Epidemiological insight in the coronavirus era

Kristopher Fennie, Ph.D., New College’s assistant professor of epidemiology, has studied infectious diseases globally for decades. He earned his doctorate in epidemiology from Yale University, worked in China during the HIV epidemic, and has conducted ongoing funded research at the Florida Department of Health to assess the health of vulnerable populations. Fennie understands pandemics from every angle, whether he is looking at the historical context or examining the after-effects of outbreaks. And he is continuously educating his students about past pandemics and their lessons for the future.
Q: Could you predict that a pandemic like this might happen? What were the indicators? 
A: As an epidemiologist, we’re always thinking about that sort of thing—the whole idea of emerging and reemerging diseases. For example, as humans take down the rainforests, we’re thinking about what’s out there that can jump species and get into humans; it’s always a concern (SARS, MERS and bird flu are all examples). So why is this one so major compared to the others? It spreads rapidly and can overwhelm the health system with severe cases where there is limited equipment. Because of the ease of travel, the spread is facile and of concern. I do work in China (I have for about 20 years, and I worked there during the HIV epidemic), so I was in contact with our colleagues in Hunan province when this first started. When COVID-19 first came out, we were very concerned.
Q: How do you think the United States (and Florida, specifically) will be impacted?
A: One of my areas of study is, I’m an infectious disease and social epidemiologist, so I’m interested in how community factors—from poverty, racism, education and access to care—can have an impact on infectious disease outcomes. One of the things I think about with the current pandemic is that there will be issues with respect to people who don’t have as much money, lack social capital, are disenfranchised or don’t have access to healthcare. Some people won’t have the luxury to stay home from work; they’ll get laid off or lose their jobs because of the slowing of the economy, and that’s going to create a bit more of the ‘haves and have nots’ situation. In Florida, specifically, I think we’re going to see a lot more cases. Florida has a high number of people over 60 who have comorbid conditions like chronic obstructive pulmonary disease (COPD) and heart disease, and they will be at a higher risk for severe disease. In normal times, we have enough respirators but, when you have large numbers, it will put a big burden on the state and medical system, and that has the potential to affect Florida a great deal.
Q: You and Professor Tabea Cornel inspired New College students to study the traveling exhibit, “Politics of Yellow Fever in Alexander Hamilton’s America” and even complete an Independent Study Project (ISP) about it this year. What can past outbreaks like that teach students about the current pandemic?
A: The ISP was an interdisciplinary look at epidemics but also the roles that racism and poverty play in them (as well as the aspect of social responsibility and how people react during those times). During a pandemic, people can have conflicting emotions and behaviors (these include fear, self-preservation, empathy, a desire to help, hopelessness, not knowing what will happen (anxiety), and a lack of knowledge). These emotions and lack of knowledge can then affect behavior. By studying past epidemics, we can see patterns in emotions, thoughts, beliefs and behaviors, and how they translate into a community’s actions to quell or fight the epidemic. For example, during the yellow fever outbreak in Philadelphia in the late 1700s, many of those in power and those with money left the city. The poor and free blacks were left to deal with the epidemic. Many people incorrectly thought that the free blacks were immune to yellow fever, and they ended up taking care of those who were ill.
Q: How do you hope to continue educating your students about what is happening? 
A: I’ve been teaching two classes this term (global health and humanity, and an introduction to epidemiology class). So, when we have class, I usually bring up the reports from the World Health Organization (WHO) and ask the students what they’ve read in the papers, and then I pose questions. The current situation provides an opportunity to see something happening in real life and think about it. We learned about the epidemic curve already and what an outbreak can look like, and now we’re seeing what happens in real time during an outbreak. That has provided an excellent opportunity for people to understand epidemiology more. We’re thinking now about ways to have group discussions now that students will be learning remotely. Faculty are discussing the possibility of having a first-year seminar or other course about COVID-19, using it as an anchor for a multi-disciplinary look at society and disease (from perspectives in humanities, social sciences and natural sciences). Right now, I’d also advise people to look to the WHO, the Centers for Disease Control and Prevention (CDC), the Florida of Department of Health, the National Institutes of Health (NIH) and PubMed for the best information.
Abby Weingarten is the editor/writer in the Office of Communications & Marketing.