Welcome to the University of Southern California online Master of Public Health program student spotlight webinar working through the COVID-19 pandemic presented by the Kech School of Medicine at the university of southern california my name is Kijuana Carter. I’m a graduate admissions advisor at the Master of Public Health online program and I will be your host. I would like to thank you for taking time out of your busy schedule to join us today now before we begin I want to review what you can expect during this presentation first if you have any questions please type them in the Q&A box located at the bottom of your screen and hit Send feel free to ask your questions as you think of them and we will answer as many as time allows at the end of the presentation a copy of this recording and slideshow presentation will be available shortly after now I will give a brief overview about the Keck School of Medicine and the department of preventive medicine and introduce our speakers Dr. Paavana Varanasi and Megan Kenny, MPH. We will hear from our guests who will speak to their experiences working during the COVID-19 pandemic. Lastly we will end the presentation with that brief Q&A session now the Keck School of Medicine was established in 1885 it is the oldest Medical School in Southern California and today it is a place of dynamic activity and patient care scientific discovery medical and bioscience education and community service together we are poised to lead medicine and healthcare in the 21st century for the benefit of humankind the department of preventive medicine as a Keck School of Medicine of USC is known as a leader in public health and population health sciences it’s organized into six divisions disease prevention and global health bio informatics biostatistics Cancer Epidemiology and genetics environmental health and health behavior research now the master of Public Health online program offers a rigorous curriculum that attracts dedicated and ambitious professionals with the passion to serve in the public health arena there are six different concentrations that students can choose from when pursuing this degree they include biostatistics and epidemiology community health education and promotion geo health Global Health Health Sciences and health services and policy and the generalist concentration now today we’ll be hearing from two of our students doctor paavana Varanasi is in her first semester of the online Master of Public Health Program here at USC she hopes to utilize the interact intersection of her MB and mph to increase access to health care and optimize health care delivery systems she earned her Bachelor of Science in neuroscience with a minor in biomedical research from UCLA in 2015 and her MD from Ross University School of Medicine in 2019 earlier this year Todd and I served as a medical volunteer during the covid-19 pandemic in New York and is now starting her residency in internal medicine Megan Kenney, mph currently serves as a Health Educator for the Santa Barbara County Public Health Department’s tobacco prevention program her goal has always been to improve the health of her greater community after receiving a Bachelor in kinesiology and 2017 Megan decided to pursue an mph degree with us ease online mph program and graduated in August of 2019 with a concentration in community health promotion. Megan was called to serve as an emergency service worker on the covid-19 response and was responsible for managing all covid-19 test results for individuals throughout the county we are so excited to have them join us today so let us begin hello Paavana, thank you for joining us today hi thanks for that great introduction so I just want to start off by saying that this is just like my own personal experience and I’m not speaking for any Hospital or anyone else’s experience doing this one here was I am with coated in general everyone I think that I’ve talked to has had a very

personal experience and the kind of personal you know the emotional fallout and all that that they went through dealing with coded so a little bit of background about how I kind of got into this I basically served as a medical volunteer during the pandemic and I really started at the peak of the pandemic in New York City and there are quite a few ways that I know I had friends that joined in New York for a similar relationship and a lot of people didn’t New York medical air nurses doctors other healthcare professionals were Coulomb quote and deployed to hospitals that needed the extra staff on the other hand I actually got my position directly dealing with the hospital that I worked at so I worked with the internal medicine resident team and I provided them with support really an extra set of hands while they handled a crisis where an extra set of hands really mental I was kind of priceless and the hospital is short-handed and short-staffed because you know the staff were getting sick slowly but surely and then definitely short on supplies and I was lucky in the sense that our Hospital and administration really handled COVID-19 in a way such that we were never concerned about not having to be here not having mass or gloves or anything like that anything to protect ourselves or to do our work properly and with patient safety in mind a little bit of background about coulded and the Bronx where I was based so about 29% of the population here lives below the poverty level and that lends to an increased prevalence of uncontrolled medical conditions like diabetes hypertension smoking obesity cardiovascular diseases and there are also increased psychosocial stressors in terms of homelessness and lower educational levels immigration problems are pretty common here a low socioeconomic status as a community really and then that lends to difficult access to health care and this leads us into talking about what happened during probit because the urban implications of the of the pandemic is very important in this community where you know when it’s an urban setting and everyone’s kind of in such close quarters how do you really social distance and how do you stay home when your family can’t necessarily afford it and all these other implications that you know generally the community and other boroughs where the socioeconomic status is higher was not really that big of a consideration of course it was a consideration for many but in this borough especially it’s very it was a very difficult thing for people to navigate so just get us started on the actual coded statistics itself so this is a graph from the New York Department of Public Health website and here we can see in the blue are the number of people tested in general in New York per day and overlaying onto the blue is in the yellow is the number of people that tested positive of the people that were tested so the day I have I lighted there it’s a little small is on April 9th which is about mid peak in that pandemic that’s right around the time that I started and as you can see over the course of time now towards the end of the graph we can see that the number of positive results per population tested has greatly decreased and we can say unlike many of the states unfortunately now but New York has really seen a great decline in the cases and the curve has declined so this is I guess now I think Keanu was saying earlier that New York is now the bottle stay and it it is and it was very hard and we finally got here but it took a lot of work and I think that’s what a lot of the other states like you know we’re kind of complacent in a sense at the very beginning and our paying the very unfortunate price of increased cases which will be changes and deaths so to understand the depth of the crisis I guess in a hospital where we have an approximate average of 30 to 40 patients

on a ventilator or life-support during cold that number doubled are almost tripled and there are an estimated 50 to 60 new patients being admitted every single day during the peak of the crisis that is and the thing to consider when the number of critical patients increase in such a dramatic way like this is you know where do we put the patients that’s a very big consideration because operating rooms procedure rooms became essentially pseudo eye seams because there’s just so many patients that needed this kind of critical care and the sheer number of missions was just overwhelming and that you know of course leads to increased lab work increased our early monitoring and talking to families I’m contacting that regarding essentially daily updates and even more than you know the quote-unquote normal families of course are very concerned about their loved ones because this was like a new pandemic this wasn’t just you know heart failure or a smoking problem or you know drugs or just I just you know that Fred them they had kind of in a ways gotten used to because it was their loved one medical problem but now is this new kind of fear that’s unknown and of course this all led to an increased number of daily deaths which is for an emotional from an emotional standpoint it’s very draining so in fact the burden in New York City was so high that Javits Center which is a conference sorry Convention Center here was actually converted into a makeshift hospital and it was staffed by I believe the doctors from the US military service and just apart from the workload I wanted to touch on the emotional fallout or just a no picture at the bottom isn’t as a picture of the beds up the Javad Center and but so back to the emotional fall and so this we are looking at both for healthcare workers and for the families so in terms of health care workers you know I think most of us in general you can say go into this career for a very altruistic reason you know help humanity save lives etc but when the pandemic hey you know there were just a sheer number of cases you know something I’m like anyone who really ever imagined and you’re doing kind of everything you can think of everything medicine trains you to do and they’re just some people you just can’t save and you know as always you know you always know that they’re going to be deaths in this career and you know you’re going to you know how the front-row seat to that but at the same time seeing so many people go through this every single day or seeing people that you wouldn’t normally anticipate would become so critical go through this is very daunting and it’s a hardly to carry and I know that now there’s even more attention being brought to physicians stress and burnout and really suicide as well and during the pandemic there was definitely an increase in these numbers in terms of the families it was also very difficult because the families had this lost memory of the patient because visitation was suspended during this time so there are lost memories of the patient being well so they cannot comprehend the decline that the patients go through and it’s it was very difficult for us to explain because how much can we really tell them over the phone you know and it’s such a hard conversation to have and honestly you don’t want to accept the fact that the patient isn’t doing well any more than the family member does and so many times we heard you know family members repeatedly saying about how I don’t understand you know the patient was just dancing two weeks ago before he went to the hospital there’s just no way that the patient is you know at this clinical status right now so we our Hospital actually got iPads for every single floor so that if the families had I for FaceTime capable devices then we could go ahead and have them see the patient so that at least then like they have a mental picture of the patient and then in addition even for the patient you know it’s been proven that family and social support really helped outcomes and reduce recovery times and so it was

kind of a double pronged effect for that so in terms of our current the current trends of Kovach so here on this graph it’s fun just from the economists but it’s based on Johns Hopkins data we see that in New York City but as I mentioned before is now on this decline the curve has come down in comparison to the rest of the country where the cases are you know it means every single day cases are going up so in terms of my hospital we’re down to about probably two to three Club it admissions a day I’m not really hearing about too many I’m not seeing too many and probably less than 10 percent of the patients in the IC are COVID-19 positive and in that sense we’ve now come back down to our covert average of the number of clinical patients we have and they’re not critical necessarily because of : mostly because of their own like there are other issues underlying medical problems just at the peak those in New York City didn’t New York State as a general actually made up about 25 more than 25 percent really in the National cases and debts and now we’ve become one of the lowest in cases hospitalizations and death so just to kind of wrap up I just want to talk about what I think the public health and patient care intersection is so they really do coexist in terms of health care and I am pursuing this mph because I really believe in preventative health and and health promotion projects and increasing health literacy and I think this is such a big deal for lower income and lower educated communities especially you know with an increase in preventative health than you know ideally and theoretically both we would be decreasing the amount of you know progressive supported that we would see in their medical problems and I think it’s such an import and aspect of health care even as a medical doctor you know it’s so important to talk to patients and tell them you know these are the ways you could prevent these are what you can do to maintain your status of health now and information and that a lot of people don’t have access to unfortunately so this is just to wrap up on the left is my picture from my medical school graduation last year and on the right is a very different picture really I’m dawned and my PPE from head to toe so I’m wearing this spacesuit jumpsuit esque thing with the hood under the hood I have a hairnet on and then a full face shield it’s a plastic shield and n95 mask I’m double gone though I don’t think in this picture and wearing booties and this was basically 12 to 13 hours a day we wore this getup we also had an extra gown that we would put on when we went into different patient rooms so it was a lot and it was very difficult but I’m very thankful that I was able to you know help in any way that I could and it was really an experience of a lifetime and I’m glad I’m here to talk to you guys about this so I want to pass it along to Megan now hello Thank You Paula it’s really amazing and eye-opening to hear your experience working on the frontlines as a physician and I can’t say this enough but our frontline health care workers deserve so much appreciation for what they’re doing and thank you to the USC Master Public Health online program. It was this time last year I was actually finishing up my last semester in the program and attending these webinars listening to alumni speak so it’s kind of surreal to be speaking today but I’m here to share my experience working on COVID-19 from the public health side of things more specifically at a local public health department and I’m really hoping to share my experience kind of as a snapshot of what so many people are doing right now and sure on behalf of everyone who’s contributing to this tremendous public health effort but I’ll just kind of mirror what Pavano was saying in that this was my experience and so I will defer back to just speaking for myself and and what I went through so I will quickly start by explaining how I got to where I am now in undergrad I originally intended to go into physical therapy and so I chose to study kinesiology and I worked in physical therapy clinics for several years but it wasn’t until my senior year that I was introduced to public health and with my degree in

kinesiology we learned so much not just about injury prevention but about disease prevention through healthy eating and active living and while I loved working hands-on with people I became really interested in preventive medicine as a whole and how it could be implemented on a community and population level so shortly after I graduated in 2017 that I came across the National Commission for Health Education credentialing website or uncheck and I learned more about what new job duties the health educator are and I remember thinking to myself this is exactly what I want to do so while I originally intended to take new year off before starting any type of graduate program hadn’t really decided at that time I came across us he’s online mph and was instantly convinced that this is where I wanted to go it was close enough to me that I could visit campus for conferences and events but I could also live at home with my mom for free and work while getting my degree and on top of that you know what drew man really was looking at the curriculum seeing me amazing professors the opportunities that they had and hearing other people’s experiences so I applied the fall after I graduated and I started the USC MPH Online program in January of 2018 with a concentration in community health promotion and I absolutely loved my strengths in the program. I learned a lot I feel so grateful to have the opportunity the ability to get a graduate degree in a field that I’m really passionate about and I was also lucky enough to be selected to give the commencement speech so that made the completion of the program extra special for me and I sat on stage and spoke just before dr barber Ferrer who I really look up to so it was truly an amazing experience of acting that an important part of my story kind of moving on and how I got to where I am right now is where I completed my practicum so knowing that I wanted to become a health educator I wanted to find a practicum working directly with the health educator at a public health department so I searched the Santa Barbara County Public Health Department’s website and I came across the contact information for the program coordinator of the nutrition education and obesity prevention program and given my background in kinesiology I was and I still am very interested in nutrition exercise so I emailed her it probably took me about three emails before she responded to me but she did and she referred me to the newly formed local oral health program and I contacted them and I was lucky enough to be hired for my practicum so I work directly with the health educator as well as with the program coordinator it was just a little three-person team so proposition 56 is a tobacco tax and some of the money goes towards funding local oral health programs in Santa Barbara County the oral health funds had previously been allocated to the office of education but the public health department had recently acquired that funding just several months before I joined so is a brand new program at the Public Health Department and I feel so grateful for this opportunity because I really kind of jumped headfirst into a lot of normal health educator tasks like community education I created a social media campaign in English and Spanish for National Children’s Dental Health Month I assisted with two of our oral health related coalitions throughout the county and I helped with some of the important state deliverables because we were a new program we were required to submit community health needs assessment and then use that information to inform a community health proven so I was able to work with a lot of the data collected for the needs assessment and then wrote a good chunk of that report as well as a health improvement plan which might not have been an opportunity if I joined a program that had been established at the public health department for some years so applying the skills I was learning in the mph program at that time in kind of real-life scenarios it not only helped me to solidify what I was doing but it was really rewarding to me and I kind of learned that this is what I wanted to do and again this is kind of an important part of my journey because shortly after I reached my 300 hours for my practicum I was hired by the hiv/aids program for a limited duration health educator position working on a special project so for three months I was tasked with educating the county’s emergency departments urgent cares and community clinics on the CDC’s route routine opt-out HIV testing protocol which was an awesome way for me to get to know the healthcare community in Santa Barbara County but also use my cold calling skills trying to schedule appointments

with various medical directors so once that position ended I was very lucky again that a full-time health educator position opened up at the Public Health Department with the tobacco prevention program and I applied and I got the job and Here I am now I never thought I would work in tobacco but I really and truly absolutely love it the tobacco prevention program works to educate the community about the harmful effects of tobacco advocates we have Kate for tobacco control and then we assist with policy development and the program again is funded using prop 56 money as well as prop 99 which are both tobacco taxes under the direction of the California tobacco control program or a CTC P so going back to my original perceptions of Public Health I wanted to work in chronic disease prevention and really only understood what that looked like at kind of a community or organizational level but in the mph program I was introduced to the social ecological model and learned how prevention could be achieved through policy work and systems change and I feel very grateful now it’s beginning experience working on this level so as I mentioned much of what we do is policy work and these are just a few images of our program and our coalition members advocating for tobacco control at local public policy meetings most recently in the county we’ve been focused on being self flavored tobacco products and then at the same time we use this is an opportunity to set up tobacco retail ison Singh as a means of enforcement we create minimum packet and price restrictions and ban the use of coupons discounts and deals and the flagrant bans don’t just target vaping products to me target flavored serios cigars chewing tobacco and especially menthol cigarettes I still find it hard to believe at this time three years ago in you know midsummer July I was looking at the end check website reading about house educator job functions and I myself now I’m working as health educator but the health educator position with the tobacco prevention program kind of hits a lot of the standard competencies of a health educator outlined by end check first there’s a lot of community education through various mediums so I help manage both our paid media which is print social media and radio as well as our earned media so working on press releases and doing interviews there are a lot of presentations the community which I love doing as well as creating educational materials and um with our recent flavor bands we’ve passed I’ve had to do a lot of outreach in education to our tobacco retailers located in the county it’s been a very interesting experience working with this population because our policy work is essentially taking away their business and I can’t say they’re huge fans of me when I walk into their shop with the pamphlet or all the products they can no longer sell and understandably sell but I’ve learned that it’s really not our jobs to be an authoritative enforcement figure with them but really we need to learn to work together with these retailers and I got very used to honors manager is just voicing their opinions and concerns about these ordinances for you know up to 30 minutes at each visit and although we come from two very opposite ends of the spectrum I try to put myself in their shoes and be as understanding as possible and at the same time also being firm and that these individuals are selling the number one cause of preventable death and disease in the United States to make a problem so what I’ve told many of them is that if you have the determination to open a small business once you can do it again just try to sell products that benefit the community rather than hurt it so a sandwich shop coffee shop beauty shop whatever we’ll see if any of their business models turn around but it’s been a really unique and rewarding experience to work with this population and as I’ve said multiple times known so much of our focus and our directive from the state on policy work so this is the system’s level change that trickles down to the individual level by making flavored tobacco and available our goal is to decrease initiation rates among youth in our community and with policy work the health educator is involved in competing task force meetings providing technical assistance to elected officials and staff and we usually do this in collaboration with the public health law center because I for one am not well-versed in legal language or the law and then we present a lot at pub

policy meetings and because we’re funded through CTC P and through propositions we are not able to lobby which means that we really work to inform and educate and provide technical assistance but that’s kind of where we stop and then on the other hand we mobilize the community who does all of the advocacy work and this is accomplished through coalition building training educating providing technical assistance to coalition communities which is something that you know I really spend a lot of time learning about in the mph program and find extremely valuable now to notice so on top of all of the awesome responsibilities of a health educator as a public health department employee and just a public employee in general I am also a disaster service worker under california government code so this means that an emergency I must help maintain essential services in the Public Health Department or serve potentially in a different capacity to assist with disaster response so FEMA has a very detailed response protocol called the incident command system for health care emergency response for ACS which is a part of the National Incident Management Systems and I found it interesting ICS was actually developed in the 1970s following a lot of the terrible fires that were happening in California and it’s still used today so when the ICS is activated EMS emergency medical services and designated health department or any public employees assume new roles in each of these kind of five functional areas throughout the ICS either command operations planning logistics for finance in administration and the actual physical location where everyone meets is referred to as a dlc or a departmental operation center or if it’s kind of more of a collective not just within one department such as the public health department it’s kind of a countywide effort at this point it’s referred to as the Emergency Operations Center and lastly another component of the ICS is the Jick or the joint information center which coordinates all of the incident related public health information Pio activities and the Jake is usually where health educators would report during emergencies kind of given our background in health communication and understanding of health literacy so my supervisor who’s been at the Public Health Department for several years held a predetermined position and DLC within the jig so she was called rather early to begin helping with the response and it was a few short weeks later in March I was asked to report to the DLC to assist with the epidemiology unit and again normally a health educator might focus on Public Information activities but we already had many of those roles filled and the pandemic kind of posed a lot of new challenges and required a different kind of response than we might be used to here in Santa Barbara and I’m an imagine so many other public health departments kind of faced the same challenge so it was really my mph that allowed me to serve and at the unit because although my concentration was in community health promotion and health education you know I took an epidemiology class and I practiced and applied it in many of my other classes so I’m grateful that I had that background I reported to the DAC in March as I said and I assisted a unit for like two to three days kind of helping with data entry and not really understanding kind of what was going on because so busy and everyone was kind of crunched for time but I think it was my fourth day we were called into a meeting and I was told that the epic unit was restructuring to have kind of three branches as they laid out here on this slide and which are surveillance cases and outbreaks and that I was being assigned as the surveillance lead so as the surveillance lead and that’s the surveillance unit or branch we had three responsibilities and we were to manage and organize co19 and then later last several weeks antibody testing data for residents throughout the county we needed to maintain a database of test results for the use of our disease containment unit and their contact tracing efforts and then report daily negative positive and inconclusive testing numbers and all of this information was published on the daily status reports released by the department to the public and over time these numbers were used in calculating

positivity rates throughout the county and I had an awesome team of all their public employees who help with these tasks because I could not have done it alone on a daily basis but to be honest this is pretty overwhelming and stressful to be kind of in such a crunch every day as soon as we would get used to the way things were being done solid workflow but you know what data we were receiving and how we were managing it and then I would train everyone on how to kind of follow this new workflow things would just change and I know this is the case I’m sure this is the case for everyone working on this pandemic it’s really kind of ruthless in that nature I know that there are thousands of public health workers out there right now solving immense problems that have huge implications potentially sometimes life-or-death and those individuals probably far too busy to be speaking at webinar right now but I have so much kind of respect and deep aberration for our public health workers in our healthcare workers despite healing overwhelmed addressed I was so grateful that I was in a safe office where I could appropriately social distance and have access to adequate PPE and just seeing images of healthcare workers like the one that paavana showed in layers of PPE working long shifts and incredibly trying hours and just think yeah like these individuals definitely are the heroes so I served as a surveillance lead up until the end of June and at that point I transitioned out for two reasons first my supervisor of our three-person tracker Prevention Program was going on maternity leave at the end of June so she needed to train me on how to manage the program while she was on and second I was starting to get really sick without even really realizing it kind of the stress started to exacerbate some health issues that I have and while I felt energized at work and was happy to give some of my time kind of the long hours and the stress of the entire situation really started to wear me down to the point where I just was not feeling well and could not perform to the ability that I wanted to and as much as I hated to admit it I had to say something and I had to ask for help and I really honestly I felt so guilty asking reduce my hours while everyone was working so hard but did kind of hit a breaking point and I truly wanted so badly just to be able to help but how does it be honest with myself and accept that my body at this point couldn’t handle that much stress so for me it was an incredible learning and growing experience as a professional but also as a person so I’ll touch on that more in a sec but I just wanted to quickly kind of show you a brief snapshot of coab in Santa Barbara County unfortunately it’s not quite the curve that paavana showed us for New York you can see that the orange line is a total cases over time so we’ve seen a steady upward trend in the past several weeks but from what I’ve seen our community is pretty receptive and respectful of our health officer orders so I’m hoping that this trend line starts to slope downward soon on that kind of same note while I’ve seen such a tremendous effort among public health actually it’s been really hard to watch our community almost be torn down a bit by the public can sometimes the media and as if these health physicians aren’t difficult enough you know to not have the support of the nation sometimes is kind of understandably grounds for making this you know significantly more stressful and I hope and wish is that everyone working in public health or healthcare and honestly all essential organs are essential jobs can still practice adequate self-care right now no matter what that looks like for each individual these are such trying and difficult times for everyone and no one alive has really experienced pandemic of this magnitude and we’re all kind of learning to adapt and cope differently and it is it’s really not easy for anyone so with that I will leave you with my amateur experience tips and wisdom as a recently graduated brand new health educator working in my first public health emergency and first global pandemic first I can make my mom for reminding me but you we can’t help others if you don’t help yourself first so just kind of like

being on an airplane having to put your mask on yourself before the people around you if you’re not well it’s really hard to take care of others or perform your job to you know your normal capacity and second um all I will say about this is that it’s always possible to be kind to everyone especially in such a stressful time I know I felt better when I was kind of people and when people were kind to me and lastly kind of this quote really resonated with me a lot during my experience but the strongest thing I ever did was ask for help and it’s really hard to admit that I’m not perfect and I’m not destructible and I’m human and sometimes a human that isn’t feeling well and has health problems despite wanting to heal everyone else around me so you know I hope is maybe some of you need to hear this right now but you’re not weak for asking for help in fact you’re very strong so I hope this information was helpful and everyone working on the covered response directly or indirectly or providing essential services while others work on response for anyone studying Public Health or thinking about studying Public Health I just want to take another opportunity to say thank you you’re making a huge impact at a very important time so with that I will turn it back to Kiana thank you thank you so much Megan for sharing and sharing your experience and yes mother knows best you have to take care of yourself first in order to take care of others and what the world needs now is love and support and so we are so grateful for all of our public service workers and the support and care that they provide so thank you all for your service and one of our other guests or participants also stated that we’re so delighted to hear the first-hand experiences of these young medical professionals and dealing with the public health crisis and we are especially how happy to hear the line COBIT responses of dr. sivana paavana varanasi and with that being said it is now time for us to go into our Q&A session and so I would like to start that with a question for paavana the question is did Hospital social workers work with doctors and nurses on their emotional state and what resources were made available yeah so the social workers did not necessarily work with us in that sense they did continue to provide a support in terms of patient care and you know disposition as we transition patients out of the hospital these social workers were also honestly there especially in our Hospital always busy always overrun and even more so during the pandemic just like any other health care worker for resources sorry in terms of resources the hospital psychiatrists were very helpful they were very hands-on they came around very regularly to every single floor to check on everyone and to offer their services both anonymously and as a group session basically whatever the individual needed and there was also a public hotline I believe it was that anyone could call if they felt any sort of stress and he sort of burnout if they just wanted to chat anything like that so there was a lot of support out there I think more more of it was trying to figure out or trying to prioritize that like Megan said it you know it’s you have to learn how to do self care in such a high-stress environment but when you’re over on how much time do you really have I don’t know it’s kind of a toss-up but there were resources available is the important thing to know wonderful thank you and and as far as the resources that were available were there resources available to be family members of the patients that were hospitalized due to cold head I’m actually unsure about that there may have been they just were not as publicized to me at least but at the same time I think a lot of the support that there was there was going towards the patient’s themselves and potentially

the family members and they have fallen through the cracks a little bit just as a whole so I’m not sure okay thank you for sharing that I have another question for you the question is how have you balance the coursework and doing your rotations and and working on the kovat pandemic any strategies that you can share with you know students in the program yeah I mean it’s definitely been tough but for me it’s all come down to this like very impressive time management that I’ve been juggling and I think that’s very key in terms of anything that you do even you know outside of school and work so for me you know I have about one one and a half days off a week and I still have school work to do and I still have classes to go to so I’ve kind of become this master juggler if you will where you know Saturday when I have it often like oh you know I want to go to brunch but I have school so I wake up early and I do school so that I can enjoy the rest of my day things like that you know if I have to study and you know I have to study and that’s just kind of what it comes down to and some of it is learning how to you know sacrifice more of a social life then I anticipated I guess but I’m glad to do it and I think time management at the end of the day will really conquer all oh why thank you so much this next question actually is from Megan Megan did certain staff members step up as as mentors in the covert war room you know what are the tips to inspire others in this since in this tense work environment yes definitely I think to me I look to our senior epidemiologist a lot it was interesting in the you know addressing the global pandemic was new for everyone and yet I could still look to the individuals who had been around for a lot of public health emergencies whether in our department or in other departments that they’ve worked at in the past and so I’m really lucky in that I truly enjoy all the people that I work with and if anything it was so inspiring just to see not only us as a public health department us as a county come together I think we really we had to work together with kind of our County Emergency Services as well because this is a huge kind of united effort so to me I look to the more senior employees they answered all of my questions because I had a lot and then yeah through all of this just seeing a lot of inspiring kind of unity throughout our County and people working together it’s it’s really it’s been a pleasure to see wonderful wonderful this next question is for you as well Megan our tobacco retailers receptive or do they have to be monitored after you informed them of illegal products I think it varies case-by-case I would say that as I started doing a lot of outreach to tobacco retailers and I would kind of come in I’d say like here’s this informational talk and I made these are all the products you can’t sell and they would kind of you know not be super happy with me they would raise their voice they would tell me how wrong this is and then they would start saying things like this is my livelihood this is how I feed my family like how could you do this to me so I learned very quickly as I kind of mentioned that it was not my place to kind of be that authoritative noise we have enforcement officers for that they can do that really my job was to work together with them and get to know them honestly because we for some jurisdictions we manage this tobacco retail licenses so we already communicate with these individuals so when I started taking that approach I listened to them I just would kind of be quiet and I would listen I’d be like yeah and I would put myself in their shoes I would say like it’s got to be really scary when you feel like your small business that you’ve worked so hard on is jeopardized or is going under and I sell when I took that approach I learned that they were a bit more receptive and I was like oh my gosh like I like what can we do what do you need and I actually put together a resource sheet for kind of more so our small businesses the vape shops and stuff like that that had free business mentoring in County at the state level and that in federal level grant programs that were available I just felt like maybe giving them a few more extra resources not just

like sorry can’t help you like here here’s some things you could do you can you know seek out free business mentoring when I took that approach when I worked with them they were a bit more receptive and a lot of them agreed they’re like you have this stuff is bad you know I sealed so many kids out vaping like I don’t want them to be using this so yes and no some are receptive and some are not what’s interesting is that the county labor ban passed in January and then another local jurisdiction passed a flavor ban that actually just went into effect in July so as far as implementation goes and seeing if there is a high compliance rate with coated we haven’t been able to do an enforcement check so we don’t know yet when it’s safe I’ll start going out with some of the officers in between those enforcement checks we’re not gonna anyone right off the bat we intend to just go out and again provide more education so I’ll be interested to see what that looks like given this environment right now so how does that answers a question yes it did thank you so much for sharing that and so our next question and I’ll you know just go back to you Megan being a recent graduate of the program did you have a favorite like community health promotion professor or chorus while enrolled in the program I don’t I don’t want to say I had a favorite professor because they I really just loved all of them as far as courses I find myself reaching for my foundations is like foundations in health education I think book and looking up some of the I know some of that more foundational stuff when I want to touch on it a lot of the theories of behavior change I like to reference a lot and just kind of think about what I’m working on educational materials I really loved communication in public health when it comes to doing more of the social media or pain media stuff I think about my program design and evaluation classes I’m working on our progress report right now so I don’t have a favorite okay and and you know what I’ll say all of the professors are absolutely wonderful so I I thank you for sharing that and so the next question is for paavana the question is and the patient’s you saw did you observe a correlation between like pre infection activity levels and kovat patient outcomes two levels and like exercise is how I’m going to take that not necessarily I think that’s hard to kind of Judge most I mean definitely do I will say obesity seemed to be a risk factor now it’s quite more publicized that there have been a lot of cases where obesity or beside patients with obesity have had you know a more severe form of kovat but then there are so many things that we still don’t know about this disease that it’s really hard to say you know a lot of the research has shown for instance that diabetes and hypertension definitely increase the risk of an of a more severe infection but at the same time what is that what is the world that obesity plays is unsure what is it well you know cardiovascular diseases other underlying problems genetic conditions there’s just so much we don’t know that it’s very hard to give a clear-cut answer about this okay thank you our next question is that to Megan I’m making did you ever get formal training on motivational interviewing or did you develop your own techniques to talk to tobacco retailers yeah I think my first experience learning about motivational interviewing was definitely in my foundations of health education boss and I found that really interesting and then with everything I learned in the mph actually went on to become certified as a health education specialist and so to some degree I received some training or rather I think that within the competencies of becoming a health education specialist we learn about some of the values and practices of motivational interviewing but I will say I know that there’s far more that can be done and there’s even certifications and stuff in a motivational interviewing and

I haven’t done any of that work but I think because I work more on a higher level and focus on policy stuff it wouldn’t be at first glance super relevant to me but I could also see how potentially you know working with any community levels especially if we were to do cessation services when it came to smoking motivation interviewing would be really important but I love to do it in the future but I don’t have any formal training at this point No okay thank you thank you for sharing for the sake of time I’m going to ask one more question and this question is actually for the both of you so dig deep into this okay and I’ll ask Pavan odd to answer this question first and then Megan you can follow up with your response so the question is why did you guys put soo an mph degree in the first place as I’m waiting for this question I know a lot of people would say you know you have a graduate degree why are you doing this and you know why do you need more education and I think for me it’s more of a double pronged response where the first aspect of it is I’ve always been very interested in vulnerable communities especially medically underserved areas and those are the populations that I’ve really done a lot of work with you know even before medical school and throughout medical school and I drew my experience as I really felt that there are so many issues that could be you know resolved in a way in terms of decreasing you know severe patient complications and you know reduce patient outcomes and all that that could be prevented or taught and I think a lot of that a lot of those techniques are er what are taught in the mph program and I’m really here to learn those techniques and to know how do I go about implementing these programs that can produce risk and improve health literacy kind of like how I talked about before the second part of it is I am more and more becoming interested in policy work and how do we change this on a more and scale not just at a local level which you know while very important and it’s on the right is very kind of situational you know it depends on the war the team members it depends on how the team members are interacting with the community and all these environmental factors how does the community feel about you know this this work that the you know Public Health Office or other governmental or non-governmental organization is doing and why I think change has to occur at various levels both at a micro and macro level and for me I want the tools to be able to deal with this at a macro level and so I think those are the two main things that I’m doing this mph for I will jump in and firstly say that I wish that more physicians in general would get their mph so thank you for having this experience now you know even if you’re working at a larger kind of systems policy level it’s important and there’s so many places for MD MPH but even if you’re working with individuals it’s really the adds a lot so thank you I wish all of my doctors had their MP but speaking for myself I knew that I wanted to go into healthcare all kind of throughout undergrad and focus on physical therapy and I really enjoyed that mainly because it wasn’t just giving medications I think that’s what appealed to me and physical therapy you saw your patient you know at least once a week maybe two to three times a week and you literally worked hands-on with them so frequently and I really enjoyed that but kind of as I mentioned they learn more about preventive medicine as a whole I got really interested in how we can implement preventive medicine on a community population level and now you know I learn and I get to implement the kind of preventive action on a policy level so for me it comes down to helping people taking care of people keeping them healthy and I think especially

right now working on you know health inequities and making sure that everyone has the same access or different access because they need more or stuff like that again there’s this equity equality issue and we want we want to make health care equitable and we don’t want to see these health disparities continue so I hope that you know with this training in with this kind of new experience I’m gaining I can take what I’ve learned and focusing in that direction and just make sure that the people who need to stay healthier is staying healthy so those are my reasons wonderful thank you so much for sharing and before I conclude I actually got a comment from one of the doctors that is you know on the other line as a participant around the support for families of the patients and it was stated as the palliative care nurses give a whole lot of supports of families dealing with you know members of their family in the hospital so thank you so much for sharing that information I want to thank dr. Pavano Varanasi and Megan Kenney for sharing their experiences with us today and I would like to thank each and every one of you who took time out of your schedules to participate in today’s webinar if you have additional questions and or you’re interested in applying to the USC Master of Public Health online program please feel free to reach out to our admissions team again a copy of this presentation will be available in the coming days please be sure to follow us on our social media platforms our handles are located on the screen right now this concludes today’s webinar thank you again for joining us today please continue to stay safe and stay healthy. Have a great rest of the day