Have you ever wondered about how infectious disease outbreaks like COVID-19 and monkeypox are investigated? It’s no easy task, but the Public Health Agency of Canada’s (PHAC) field epidemiologists play a leading role in many outbreak investigations.
An epidemiologist is a public health professional who studies the distribution, causes and risks of health related events in a population. A field epidemiologist responds to urgent public health events on the ground and in real time. This means mobilizing on a moment’s notice to go to the front line of public health emergencies and urgent events, such as disease outbreaks and natural disasters.
On a day-to-day basis, field epidemiologists work in many areas of public health, depending on their expertise and interests. They monitor and report on diseases and other public health issues, design and evaluate public health surveillance systems to track diseases, conduct epidemiological analyses, and communicate public health findings for numerous audiences.
During public health investigations, field epidemiologists take on a variety of roles. For example, this can include developing questionnaires, interviewing cases, setting up data collection processes and tools, reporting real-time status updates on the investigation/outbreak to stakeholders, and attending team meetings to recommend public health control measures. These mobilizations typically last three to four weeks and can involve long and intense working hours.
The Canadian Field Epidemiology Program (CFEP) is Canada's own applied field epidemiology training program (FETP). As one of the first countries to establish a FETP, Canada has created a strong network of field epidemiologists to be mobilized anywhere they are needed. During the two years of this on-the-job training program, field epidemiologists are required to complete eight professional experience guidelines, including at least one mobilization.
Chatting With Two Current Field Epidemiologists
Elaine Chan is a second-year field epidemiologist and soon-to-be graduate of CFEP placed at the British Columbia Centre for Disease Control. Prior to participating in CFEP, Elaine completed her Bachelor’s of Science in Behavioural Neuroscience at the University of British Columbia and Master’s of Public Health (MPH) in Epidemiology from the University of Alberta. During her undergraduate degree, Elaine had the opportunity to complete a co-operative work placement in a public health setting, where she first learned about epidemiology.
This experience inspired her to pursue her MPH degree, and following that, she worked as a Public Health Officer-Epidemiologist with the Canadian Public Health Service for three years before joining CFEP. This was a great opportunity and allowed Elaine to gain the minimum of two years of experience working in public health which are required for CFEP applicants.
During her time with CFEP, Elaine has engaged in a wide variety of tasks. For one mobilization, Elaine was working to support a health region in investigating and managing several multi-jurisdictional COVID-19 outbreaks in industrial work camp settings. She participated in outbreak management calls, designed and created epidemiological reports, analyzed outbreak data, and helped to recommend outbreak control measures.
At her provincial placement site, Elaine has been involved in designing and implementing a voluntary COVID-19 surveillance program for mink farm workers, investigating provincial outbreaks of Salmonella, analyzing data on the emergence of the SARS-CoV-2 Delta variant of concern, and conducting an interrupted time series analysis on the impact of COVID-19 on syphilis testing in British Columbia.
Katharine (Kate) Fagan-Garcia, is another second-year and soon-to-be graduate of CFEP placed at PHAC. A fascination with microbes, pathogens and diseases sparked an interest in microbiology for Kate in high school, which led her to Western University where she completed a Bachelor’s degree in Microbiology and Immunology, followed by a Master’s in Virology at the University of Alberta.
Kate then became interested in the bigger picture of microbiology and public health, and began her pursuit to become an epidemiologist by completing a Master’s in Epidemiology at the London School of Hygiene and Tropical Medicine. Through her experiences, Kate developed her love for working with data and in the field. When researching career paths, she came across the CFEP website, and set a goal to join the program.
Since beginning at her placement site at PHAC in late 2020, Kate has been mobilized to support investigations of emerging infectious disease outbreaks in three provinces, of which two were in-person at the locations of the outbreaks and one was conducted remotely. She had unique and fascinating experiences each time working with the teams to understand and stop the outbreaks.
At her federal placement site, she also supported investigations of a variety of zoonotic disease outbreaks, including a Salmonella outbreak linked to pet hedgehogs. Kate also worked on a variety of other projects including the development of a companion animal surveillance initiative for zoonotic diseases, an analysis of rabies surveillance data, and the national public health responses to avian influenza and monkeypox.
Challenges and Perseverance
The COVID-19 pandemic has presented unique challenges for Elaine, Kate and their field epidemiologist colleagues. One very important aspect of being mobilized is physically being on the ground in order to get a comprehensive understanding of the situation and to help in building rapport and connections with affected individuals, as well as the healthcare workers and other team members they are working with. With COVID-19, many mobilizations in CFEP were conducted remotely, adding another layer of difficulty to the field investigations.
COVID-19 is one of the many challenges field epidemiologists face in the workforce, however, regular day-to-day work can be challenging as well.
"Remind yourself to prioritize your own mental and physical well-being, and work-life balance. The scope of public health [is so large] and all the things you could be doing, that is challenging. You know there are always more things that could be done," Elaine noted when discussing the range of issues field epidemiologists deal with.
Kate identified similar challenges within the job. “One of the challenges of being a field epidemiologist, like many people who work in science, is that you don’t always find all the answers to your questions. Sometimes a disease spreads in unexpected ways, or the source of an outbreak remains a mystery. This can be very frustrating, but it also stretches your problem solving skills. It pushes you to explore different ways of looking at things or to learn new skills, to try everything you can to find the answers.”
Although working as a field epidemiologist is demanding, both Elaine and Kate believe that it is a very fulfilling job and definitely worth the struggles. For those looking to pursue a career in field epidemiology, the best advice given by our two field epidemiologists themselves is to work hard and keep trying! Applied epidemiology training programs such as CFEP are very competitive, so applying again after rejection is common.
If you’re interested in applying to the program, you can find more information on the CFEP website. To learn more about field epidemiologists and the work they do, follow PHAC’s social media channels and stay tuned for our celebration of World Field Epidemiologist Day.
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