Jessica Goodell

Jessica C. Goodell

Q: This is Sam Robson on the phone with Jessica Goodell. Today's date is June 8th, 2018. I am in the audio recording studio at CDC's [United States Centers for Disease Control and Prevention] Roybal Campus in Atlanta, Georgia. Jessica is on the line from Baltimore, Maryland, I believe. I'm interviewing Jessica as part of the CDC Ebola Response Oral History Project for the David J. Sencer CDC Museum. Jessica, thanks so much for joining me on the phone today. Would you mind starting with saying, "my name is," and then stating your full name?

GOODELL: Sure. My name is Jessica Carroll Goodell.

Q: Perfect. What is your current position with the agency?

GOODELL: I'm currently with the Office of Public Health Preparedness and Response within the Division of State and Local Readiness within the Field Services Branch. I've been with the Maryland Department of Health Office of Preparedness and Response as a career epidemiology field officer. Well, now, I'm 00:01:00a career epidemiology field officer--I was previously a temporary epidemiology field assignee. That's how I know Victor [M. Caceres], that's how Victor became my supervisor.

Q: Sure, gotcha.

GOODELL: It's a little convoluted. [laughter]

Q: Listeners, if you are browsing on Global Health Chronicles and you find the Victor Caceres interview, I would direct you there too because that's a neat one and he works with Jessica.

GOODELL: Yeah, and he's wonderful.

Q: If you were to tell someone in just a few sentences, three or four, what your role was in CDC's Ebola response, what would say?

GOODELL: I would say that I was a field epidemiologist doing contact tracing, among many other things that are required during a response.

Q: Perfect, thank you. In Sierra Leone, correct?

GOODELL: Correct, yep, in Sierra Leone, in Port Loko [District].

Q: When and where you were born, going back in time?

GOODELL: I was born in Miami, Florida, in March 1985.

Q: Thank you. Now we're reaching the point of the interview where you can feel free to extrapolate if you want to. Basically, you have a wide space. In line with that, could you just kind of--did you grow up in Miami? Can you describe growing up?

GOODELL: Sure. I did not, I moved from Miami to Fort Myers, Florida, when I was about four months old. I grew up in Fort Myers, Florida, in a very small--it's grown immensely since then, but it felt like a small town when I was growing up there. I have an older brother who is one of my closest friends. We did a lot of community service growing up. We did a lot of sports growing up. We read a lot. 00:03:00What else do you want to want to know about Florida? Florida is the Sunshine State, we love Publix. [laughter]

Q: When you say that you did community service, what are you referring to?

GOODELL: I just feel like from a young age, we were really engaged in a lot of different community service activities like volunteering at local shelters or engaging in our different school activities that would have Christmas wrapping things or car washing fundraisers. Any of those sorts of activities, or helping to clean our neighborhood or our school campus. We were always doing something that I feel like was thinking about the broader picture of our environment and 00:04:00our community.

Q: And at a young age, did you feel like you had a goal in mind for your career?

GOODELL: I did, actually. My goal in mind for my career when I was younger, I wanted to be a psychiatrist. [laughs] I've always been interested in people and how they work and their underlying reasons for what they do every day. That's been always an interest of mine.

Q: Can I ask what your parents did?

GOODELL: Sure. My family is actually in the hotel business, which probably relates because I had been working with people since I was little. My grandparents owned a hotel that my dad and my mom ran together. I was always helping out at the hotel since I was little, answering the phones, checking 00:05:00people in, working in housekeeping. My mom also worked at our--it was basically a lounge, where she did a lot of singing and theatrical stuff, so we were also really involved in that.

Q: So you actually did acting and such at a young age?

GOODELL: Oh yeah, singing and acting, lots of that. [laughs]

Q: Oh, that's cool. Were you in your school's theater program or anything?

GOODELL: Yes, thespian, for sure. I would do volleyball in the fall, and then I would take a break to do the musical, and then I would do basketball in the winter. Then I would take a break to do the play, and then it would be the summer. There was always on/off sports, theater, sports, theater.

Q: As you were wrapping up high school and thinking about going to college, were 00:06:00you still thinking of being a psychiatrist, or what was on your mind?

GOODELL: I started school--I went to the George Washington University in [Washington], DC. I started school as a psychology major, but one of my closest friends since I was little--I went to the same school from third grade to senior year, it was a very small school and we had like fifty kids in my class, so we were very close. One of my closest friends, we're still good friends today, she was volunteering at an organization called the Safe Haven Project, and it's for children who were born with or affected in some way by HIV [human immunodeficiency virus] or AIDS [acquired immune deficiency syndrome]. She had been volunteering at this organization since she was maybe fourteen, and she got me started probably right before college, around seventeen. I started 00:07:00volunteering there right before freshman year of college, and still went into college expecting to do psychology. But as I was exploring more about what I could study, I learned about public health, basically. I kind of tied the two volunteer experiences and the educational area of public health together through my experience with the Safe Haven Project. That's what led me from psychology, really only for a semester, to public health.

Q: Were you thinking of public health still in the sense of--I'm sorry, for some reason I was thinking--were you still tying it together in terms of mental health? Like looking at mental health at the population level?

GOODELL: Mental health, but also social disparities. For me, I--no, I guess not, it would be--I guess I disconnected from mental health. But looking at community 00:08:00and how growing up in certain environments or with certain influences could impact the way that you live, and long-term, impact the way that you grow up. For me, that was part of the connection.

Q: What happens after college?

GOODELL: After college--what did happen after college? After college, I went almost straight into a master's [degree] program, still at GW [George Washington University]. I knew I wanted to continue within public health, and so I continued--so, all throughout undergrad [undergraduate school], I worked, and I developed a really close relationship with my boss at the athletics department within GW. He offered me a position as an event coordinator and manager, to work 00:09:00full-time but then go to school part-time for my master's. That gave me the great opportunity of getting some work experience and then also having full tuition benefits for my master's, which was amazing.

I took a month off between undergrad and graduate school. I backpacked through Thailand with one of my best friends, and then went straight into the master's program. It was a really busy couple of years. I didn't have time because I was working so much with my full-time job and then going to school in the evening to do a practicum or a thesis, so what I did for that was I did Master's International. Are you familiar with that program?

Q: I'm not, no, can you tell me about it?

GOODELL: Sure. Master's International, I don't think there's actually any standard program for it yet, but Master's International is an opportunity for 00:10:00you to do the Peace Corps for your practicum and thesis. I had always known since I was younger, again, with my close friend that I had done the Safe Haven Project with, that I wanted to do the Peace Corps. I think I was just meeting with one of my advisors one day, and I saw some pamphlet for Master's International. It clicked almost immediately in my mind that this was my opportunity to take advantage of finishing my practicum and my thesis while also doing this lifelong goal of joining the Peace Corps. So, my master's took a long time. [laughter] It started in 2008 and I finished in 2012.

Q: Fitting in the Peace Corps during that time, that seems like a great use of your time.

GOODELL: Yeah, it was wonderful. The Peace Corps can be really--you don't--you really have to create your own accountability. You have to find a project, create your relationships, and I feel like Master's International gave me some 00:11:00real direction. I had to do this for my practicum, I had to do this for my thesis, and it really helped ground me during that experience when there's a little bit of [ambiguity]. You really have to hold yourself accountable.

Q: Were you still kind of in a research mindset? Were you, throughout your time in Peace Corps, trying to answer questions that related to a common theme?

GOODELL: I mean, I guess you're right, it would be a research mindset, but what I tried to do was really, really engage in my community and hear from them what they felt was needed and then build around that, which is something that I always try to do. Let the questions form more organically and naturally. One of 00:12:00the things that came up almost within two or three months of me being there was this real need for maternal and child health infrastructure and building out childbirth education. Education and classes, because we have this--in America, if you become aware that you're pregnant, there's all these opportunities to do prenatal classes. That didn't exist in Albania, where I served. That became my practicum. I launched an initiative for childbirth education classes. I think it's still going on today, too, which is pretty cool.

Q: Oh my goodness, wow. Was this then just your second time abroad? Had you travelled before Thailand or any time after or in between?

GOODELL: Yeah, I had that--I would say I've done a fair bit of travelling since I was young. My mom was very, very--she really wanted us to have that 00:13:00international experience in a way to better understand culture and how that influences how people think and act and all that sort of stuff. I really give that credit to my mom. We did a lot of travelling around Eastern Europe and Western Europe, and all your usual--we did cruises and stuff like that, but whenever--she's an artist, she sings, and whenever she had the opportunity to take us on a trip with her for one of her concerts, she would do that.

Q: Can you tell me what happens after Peace Corps?

GOODELL: Sure. After Peace Corps, I was looking for a job. [laughter] One of my advisors within my master's program had sent me a link to the CDC Public Health 00:14:00Prevention Service fellowship that was coming up. I applied to that, and it fortuitously lined up really well with the end of my Peace Corps service. I finished Peace Corps, and then I went to Atlanta to do my interview for PHPS, Public Health Prevention Service. I got accepted to--the last class of the Public Health Prevention Service, sadly.

Q: Can you tell me more about the Public Health Prevention Service?

GOODELL: Yeah, the Public Health Prevention Service is this amazing program, we're very sad that it's over. It's formatted in a way that you're a Public Health Prevention Service fellow for three years, and it's for master's-level folks. Basically, what it does is it brings you into Atlanta for your first year 00:15:00and you have two six-month rotations within one of the offices or the administrations within the CDC. Then you have two years out in the field. My first year in Atlanta, I was with the--what is it now--I was within the [Physical Activity and Health] Branch. I was on the epidemiology and surveillance team there, that was my first six months. And then my second six months I was with NH--what is it?

Q: Oh, sure. National--the HIV and STD [sexually transmitted disease]--

GOODELL: Yes, NCHHSTP [National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention].

Q: Mm-hm, yeah. I can't ever remember that one.

GOODELL: I know. So I was in the Office of the Director there, and I was doing a 00:16:00PCSI project, which is program collaboration and services integration. My role for that six months was to support the grantees and figuring out how to integrate all the different STI [sexually transmitted infection], HIV, and hep [hepatitis] programs to see how they could work better and more aligned.

Q: Can you tell me a little bit about what you feel like you gained out of both of these six-month rotations?

GOODELL: So much. I actually think that this first year within the program in Atlanta is integral to the success of the PHPS fellows because it gives you a grounding and an understanding of how the CDC functions. It also gives you these 00:17:00really important connections to people at the CDC, so that when you're in the field you have someone to reach out to, to answer questions, or to ask, hey, what's going on with this? I think in some of the other field programs that don't allow for that year of relationship-building and understanding of the functions of the CDC--I think it's a real strength that could be added to other programs. But I know there's cost and everything associated with that. I feel like that was one of our biggest strengths of our program.

Q: Who are some of the people who were really important to connect with?

GOODELL: I still talk to all the folks who were in my rotation. Prabasaj Paul was one of the epis [epidemiologists] that I worked very closely with. I still 00:18:00ask him questions today about projects that I'm working on in the field. He's amazing. Every time I come to the CDC, we have lunch. Elin Begley, who I worked with at PCSI, she has this great perspective of how you can cross-collaborate and integrate programs in a way that at a national level, maybe can inform programs at the state and then at the local level. Then even with all of my different deployments, it helped me to understand where people fit when I come back so that I can also connect with them. Dan [Daniel W. Martin] is a great example of that, who connected us.

Q: Absolutely. It was then about like 2012 to 2013 were those two rotations?

GOODELL: Yep.

Q: And then--so what was your first year in the field, then?

GOODELL: I was placed in New York, in New York City. I was placed with a public 00:19:00health institute.

Q: Can you tell me about that?

GOODELL: Sure. With PHPS, you can be placed in the field at a state, local, or public health institute. I think it was myself and one other person that was not placed within a state or local government. What public health institutes do are basically, they help to bridge public and private organizations so that they can speed up processes. When you work in a government organization sometimes, systems can be slower for procurement and all of that. Public health institutes can help speed that up. I worked at the public health institute called Public Health Solutions in New York City, not to be--I mean, there's a lot of public health acronyms going on right here.

Q: Oh, it's good, it's good.

GOODELL: I was a PHPS fellow at PHS in New York City. [laughs]

Q: That's good. I always add it to the transcript in brackets. Yeah, it's cool.

GOODELL: At that time, I was really interested in doing food and nutrition projects, which I'm still very, very interested in. I was placed there as basically the special projects manager with an eye on data collection and information. I worked on all different sorts of projects with WIC [the Special Supplemental Nutrition Program for Women, Infants, and Children]. I did an analysis of the food environment around three of our WIC sites, it was called the Queens [Neighborhoods Street] Mapping Project. That took about a year to do the study, and then a year to do--it wasn't really a study, it's more like an 00:21:00information gathering process, and then a year to do the analysis. Then I also worked with our school food focus group, which did a lot of looking at nutrition labels and helping to support looking at ingredients of concern and doing analyses around what some standards should be for schools if they're looking to procure local and sustainable food. It's always been work that has an eye at using data to inform policies and standards. It's kind of been the theme throughout all of my work.

Q: I think that takes us--you must have still been in New York in 2014.

GOODELL: Yes.

Q: What happens then?

GOODELL: In 2014, that's around when we started hearing about what was going on 00:22:00with Ebola. I was coming towards the end of my PHPS, towards the end of my fellowship. We started getting some information pings about people who were able to deploy and support any of the activities that were starting to gear up. I was specifically targeted because I was a Peace Corps volunteer to engage in some of the activities. I'm trying to remember the timeline--

Q: Was it like an email that you received that was sent out to returned Peace 00:23:00Corps volunteers?

GOODELL: One of the initial contacts was via email. It was to maybe--it was not a lot of people, but it was--I'm trying to remember if it was a blast email to folks for Peace Corps experience, and then another more specific email to a couple of people who were identified as Peace Corps volunteers. I can't remember exactly the details. But that was, I remember, the introduction.

Q: What do you remember thinking about it?

GOODELL: I remember thinking immediately, anything I can do. I was a little concerned because it was coming towards the end of my fellowship and I didn't want to leave anything unfinished, but I also knew that if they needed people, that I would go without hesitation. I'm trying to remember--I think that we were 00:24:00also dealing with our first case in New York, because I think that was my first deployment.

Q: Really?

GOODELL: Yeah.

Q: Around when Dr.--his name is public now, Dr. Craig Spencer went to Bellevue [Hospital]?

GOODELL: Yeah.

Q: Oh my goodness.

GOODELL: I was deployed in New York City for that. I went to work with the health department for that.

Q: Can you take me through that?

GOODELL: Sure. It was very similar--it was, hey, you're in New York City, we need people to support this very small team that we're sending to support the health department. Your role is going to be to help set up the call center, to do data quality assurances, and then to support any of the travel notifications that would be coming through to make sure that they're all monitored and caught and any actions are made. We were part of the very first team that were helping 00:25:00to develop the scripts and helping to develop the database and helping to develop the methodology of the call center itself, and then helping to follow up on any of the travelers who were coming through New York and New Jersey.

Q: What was this call center?

GOODELL: It's just the New York--I don't know if it actually has an official name, but it's the New York City call center. I can send you some of the MMWRs [Morbidity and Mortality Weekly Report], "Notes from the Field" that's come out of it, if that's helpful.

Q: Cool. Was it a general call center, for the public?

GOODELL: The call centers were set up because travelers who were in the area of any of the Ebola-affected areas would have to be monitored for twenty-one days. What the call centers would do would basically be told that if someone is in the 00:26:00New York area of required monitoring, they would then have to call every single day for twenty-one days, twice a day, to report their symptoms. That would be if they're feeling okay, what their temperature is, all these Ebola-related symptoms.

Q: You were working up scripts for that?

GOODELL: Yes. When I first got there, people were taking calls on--they were inputting all of the information on Post-Its.

Q: Oh no. [laughs]

GOODELL: Yeah. We got much more sophisticated by the end of our time there. But yeah, it was fast and crazy. What I took away from that, the call center infrastructure is still even used now--I think they set up again for Zika. But I 00:27:00was really impressed by New York City. It was the New York City Department of Health and Mental Hygiene. Their preparedness infrastructure, I was really impressed by. One of the cool things being a field assignee, I can look at all the different structures that the state uses. Every day they were activated, obviously, and they had basically incident command structures for--you know, you'd have your incident commander, your ops [operations], your data, your planning, and they would have report-offs every single morning and every single afternoon. What they did was they had people throughout the entire health department that were assigned to take part in this active response. I know not every health department does that, so I thought that was really great. It doesn't--here in Maryland, we have the Office of Preparedness and Response, and when we're activated, it's really only our office that engages in those incident 00:28:00responses. What we've taken away from that is maybe we should be reaching more broadly across our own department to engage people and train them so that they can be involved in incident responses. That's been really helpful for us, here in Maryland.

Q: In addition to helping create the infrastructure to better take these calls and manage the data that came along with them, were you ever involved in any specific calls that came through that were concerning?

GOODELL: What you would get is sometimes, you wouldn't be able to reach somebody and that would be concerning. Then you would have to follow up on that. If you didn't have somebody who called in for a day or didn't call in for two days, then that's when you really had to elevate an issue. We had times where we had 00:29:00to send people off to folks' homes to make sure that people were okay. Those are the kinds of even policy things that I took away. How do you standardize that kind of situation so that if you're going to someone's home, that you're not scaring them? Then, even sometimes the quarantine procedures and policies. Those are the things that really elevated in my mind as things that we needed to work out for these kinds of incidents and outbreaks.

Q: Can I ask, what's one example of how you might avoid scaring them?

GOODELL: It's a hard question. I think the call center, building out the relationships was really helpful. People started really--sometimes at the end of the twenty-one-day period, some people would be sad that it was over. [laughter]

Q: Really?

GOODELL: Yes, some people would really enjoy talking to somebody every single 00:30:00day, twice a day, at around the same time. It became a nice routine for them. So sometimes it got that it would be sad that it was over. So potentially, building in pieces of the script that we could say, "Listen, if we don't hear from you, these are the things that are going to happen. Don't be alarmed." Those are things that you could think about building into your scripts.

Q: Does the focus on relationship-building mean that the questions aren't just a list of very formal questions with checkmarks, but they can actually be personal sometimes?

GOODELL: Yeah, I mean, you have to fill the checkmarks. You have to cross the Ts and dot the Is, but you can still be a person and just talk with people and chat with people. There was a lot of people that we had to monitor at the beginning of starting up the call center, but the staff of the call center stayed pretty 00:31:00regular. Of course, if you call somebody every single day, then you just establish that rapport, and I think that was helpful and important.

Q: What was it like working--were you working directly with the people who were making the calls?

GOODELL: Yes. Sometimes I would make them myself, and then yes, we were all in this very large room together. I remember we started in a very dark, dingy room with no windows, and then we moved basically into this higher-level conference room that had an entire view of New York City. It was gorgeous. I think even that small move of having access to sunlight was really helpful. [laughter] We would eat breakfast, lunch, and dinner together.

Q: Are there any of the calls that you specifically made that when you look back 00:32:00kind of stand out to you?

GOODELL: No, nothing specifically. I do remember, though, the kind of panic if you haven't heard from a person and if they're okay. Then the different actions that had to be elevated in response to that. That happened at least two or three times.

Q: And every time, it turned out--how did it turn out?

GOODELL: It was fine.

Q: How long were you doing that work?

GOODELL: That was about a month and a half.

Q: And then what happens?

GOODELL: Then I went back to work. I was getting ready to close out my 00:33:00fellowship, and then I think that another email came out saying that they still needed people to go abroad. So then I remember I talked to my [CDC advisor and NYC] field supervisor. I basically had to talk to a whole lot of people to see if it would be okay before I could formally respond that I was interested in deploying or that I could even deploy.

Q: Why was that?

GOODELL: Well, if you're at the end of your fellowship program, there are things that you have to complete. I basically would come back with only a month of two left of my fellowship with NYC PHS [New York City Public Health Solutions]. It could leave my current colleagues in the lurch if I left and then wasn't able to 00:34:00come back and finish all my activities. I wanted to make sure that I was doing my due diligence before I deployed, and that I would be able to come back and finish everything in time.

Q: How did that turn out?

GOODELL: It was fine. It was good. Everyone was very supportive. People were worried about me deploying, but no one was really concerned about what would happen if I wasn't able to finish my work, which I did. There were no issues there. I'm not scared of working hard and getting it done when it comes down to it, so it was fine.

Q: I think we're probably about to hear a bunch that testifies to that fact. [laughter] How did things advance from there?

GOODELL: I responded that I was able to deploy. I also had to talk a lot with my family. My family was nervous, and there was a lot that I had to do on that end 00:35:00before I finally was able to confirm, and then it went pretty quickly.

Q: Tell me more about the family part. More that had to be done--what kind of conversations were you having?

GOODELL: My brother and my father were just concerned, and they were more concerned than I have probably experienced before because I think they're pretty used to me being able to pick up and go, which is not unfamiliar to them. Specifically for this, I think that there was a lot of hype going on in the media, that I had to have more conversations with them around what I would be doing and the protections that would be in place before they were really comfortable with me going. My dad also found the calls, the family calls that 00:36:00CDC--I don't know what the official names were [note: Family and Loved Ones Outreach Conference Call], but they had calls specifically for family members for people who were deploying to call in to and ask questions. He found that really helpful.

Q: Was that before or during your deployment?

GOODELL: That was before.

Q: So they would answer questions like, what kind of danger are they going to be in, what kind of work they're doing?

GOODELL: What kind of work they're doing, what kind of protections would be in place, how they could communicate, what would happen if there was an emergency, what kind of evacuation procedures would happen. Then any other questions I think that came up they would answer, and I think he called in maybe two or three times for one of those.

Q: And he's talking to people, right, not just robots?

GOODELL: Yeah, he's talking to people. I think it was actually people who had 00:37:00deployed, and then CDC staff, and then also other family members. It was just like a forum where you could call in and get your questions answered. I actually had that, too. They had a similar setup for folks who were deploying, as well, so they could ask anybody who is maybe currently in the field or just returning, any of those kind of logistical questions or what to expect and all that kind of stuff.

Q: Did you use it yourself?

GOODELL: There were different kinds of calls that were set up for responders, and one was specifically for deployers to ask folks who had just come back or who were still there what to expect and what to bring and all that sort of stuff. Then there was another one specifically for family members.

Q: Right. But can you tell me a little bit more about when you were able to use it and the kinds of questions that you had and how they answered?

GOODELL: Sure. In all honesty, I just listened because a lot of the questions I 00:38:00felt were around what it was like to work in austere conditions. It was more like, who's going to pick me up? What kind of money do I need to bring? How am I going to contact my family? What kind of clothes should I pack? What's the weather like? Those were the questions that I really remember the most. What I found most helpful was the ability to actually connect with my team who I was going to be joining. Being able to ask them questions about where they were in the current response and if they could give me an idea of the actual activities that I would be doing on the ground, and if they needed me to bring them anything, like if they needed additional equipment or if they needed anything 00:39:00from the EOC [Emergency Operations Center] or anything like that.

Q: What did they say? Did they say they needed anything?

GOODELL: Oh, yeah. I had to bring a bunch of different equipment. I tried to bring some polo [shirts], some CDC polos for some of the ground staff there. I remember when I came back also. We actually didn't wear our gear publicly. We weren't supposed to do that, but it was always nice to give one of the shirts to the drivers or the hats to the folks that you were working with in the field. They really like that stuff. Those little relationship-building things that you can show as tokens of appreciation, like the CDC polos and the CDC hats. People love that stuff.

Q: Were the people on the phone people you actually then ended up working with?

GOODELL: On the smaller calls, yeah.

Q: Who were some of them?

GOODELL: Dan was the first person that I immediately think of. He was my team lead. I'm trying to remember some of the other names. Jessica [Simpson, Tracy George]. I worked with [Tracy] closely. Most of the people that I worked really closely with in the field were also WHO [World Health Organization] folks, which I know Dan mentioned. Patty [Dietz] came after [Dan as the team lead].

Q: So the WHO folks wouldn't have been on the--

GOODELL: No.

Q: --preparatory. When was it that you actually deployed?

GOODELL: I deployed June to July.

Q: Of 2014?

GOODELL: Mm-hmm. Was it 2014 or 2015?

Q: Was it in the height of the epidemic or--

GOODELL: I think it was 2015.

Q: Okay. That makes sense, because you were in New York when Craig Spencer--so it must have been--

GOODELL: Yes, mm-hmm. Sorry, I'm trying to remember all these details.

Q: No, you're good. Can you take me through that deployment starting from the beginning?

GOODELL: Sure, okay. I got the final okay to deploy, and with any deployment, you have to be extremely flexible. I was given some bullets of what I was going out there to do. Again, reaching out to some of the folks who were actually there via phone and really more with email. I remember I was able to talk over 00:42:00the phone quickly, quickly with Dan and some other folks because the phone is not easy there. Then I remember shopping and getting all my gear together. I really only had one bag. I had one large cargo bag, and I got on the plane, and I remember meeting with my other teammates while at the airport, which was really helpful. Not necessarily that they were going to be on my team, but we were all going to Sierra Leone together. Then we would disperse when we got there.

I remember we got there very late at night, and we had to take a ferry to 00:43:00Freetown. I very specifically remember it being really dark, and I remember seeing all of these insects floating around the lights that were in the docking area when we were waiting for the ferry. That was my first real vivid memory of being there. We got on the ferry, and I remember being like, alright, we're here, this is for real. [laughter]

I had maybe a day or two in Freetown. I was really not supposed to be assigned to Freetown. I was supposed to be in Port Loko, which is one of the northern districts. In Freetown, we had this very small EOC. It was basically a basement 00:44:00conference room in the hotel, and I did everything that I could do to make sure that I was able to travel to Port Loko pretty quickly. There were a lot of different logistics that needed to happen when I got there. I needed to look at where I was going to stay, who my driver would be, because we each had our own drivers and cars. None of that had really been worked out as of yet, which wasn't surprising. There is so much going on that you have to be flexible when you respond, to go with the flow and make things happen when you can. I basically connected with my driver, Lamine, who was like my closest ally while I 00:45:00was deployed. And we drove to Port Loko, which is maybe an hour or two from Freetown.

We get to Port Loko, and I'm there, and I don't know anybody. We come up to the hotel and basically, I had to figure out where I was going to stay when I first got there. I remember that.

Q: You didn't know where you were going to stay?

GOODELL: It was unclear when I first got there because they were trying to rotate some of the people around and bring people back to Freetown. I remember my first night when I stayed there, I actually stayed with another one of the deployers who was actually a PHAP fellow. Are you familiar with the PHAP?

Q: I am, but would you mind describing it just briefly?

GOODELL: The PHAP is the Public Health Associate Program. That is similar to PHPS, but different in that it engages with folks straight out of undergrad typically. I know now they're actually--they have more master's and PhD-level folks, but it's basically--they bring people straight into the field. They connect them with state and local governments to do any sort of technical assistance that the state and local site needs and that they've described in their narrative for the application. I'm trying to remember where she had come from, but I don't remember. We stayed together for the first night in Port Loko until they could figure out where the rest of our arrangements would be.

Q: Where'd they end up putting you?

GOODELL: It's still in the same hotel [note: MJ Motel], but just a couple rooms 00:47:00down. Basically, we had to wait for somebody to finish their deployment before I could move into their room.

Q: What happens from there?

GOODELL: I went out the first day and met our team. In Port Loko, we were all on the same site, so it was the CDC, UNICEF [United Nations Children's Fund], WHO--I'm trying to remember if [International Federation of] Red Cross [and Red Crescent Societies] was there with us, as well. We all worked out of the same compound, and I remember the very first day that I got there, we went immediately out to a village and started doing a case investigation within hours of me checking in. The WHO epi [epidemiology] lead, Yogi [Yogesh Choudhri], who 00:48:00I still talk to, he basically was like, this is the only way you're going to learn, so let's go. [laughter] He had me doing some of the investigations from the start.

What had happened was we had a pregnant mother who had traveled for days to get to her home village to help oversee her childbirth. She was EVD [Ebola virus disease] positive. She arrived at her home village where her auntie was going to oversee her delivery, and unfortunately, she had died during delivery. That was our first--my first case. We had to do all of the investigations of where she 00:49:00had passed away, and then also all of the case findings for all the places she stopped along the way from her original village to get there.

Q: Had there been signs that she had potentially had Ebola?

GOODELL: Oh, yes. We knew she was EVD-positive.

Q: Oh, okay--sorry, I missed that. Were you doing interviews that first day then?

GOODELL: Yes, we did interviews all day. We had to create a census. We had to figure out all the different levels of quarantine that would need to be instituted. At the same time, you're there doing--your main role is to do the field epidemiology, but at the same time, people need food, they need supplies, they need all these different sorts of resources. I remember we also really had 00:50:00to figure out where the water was. Where the food supply was going to come from. How we were going to set up these quarantine homes. How we were going to move people around. I vividly remember being on the phone--again, this is my first day, so I don't actually even really know who I'm supposed to be calling, but I'm trying to get a hold of an Oxfam contact to bring the water and rice to the quarantine homes that we had been establishing. That's also a vivid memory.

Q: Do you remember how those decisions get made about exactly how to build that quarantine?

GOODELL: How to build the levels, or which--

Q: How to build the levels, and then how to organize all of the resources. Like, what effects does where the water comes from have on the quarantine, for example?

GOODELL: It was less about where the water was--sorry, to answer your first question.

Q: Sorry, I had a couple.

GOODELL: How do we determine quarantine. Basically, what I was able to do with Yogi--Yogi spearheaded this. Basically, what he came to put into standard protocol was, we didn't need to put everyone who had exposure baseline in the same area because they all had different risk levels. What we were able to do was institute quarantine based on risk. If we knew that the mom had these five women around here while she was going through labor and they were all exposed directly to whatever fluids or blood that maybe came about during her childbirth, we knew that they were probably the highest risk of exposure. We 00:52:00knew that they should probably all be in the same quarantine area. But then we know that potentially before she went into labor, there are folks that talked to her or maybe touched her or maybe helped her travel. For example, she traveled on--I can't remember what it's called now--but there's a very specific word that they use in Sierra Leone for the motor cars.

Q: I forget what it is too.

GOODELL: Like "owatu?" No, owatu is white woman. I can't remember what it is [note: okada], but basically, she was on the back of a motorcycle for a long part of her travels, and we knew that that person she was traveling with would be at high risk as well because she was developing symptoms as she was on that motorcycle. That person would be together with another, equal risk level. But then the other people that came to visit her that maybe didn't touch her but 00:53:00just talked to her would just be a risk level three or something like that. Then we would have to figure out the logistics of, okay, if we know that each of these people are at different risk levels, then which house did they stay in, and is that house available, and all that stuff. That was all part of what we had to do within our case investigations.

Q: Are you making these decisions, considerations, alongside Sierra Leonean colleagues?

GOODELL: Yes, for sure. We couldn't do it without them. Each of the villages, there was a community representative that was assigned for us to work with.

Q: Was the representative from those communities?

GOODELL: Yes, and they were usually somebody who had some previous experience, who had some sort of lived experience [with Ebola]. Which, unfortunately, was 00:54:00not difficult.

That was the quarantine piece, and then the logistics piece was, within incident command, there's always a resource section. It was our job on the ground to communicate closely with the [resources] section, what was needed and what hadn't arrived or what had arrived. In the case of the water, it was my job to call the resource section and say, hey, this is still a need, when is the truck going to get here? Remember, this is in a remote village, and so sometimes it's hard for the trucks to get there. Sometimes it's hard to even get cellular reception. Those are different challenges you deal with.

Q: Were you working on this one particular situation for much of your deployment in that particular village?

GOODELL: I had basically three or four different villages I was following up on. 00:55:00This was my first one. Unfortunately, all of my subsequent villages were actually linked to this. The epi link was strong. This was my first one, but in finding out more, then you realize okay, I have to go here. A lot of my time outside of doing the contact tracing and the interviews is also traveling. Dan had mentioned Anna [Anna-Lena Arnold], who is the other WHO field epi. A lot of what we did was we had to travel together to basically follow up on case 00:56:00investigations. Our pregnant mom who was the first case I was just describing, she had stopped at three or four villages along the way. Then we also had to follow up on other active incidents that had occurred before I had gotten there. It was a lot of traveling to villages and speaking with people and checking in on people and doing a lot of the twenty-one-day investigations. Once we would be at a village and we would see, okay, there's some sort of EVD-positive event that happened, then the twenty-one-day timer would begin. Does that make sense?

Q: Yes, it makes total sense, and it also makes sense now because you say you're spending so much time traveling that you referred to your driver as your closest ally.

GOODELL: Yes. [laughs]

Q: Can you tell me more--his name was Lamine, is that correct?

GOODELL: Yes.

Q: Could you tell me a little bit more about him?

GOODELL: Yes. He's a great guy. Every morning, he would pick me up and we would chat and I would ask about his family. He played soccer every Wednesday. He, I guess, was an old Sierra Leonean soccer superstar. He had five kids or something like that, and he was just great. He would pick me up, drive me to the compound, and then we would get our updates for where we needed to follow up on the investigations, and then we would hop in the car. It would usually be me, Lamine, and Anna, and then we'd head off. We shared breakfasts, we shared lunches. He didn't speak a lot of English. He tried to teach me some important 00:58:00phrases [in Krio, an English-based creole] that were really helpful during my investigations--again, building on the relationship. I'm trying to remember, can I remember any of them now?

Q: Were they like, greetings?

GOODELL: Yeah, different greetings and different ways to ask how family members are and how people are in health. "How di bodi," I remember, that was an easy one. I have a whole list of them written down. I'll have to pull that up. But one of my very, very vivid memories of Lamine, he would go anywhere. He was so amazing, and one day we were really lost. We were really lost, trying to get to a village. I think we were basically in a Toyota RAV4, that was the kind of cars 00:59:00we had. We kept going deeper and deeper into the bush, and I remember we had to get to this village, but basically the road had run out. We managed to ask directions from some random person who was walking, and they told us we were going in the right direction, but basically we ran out of road. He looked--so there's this sound that is very regional, and it's like, "Ah!" [laughs] Even sometimes I heard people do it and I think, oh, are you from Sierra Leone or Ghana? I just remember him looking at where we had to go and the road being run out and him going, "Ah!" Shoulders raising. We all just like, really, yeah, 01:00:00that's where we had to go. It ended up actually being the totally wrong direction because not surprisingly, the village had--there were multiple villages with the same name, so we had to turn around. But I just remember his "Ah!" Whatever you say, "Ah!" [laughter]

Q: Can you tell me how your investigations proceed? Oh, wait, hold on. I need to mention, it is eleven thirty now. Are you okay to keep talking for a bit longer?

GOODELL: Yeah. I have this meeting at--yeah, okay.

Q: Okay, cool.

GOODELL: Am I giving enough detail?

Q: You are, you definitely are, yeah.

GOODELL: Okay. What was the question?

Q: I was just turning the conversation back around to what was going on with your work and how that developed, investigating these different villages.

GOODELL: So, what was an investigation like. When we first would hear of any kind of incident, the first thing we would try to do is create some sort of census of the village. We would try to number the houses and get a good idea of how many people were in each home, and then we would try to figure out who were the folks who had any kind of exposure. Again, that goes to the risk-based exposure. We would try our best not to quarantine entire villages, but sometimes there's not a lot of people in a village, so that would end up being the case. The process was always doing the census of the houses and the families living in them and having to go through--very similar to what we would do in the call 01:02:00center. How are you feeling today, what is your temperature, do you have any updates for us, is there anything of importance that we need to know that happened from the day before today? A lot of it was also that resource allocation. Have you gotten your food, do you have light, do you have any batteries to put in your lights? Because these are very rural villages, so some of them work entirely off of one generator or something. Then if anything did happen, trying to reach somebody to say, okay, we're hearing this person's eyes are red today or their temperature is heightened, what do you suggest for us to do?

There was always a medical person in the field with us. For me, that was 01:03:00primarily Yogi, the man I mentioned earlier. I very vividly remember one day--this is a separate village from [name removed], who is the pregnant woman, where we had some case investigations we were doing. We had basically one house where it was an older woman, and she looked to us like she was potentially experiencing some symptoms. We were trying to figure out what we were going to do, and then at the very same time, another woman in the village started going into labor. [laughter] Again, we're in really, really remote areas. This woman who is going into labor had no exposure to the case we were there for, but at 01:04:00the same time, we needed to figure out how to get her out of this quarantined area to a hospital and whether or not she needed to go to a normal hospital, or whether or not she needed to go to an ETC, an Ebola treatment center. Those are the kinds of questions you have to figure out while you're in the field, the policy-level discussions. She had very minimal exposure. The only exposure she had was that she was in the village where that happened, but still there was that potential.

Q: What did you decide?

GOODELL: I'm trying to remember. I'm pretty sure she just went to an MCH [maternal and child health] ward in a hospital. I think that was the ultimate decision.

Q: Do you remember if she ended up having Ebola?

GOODELL: No, no she didn't. She was fine, and she was able to come home once the quarantine was lifted from that village, and it was a huge party. I remember, always when the twenty-one days were over, that was always the most fun. There was always singing and dancing and even more allocation of food to celebrate the moment. Those are very vivid memories.

Q: I have a question about how quarantine looked. Was somebody told they can't leave a circumscribed area? Was it enforced in any way?

GOODELL: Yeah, it was. Basically, what we would have to do was, once we had the 01:06:00levels of risk figured out and we had the census and we knew where people would be staying, working with the community around what areas and houses were available, we literally had to cordon off each of those areas. Folks couldn't leave their homes for twenty-one days, or they couldn't leave that facility for twenty-one days, and usually it's just a one-room structure or something like that, and then there was some yard space that was also allocated. We would put up the orange caution tape around those areas, and that's where we would stand on one end and conduct the case investigations from the end of the caution tape. Then we would talk to the people within their homes. They were expected not to 01:07:00leave that area for those twenty-one days, and sometimes the twenty-one days would re-up. So it wasn't always a consecutive, one standing twenty-one days. Maybe something would happen or somebody would develop some sort of symptom and then people would be re-exposed.

Q: Was there anyone guarding the quarantines?

GOODELL: It depended on the village in terms of how close folks were guarding. In most of the villages, what we would do--and this is something I participated in when I first got there--was making sure there was oversight, but not directly in front of each of the houses because it's scary. Again, trying not to scare people and trying to make it as easy a process as possible. That's what we 01:08:00implemented. I remember when we first got there, at least when I first got there, was having--at least the villages I was involved with--having those people who were regulating that folks were staying in their homes, just on the outskirts of the village. What they would do, they would do checks, like walk around, but they wouldn't be directly embedded in the village. That was the process.

Q: Do you remember--I don't know if you were ever able to ask someone how they felt about being quarantined, or if someone just told you--hearing opinions about the process?

GOODELL: Oh, yeah. [laughter] People did not like being quarantined. I don't know if I'm allowed to say that.

Q: Of course!

GOODELL: Quarantine is a really hard thing. It's one of the things I wanted to 01:09:00better understand and even research a little bit when I got back, was what are our quarantine standards and policies, and how do we enforce those and what are the lines. Because I don't think it's really well-established, and even in talking through some experiences with other folks that deployed internationally and domestically, because even we had some cases--I described my case in New York, I worked with some folks who were involved in some of the quarantine practices that needed to be instituted in Georgia and Maryland. It's really hard, especially if you're--I mean, it's hard for the families, it's hard for the person, it's hard all around. But once you--again, I think the thing you 01:10:00probably hear me saying is establishing that relationship and that rapport. You get to know those people because you're seeing them at a minimum of twenty-one days, so they're telling you what they're going through and how that quarantine effects them and all that sort of stuff. Does that answer your question?

Q: Yeah. For sure. Did you ever have any opinions, coming back--thoughts about--I don't know, about this specific way we're doing it? Trying to research other ways we--that CDC or other public health agencies might address quarantine in the future?

GOODELL: I think it's a really complicated issue. I think we could do more to have conversations around how it would be best implemented based off of the lessons we've learned with doing it. I think that it hasn't--I don't know if 01:11:00those conversations have happened. I know that when I came back, Yogi and myself and Anna, we had wanted to do a paper specifically around quarantine practices, but you get back and life takes you back over, so we never ended up doing it. But I think we could, as an organization or as deployers, look at how we can improve upon it and what the standards should and shouldn't be.

Q: I've heard you mention of course building trust with the people who were quarantined. Were there any other thoughts that you had regarding that, regarding how to address quarantine?

GOODELL: Building trust is absolutely one of them. Also, making sure folks have what they need. Food was always a question, and these are small villages who 01:12:00don't have a lot. When we would go out for our investigations, it was always, okay, do you have the food, did you get your food delivery, did you get your supply delivery? Even if they had gotten it or if they needed more if they had run out, because these villages are very communal, so they share. For me, it was always, it doesn't matter--it's hard. I think that if you're in quarantine, you should do whatever you can to make sure the person is--their needs are met. If that means giving them extra food or extra resources, for me, that makes sense. 01:13:00I would do anything I could to bring more food or bring extra tarps, because again, we were there during the rainy season, so another question that was always asked is, "My roof is leaking. Can I get a tarp, if you're going to keep me in this house that's leaking?" Another question that always came up was mosquito nets. A lot of people didn't have mosquito nets, so we did what we could to work with UNICEF and Red Cross to make sure that if we were quarantining a home, they had extra mosquito nets. You would see people in the middle of the summer, of the rainy season, wearing sweaters because they didn't want to get malaria. I think for me, it's a fine balance in quarantine--how do you supply people with the needs while also making sure you're not running out 01:14:00of things yourself.

Q: That makes sense, because you have finite supplies.

GOODELL: Right.

Q: Did you have some team members at any point saying, we can't afford to provide this to them, even though they're asking for it?

GOODELL: Oh, yeah, for sure. That was always--and I can totally understand that. You have to keep in mind the broader picture, especially for an incident that size. I think that could definitely be a question that's looked at around standards for quarantine.

I'm trying to think of any of my other research questions that I had. How do you allow people to be physically active when they're in quarantine? How do you allow enough space for them so that they can not feel so closed off, but also still are in a monitored area? Part of what we would do sometimes with our 01:15:00investigations is, "Did you do any of your laps today around your area, just to keep active?"

Q: You were asking them to take laps?

GOODELL: Well, if they wanted to. If they felt like they were antsy, we would be like, okay, let's do a lap while we're doing our investigation of the area.

Q: So you would walk along with them?

GOODELL: Yeah, mm-hmm. I remember we had one house with three young guys, and the community person we were working with in that village, he would make them do push-ups and sprints and stuff like that within their area. [laughter] I didn't do the push-ups, but I would walk with other people.

Q: You've mentioned Yogi a couple times. Would you mind describing him for me?

GOODELL: Yogi. He was the lead--I don't know what his exact title was, but he's a physician, and he was the lead epi for the WHO team. He's this older Indian man who is very warm and intelligent. He's done an amazing amount of outbreak responses, and he's just a wealth of knowledge. I developed a relationship with him very early on. I'm trying to remember where he said he is now. I feel like he was just in Indonesia doing another investigation. You're inspiring me to 01:17:00read up on my quarantine paper with him. [laughter]

Q: Sounds like it could be fruitful. Who are some other people who you worked closely with?

GOODELL: Anna was the other person from WHO that I worked very closely with and she led all of the investigations with me. Basically, the core field epi team was CDC, WHO, and we would lead all the investigations, and then UNICEF and Red Cross and OXFAM, they would support the investigations. Anna and I were there for the whole two months together, and would basically just support each other throughout the contact tracing and investigation.

Q: What does that mean, support each other?

GOODELL: She would take one end of the village or the other, or we would check--or I would check on resources or she would try to make a phone call if we needed to follow up on something. Basically, we would have a protocol of things we needed to complete for the day, and instead of me doing all the--we would kind of task it out to each other, and then others who were working with us in the field. Then, we were also emotional supports for each other, which was super helpful in the car as well.

Q: Can you tell me more about that?

GOODELL: Sure. When you're doing this work out in the field every day and you're building relationships with people, you're always going to need some sort of support to talk through any of the things you're experiencing or seeing.

Q: Were there some particularly difficult moments that you think you really benefited from that?

GOODELL: Lots of moments. I think your question about quarantine practices is a really good one. There were a lot of things that we would try to help improve the situation for folks in quarantine, and sometimes, again, with the broader picture in mind, you can't always give everything that you've been asked for. I think that's always good to have somebody there to support you, to go through it together.

Q: Did you ever have to tell communities that, you know, we have tried to find something for you and we just can't?

GOODELL: Oh, yeah.

Q: Do you remember any of those conversations in particular and how they went?

GOODELL: Really it would just be like, sorry, we don't have it today, or sorry, this came yesterday, and now it's going to come in two days. You would, of course, get the emotions that come along with that. Because again, these people are in quarantine, there's nowhere they can go, and they're also dealing with the stress of, are their loved ones okay, or is something happening. Because again, even though these are remote villages, everybody's connected and everybody knows each other. Somehow, they all hear about how their family members are doing.

Q: I want to ask you about a couple other things, but did you say you had a 01:21:00twelve o'clock?

GOODELL: Yes. Oh gosh, I do.

Q: Sorry, I didn't mean to make you late for that. Would you mind if we continued the conversation at some point in the future?

GOODELL: Sure, yeah, of course.

Q: Great. Thank you so much for joining me on the call.

END