A smorgasbord of national enteric outbreak investigations, video chats with accomplished epidemiologists, data visualization activities, statistical analyses, a COVID-19 surveillance rotation… What could this delightful array of experiences be? You guessed it – my virtual summer practicum with the Public Health Agency of Canada (PHAC)! As this chapter comes to a close, I am humbled by the lessons I have gleaned and incredibly grateful for the valuable connections I have made. Prima facie, the pandemic seemed to pose an insurmountable barrier to a worthwhile practicum. Yet by viewing challenges as windows of opportunity (remote work means you can take the office outside to soak up some vitamin D), my time with PHAC has served as a substrate for immense personal and professional growth.
My main project was with the Outbreak Management Division (OMD) at PHAC, which serves to safeguard the health of Canadians by assessing, detecting, and responding to multi-jurisdictional outbreaks of enteric illness. When outbreaks are identified, they are often investigated through Outbreak Investigation Coordination Committees (OICCs). These committees are comprised of federal, provincial, and territorial partners under Canada’s Foodborne Illness Outbreak Response Protocol (FIORP) and are used to make informed decisions regarding the appropriate measures to identify the causes of outbreaks, as well as propose interventions to limit the spread of pathogens.
The purpose of my work within OMD was to shed light on the solvability of enteric outbreaks identified through whole genome sequencing (WGS). Essentially, I described trends in multi-jurisdictional outbreaks of E. coli, Listeria, and Salmonella investigated in Canada since the implementation of WGS via interactive dashboards in Microsoft Power BI. Pertinent metrics examined included the number of outbreaks investigated by year, pathogen implicated, allele ranges of clinical isolates, number of cases, temporal considerations, actions taken (such as Public Health Alerts and traceback activities), source identification, and whether control measures were taken (like recalls, public communications, etc.). Moreover, the characteristics of investigations that resulted in the identification of a source were compared to those that were unsolved through statistical analyses in STATA. The results of my work may be used to develop specific criteria for initiating enteric outbreak investigations at the national level, thereby improving resource allocation and increasing the likelihood of source identification.
During my practicum, I also had the opportunity to complete a short-term rotation with the Health Portfolio Operation Centre’s (HPOC) COVID-19 Surveillance and Risk Assessment Team. During this week-long endeavor, I worked 12-14 hour shifts with a team of other web scrapers, a policy expert, and a coordinator. With our combined brain power, we produced daily epidemiological updates including provincial and territorial case counts/hospitalizations/deaths, information on local outbreaks that had been reported publicly, data pertaining to high risk populations, as well a summary of provincial/territorial plans for reopening. Our mornings were focused on documenting new outbreaks of COVID-19 identified from public health unit websites and extracts from the Global Public Health Intelligence Network (GPHIN) into an internal database. Afternoons and evenings were then devoted to taking notes from press conferences, conducting media scans to compile newsworthy developments for each province/territory, and entering new data into a shared spreadsheet. These deliverables were then used to generate daily summaries for various audiences, including the Office of the Chief Public Health Officer.
Having completed this rotation, I can confidently say that I am more knowledgeable than ever on the current status of COVID-19 in Canada and its impact on vulnerable populations. I have come to fully understand the gravity of adherence (or lack thereof) to public health precautions and I’m doing my part to support control measures by spreading awareness of good pandemic etiquette to my peers. My rotation was incredibly eye-opening and I also established lasting professional relationships with my surveillance colleagues – I’m very grateful to have had this experience as a mere student! Likewise, during my time spent with OMD I was fortunate enough to get an inside view on the evolution of enteric illness clusters under monitoring to the activation of national investigations, such as with the recent Salmonella Newport outbreak associated with red onions. While shadowing OMD’s Assessment and Detection Team (ADT), I listened in on calls with the Center for Disease Control (CDC) and Public Health Ontario (PHO) to exchange information about new enteric clusters, as well as learned how the team assesses and triages clusters for further investigation.
Overall, my placement at PHAC has surpassed my expectations, both challenging and cultivating my abilities. I gained insight into activities at the federal level of public health, acquired skills that will serve as assets in my career, and became significantly more confident in using STATA. I really enjoyed the positive work environment and everyone I reached out to for advice on various components of my projects was so kind and helpful – the physical distance was barely noticeable! Thanks to my brilliant colleagues and supervisors, this practicum has been a dynamic process of self-improvement and solidified my interests in epidemiology. I’m excited to enter the new semester with a strong sense of direction and look forward to further growing as a public health professional!