the CDC clinic
to get all your shots before you do anything, so I think I went and got vaxed. I
showed up one day before I went to Senegal and they’re like, all right, so you
get—you do yellow fever, you got—it’s like boosters for everything, so I think I
got like six vaccines in one day when I went into the clinic. The folks was like
[phonetic], “Like have you ever done work like this before?” I was like, “No,”
“No? Okay,” so.
But I think in December or November, I volunteered. There’s a call for—to
support the polio surge. This is not a branch or not an activity in my division
really. The EOC is activated, the Emergency Operations Center is activated, and
they’re calling for more people to support this polio outbreak effort, and I
volunteer, and I think a lot of my EIS classmates volunteer. This is a big—like
a lot of, I think at least ten, fifteen people. We have a few emergencies
happening then at the end of 2019. There’s Ebola [virus] going on, people are
deploying to DRC [Democratic Republic of the Congo] for Ebola, polio surge is
going on, there was the EVALI [e-cigarette or vaping use-associated lung injury]
domestic vaping outbreak of lung disease that happened. A lot of my classmates
immediately after summer course ends in the backend of 2019, people are
deploying all over the place. I jump on and do polio deployment, and this is to
Côte d’Ivoire in I think November, December 2019.
Q: Okay——can you describe what you did there?
BRYANT-GENEVIER: Yes. I joined a group of two scientists from the GID, which is
Global Immunization Division, who are experts in polio. The three of us joined
together with the two guys from WHO/AFRO [World Health Organization / Regional
Office for Africa] who are leading the outbreak response, the team. We joined
the WHO team, and they’re leading that team and then we’re partnering with the
country ministry of health in Côte d’Ivoire. This is all happening in Abidjan
[Côte d’Ivoire], so we fly to Abidjan, we set up shop in the WHO office there,
and there was a meeting with different partners in—with the ministry of health
to get them started on outbreak-response activities. It’s like a combination of
surveillance strengthening, so training all the surveillance officers again on
the practices for acute flaccid paralysis because polio is monitored—the
surveillance for polio is syndromic. You’re basically looking for the paralysis
and then basically the processes for doing the testing, it’s collecting stool
samples and the transport of those samples. We’re involved in writing the budget
plan, writing the proposals, working with the ministry of health to get them—who
needs to be involved, doing some site assessments of different places. We did
make some visits of local clinics in what you call like active surveillance,
basically reviewing the registries, similar to what I had done in Senegal but
looking and seeing, okay, were there any cases that—a registry, and I don’t know
if anyone doesn’t know what registry is. A registry in this setting is basically
where the doctor records, okay, and one entry will be a patient came in and
presented with these symptoms, et cetera, and then diagnosed with X blah-blah-blah.
The purpose in a public health or a surveillance setting is that you review the
registry, look at all the different patients that came in, and then try to see,
okay, did anyone fit the case definition for acute flaccid paralysis? Should
they had been notified as a—because then that would be, okay, then you got to
fill out the notification forms for a potential possible polio case, right? We
just describe it as acute flaccid paralysis, but anyway, so we were doing the
registries in some of the local health clinics to see if they missed stuff. I
get pulled into doing some of those activities, and it’s—it’s a mixed a bag.
We’re in Abidjan for maybe three weeks or something and right around the middle
of December, we—it’s basically that we realized that everyone—everything is
going to for the Christmas holiday. Everyone, all the public health department
is going to go on vacation, and everything is going to shut down, so there was
nothing for us to do the back end of December, so they were like, “Okay, we’re
all going to go home and then we’ll be back in January or something, so we’re
just going to fly everyone home.”
I come back after being a few weeks in Côte d’Ivoire with the expectation with—I
was planning that I would just—I would come—I would be kind of U-turning and
heading back in another month or two. Because I spoke French, and I was working,
I knew a bit of the team, I knew who the members—I knew who the partners were, I
had that, I developed a little bit of relationship with some of the other people
at the ministry of health there.
Q: Yes, okay, and so we are now at this pivotal part in the whole world
where—we’re starting to hear these rumors about SARS-CoV-2 [severe acute
respiratory syndrome coronavirus 2], although it was not called that, it was
called—I think it was pneumonia?
BRYANT-GENEVIER: We didn’t know— we didn’t have a name. The EIS rumor machine is
strong and so we all—it’s a pretty—we all get together, but they were still
doing what we call Tuesday Monthly Seminar, which is you’d go—all the EIS
officers go gather in a conference or an auditorium. Someone gives a
presentation, and basically we all chitchat, and then go to the bar afterwards
and talk. We had like a New Year’s Eve thing, I can’t remember what it was, but
it something like New Year’s Eve in—of 2020, right, so the end of 2019,
beginning of 2020. We’re all getting together, and one of our classmates was
like, “Yes, I think I might go to this new pneumonia thing.” We’re like, “Oh,
cool,” because we’ve been deploying all over the place for Ebola, polio,
everyone was like, “What are you doing, what are you doing?” That’s how the
culture works or it did anyway in—when I was, yes, at that time.
Q: Right, so they’re all discussing it and to—your thoughts on that? Did you
think like, oh, yes, pneumonia or—?
BRYANT-GENEVIER: Yes, it’s really hard to say because we’d been involved in—I
mean not that pneumonia isn’t scary, but it was this thing where we—people had
been on the polio deployment, we had several of our classmates who had been to
rural parts of DRC who had gotten the Ebola vaccine and then we’re—polio. I
remember when we were doing polio, I don’t know, but basically the severity. I
don’t know you get roped in, you—I don’t know, it’s a hard thing to describe.
You don’t have a good emotional link to how serious the risks are because if you
think about it too much, you—it’s hard to do your job a little bit. You are kind
of like zoomed out and thinking at it a little bit more from a public health
data lens. The immediate reaction is when you Victoria (another EIS officer) was
going to go to do some of this stuff, it’s like, “Oh, where are you traveling
to? That sounds great,” that was the immediate response. We didn’t have a good
understanding of the risk, yes, that was on the horizon.
Q: Right, I don’t think anybody had the understanding of this, what was coming.
All right, so after that get-together, you were starting to hear more and more
about the unknown cause, which is now becoming more like an official name. In
February, it’s officially named COVID-19.
BRYANT-GENEVIER: Well, yes, so, yes, so I—end up not going back to a Côte
d’Ivoire, and I start getting on the—and I volunteer for a COVID deployment. At
that point, it was still nCoV [novel coronavirus] something, something. It was
like the very beginning of February— I volunteer for a team that’s doing the
investigation of a travel-imported case on which is the twelfth, was the twelfth
case in the United States in Wisconsin so this is—
Q: The twelfth case of CoV-2?
BRYANT-GENEVIER: Yes, and right, twelfth detected case in the United States.
This was around the time of the—while the—I don’t know, the dates, but it was
around the time, maybe a little bit before the nursing home in Seattle, so it
was right around that time. It was like the first-time people realized how maybe
dangerous it was.
Q: So, describe that investigation. This was in Wisconsin?
BRYANT-GENEVIER: Yes. So, this is in Madison—
Q: Case twelve.
BRYANT-GENEVIER: —case number twelve, yes. We fly out, it was the first week of
February, or, yes, middle of the first week of February, and I had a buddy, one
of my EIS classmates was assigned to the department of health in the Wisconsin.
Q: What’s the name?
BRYANT-GENEVIER: Ian, Ian [W.] Pray at the time. I believe Ian still works
there, but anyway. So, Ian wasn’t working specifically on this investigation,
but he was a buddy, and I was like, oh, I’m going to get to see Ian when I go
out to Wisconsin, and so I—it was one—it’s just part of the mindset. We deploy
out of the objective of this group is—of this mission is to conduct—essentially
do contact tracing for this travel-import case, to conduct the case
investigation, and then what we end up doing is basically all the specimen
collection for all of the contacts that this person came into contact with and
all the people that they sat near on the plane, family members, and all—and
healthcare workers who—the case that come had—knew they were sick and had
basically gone immediately from the airport to the hospital and said, “I am
sick, I know that there was something in China where I was, and I—” so had
basically done their—had been very careful. But in that process, our job was to
do the legwork on going to collect those samples, and at the same time, we were
doing capacity work on the—for the county health department there. I can’t
remember what the name of the county is there in Madison and then also—
Q: Dane?
BRYANT-GENEVIER: —working with the state. What’s that?
Q: Dane County?
BRYANT-GENEVIER: Yes, yes. We did a training for NP [nasopharyngeal] swabbing,
right, or NP/OP [nasopharyngeal and oropharyngeal] swabbing. The other three
people on the team with me were physicians and so I was—so they mostly did that
part, but I got swabbed. This was like the very beginning of February, and so
we’re like, oh, this is uncomfortable, man, I don’t have to do this much, very
much, so. That’s basically what we do. We spend two weeks in February driving
around to collect specimens from people who had come into contact with this
case. But remember, February, we were—it was low-profile time right? CDC didn’t
know what we were dealing with, so when we would go—we’d drive to someone’s
house, we would arrive at their house, we would put on PPE [personal protective
equipment], which was like the full gown, gloves, and then N95 respirators, and
face guard. We were in full garb, what would you expect to see in a hospital
operating room basically. We’re out in the real world and so we would like tell
people, “Okay, open your—do you have a garage? Open your garage, we’re going to
drive in, close the garage door behind us, and then we’re going to suit up in
the garage and come to your house” because we didn’t want people’s neighbors to
see the blue spacemen walking up. There were some sensitivities to that, so we
would go, and we would go to people’s house. We would call them ahead of time,
“Hey we’re doing this, this is what we’re trying to do, this is a question we’re
trying to answer.”
Essentially for me, this was like this eye-opening moment because you’re going
to people’s houses and you’re the CDC, and you’re showing up in this outfit, and
you’re telling people like, “Don’t worry, it’s cool, we’re just going to get
some—collect some specimens from you,” and people, a lot of people were really
scared. Yes, there was one group, they had their children, right, their children
are there and they’re—one—this person you’re collecting the specimen from them
because they were in contact with this person like, “Do you need to test my
kids, what are you doing?” and we were like, “Uh, we don’t have any guidance on
that, so no, not going to do that.” You’re the frontline person, you’re the
first person they talk to, they don’t have anyone else to call and so there was
nowhere to find information on what they’re dealing. This was eye-opening for me.
My main concern going into this was try and make—to reassure people, to tell
them we were going to—we’re going to try to help them. I’m not a clinician, I
don’t have like—I think clinicians have this—they just have training on you can
only do so much to help a patient, your job is to treat them for what they have,
but you can’t—you know. It’s a little maybe ingrained in their training to
understand that mindset, and it wasn’t for me, so I—it was very—it was an
interesting space for me to be in there and pick that up firsthand. Because this
was the first time I’m interacting with, yes, doing like the—just seeing people
who could be in impacted by what you’re trying to do, like you’re having
conversations with them. That’s what we were doing, so for two weeks we’re
driving all over was Wisconsin basically, donning these outfits, and generating
a—putting a lot of PPE waste in the bin, driving the specimens back to the lab.
This was the time when there was the snafu with the lab samples. The Wisconsin
state lab is doing those analyses, we were driving to the lab at the end of the
day to bring them all the specimens, and I think they were pretty good. There
might have been like a day or two where we had some snafu, but it wasn’t—it was
mostly resolved by the time we got going.
We do all the assessing in the, and what we find was that no one had—no one else
tested positive. So the case tested positive for a few more days and then none
of the family members—like they had moved out of their house and gone to stay
somewhere else, a hotel or somewhere, I can’t remember. Yes, we tested the
family members, we were testing everyone sequentially, so everyone who came into
contact, they would get multiple tests every other day for two weeks, and no—all
of those tests come back negative. Everyone who tests—so we feel ecstatic. We’re
basically like, yes, contained, we’re good, we’re going to go home now. We
celebrated, we go to the bar, and we have a beer, it’s February in Wisconsin,
and my buddy Ian, he’s—joins us for a drink. I think he joins us one day and
then the next day, we leave or we’re going. I don’t know, his wife has a baby
right around that time, so we’re—it’s a celebratory mood is what I’m trying to
capture. We didn’t test any positives, we contained this thing, we felt really
good about it. Ian, his wife had a baby, everyone is really happy. Yes, I don’t
know, that was the mood, that paints the picture
Q: Wow, yes, I can just imagine how the children in those homes are remembering this.
BRYANT-GENEVIER: Yes, I have no idea. I remember the people were—by and large,
they were scared but they—we talked to them, they were aware of what was
happening. We were telling them this is overkill, this—none of this gear is
probably necessary—I mean it ultimately is probably pretty necessary, but we
were trying to reassure people. Yes, I remember one, at one point, the guy was
like, “Hey, do you mind if I take a picture with you? I think it will ease the
situation and make my kids see this is—” I’m like, “Yes, sure, absolutely.” If
this is going to help calm the situation down if someone takes a picture of you
next to me, I’m okay with that. I mean in the hindsight, I don’t know, maybe
that was a bad call, maybe that’s not how we should behave when we’re in the
field, but I do think we asked a lot. It was my impression, and this is my
first—is we asked a lot of people when we were asking them to comply with these
sorts of things, and it is voluntary, and it goes a long way to help, be as
human as possible throughout that process, that was that was the best way I
could approach it. Yes, the human thing to do is smile, I mean we can’t smile, I
had a whole mask on, you couldn’t see my face at all, but, yes, take a picture
with the—with someone who’s helping you out.
Q: You tested them more than once, so this isn’t just like one day in, one day
out, you were testing them multiple days just to make sure it was contained.
BRYANT-GENEVIER: Yes, yes, that’s correct. We didn’t know what the—like latency,
we didn’t know how long it was going to be between exposure to outcome. They
hadn’t really picked up on that time, and we’ve been told when we first showed
up that it could be five days or fourteen days, and we were like, okay, but—so
that’s why we were there that long. We basically tested everyone to day fourteen
and then when no one tested positive, that’s when we came home.
Q: Yes, well it was a virus nobody knew anything about at all, so guidance was
changing constantly and how did—did you feel supported when you were in the
field? You’re saying you’re donning PPE, and now that I think about how much PPE
you may have gone through that one week and could have even—and all the ICUs
[intensive care unit] that were reusing theirs—
BRYANT-GENEVIER: It was before—we knew any of that.
Q: Before we knew anything like that and—yes.
BRYANT-GENEVIER: Yes, they would send us out, when we flew out, they would
ship—actually, I can’t remember, maybe they—we flew with the PPE. I don’t know
if we—I can’t remember. On later deployments, they would just mail the PPE to
whatever hotel we were staying at, and you would get your cardboard box of
whatever and so most of the other deployments and whatever. I think this first
one, I showed up at the EOC, you go to the equipment room, you request PPE for
whatever, and they give you like two—basically a garbage-size bag of stuff, and
you just packed. I think I packed it in a separate suitcase and just flew with
it, so I brought it all, and then we left it all. You left all the spare stuff
at the health department because, I don’t know, we used like half of what they
gave us or something. But, yes, this was just a different time, and the mood was
so different in the early phase. This was investigating something that we didn’t
realize—I mean I remember asking one of the senior guys because this was my
first time doing this kind of outbreak response in that kind of way, and I
remember thinking like, how do—do we know these activities work in terms of
containment, how do we do them, what’s our mindset when we’re going to this, is
this this severe, do we need to be this? I didn’t know what’s the default
practice beforehand, and maybe I should’ve. But the mindset was, he told me this
and I’ll never forget this, it was basically like, well, if we don’t know, we
approach it like Ebola, that’s the level of precaution you take until you know
better, and it’s like, oh, so obvious, duh, absolutely, that’s how you go about
it. So it was like the mindset until we know it’s less severe, this is how we go
into it because you don’t know what you’re going to get too on the other end and
so that’s why we wore all the PPE, that’s why we took that precaution, all those
precautions, and that’s why we went and did sequential testing. That was the
early phase, it was—in hindsight, it was what we needed to do. Yes, yes, I don’t
know, I don’t know, that was—
Q: You deployed a lot thought during those early months, you deployed again to
Rhode Island.
BRYANT-GENEVIER: Yes, yes, so I get back from Wisconsin, right, so then I’m home
for probably about two weeks, and then I get a call for another opportunity to
go out. I come home, I think it’s like mid-February, and then in late February
or really—I think, yes, maybe the first few days of March of 2020, I get an
opportunity to do another deployment, this one to Rhode Island. I jump on that,
that sound great. This team’s mission was to again investigate a
traveling-import case or a couple of them that were in a school with the idea of
doing something like an exposure study at the school to say, okay, you had a
symptomatic person in the school and there was contact in a school setting, how
many other students or staff at the school test positive, right? It’s a school
setting, a place where you could see transmission. This was the purpose of the
study, and this was a great project, I was like, oh, yes, that’s super important
to understand and so much more important than I ever would have—like later on,
like oh my God. Yes, so we fly out to Rhode Island, and I joined my team
of—there was five of us.
The health department of Rhode Island is all centralized. It’s very small, so
there’s no county health department, things like that, it’s all happening in one
building, and the laboratory is like right next door. Everyone is in the office
at this point, right, everyone is going in, there’s—everything’s normal and so
we go and we have a conference room that we basically set up shop in and—or
maybe it’s a basement, I can’t remember. But anyway, the punchline is there’s
five of us and we’re all—we’re staying in the hotel across the street from the
health department, and we start setting up this study. We had two objectives,
right. So one objective is to investigate this, run this little study, this
project on the transmission in the school because the school had been notified
they had a case. They shut down that school and then they were doing—waiting,
this was early March, they were like, no other schools were closed, this was
just—they—and this wasn’t like wasn’t like a demand, they had shut down
practically. So, we’re doing that.
Oh, the other aspect of the project was to support processes related to case
investigation and contact tracing for Rhode Island, so we were basically
reviewing their protocols. Like what do you guys do for case investigation, what
do you guys do for contact tracing, and this is everything from what questions
you’re asking, all the way down to like how are you recording the information,
this was process flowing, how are you sorting the data, how are you uploading
it. With the backend and what we end up realizing later on is that the scale,
like how do you this at scale, right. If your process is you talking into the
phone and you—and then filling out a paper and had that piece of paper to Steve
[phonetic] and then Steve does it, but then someone enters an Excel spreadsheet,
oh, but Peter has this Excel spreadsheet open. If you have that kind of process
going, it’s going to be really, really hard. We were trying to basically, yes, I
don’t know, shed light on those processes and help build capacity where we
could. I can’t remember exactly where we—what their processes were at that time,
but we were effectively trying to do process improvement on that aspect. So
those are the two things we were doing in Rhode Island.
Q: How do you communicate though to parents and the school administration as
well, and was that an incredibly smooth process or was it not?
BRYANT-GENEVIER: Well, so yes. We show up, and it’s the beginning of March, and
things were still pretty normal. We’re going to restaurants for dinner, we’re
hanging out, no one’s really—no one’s wearing masks, where—this is before any of
that. Everyone is having a good time. And so we’re doing this case that the—and
maybe we shouldn’t have been, right, I don’t know. Basically, we started the
project, and in the time that we’re starting the project, the scale of the
problem around us, like the tension around us starts to go. Halfway through
we’re there, that’s when everything starts to shut down, people—I remember my
family members calling me and texting me and be like, “What is this thing, what
are we doing?” and so everything is shut down there in the middle of March. I
can’t remember the exact date, but basically, even we were like, oh wow, this is
a big deal and so it would—
Q: March fifteenth, President [Donald J.] Trump declares a nationwide emergency.
BRYANT-GENEVIER: Right, so that’s right in the middle of our time there. When we
first started the project, we meet with the school officials, we meet with some
of the administrators, we have a good, smooth relationship, things seem okay,
like we have a plan for okay, we’re going to run an event essentially—well, I
don’t want to call it an event. We’re going to do a testing event, so we’re
going to provide the testing. We’re going to basically do swabs and blood draws
for anyone who volunteers, and we’ll do it in the gymnasium of the school, and
basically then we’ll have a little questionnaire where we’ll ask some people
some questions like did you—basically to the effect of were you in this class,
do you—period four, so-and-so, or were you—you know? If you were, which desk did
you sit in? We had a map. This was a high school, so we had like a map of the
room of where people are. So we basically had the questionnaire, it was like
that. Oh, I didn’t take any of those classes and so we—that was the event that
we were planning. We had coordinated with the health department to have people
to do the blood draws, to do specimen collection. We had a lab guy come from CDC
to help get everything ready for the lab side, so all specimens could be
analyzed and prepped and organized and everything. It was a good, quick—in seven
days, we—even less than, we had the plan for all of this stuff, and we’d send
out materials to the school, so all this.
Basically, when things start to close, it changes the mood. Everyone gets a
little nervous, and we’re not sure it’s going to even happen. I don’t want to
say, it sounds so silly, so one of the parents had sent our flyer to a local
newspaper, and it was like—it felt like it was going to explode, like we’re
going to get some sort of a crazy media presence at this event, and we are like,
this—it’s not what we want. We were going to start to have to talk to parents
and stuff like that, so we—CDC sends us a comms [communications] expert to come
to the team like a day before or two days before the event to basically walk us
through like how to have these conversations, what to be aware of, how to—and
support us in that. Yes, we were a little nervous, this could be a media event.
Then the week after, everyone’s already locked in their houses is what I
remember and very few people come to the event. We got enough to do the study— I
think we probably had twenty, thirty kids come by to do—to volunteer. Again,
they’re coming, they’re doing a blood draw, it’s not nothing, it was a big step,
a big help too, and so they come in, and we do that and then we write the study.
In this time, we’re trying to also—
And then the case number arise, right, and so we’re trying to help Rhode Island
manage how they prep for that like you’re going to have a scale up. And then the
other things we were starting to realize, like you got everyone in one room, all
your people on your staff are in one room, they’re all on top of each other, we
need to out a way to get people spread out a little bit. We start to think about
how to do social distancing and all that stuff is—that’s happening in this
moment. We didn’t have plans for those things, it didn’t feel like we had plans
for those things in the beginning in March, but then by the middle of March,
we’re like we need this immediately, so that’s the space we were in and so we’re
navigating in those months. We did talk to some students and some parents. It
was more familiar than we thought. It was pretty straightforward. When it’s
small numbers of people, you have three students, a couple of parents, and you
can have a one-on-one conversation that feels—you’re easy—it’s easier to convey
information. It wasn’t like a big media thing where there was like fifty people
and a crowd and a bus with a camera or all that stuff. It ended up being a very
small thing. But again, I think that project was useful. Yes, it takes us a
while, but we write up, and we learn some stuff.
The major takeaways from that project were at that time with that variant,
right, it wasn’t really—the school setting didn’t really result in that many
infections, a few but not a lot, so it was a little bit of what we—it was
building on that, what-did-we learn space, and I thought it was useful.
Q: Okay. You’re doing this right at the time when the whole country is starting
to shut down, schools are shutting down, the government is going home. We, CDC
was now working completely through telework, which is a completely different
feeling when you’ve been so used to working with other people and how that must
have affected the response as well?
BRYANT-GENEVIER: Yes, yes, yes.
Q: I mean it’s easier to run down the hall and say, “Hey, I have something here”
rather than you go and set up a Zoom call and we’re going to talk about this.
I’m just wondering if telework is slow—do you think it’s—it may have
had—affected the response at all?
BRYANT-GENEVIER: My sense is when you’re on response, there’s no telework, I
mean when you fly into the field, right? When you’re in the field, you’re going
to do stuff anyway, and there isn’t there—there’s less—yes, you social distance,
you do what can, you have Zoom calls with the team back in Atlanta, but the work
in the ground is still—I mean so much of it was just face to face. We were
driving to the school, meeting with the administrators, setting stuff up. You
were physically needed to collect blood from these kids, so we were—we met with
phlebotomist team, and we—so we had all this. Oh, in the field, you don’t notice
it because you’re doing it anyway. What we noticed in the field was like as the
emergency arose and the scale arose and there was so much more happening, we did
get that feeling of like did CDC remember they sent us here? We would have
calls, and they’ll be like, “Where are you guys?” and we’re like, “We’re in
Rhode Island, you sent us to Rhode Island, do you—?” Our team, we were so
worried that they were going to cancel all the flights and that there was going
to—no CDC plane to get us home that we rented a car to drive back to Atlanta
from Rhode Island that we—thinking we would never be able to get back. Yes, like
a lot of people on the team, they had kids, they had kids in school, they had
kids in day care, they were trying to navigate that with their own families. It
went from organized to what felt like not organized— very quickly, and while we
were in the field to see that shift. I don’t know if telework made it that way—
I can’t speak to that. I do think that there was this sense of we’re on the ball
in February and then there was a sense of by the late March, we’re not on the
ball anymore. That’s what I felt like from my vantage point.
Q: Do you think it was due to the fact that it was spreading so quickly in the
country, or do you think it was more of leadership, or lack of leadership?
BRYANT-GENEVIER: It’s really hard to say, I mean there’s certainly some elements
of the latter, right? There’s certainly some elements of leadership and
then—that probably could’ve stepped up and said some more things. I remember
attending an EOC call, one of the early ones that Nancy Messonnier did, and I
remember she kind of put the fear in me. I don’t know if that was the impact
other people took away, and I was like, oh, this is a big deal, okay. Because I
came back from Wisconsin thinking, okay, we crushed, we’re good, this is not
going to be a thing, I’ll go do something else in a month. I remember listening
to that seminar and be like, oh, or yes, I was sitting in on that IM [incident
management] meeting or something, I can’t remember what it was, but I remember
thinking like, oh, this is serious, okay. We need to refocus, I need to have a
different mindset here, and they helped me change that. I remember changing the
way I looked at the problem at that space.
Again, everything was changing so fast. I think it was partly that it was
changing fast— I think it was part that the processes we had to manage things
like that, like contact tracing and case investigation, that those processes
didn’t include modern tools. In many of the places I deployed later, it was
still like phone calls, it was filling out paper forms, it was filing that paper
form, it was someone putting in an Excel spreadsheet, it was—we didn’t have—and
when we talk about public health systems, that’s what I’m talking about, that’s
what everyone is talking about. It’s just like the transfer of that information
if it’s not done in an efficient, automated way, then you—it just takes too many
man-hours to do. When five cases a week, yes, you can probably do that with the
staffing you have, but if you get fifty, you can’t, all of a sudden, you’re
going to be backloaded, and if you five hundred or five thousand, yes,
you’re—it’s a completely different system you needed. Those were the types of
things people were starting to realize in March was my sense and so that’s what
the—yes, that’s what I—that’s what you felt. When visited the following month
in—even in April—in April 2020, those were low numbers of cases relative to what
we saw later on, right? Already people were so swamped, it was like they
couldn’t—they were doing five hundred a week, and they just didn’t have the
staffing and the capability to do that.
Q: Yes, it shed a light on how public health departments were a little bit
understaffed and a little bit technically not all at the same size of technical—
BRYANT-GENEVIER: Yes, yes, absolutely.
Q: —expertise and so it helped bring everybody into a similar position, this
pandemic, I think.
BRYANT-GENEVIER: Yes, absolutely, I mean it shed light on that key problem I
think and—yes, but it was just a sheer scale. That many cases spreading that
quickly, I mean, yes, none of the systems were really ready to handle that was
my takeaway.
Q: Then you go on again in April to another deployment—
BRYANT-GENEVIER: Yes. Right. So, I get back, I’m home. I missed Valentine’s Day
because I was in whatever it was, Wisconsin. I’m gone for most of March and
during—while everything was shutting down, my wife is calling me and being like,
“I’m freaking out.” I think I told her like that day, maybe two days before, I
didn’t know everything was going to shut down, but I was like, “Things are
getting kind of serious, go to the grocery store and buy like a month’s worth of
food, just do it.” and she’s like, “What, is this going to be a—?” because
everyone had heard of it, of COVID, but no one was taking it seriously. I
remember telling her that. And then while I’m away, she’s—we’re talking every
night, we’re—it was hard, it was hard to have family members far away. Remember,
we don’t know that many people other than the EIS officers in Atlanta, right, so
it was—I think she got a cold or something and she was like so—right in
February, so it wasn’t COVID then, but she was so scared. Anyways, so this is
like all the stuff that’s happening, you’re managing what’s—and I have a text
chain with all my family members and cousins. My sister is a physician, and my
dad is in cancer treatment, you have all these different pieces of your life
that you’re navigating at the same time, trying to help while you’re doing your
job. I mean you are the resource for them as much as you are for your—outside of
nine-to-five, right, I’m the one who they call. Anyway, you’re trying to do that
as well. But yes, so then I volunteer, I get back, I’m home for about two weeks,
and then I volunteer again to go to North Dakota.
I was on a circuit, I think they had my number, and they said they would call
and then say, “Hey, can you go out again?” We were all working from home, and
all my—I came back, and I had all these analytic projects and other things I was
supposed to do, data analysis and manuscripts for regular branch activities, but
just—everything got dropped essentially. No one was focusing on that, everything
was focusing on COVID, and people were volunteering to go everywhere. I took a
little bit of a break, but then I was like I can go back out. A lot of people
couldn’t, and I could, so I volunteered. But it starts to change a little bit.
So, April and then I go out again in June to Pennsylvania, but those two—so
those two deployments, they were less in the space of a specific epidemiologic
question and more just— go help. They had some definition of what the mission
was going to be, but effectively what it was, was just go try and help that
state health department or local health department.
Q: Right, so we’re also we’re also in the middle of are we masking or are we not masking—
BRYANT-GENEVIER: Yes, yes, we’re masking at that point.
Q: —changing, and this is where you guys come in to fill in those gaps of here’s
what we say we should do, but that guidance kept changing. There were constant
White House press briefings indicating all sorts of interesting guideline and
recommendations. And then Dr. [Anthony Stephen] Fauci stepping that back a bit,
but we don’t see a lot coming out of CDC at that time.
BRYANT-GENEVIER: No.
Q: Either we’re hunkering down trying to get our plan together or something is
happening. I’m not sure why we—maybe it was leadership.
BRYANT-GENEVIER: Yes, it felt very reactionary in that moment, and you would
need something, and it wasn’t there, and you’re like, “I just need an 80
percent, I need good enough, I need—what’s our best advice now?” and like, “Well
we don’t have a guidance document for that.” I was like, “I don’t need a clear
guidance stuff, I’m try—we need something now.” There was this push and pull.
Like I was volunteering to go to the field, and from the field, the kind of
mindset was you’re never—we aren’t getting the advice we need to give to the
people in the field. They have a need today, not for what document you can give
us in two weeks, not for the clean, polished, media-ready version you can give
us in two weeks, we need it today. We have the relationship now, and we’re going
to lose it, and we’re going to—people are just going to do—they’re going to do
their—whatever they think is the best call if we don’t help. So, there was a lot
of duplicates, what felt like a duplication of effort, there was a lot of—yes, I
mean lack of trust. CDC would show up and then we’d say, “Hey, do you have the
guidance?” It’s like, “No, I don’t know, I don’t have it.” Or “Hey, can we talk
to your expert on this?” but like, “Oh, we don’t know, we can’t get them there.”
It was tough.
My takeaway in the moment was that by April, we had hit a pace where it was like
the guidance documentary is changing, the guidance often were—guidance documents
were very difficult for regular people to read, and there was just so much
happening so quickly and so it was just tough. I think there was just too much
work, not enough people, and then not enough time to have the conversations that
needed to happen. Yes, I think that was true for the April deployment, it was
true for the June deployment to an extent, and what it felt like, a lot of—I—we
started skipping. We didn’t watch the press briefings, we didn’t watch those
things when you’re in the field because it was just distracting, it was just not
helping. A lot of it came down to common sense in the absence of proper steps.
It’s like, okay, let’s just think about this and come up with a common sense
approach and so we did that a few times in North Dakota where we were like we
had—we would encounter. What was one of the examples?
We had a situation where there was nursing homes, so they were trying to come up
with a way to understand what was happening at the nursing homes, and they
didn’t have a system, so we’re like what do we ask the nursing homes to give us,
what information we need from them, what—how do we prioritize which ones to
focus on and which ones not to? We’re just brainstorming, and this is like a
ten-minute conversation. We’re doing a dozen other things, and we sit down with
the VIP [very important person] from the North Dakota Health Department. Again,
we’re in conference rooms, we’re masking, but like effectively the five of us
are like a family at that point. We’re like, okay, how do we do this? And so, we
come up with like, what about if we just say if you don’t get any information
from the nursing home, that’s a red flag, like that’s that—you need to say,
okay, we don’t know what’s happening there, that’s a red. If they have
confirmed, locate, like they have confirmed zero, like they know they have zero,
they’ve been testing people, and they’ve got a zero, like a confirmed zero, then
that’s a green one.
If it’s like a confirmed any number less than—I don’t remember where we were at
that point, but we come up with some threshold arbitrarily and said, okay,
you’re a yellow. It was this brainstorm off the envelope kind of approach that
enabled them to say, okay, now, I can tell that the junior members this is how
you’re prioritizing, this is—I need the priority list of nursing homes now,
blah-blah-blah. There was just little things like that happening all the time
that we were always trying to navigate and then little things like we were—had
feel—inklings of no one knew long COVID at that point, but we had some cases of
unusual things and so the team is like, okay, how do we forward that, how do we
get that information to the right people to look into these special cases and so
that was happening in North Dakota. North Dakota was an interesting case because
every state navigated this in a different way. After having seen at several
different states, it stood out to me, in North Dakota, it was—the response, the
emergency operations center was being led by the National Guard and so the
National Guard had taken charge of the—a lot of the key roles. In theory, I
don’t think there was anything wrong with that specific approach, but then there
was again a lot of duplication of effort, and the health department actually
been sidelined, and in particular, a lot of the epidemiologists had been sort of
sidelined in this process. When we came into North Dakota, we’re like, why, who
requested us, why are we here, what are we supposed to do? We were nominally
linked to the health department, but then the health department wasn’t really
linked in very well to the response effort. We did a little bit of bridging, and
we’re working across those two spaces.
In North Dakota, we ended up doing a mass swabbing—like we ended up being the
specimen collectors for a big swabbing event, so I was happy that I’d learned
how to do the swabbing in Rhode Island. I then knew that, so we stand it up, and
we were working with the National Guard to prep that. Their response effort was
like every state had different needs, some states had—like Rhode Island had this
sort of—they didn’t have the electronics systems they needed and then North
Dakota had like a different set of needs, right. It was a very different
problem. They had all the testing equipment they could want, they had all
the—they had purchased tons of software, so they had software systems. Resources
weren’t the problem— it was more like coordination and prioritization. They had
these mobile testing labs they would send out for these big testing sites, but
they were sending them to places like on a whim, and it was like, well, we need
to prioritize a little bit how we’re doing this because if you send them to a
rural—an area where there’s not going to be much transmission, then you get
nothing. It’s not like you’re in control, you need a broader picture, right.
They were basically doing snapshots with the mobile truck in all these places,
so it’s more like you need to build a more collective view. I’m kind of
rambling, I don’t really know exactly what I was trying to make the point here,
but my—
Q: Yes, the picture of what it was like there. As you said, each state has its
own way of responding, and that is because it’s inherent in state’s rights
because each state had its own health rights. So that is why each state is
different and—
BRYANT-GENEVIER: Absolutely.
Q: —it’s a good thing, and something like, this can also work against you sometimes.
BRYANT-GENEVIER: Yes, oh yes, for sure, and that we didn’t have a clear message
on what to tell people either in a lot of ways. When we would show up, they’re
like, “What—where, we need help, what do we do?” and we would be like, “I don’t
know, what are you doing now?” It’s very weird. The first two deployments or
whatever with COVID, we had missions, we had questions we were trying to answer,
and then later as it starts to be the support thing, you, kind—I—yes, it got a
little off the rails.
Q: I think a lot of people got off the rails there. Everybody is shut down,
we’re all home, and we’re all thinking about one thing. Besides getting our
children up online and doing online learning and teleworking, we’re all thinking
about how long will this last, how long am I in my house. Some people are alone,
some people are not alone, some people are in nursing homes, people are in
nursing homes not being able to see their loved ones, there was a lot of
isolation happening.
BRYANT-GENEVIER: Yes, it was, yes. I mean, yes, yes, absolutely, absolutely.
Q: Of course, then, we do start launching into looking for a vaccine sometime in
April, which is really interesting that it—that all went down pretty fast, which
is great.
BRYANT-GENEVIER: Yes, absolutely.
Q: But back to you.
BRYANT-GENEVIER: Well so yes, I guess I—so I do all these field deployments in
the first half of 2020 and then I sort of hit a wall that I—I think the last of
June one in—it was Erie County, it was a small county health department in
Pennsylvania, and we had the same problems as before. It was June, and we
were—it was still happening, and I think all the same problems I had encountered
on the previous deployments were still there and there didn’t feel like anything
I could do. I got a little burned out. I remember being irritated and
frustrated, and they’re bringing basically previous frustrations with me and
realizing, okay, I wasn’t being as objective as I needed to be because I
was—well, yes, I was distraught by what I had—the past experience is another
one. I take a break after I come back from Pennsylvania, I say I’m going to—I’m
not going to do any more field deployments for a little while, so I take a break.
I work on some other EIS, I had a lot of projects, I worked on this analytic
project, I write a paper totally unrelated to COVID, I’m just sitting in my
apartment. My wife and I, we have this one, little one-bedroom apartment in the
city, and we’re sitting on top. Both of us working from home on top of each
other in this little space, but we didn’t really want to go to at that point, so
we were just at home.
The next project I volunteer for is a—is locally. It’s in Georgia, it’s
in—basically—well not Atlanta but like nearby. I volunteer because it’s a
question, right, they had a clear mission, they had a problem they wanted to—a
question they wanted to answer, a problem they wanted to address. It was about
looking at the efficacy of this point-of-care diagnostic tests. This this is
probably October of—maybe September, October of 2020, and this is when those
like the swab, like the home test kits swabs, like that was the first time any
of that started coming up, right. People couldn’t buy them regularly, they were
still not quite widely available, but they were in a variety of like nursing
homes and testing locations. The question that we go out is to find out does—do
these test kits work in a nursing home population? They had—sort of making a
mandate for a lot of—or not a mandate but a request for a lot of nursing homes
to do testing of all of their residents every—once every week or something to
track and monitor the nursing home and—as a mitigation strategy or a containment strategy.
That was the purpose of the project and so I volunteered for this project, and
we—the way it works is they were—the team was working with—nominally with the
Georgia’s—from what I understand, the Georgia state health department. I’m not
on the project planning team, I’m on the field group that’s going to go out and
do the swabbing, so we are waiting to find out. Well, uh, anyway, so we do our
training and then we’re waiting like, “What nursing home were we going to?” “We
don’t know yet,” “And when we are we going?” “Oh, we don’t know that yet
either.” We’re waiting to find out the finer detail. And then eventually, they
identify a nursing home, and in order for it to be—collect data that we needed,
they needed to wait for a nursing to be having an outbreak. They identified this
nursing home, and we’d go, and they’re experiencing a COVID outbreak. In
exchange for helping, like we’re going to do all the swabbing of your residents
for a couple of weeks, and in exchange, we’re going to the—we’re going to
do—we’re also going to test them with these separate kits. So, we’ll do a PCR
[polymerase chain reaction] test and then we’re also going to do a—the sort of
point-of-care diagnostic testing kit. So, we’re doing a lot of swabbing every
other day for all these nursing home residents, and it’s a, yes, low-income
nursing home area. This was a tough place to be, and I had never spent any time
in a nursing home like this before or any nursing home really but—and so we
weren’t exactly welcome. There was not a great working relationship with—I mean
there was a working relationship with the facility, but it was not—we weren’t
collectively involved in the project. They were running the nursing home— we
were testing stuff. Anyway, it was a tough space to work in.
I volunteer for this project, but it ends up being like my—and I think we write
a paper, we finished the project, we get some answers to these questions. But I
have a tough time with this project because we asked a lot of the nursing home
residents to do this, just testing for several weeks, multiple times a day—or
not excuse me not—multiple times a week, like two, three tests a week and with
the value to them being not a lot, right? We asked a lot of people, and I don’t
think we brought that much to them or to the nursing home facility itself and so
it was just a hard space to be in. This is a very deadly virus for this age
group and for this population, and I just—we were there, and we were answering a
question but it—the juice didn’t feel like the squeeze. This was a hard moment
for me because I’m there working, and I just don’t see—it doesn’t seem to fit
with the—what should we be doing here, are we answering a question we really
need to answer here, and I was a little torn.
Q: Part of the COVID pandemic has really shown a huge light on health equity,
and CDC has always been a big supporter of health equity and works hard at that.
Do you feel that part of this long-term care sitting—setting was part of that
or—? I’d like your opinion on that.
BRYANT-GENEVIER: Yes, it’s a great question. The line on that gets blurry when
it’s an emergency, and that’s what I started to realize is that when in the
emergency setting it changes. We’re like well, yes, well that’s our line, we
know, but that is an emergency. That was where I struggled, and I think that’s
where the project kind of—because if you’re going to instruct me like why are
doing this here, do we need this is, is the answer we already have, which is
that they work okay, is that we need a better answer and if we do, who should be
running that, right? For me, it was this question of what is CDC’s role versus
what’s FDA’s role when it—like if FDA releases this under a thing, then we—we’re
collectively agreeing this works. We all know maybe it doesn’t work as good as
it should, but should we be the—taking our time to do that in this setting? It
just felt like we weren’t giving everyone the option to opt out of this. Like do
you want to be the data for this study? It was a hard question because if I had
been, I would have no. If it had been me, if I had been a resident of the
facility, I would have said no, and I didn’t blame anyone who said no, I thought
they don’t want to do this. It was a hard space because it was—you know. I mean
anyone who spent time in a nursing home see this, there was a memory unit, and
we were trying to swab. The memory unit, you’re—it’s—you’re not gathering—you’re
not—consent isn’t the same kind of conversation.
The takeaway, yes, in—this was 2020, this was October, we were
still—collectively the nation was asking itself a lot of these types of
questions. I can’t speak to the larger agency, but it certainly felt to me that
we were stepping into a space that maybe we should really be thinking about is
it worth.
Q: You bring up a good point of the line between what you do in an emergency and
is it useful. Right at this time, I just want to insert this for the historical
record that COVID death toll was at two hundred thousand and so I think a lot of
people were incredibly fearful.
BRYANT-GENEVIER: Oh yes, oh yes—
Q: There is that part where you need health equity and respectfulness and—but
also with an emergency in mind. And that brings us to my favorite topic through
this, and that is panic and mental health of the people around us. And this work
on mental health, and I want to ask that as we—it’s another thing that COVID has
brought an overarching theme is mental health and how that has affected us in so
many ways during the pandemic from isolation to fear to death of a caregiver,
death of most of your family. All of that has played a huge part and so you are
going to tell me about those work that you did on the mental health survey and
Carol [Y.] Rao.
BRYANT-GENEVIER: Yes, yes, Carol, oh man, Carol fan club, a big member of the
Carol fan club, Carol is great. In November 2020, we have the election, I finish
this project at the nursing home facility, again it throws me for a loop. This
was a hard deployment for me, I’m reeling from this, I don’t deploy again for
little while. I come, we do the holidays, I can’t remember, maybe—I don’t even
remember what we do for Christmas 2020. I can’t remember what we do.
Q: Well, it’s a very separate, everybody—there was not a lot of travel.
BRYANT-GENEVIER: I think we were just home, yes, I think I remember being home,
we did Zoom calls with family, we didn’t go anywhere, so we were in Atlanta.
Later so in—I think it was early the following year in 2021, I—Carol is involved
in a project that is looking at mental health outcomes among public health
workers. She knows a few people in the project, and she—and I’m—Carol is my EIS
supervisor, and she brings me in to do the analysis on this project and write it
up, so be the data analyst for this.
She’d built the survey or been involved in the team that built the survey.
Essentially this was an online survey that they were going to distribute to
public health workers through national or just like partner organizations that
were involved. It was a convenient sample, and we were going to look. The survey
included some indicators of depression, anxiety, post-traumatic stress, and
suicidal ideation, so the standardized screening tools that you’re probably
familiar with that you would see for a lot of—yes, very similar. We were
basically employed in those and then linked them to some questions about public
health work, what type of public health work did you do, how many days did
you—how many hours a week do you spend working period, how many hours a week do
you spend working on the response, the COVID-19 response activities, have you
been able to take time off, have you—? We basically have this list of what we
think—what the team thought were the risk factors, like things that were—could
be causing some problems and stressors or potential traumatic stressors, so
things like losing a family member, things like being isolated, like not having
social network, things like being targeted at work, so experiencing bullying or
threats or something in the workplace.
That was something people had started to see, like people were reporting that
I’d seen that. One of my county health departments they were just like a group
of protesters outside the health department and so then we started to see that
kind of stuff, and so. At that time, no one did a survey to figure out what’s
the impact of this. All of the evidence was anecdotal. The survey was to look at
the link between some of these factors and outcomes, right. Who among the public
health workforce is—has these symptoms of mental health conditions. That’s what
the project is.
That goes out in April of 2021, and we get an enormous response. Just over
twenty-six thousand respondents take this survey. For reference, the public
health workforce, like the entire thing is about—is probably closer to—the best
assessments we could find were like two hundred fifty thousand people to three
hundred thousand people, so this is like 10 percent of the public health
workforce. This wasn’t that federal, we excluded federal, it was only the state,
local, tribal, and territorial public health workers that were solicited.
Basically what we find, it was pretty shocking, it was pretty hard. I was the
first one to look at the data, and most of the data I’m analyzing is just these
scorings for stuff. It was answer, check boxes and so it’s numerical responses,
but there were some—there was a lot of open text, and I had to—I wasn’t going to
look most of the open text, but there were some and so you scroll—you end up
seeing it. Yes, a lot of the responses were people were having a hard time. It
was hard to read that data.
We summarize the data, and what we find is that the prevalence of these symptoms
are the same, if not more than a lot of what you’re seeing in the healthcare
communities, so physicians and doctor—doctors, nurses on the frontline caring
for people. I don’t think anyone had really thought it was that bad, but I think
people kind of—the thinking maybe, but—so we kind of—that was what this project
was all about. I think it was the kick, it may have—I don’t know if it was the
kick. It was certainly a factor that helped bring attention to this. Because
right after we put this out, if people know that this report is coming, they
knew we put out this survey, and when we get out this report, it gets a lot of
attention, yes.
Q: You said this was April 2021, this is right around the time that people are
getting vaccines too.
BRYANT-GENEVIER: Yes, right, so right. Most of the project team, I had been
vaccinated by that point. We’d seen vaccinations start to go out to seniors
earlier like in December of 2020 and then by—and then healthcare providers and
so on were eligible in the first part of 2021 and CDC responders, we—they had—we
had got, in some—I think it was March or April, I can’t remember, but, yes, the
general public was—it was coming on deck, it was starting to be—it was going to
be a little while but not too much further, and certainly by the time the report
is published. I think it’s published in June, which is pretty quick. So we put
the survey out in April, we get the data back a couple of weeks later, we run
the analysis, run it through, get it through clearance, all that stuff, and then
it’s published and—I have to look it up, but I think it was like late June or
early July, so it was a couple of months, which for me is like the fastest I’ve
ever seen anything happen and that kind of thing. It was a high priority. It was
my only—the first project I’d work on that had that high priority lens to it.
When you’re in the high priority category, you do move—you move through a lot of
those process pretty quick.
Q: We just touched on this real quick, the vaccine, you had your vaccine. I just
wanted to ask, just as I’ve asked everybody, what was your thoughts and feelings
when you got your first shot?
BRYANT-GENEVIER: Oh, man.
Q: I know, I’m sorry. It goes—
BRYANT-GENEVIER: No, no, no, this is good, it’s a great question. When I was in
the field, when I was deploying to the field, I was in the—working in nursing
homes, working at health departments, and I was getting on a plane, and I was
putting myself out of the house to respond, then, yes, then I felt like okay,
I’m—then I felt like should be on a list. I was very anxious to get a vaccine, I
was super, super thrilled. But then by the time I was working on the back, and I
wasn’t going to the field, I did like the last the mental health project was—I
was working from home, it was all remote. Basically, my takeaway was, oh man, I
felt like someone else should be in line before me. There’s probably someone
here who should get this, who needs this more than me. What my takeaway now is
that everyone who wants it has it, in the U.S. anyway, and so there’s sort
of—you feel there’s plenty of people who just didn’t want it, but I do remember
feeling like I was cutting the line a little bit. I remember talking about with
Carol, she’s like, “No, you’re not cutting the line, you’re fine, just it’s
okay, everyone is getting there, we just need to—we need to get people through
the assembly line.” That was a strange feeling, yes.
Q: Right, which leads me to your assessment of those who don’t want the vaccine.
BRYANT-GENEVIER: My God, oh jeez, ah. Well, how do I put this? There’s so
much—so I quit, I’m on a tangent, I’m going to try not to spend too much time on
this, but I quit social media several years ago before I joined EIS. I don’t
have a feed of any kind, there’s no—so I don’t get any of my information from a
feed. When I don’t know the answer to something, I have to go look it up, and I
have to be conscious about how I’m vetting that information that I’m getting. It
takes longer, it’s slow, and I usually don’t know 90 percent of the current
whatever is happening in the news today. What’s trending today, I have no idea,
I don’t pay any attention. For me having done that before the pandemic, like
before we did this, I had already pulled that habit out of my of my day-to-day
life, I think it was a good idea. Obviously, everyone home, everyone was working
remotely, everyone is scrolling through their feeds, and the knowledge that they
have on any given moment is just what the Facebook algorithm thinks is going to
keep you on that screen, right. So much of the information people are getting
isn’t based on—you know, it’s just that. When you combine the level, just the
anxiety people are having with the amount of time they’re spending on devices,
the lack of connection they have with other people, you put all these things
together, and I’m not trying to build excuses. Objectively wrong if you’re not
getting a vaccine, I’m sorry, but I am looking at it from this other way, well
how did they get there?
If we don’t ask that second question, I feel like we’re missing a point and so I
look at it from that other way, how are we all getting our information, how are
we all processing that, and how are we all doing that? I try to find what piece
that I can own and what we can do, how you can resolve it because running around
and vaccinating people like requirements, well I would—you know, I don’t know,
you’re always going to run into a problem there. It has to be—I don’t know. We
do it for our kids and polio, right? So, I guess I can’t—I guess I can’t really
disagree. I feel that we should do it for the kids. We’re May of 2022, and we
still don’t have a vaccine for little kids. Like my daughter won’t have a
vaccine before she goes to day care, and all the people I know who have small
kids, they’re sending their kids to day care, and for them it’s still happening,
right, these questions are still going on. Yes, we should have mandates,
absolutely, yes, the people who don’t get vaccine are objectively wrong, but I
think there’s more to it than that.
Q: Yes. Yes. I agree with the—I shouldn’t have said this. There’s a lot of
misinformation out there, and the role of media has become another part of the,
what we—what CDC have to work through to get science out there. Okay, and I’m—
BRYANT-GENEVIER: Yes, absolutely, yes.
Q: —going to pivot now because you are now no longer in EIS. You graduated with
full honors from the EIS officer program. Huzzah! But you stayed on at CDC. A
lot of people don’t always do that. They go off and they become something else,
but you stayed on.
BRYANT-GENEVIER: I did.
Q: What made you want to stay here?
BRYANT-GENEVIER: It’s a tough call. I actually took interviews for jobs outside
of CDC too. When I was doing the climate work outside—after EIS, I took some
interviews elsewhere too because I wasn’t sold. I guess a lot of people come and
its sort of every—where they always dreamt they’d be, and I didn’t have that
coming in. EIS itself was everything I could’ve hoped it would be. Everything I
could’ve thought I would want to learn out of this program, I got it, so I feel
strongly about that. I think the reason I ended up staying is because I had a
lot—oh, I don’t know. One of my classmates and I we talk about this a lot. We
see the potential, right, there’s a lot—CDC does some great stuff, and it could
do even better stuff, right? But you need people to stay and—to do that and so
there’s a little bit of belief in the potential of what the agency could be.
It’s got a long way to go now, but we’re at the beginning of some—what could be
something new. So, I think there was part of that. I think there’s a lot of
opportunities that staying with the agency kind of opened.
I’d love to go work overseas, and I think there’s some door—some pathways to
that type of work that are probably more open if you’re still at the agency. But
basically, the thought I had joked with my classmates, I says, “CDC is—when
you’re at—when you’re in Atlanta, when you’re in CDC, I always felt like I’m the
small—like the little fish in the big pond and then when you go to deployments
to elsewhere, you feel like the big fish in the little pond.” It’s just there’s
not as many public health workers in those other spaces and so I know that I’m
learning a lot, I don’t want to say more, but I am learning a lot in kind of
navigate the big pond. Those are the top reasons why I stay. I have good friends
here, we’ve made Atlanta a home, it was the other part that we bought a house
here, we live here now, so we—for us, it made sense, for now, it made sense.
Q: Hmm I like your thoughts on staying on and using your institutional knowledge
to create a new or better or new—I think I already said that—new CDC or with
that knowledge. It’s great. It always a shame that sometimes people take their
institutional knowledge and go elsewhere with it, which is good also but
sometimes you need—
BRYANT-GENEVIER: Yes, my sense is it’s good when that institution knowledge
includes some frustrations, right? If you only keep the people who stay, that
already agreed with the way you were doing everything, you don’t change much,
right? So it’s good—when people who don’t always agree stay.
I don’t know, I don’t want to say I’m an objector to that, I don’t agree with
that, but I do think that I—we do need to change how we do things in some way
and from my lowly perspective and so I think staying on to try and help that,
that’s—that feels like what I should do, I don’t know, for now.
Q: Once again, quite honest. We touched on the role of media and social media,
which was fabulous— I’m so glad you got there. And then CDC’s communication to
the world was a little dodgy and spotty at times because, as we said, the virus
is moving and changing so fast, CDC is a very large organization, and sometimes
can’t be that nimble. Do you have any thoughts on that? I mean we had a lot of
communication to the world, but communication to—employees and even you guys in
the field was a different—I don’t know, I it wasn’t there, what it was like?
BRYANT-GENEVIER: Depended on when and where and so it was just luck of the draw.
There were so many deployment roles, people are stepping on and off the response
that a person you talk to at the end of every day may be a different person,
right? You don’t know who you’re talking to, so, yes, it’s tough. I think
the—how you feel about that communication, I don’t know.
Q: Yes, it’s true, you have to explain the fact that people were—when you said
people are on and off deployments, so there’s people being deployed to the EOC
and they’re there for just, what, three or four months and then they leave.
BRYANT-GENEVIER: Yes, maybe that long, maybe less.
Q: Yes, there’s a lot of continuity, maybe not always. I know they probably get
briefed, but sometimes that doesn’t always—
BRYANT-GENEVIER: A lot gets lost in translation, and—I don’t know. I did a brief
time in corporate, and I didn’t like it, but you do some—you learned some
lessons about how to be—I don’t know my mindset on how to be agile is when you
have all these—ah, what’s the old saying—the two pizzas. If you’re trying to
solve a problem, you should only have enough people in the room that could be
fed by two pizzas, right? If you have more than that many people in the room,
you have too many people in the room. Sometimes there’s this ability to be—that
you need a smaller team to solve a specific problem, and if the problem isn’t
specific enough, you need to separate it out. A lot of my deployments, the ones
that went well were when the small team was given a little bit of decisional
latitude to navigate their problem. We’re giving you a problem, we’re not
telling you exactly how to solve it, we’re going to give you some wiggle room to
solve some of these on your own. We’ll support you— you tell us what you need,
and then approach it that way. Those types of settings, it worked well.
Remember when I was working on the paper for the mental health study, one of the
things that I learned that I honestly didn’t know, I imagine could be true but
had never really studied, was this idea that when you give someone a high
workload and very low decisional latitude to navigate it, it’s going to result
in stress and frustration and lower productivity overall. One of the—I don’t
know if you call it—industrial psychology, whatever you want is—but it is to
empower people to make decisions and solve their problems. In a part of a giant
organization that’s got a very strict hierarchy and no rigid checks and
balances, it’s hard to do that, but I think that’s our challenge, right? So
that’s kind of—yes, I don’t know, I don’t know. Without soapboxing too much, I’d
say that’s—we have to figure out a way just to address those problems.
Q: Thank you for that assessment, which you were on—you were working in the
areas where we had leader—a lot of leadership changed not only the center—oh,
yes, we are—we did, yes—not even at CDC but also at the federal level. Do you
think of that change in leadership affected your work, or did you see it change
while you were working while there was?
BRYANT-GENEVIER: I thought it would impact it more to be honest. I thought it
would have a large impact. I remember asking questions to that affect even
before COVID started, saying like have—to my colleagues who I was working with,
like hey, have you noticed, have things been different in Global Health, how our
relationships with these different countries are going? Or like with WHO
when—with the previous administration, how has that impacted our working
relationships? Most of what I got was like an eye roll and a, huh, and I
remember thinking like, well, what does that mean? What I tended to find was
that a lot of the good work that people do, you just do the work that you need
to get done. If the work requires you to circumvent and do more tedious steps to
get the work done, you do it, right? What needs to be done is pretty much the
same, so it’s just people spend less resources, right. I don’t want to say
circumventing because that’s not the word at all. What I’m trying to say is like
it just is that much more work to maintain a relationship, right? So, if you
need to have a relationship with this partner in order to get this project done,
and people above you break that relationship or make it very difficult to
maintain, it’s just more work for you to maintain it.
Having the leadership turnover and changes that we did even in my time, I
thought they would cause us more of a problem, but I think what makes CDC a
strong place is that pretty much everyone who’s working at—I don’t want to say
my level, but like the general level, the just the regular folks, not
supervisory leadership, it has a pretty good sense of what needs to be done, and
they’re pretty open to collectively agreeing on that. I don’t see a lot of
individual teams disagreeing vehemently on the solution to a problem. People
generally assume, and I’m like, okay, how do you think of it? Okay, I think we
should do it a little bit this way, okay, let’s split the difference, let’s talk
about it, we’ll revisit it in a couple of—and so it’s a collegial place to work,
and people are generally interested in the greater good. There’s very
little—yes, so I don’t know. So, the leadership impacts, it matters, but it’s
almost more the leadership is painting the brand of the agency and how people
outside of the agency perceive us and how they work with us and so how our
relationships work with them. That’s where I see the leadership piece having the
most impact.
Q: Thank you. Do you think COVID will have a lasting impact on public health and CDC?
BRYANT-GENEVIER: I don’t see any way that it won’t. I think the bigger question
for me is what will that impact be. I think we had a lot—I don’t want to call
them failures, but we had a lot of failures. My approach here to this was we
joined EIS, and this was a big thing, and we learned a lot, but we were the
frontline foot soldiers—I don’t know how else to describe it—in what amounted to
probably the biggest public health failure in a hundred years, right? I will
live with that forever, right, so that is my mindset. Every time I approach a
public health problem, I’m approaching it from, God, I don’t want it to fail as
that other thing did. I don’t know, in my opinion, anyone who’s involved in
public health during the last three years, if they don’t have that mindset,
they’re looking at a problem the wrong way. Whenever you think of a problem, how
do we build a data system for this? God, I can’t fail as bad as those other data
systems we had, right? That has to be the coalescing moment, and just a complete
unwillingness to accept that level of performance again. It’s personal, I think
it comes down to it, you don’t—yes, I don’t know. Yes, I don’t know if that
answers your question, but I do think it’s going to have an impact if only
because most of the people that I interact with have the same—I don’t know. Many
of my classmates have—I don’t know. I mean we don’t talk about it all that much,
but yes, I think people do feel like yes, we kind of—we lost this one, badly, so—
Q: What do you think we need to keep in mind for the future then?
BRYANT-GENEVIER: You can lose.
Q: Okay, yes.
BRYANT-GENEVIER: I think I came to CDC and the sense was outbreak’s happening,
we stop that, that’s what you’re here to do. I was like, oh, okay, cool. What I
learned was outbreak is happening, you can’t always stop that, and the impacts
can be very big. I think there was a humbling element to that. I mean it’s a fun
job, it’s a fun in the sense of like it’s a challenging mystery to solve, and
how do you do that? For people who are academics who like solving problems, it’s
a great puzzle, but it’s very serious, and I think we need to remember that. I
think in line with you can fail is the same thing of being sensitive of the cost
of answering a question.
We are not an academic university, we are not writing R01s [NIH research project
grant program] and doing basic research, that is not really our job. We have a
responsibility in a different way that’s not just academic, that is about—so we
have to ask questions from a different lens, a different mindset, and it’s about
how that question is going to be actively used to solve a pressing problem for
the American people, but really the people overall, right? You have to look at
it that way. Is the juice worth the squeeze is the question, and if it’s a
science project, no, we don’t do that, we don’t. If you want to run science
projects, get a different job, go to a different place. We have to answer
science questions, and we have to make our decisions in a science-based way, so
that’s why we need that, but the questions we ask have to be prioritized in a
way that matter to the people who are expecting us to solve that, right? I don’t
know how to say that in a less wordy way, but the juice has to be worth the
squeeze. We have to have a better—I don’t know if it’s an ethical
decision-making process or a—I don’t know, we just have to trust our instinct on
that. I remember thinking that was a weird thing to have instincts about that.
Now I’m realizing, oh, no, that’s s so important, the empathizing with the—yes,
the public, that you are responsible for. I think there’s a huge piece of that,
and I think that that’s a—oh man, looking back, that’s probably one of the
bigger pieces of how to do this job really well. You need that, yes. But, yes,
so those are the—I don’t know, those are my two bits, you can lose and more
empathy, yes.
Q: Do you think there are parts about your job or your experience, even your
background that you want people to know? I mean your back—
BRYANT-GENEVIER: About me?
Q: About you and how you responded, I mean your background without you even
knowing it prepared you for work you did during the pandemic, actually it did
very much, so.
BRYANT-GENEVIER: Right, so I think a lot of public health problems are that it’s
not—there’s a technical problem, right? Someone has to make a vaccine, and
that’s very difficult to do, so someone has got to do some very complicated
stuff, but a lot of the work is not—it’s not and it’s—it broke. Yes, so I don’t
know how to say that another way. Like writing a symphony is hard. What we do is
difficult, and it requires teamwork, and the teamwork and maintaining the
teamwork, that’s a challenge. You got to have these people working together and
that keeping those teams together is hard, especially when everyone is pulled in
so many different directions and have so many concurrent problems to address.
Q: But you’re teaching that skills are also part of what you are using.
BRYANT-GENEVIER: Yes, yes, absolutely. Yes, there’s value across the work—
Q: A value there?
BRYANT-GENEVIER: —I think. Yes, absolutely, and I think we—there’s—yes, a lot of
it when you go to the field and you do public health work, you find a lot of
people doing public health work at the county level and the state level. They
don’t have the kind of training I have necessarily, but they’re doing so—they
have everything they need to do the—and they’re amazing at their job. I got a
window to see into that world a few times, and it was really eye-opening because
what they—the last thing they need is—in a lot of times is a science project,
right, a PhD just coming and ask all sorts of esoteric questions that maybe
isn’t a practical solution to their problem. So I think it’s kind of being
sensitive to that. I try to think of it as what work needs to be done and what
can I do to solve those problems. It’s a mindset shift. I don’t know, I didn’t
go into—I didn’t learn what I learned to think about it that way or I don’t
know, I don’t know how to—yes, sorry, I don’t know. I’m having a difficult
problem answering your question.
Q: Oh, okay, I’m going to stop pestering you with the reflective questions and
start turning towards something personal.
BRYANT-GENEVIER: Oh, okay
Q: Well, we have gone over time and I’m—
BRYANT-GENEVIER: I know—
Q: —that we have.
BRYANT-GENEVIER: I told you this would happen.
Q: It was really a nice chat, and I really thank you for this. But I must ask
you, is there anything that we haven’t covered you’d like to share?
BRYANT-GENEVIER: No, I think we—let me see.
Q: You didn’t take up any hobbies like sourdough breadmaking? You do have a—
BRYANT-GENEVIER: No, I mean—
Q: Rituals would have been a habit. I mean I wouldn’t call them rituals, but
things that you would do to get through the day. Like if you had your groceries
delivered, a lot of people would wipe them down before they came in the house.
Did you change your clothes when you came home from wherever you were?
BRYANT-GENEVIER: Yes. It’s all of those, all of the things. Everyone was doing
it, and it became habits. I think the job was stressful. There were several
times when I—in the last several years when I had a—doing this job was really
tough. The mental health project, the personal takeaway from that was just the
importance at an individual level to prioritize your mental health. I had always
like put it on the backburner, I’ll solve a problem, I’ll figure it out later,
but it pushed to the forefront that it has to be part of the process of how you
work from the beginning. It’s almost like you can’t if—you can’t build it in
after the fact, right? If you start and you don’t have a sourdough bread—I mean
people were making bread because they didn’t have anything else to do, but I
think if you don’t have an activity or a thing that you do or some habits that
you have that keep you grounded—I build boats, my hobby is I build wooden boats
in the basement, so I—
Q: Ones that you can sit in or small ones?
BRYANT-GENEVIER: No, no, like row boats and sailboats. The one I have in the
basement now is about a thirteen-foot little skiff. Yes, and I built a couple,
and it’s a hobby, and it’s a bizarre thing to do, and I—but I love it because it
gives me something I can physically do with my hands that I separate entirely
from screens and from what I’m doing and then you have something to work on.
After we moved to the house, I would down every day for like an hour and just do
whatever I was going to do.
Q: Park your brain?
BRYANT-GENEVIER: Yes, and it doesn’t matter, it almost doesn’t matter. It’s
about having something to do, an activity because for me that’s how I would keep
my—I would recharge, so in the next day, I can do the same project. Because we
face the same problems over and over again and they—a lot of them are
heartbreaking, so you got to have a way to navigate that. It’s weird, you don’t
realize it until you get—until it’s not there, until you don’t have it and so,
yes, it’s something to be mindful of.
Q: Yes, this brings us back to health equity where you’re not in a place where
you have that ability to be able to get out of your apartment or get out
of—you’ve got like two jobs that you’re just running between—
BRYANT-GENEVIER: Oh yes, oh yes.
Q: —hoping that you don’t get sick between those two jobs.
BRYANT-GENEVIER: Yes, I mean the level of stress and the level—what it costs.
The schools closing, like the value—a lot of the stuff happening now in the last
few months has been a lot of the impact on adolescents, right, the impact on
young people and their mental health, and that’s huge. So I think some of my
bigger takeaways from all of the COVID-19 responses is just a difference in your
priorities. We were thinking, yes, okay, morbidity, mortality, obviously, we
want to reduce those as much as possible, but I think we have to—it’s important
to put a slightly finer lens on that. And, yes, youth mental health is like—it
should—it has to be a higher priority item. The schools be closed so long and
what—the impact of that on the long term, I—yes, it’s changed our mindset. I
think when we first had those conversations, I was very much close the schools,
lock it down, and then, yes, after the year later, you think, oh man, no, I
think—yes, I think we got to—we have to recognize when we’re going to fail and
then prioritize. Because we failed and then we—I don’t know, anyway, I don’t
know. Not to yammer on, but I think how we prioritize the risks and what we’re
sacrificing is something to definitely be mindful of.
Q: Yes, lessons learned.
BRYANT-GENEVIER: Yes. Not my department, but I do think it’s important to share.
Q: I think really important to share, yes.
BRYANT-GENEVIER: Yes.
Q: Well, I think we can end there, question mark at the end of that?
BRYANT-GENEVIER: Sure, yes. No, I don’t have any other closing remarks. Thank
you for letting me participate. I feel like this was great opportunity for me
just to chat. In talking with you, I realize I haven’t really talked about most
of these things. There rarely is opportunities for this type of conversation I
think, so this was great.
Q: Yes, thank you, this has been wonderful.
[END OF INTERVIEW]
00:01:00
