{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://globalhealthchronicles.aviaryplatform.com/iiif/b27pn9032j/manifest","type":"Manifest","label":{"en":["Rekant, Steven"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/289/original/CDCM_Mark_2.1.png?1728486742","metadata":[{"label":{"en":["Source Metadata URI"]},"value":{"en":["12855"]}},{"label":{"en":["Publisher"]},"value":{"en":["David J. Sencer CDC Museum"]}},{"label":{"en":["Rights Statement"]},"value":{"en":["All rights to the interviews, including but not restricted to legal title, copyrights, and literary property rights, have been transferred to the David J. Sencer CDC Museum","Interviews may only be reproduced with permission from the David J. Sencer CDC Museum."]}},{"label":{"en":["Agent"]},"value":{"en":["Steven Rekant (Interviewee)","Mary Hilpertshauser (Interviewer)"]}},{"label":{"en":["Date"]},"value":{"en":["2022-07-29 (Created)"]}},{"label":{"en":["Language"]},"value":{"en":["English"]}},{"label":{"en":["Format"]},"value":{"en":["audio"]}},{"label":{"en":["Identifier"]},"value":{"en":["2022.800.021 (accession number)","OHCDCM800 (collection call number)"]}},{"label":{"en":["Relation"]},"value":{"en":["COVID-19 Oral History and Memory Archive (is part of)"]}},{"label":{"en":["Type"]},"value":{"en":["oral history"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["All rights to the interviews, including but not restricted to legal title, copyrights, and literary property rights, have been transferred to the David J. Sencer CDC Museum","Interviews may only be reproduced with permission from the David J. Sencer CDC Museum."]}},"provider":[{"id":"https://globalhealthchronicles.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["David J. Sencer CDC Museum"]},"homepage":[{"id":"https://globalhealthchronicles.aviaryplatform.com/","type":"Text","label":{"en":["David J. Sencer CDC Museum"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/289/original/CDCM_Mark_2.1.png?1728486742","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/249/548/small/RekantSteven.jpg?1728012292","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548","type":"Canvas","label":{"en":["Media File 1 of 1 - 12855_steven_rekant.mpga"]},"duration":14624.136,"width":640,"height":40,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/249/548/small/RekantSteven.jpg?1728012292","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/content/1","type":"AnnotationPage","items":[{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-globalhealthchronicles.s3.wasabisys.com/collection_resource_files/resource_files/000/249/548/original/12855_steven_rekant.mpga?1724662028","type":"Audio","format":"audio/mpeg","duration":14624.136,"width":640,"height":40},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548","metadata":[]}]}],"annotations":[{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860","type":"AnnotationPage","label":{"en":["content172466200620240826-2043719-spa75.xml [Transcript]"]},"items":[{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Today is Friday July 29, 2022. This is Mary Hilpertshauser for the COVID-19\nOral History and Memory Archive Project. I am in Atlanta, Georgia and I will be\ntalking to Steve Rekant, who is also in Atlanta. We have had one pre-interview\nand we are recording through Zoom. Steve, do I have your permission to record this?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, you do.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Thank you so much for being here with me today and being part of this\nproject. For the record, can I ask you to say your full name and then tell me\nwhat your current position is?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: My name is Steven Isaac Rekant, and I am a public health veterinary\nmedical officer with USDA [United States Department of Agriculture] APHIS\n[Animal and Plant Health Inspection Service] Veterinary Services, One Health Coordination.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/5","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Thank you. Before we dive into the details here about CDC [Centers for\nDisease Control], and COVID-19, and EIS [Epidemic Intelligence Service], could\nyou tell me a little bit about your family background and the community where\nyou grew up?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/6","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I am the oldest of three children. I was born in Red Bank, New Jersey, I\ngrew up in Central New Jersey. We lived there—actually my parents still live\nthere. We went to school through the public school system there and it wasn’t\nuntil it became time to start looking at colleges that we started to disperse,\nand I guess disperse we have. Yes, I always a math and science kid growing up.\nWe had a lot of outdoor space, played in the woods a lot, went on little like, I\nwouldn’t call them hikes, but exploring on the trails and playing with the\nneighborhood kids. We were on a cul-de-sac, so it was a relatively safe place to\nspend a lot of time outside.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/7","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: What got you interested in the sciences other than, it looks like, playing in\nthe woods?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/8","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I’m not sure if there’s another sparking interest there. I’ve really\nalways been fascinated with kind of the how of things and even to this day I\noften go for a walk at the end of the workday, which is a bit of sanity\nmaintenance from the work from home environment to just get out, and have a\nsignal. I often am whistling back at birds, I am stopping to look at bees\npollinating the plants, and I am still just kind of fascinated by the little\ndetails, and how a lot of these things fit together, or don’t kind of obviously\nfit together, and I then I like to explore a little more deeply.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/9","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: A natural curiosity of nature. Were you interested in biology when you were\nin high school or once again was it just your natural curiosity in nature?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/10","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, I think to a certain extent it was the path that was laid out for\nus in some ways. In my high school if you were slightly advanced in—I take that\nback. I think even in elementary and middle school I was just more deeply\ntackling science questions and kind of more interested in those kinds of things,\nscience and math. Then when it came time for high school the path that was laid\nout for some of the kids who were either a little further advanced in math, or\nkind of thinking about things, was biology class. We all had to take biology,\nphysics, and chemistry at some point, but early in high school the advanced\nclass for the freshman was biology. I think that, again, really helped spark\nsome more questions, really show me where they were—help explain some of the\nthings I did know, and I think the good metaphor is like an expanding balloon.\nIt’s full of more air so there’s more stuff you know, but the surface area, the\nstuff you don’t know, keeps expanding, so it really helped kind of expand that\nsearch of – okay, I found this thing, where do I look next, I’ve got more places\nto look now.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/11","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Then you went off to college. How did you pick that college?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/12","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I went to the University of Virginia, and I was—there were two of us\nfrom my high school my year I went, and we were, I believe, the second and third\npeople ever from my high school to go UVA [University of Virginia]. A lot of\nfolks, being in New Jersey, there are a lot of really good schools in the\nMid-Atlantic, in the Northeast, that I think people tend to go to, and for\nwhatever reason they tended not to look south all that far, not to look all that\nfar west. I grew up fifteen minutes from Rutgers University, which is a great\nschool, and we would send probably ten percent of the graduating class there.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/13","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I did extensive touring. We traveled up, we traveled west a little bit, we\ntraveled south for a couple of schools, and I really just—it’s funny in\nretrospect to think about the things that resonated with me at UVA, but the tour\nwas great, and there’s also kind of funny stereotype of the tour guides being\npretentious, once you’re a student there, and that was kind of entertaining. UVA\nhas rooms on the Lawn, so the Lawn is—gosh, I’m out of practice, I should know.\nIt’s a UN World Heritage site, but it’s effectively the Quad. There are some of\nthe academic buildings there and lining it are the Arcades? The Colonnades? I\nthink the Colonnades. These are a series of residential facilities, I guess.\nReally, it’s this one room dorm rooms that are reserved for fourth-year\nstudents. Frankly the idea being able to wake up, take a step out, and already\nbe on the Lawn, it really seemed exciting. I took to UVA just kind of generally,\njust felt pretty good there. I did an overnight for accepted students and I\nremember this very clearly, I was staying with some first years, we played\nvolleyball on the courts between the dorms, and we played video games for a\nlittle bit, we watched The Usual Suspects, I had never seen that before. I just\nkind of felt comfortable. I felt like yes, this is a thing, I could do this for\nfour years, this would be neat. It worked out great. I loved my time in Charlottesville.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/14","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It was a bit further away than I think I might have been—I thought I was ready\nfor, but once I settled in, actually partially driven by some weather. I was\nsupposed to come home after the first month or so and Hurricane [Isabel], I\nforget what it was, in 2003, which one it was. It was so severe power was out\nall over town and the train back to DC [Washington DC] and back to home was\nactually not running. I had to reckon with this idea that I wasn’t here for a\nmonth vacation at a time like summer camp, I’m here, and I’m staying here, and\nthat was a really turning point for me. Then I think once I accepted that, once\nI knew that I was there, once I kind of internalized that, really took to UVA,\nand had a great experience there.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/15","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Then you graduated with this BS [Bachelor of Science] in Biology –and then\nwhat did you do?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,0.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/16","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, I knew about halfway through undergrad that I wanted to go to\nveterinary school. Being a math and science kid, I think the tendency is—I think\nthe tendency that follows well is to look at human medicine. It’s more than\nthis, I don’t mean to be too cheeky about it, but I hung out with some of the\npre-med kids, and they frankly weren’t all that much fun. I got to do a little\nbit of work with the animal sciences, took some animal morphology courses, and\nit really just resonated with me. At that point, again, through third and into\nfourth year of undergrad I was going to be Dr. Steve, pillar of the community,\ntreat everyone’s cats and dogs, sponsor a Little League team, that sort of\nthing, and was looking forward to that. I went home. I had planned to take at\nleast a year off between undergrad and vet school. Not a year off, a year to\nwork, to gain experience. I had some research experience from my time in\nundergrad, but I really didn’t have any clinical experience. I’d come home over\nthe summers and apply to vet clinics to be a technician for the summer, and they\nunderstandably wanted someone more than just the summer, they wanted someone to\nbe there for a bit. For one summer I split my time between a—sorry, for one\nsummer I split my time between a pet store, a lab associated with a vet clinic,\nthen I was volunteering for a vet clinic just in my hometown. I was driving for\nthe other two ones, and this was a bit closer where I had contact with a\nveterinarian and he said, yes, if you want to come shadow me a couple days a\nweek, and kind of see what this is like, sounds great. I can’t pay you but come\nsee what this is.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=0.0,1.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/17","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I ended up doing that for two days a week, two days the other onenm[pet store],\nand three for the lab. That summer I found myself quite full getting a good\nvariety of experience. I was an undergrad so when it was time to [graduate and]\ncome home and looking for experience I actually called back that veterinarian\nthat I had been shadowing and asked kind of wink-wink, do you know anyone who is\nhiring someone for a technician spot. He said, I know you’ve got no real\nexperience, but if you want to work here, we’d be happy to have you. I worked\nfor the vet clinic for that year. It’s interesting because at that point I think\na lot of folks who are my path had had clinical experience, had had some of that\nexperience handling cats and dogs, and giving injections, and all these kind of\nclinical things. We had a dog growing up, but otherwise I didn’t really have\nthat experience. My father is allergic to cats, so I hadn’t really had any cat\nexperience growing up. I’ve gotten quite a bunch since and I have a cat now, so\nI’ve come around there.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=1.0,1.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/18","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: What about scaly and feathered?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=1.0,1.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/19","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Not real experience there. I think one of the things that was\ninteresting, it’s funny to think about this being a formative story because it’s\nsuch a small thing, but it stuck with me, I think I was game kind of for\nwhatever came in sometimes. Like I said, I had research experience and at least\nonce, if not more than once, on my day off from the clinic someone was coming in\nwith a pet mouse. And as my friends and parents like to joke, I am a certified\nmouse wrangler, I have taken that training, so I was able to come in and help\nwith that kind of thing. Like I said, I remember one day in particular someone\nhad found I think it was a small garter snake in his trash can, covered in\npacking tape, and he’s like, I don’t know what to do with this, but you guys are\ngreat with my pets, I figured I’d see what you can do. We looked up for some of\nthe potential problems here because even the vet I was working for wasn’t too\nfamiliar with reptile issues, but we looked up how to safely remove this, and I\nspent probably an hour or so with a q-tip and a vat of mineral oil and was\nsteadily slowly disentangling the snake from the bit of tape. Again, it was\nsomething I had no experience with, but we had a pretty good sense of what to\ndo, and how to provide good care for this animal. Fortunately, I had the\nflexibility, I didn’t have to—I was given the leave to focus on this, to\nactually spend the time to do this part right. It was interesting, had a breadth\nof experience there.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=1.0,1.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/20","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"For better or worse, and ultimately for probably better, one of the\nveterinarians, not the practice owner, but one of the veterinarians, was a bit\nless comfortable with my kind of steep learning curve and learning some of the\nthings on the fly, especially when it came to, as we touched on, restraining\ncats, which can be pretty complicated. Especially if we’re talking about getting\nready for surgery and that kind of thing. Combine that with the fact that the\noffice manager had gotten pregnant and was having issues with morning sickness\nand I’m not shy around computers, I spent a chunk of my time, most of the time\nfor the first six months of that year as a technician, but a little bit more and\nmore helping with management things. For the last half of the year, I actually\nspent a whole lot more time being upfront. I was taking phone calls, checking\npeople in when they arrived, which was also interesting because I think\ntypically when you walk into a vet clinic you expect a young female person, and\nto see an early-twenties, over six-foot tall, male person, checking you in puts\npeople, I think, generally at ease. It’s more of a surprise maybe, but I had\nsome really good conversations with folks about their pets and was able to\nhopefully do a good job in that part of it. I also worked a lot with the\npractice management and kind of some of the protocols for running the place,\nsome of the financial work. One of the last things I did when I was there was I\nhelped the veterinarian search for and buy a therapeutic laser, and were looking\nat different real estate spots for him to expand to, and negotiating—not\nnegotiating, I didn’t do any of that, but picking the right credit card\nprocessing deal to kind of understand how the clinic worked.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=1.0,2.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/21","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Remember at this point I’m following his path, I’m going to be Dr. Steve, and\ntreat cats and dogs, and snakes, and mice, and whatever else comes in. I talked\nto him about it, he was really good about giving career advice and kind of\nhelped me on my path. I realized that for one, I was more fulfilled by the\npractice management work than the day-to-day medicine, and for two, I kind of\ncraved a bit more variety. Each individual day was good. Some were not, of\ncourse, but in general the days were good. I’d get to the end of the week or a\nmonth and say, hey, you did a lot of upset stomachs, and skin problems, and new\npuppy vaccines, and this kind of thing, and it’s like, yes, that’s what this is.\nThat seemed ninety-ish-percent of this is that and that ten percent is the\nvariety. I remember thinking to myself, I don’t know if that’s enough. I like to\nkind of bounce around, I like to have just a wider variety of things to think\nabout, to focus on. I still applied to vet school and fortunately had some\nreally good conversations along the way that really helped shaped what I was up\nto next.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=2.0,2.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/22","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: You were trying to expand your balloon and your balloon wasn’t expanding with you.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=2.0,2.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/23","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, I think that’s a good way to put it. At Virginia-Maryland [College\nof Veterinary Medicine], where I eventually went to vet school, the way they do\nthe interview is they have a hot interview and a cold interview. At the hot\ninterview they know everything about you, they’ve got your whole application,\nand they ask you specific questions about your experiences just to kind of\nunderstand what’s not on the page. In the cold interview they know your name,\nand I think they know where you’re from, and that’s it. You just have a\nconversation, you help guide it, and then they help kind of see where it goes. I\nended up applying twice, so the first time I applied the windows are, I think,\nsupposed to be fifteen minutes, fifteen for the hot, fifteen for the cold.\nComing in on like half an hour I actually had to stop my cold interview because\none of the two interviewers was this old Army veterinarian, and we started\ntalking about some of the interests I had picked up through college as things I\nwouldn’t—I wasn’t sure that they’d necessarily be related, but were still\ninteresting to me, in particular food security, but also infectious disease was\nalso a thing that I found interesting, and I really took to in some of those\nanimal disease and animal physiology courses. We kept talking kind of thinking\nabout other ways this can go because I think a lot of folks, and frankly a lot\nof my classmates, a lot of people that I ever talked to, think vet medicine is a\n[strictly] clinical field. It’s really important to have that understanding, but\nthere’s a ton of work that can be done outside of the clinic, and I just hadn’t\nbeen exposed to it at that point.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=2.0,3.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/24","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I remember very distinctly, and this is where the EIS part of the story really\ndoes start a full ten years before I would actually join EIS. Again, this Army\nveterinarian, Dr. Michael Reardon, he, after having the conversation, introduced\nme to Dr. Bettye Walters who was at FDA [Food and Drug Administration] at the\ntime. I believe Dr. Walters has since retired, I’m not sure. He’s [Dr. Reardon]\nlike, hey, this is someone who is interested in doing kind of the broader work,\nis thinking about being a veterinarian in potentially government work to look at\nsome of these issues. Dr. Walters, I think you’d be able to have some good\nadvice for him. We talked, we talked about a bunch of things, talked about her\njob at FDA. She asked me, hey, have you ever heard of CDC’s EIS program? At that\npoint I had not. This was the spring or summer of 2008. I had not, I looked\nquite a bit into it. There’s good stuff on the website and I was able to really\nget a sense of it and it just sounded exciting. It sounded like something I\nthought I wanted to do. I’m trying to think how short I can make this part of\nthe story. I ended up getting into that school [Virginia-Maryland College of\nVeterinary Medicine] but declining. I was an out of state student and when you\nget in off the waiting list in kind of mid to late July, what they do is they\ncall you up and say, hey, congratulations, you’ve been accepted to vet school,\nplease let us know by tomorrow morning if you’re going to accept.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=3.0,3.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/25","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I understand [the urgency] because if I say no, then the person they call\ntomorrow has that same conversation but one day closer to school, so I get that\nfrom their perspective. I actually was getting ready to leave for a friend’s\nwedding, I was going to drive from New Jersey to Virginia and Virginia to\nTennessee. I forget exactly what days it was, but I think they called me on\nMonday, I declined on Tuesday after making a bunch of calls, and Tuesday evening\nI drove down to Virginia. At that point it had been about four, five months\nsince the interview, a couple of months since I talked with Dr. Walters and\nlearned those things—(sorry, my Adobe is uncooperative apparently)—since then I\nhad looked at some other options. I was looking at getting a degree in\nagricultural economics as a potential option and was offered a spot in school\nshortly after that, that was an even tighter timeline. But my younger brother\nwent to Michigan State University, so we took a family road trip to get him back\nto school at the end of the summer, and they just so happened to have an Ag Econ\n[Agricultural Economics] program there. I had a good chat to a couple of\nprofessors and when he was moving stuff into his—I think he was in the frat\nhouse at that point. When he was moving stuff into his room, I was taking\ninterviews. I was going around the Ag Econ school and talking to folks about the\nprogram, and how it might—again, I was really thinking about food security as a\nmajor interest and that’s where I think things could go, that would be a\npotentially good degree for that. After talking to some folks both there and\nback at the vet school I really came to think, and I think this is still true,\nalthough I have to say I’m a bit biased, that the Ag Econ degree was going to be\na bit more focused and narrow than what I was hoping to get from it. One of the\nthings, especially after talking to some of the veterinarians who had a\nperspective that was a bit broader than the clinical only perspective, was that\nthe veterinarian degree really is pretty flexible. It’s the kind of thing where\nI didn’t have to be Dr. Steve and work on cats and dogs, and snakes, and\nwhatever else came in the door, that I could do policy, I could do infectious\ndisease, there’s international work to be done, there’s food security work to be\ndone, and not just the food safety or the production—production animal work.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=3.0,4.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/26","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"At that point I decided that vet school was the plan. I was still okay with my\ndecision to decline, because as an out of state student the math of going to vet\nschool, it was a little bit tough to square. With a better plan and not much\ntime to execute that plan, this being early August I think at this point, I\napplied again. I picked a couple of schools— I think I cast a wider net the\nsecond time. I also knew more about EIS at this point, so I looked for schools\nthat had an MPH [Master of Public Health] option because I knew that was going\nto be important for my EIS application. I wouldn’t know that would be many, many\nyears down the road, but important to know at that point. I looked at the states\nthat I was interested in possibly going to and what it would take to establish\nresidency. It turns out that going back to Virginia with some of the connections\nI had, and the timing was going to work out pretty well, so I moved back to\nVirginia, I got a job in a research lab through some old connections I had. I\nmight have the dates a little bit wrong, but it has been since summer of 2008,\nhopefully I’ll be forgiven for getting the day wrong, day or two wrong, but I\nbelieve I was told I got the job on August 20, which was great because I needed\nto be working in Virginia for a full year before school started to become a\nresident to become an in-state student. That was August 20, classes started on\nAugust 25 the next year.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=4.0,4.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/27","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I was golden, five days, plenty of time. As I’m kind of reveling in getting a\njob, I’m all set, they’re like all it’s going to take is a week-long background\ncheck before we can officially hire you. I’m like, no, that’s the 27th, that’s a\ncouple days late. I reached out to folks around town. I remember this pretty\nclearly— I was applying to be a waiter at a brick oven pizza restaurant.\nFortunately, I got a call back from a job I was more excited about. When I was a\nfourth-year undergrad I had actually done some volunteer work with an equine\nvet. I set it up, so my classes were such that I had, I believe I had no Friday\nclasses. I forget which day it was—I think it was Fridays. This was an entirely\nambulatory practice, so I’d meet him outside of town on Friday mornings, I’d\nspend all day riding around with him, and just getting equine experience. Like I\nsaid, I’m from the suburbs of Central New Jersey, I rode horses at summer camp\nonce or twice, but I didn’t have the breadth of experience, so it was really\ngood to get that from him. When I called him up, I’m like, hey, Dr. [Jeff]\nShane, I’d love to work for you for a little bit. Here’s my situation, I’m\nreally trying to establish residency so if there’s something—I’ll organize your\noffice for a week or something, whatever it is, just let me help out because I\nneed to establish residency. Fortunately [he said] yes, come on board, we’ve got\nstuff for you, we’ll keep you on. I worked for him for a week and switched to\nthe research lab. Which was great, he actually came to give a talk while I was\nin vet school, so I got to reconnect with him and thank him in person a couple\nweeks later for the weeklong job that saved me tens of thousands of dollars\nbecoming an in-state student.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=4.0,5.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/28","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Your path it’s like fate, and destiny, and happy coincidences that just seem\nto all happen almost at the last minute.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=5.0,5.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/29","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: It’s funny you say that because one of the things I do really like to do\nis to talk to vet students and early career veterinarians to kind of pay back\nwhat was given to me, the sense of it’s a pretty broad field. One of the things\nI remember very distinctly was—I feel like I’ve used that phrasing a bit, but\nI’ve got some of these really clear memories. Between second and third year of\nveterinary school I was at a summer program up at Cornell University and someone\nwho is now a friend of my mine, Dr. Jason Baldwin, was running this training\nprogram. He was the first person who told me, and again this was halfway through\nvet school, he’s the first person who told me, Steve, if you don’t want to\npractice clinically you don’t have to practice clinically. You don’t have to do\na year in a small clinic just to kind of show people that you’re a real\nveterinarian or any of that, do what you want to do, you have this flexibility.\nThat’s a thing I really like telling folks as early as I can.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=5.0,5.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/30","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One of the things, and I like that you invoke the metaphor of the path, because\none of the things I tell all the students, anyone I talk to, is that they can’t\nfollow my path. That’s not a reflection on them. Many of the kids I actually was\nspeaking with—I picked up a new mentee on Wednesday, this is a student that I’ll\nbe working for the second, third, and fourth years of her time in veterinary\nschool, and the training she has, the experience she has, the kind of focus that\nshe has at that point, is so far ahead of where I was at that point. This is not\na reflection on their not having the ability to, not being able to follow my\npath, it is just hey, some of these things kind of come up, and you have to be\nable to be walking along your path and look out to the side, and be like oh,\nthat’s interesting, maybe I’ll go that way. It’s one thing to just do that on\nyour own, and hopefully for all these students that I talk to, it’s really\nhelpful to be like Steve told me about something that was kind of over there, I\ndon’t want to go over there, that route’s closed off, but there’s something\nnearby, I’m going to go take a look. Or this looks kind of familiar, so I feel\nempowered to walk down that way and at least give it a try, be game, and see\nwhat comes of it. I think yes, some of the things do feel a bit like kismet,\nthat’s the word I’m searching for, but there’s also a certain amount of\nunderstanding what you’re trying to do, kind of boiling it down to that\nmotivation, and being game, going for hey, this is a way I can solve this\nproblem, I can answer this question, so let’s give it a try.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=5.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/31","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Fortunately, I’m making all these decisions from a place of relative comfort. I\nhave the support to be able to give that a try, go over that way and see what it\nlooks like. They haven’t all worked out, but I probably—there’s a bit of recall\nbias here, I remember the ones that worked out, or the one that taught me\nsomething, of course, as well. It is, I think, really helpful and frankly one of\nthe reasons I was excited to jump at this opportunity, is to get more of a path\nout there. There are people at CDC who helped shape my path doing the same\nthing. Again, the more stories that are out there, the more folks realize that a\nnon-clinical career is an option, is potentially fulfilling, I think is really\nhopefully helpful.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/32","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: I think so too. It’s nice to hear a story where it’s not just go to school,\nget a job, and then you’re out there. Sometimes you don’t really know what you\nwant even when you are in college or even before college. It’s important to know\nthat you don’t have to always decide everything when you’re eighteen.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/33","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, like I said, I was really excited about EIS, but I also remember\ntelling people during interviews, they’re like, wait, you’re not going to work\nin a clinic, what are you doing to do, and I told them, and I felt confident in\nthis answer then, and it fortunately worked out, like I don’t know, but I have a\nsense of the kinds of things I want to do, and I want to go to vet school, and\nget those experiences, and give it a try. I’m going to get that experience— I’m\ngoing to see—fortunately for me I knew the rotation schedule was pretty\nflexible. I didn’t know which would specifically be my options a couple years\ndown the road, but I was going to work at an import center and see if that was\nwork, I wanted to do. I was going to have an office job, I had never had an\noffice job before. Just to see what it was like to be a veterinarian who sits at\na desk and works the computer like I do all day every day at this point.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/34","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Right, because we talked about something called a public corporate track. I’m\nnot quite sure what that means when you’re talking veterinarian, vet,\npublic/corporate vet—","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/35","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Virginia-Maryland, I’ll actually use the full name even though the\nalumni are salty about it, it was the Virginia-Maryland Regional College of\nVeterinary Medicine and I think there’s a sweatshirt on the couch behind me\nthat’s got the R for regional. But a couple of years ago they became the\nVirginia-Maryland College of Veterinary Medicine, and they dropped the regional,\nand now all of our alumni gear has that weird typo. Virginia-Maryland tracks.\nFor all vet students you have to declare a track, which is kind of like\ndeclaring a major in undergrad. You can track small animal, you can track large\nanimal or production, you can track equine, you can track mixed animal which is\njust like it sounds, a bit of everything, and you can track public/corporate.\nThat is becoming kind of a catch-all. It’s everything from shelter medicine to\nwelfare policy, to zoo medicine, to what I ended up doing, being an\nepidemiologist and working in public health. The corporate side I think that\npeople certainly know about the vets at a clinic like Banfield, but they also\nemploy epidemiologists and people that knew that kind of work, they’re industry\nveterinarians who work in the research lab, who work at the bench top. It can be\na bit of a catch-all but one of the nice things is gives you the latitude to go\nwithin that and get those experiences. Fortunately, with some of the other\ncampuses that are part of the Virginia-Maryland part is there is the proximity\nto DC and there’s other experiences to get, other connections, to some of the\nfrankly people that we might not otherwise have access to. I remember at some\npoint in vet school we had Dr. John Clifford come talk to our class.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/36","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"He at that time, I believe, was the Deputy Administrator of Veterinary Services\nand he was the chief veterinary officer for the country. He was a representative\nto the World Organisation for Animal Health. He was giving us a lesson about—it\nwas a retrospective on the Cow that Stole Christmas, which is a case of bovine\nspongiform encephalopathy, Mad Cow, that was detected in, I think, the week\nleading up to Christmas in 2003. Giving us the history and talking about what\nthey would do, kind of what the response was. For a learning experience it was\ngood timing because not a month later there was another BSE detection and we got\nto see Dr. Clifford really playing out the kinds of things that he had been\ntalking about. Blacksburg [Virginia] is a couple hours’ drive from USDA\nheadquarters [in Washington, DC], so our proximity got us some access to folks\nthat might not have otherwise come down for those kinds of talks. Frankly our\nprofessors had connections to those folks as well, so it was really good to get\nthat kind of great experience, that perspective of, again, what these jobs can\nbe like, what this work can be like.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/37","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Another fortunate perk.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/38","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/39","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: That’s what the public/corporate track is and that’s what you went for? That\nwas your track?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/40","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/41","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: How did you incorporate—well, that would be easy. How did you incorporate\npublic health into that? Are you doing your vet and masters at the same time?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/42","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, that’s actually a great thing I should bring up is that the MPH\nprogram was launching when we were arriving. It had not officially launched\nbefore we started school but when I got into—when I was—I actually got\n[accepted] off the waiting list the second year as well, just a little bit\nearlier this time, I was on the phone with Dr. François Elvinger while he was in\nLuxembourg because he was, I think, taking the summer off because professors are\nable to do that kind of thing sometimes. But I called him and I said, Dr.\nElvinger, I’d love to attend Virginia-Maryland, I’m going to be in-state, this\nis going to work out, but I need to know that this MPH program is going to be a\nthing, that I’m going to be able to finish with an MPH, because as we talked\nabout earlier, I need that MPH for EIS, it’s got to happen. I had actually been\naccepted to the University of Illinois, which had an established MPH program,\nthough I would have been out of state, I think. Who knows what would have\nhappened if I didn’t get into Virginia. I think I was prepared to go out of\nstate because I was going to get the MPH because I knew that was there.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,6.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/43","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One of the interesting kind of somewhat formative things for me that was\nunexpected was we got some input on what this program would look like. It\nlaunched while we were in vet school, so our first year there wasn’t all that\nmuch going on, but during our second year we started to—I think we took a class\nor two on top of that curriculum, but we also talked about what the path would\nbe like for the students, what it was going to be. Because initially there was\nsome discussion about just taking enough classes during the four years, having\nno extra time. Then at some point there was a proposal to do two years of vet\nschool, take a year off to do MPH things, and then rejoin the vet school stream\nwith the class behind us for the other two years. We were able to push back\nagainst that. Again, being in the room with a handful of professors, and the\neleven of us in my class. I think twelve. There was someone in the class ahead\nof us who was also coming along. Effectively negotiating what our program was\ngoing to look like was really interesting and I found myself in a—excuse me. I\nfound myself in what would eventually become a familiar position of leading by\ndefault or kind of looking at a place where, well, something’s got to get done,\nand I don’t know if I see other folks doing this, so I’ll just start talking,\nI’ll just kind of work on this. Over time that confidence builds on itself, and\nyou learn oh, I—I don’t want to get too philosophical or self-aggrandizing here,\nbut oh, my opinions are valid. My thoughts are worth talking about, and\nsometimes that’s because that’s what other people are thinking, sometimes it’s\nbecause people aren’t thinking, and it sparks thoughts in them. It was worth\nwhatever potential embarrassment of saying the wrong thing, of just feeling\nanxious about talking, to start things going to kind of help facilitate that\ndiscussion, and frankly make sure that my thoughts, but also the thoughts of my\ncolleagues, were coming out.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=6.0,7.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/44","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: That was a fairly collaborative environment. You were allowed to voice your\nopinion, others were voicing their opinions, and together you filled in the gaps\nthat needed to be filled.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=7.0,7.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/45","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, certainly. It was really pretty empowering to give to the students\nthe ability to have that chance to shape things or even just to provide the\nfeedback. I think there’s probably a bit less of that now, but when the program\nwas starting, especially for those of us who were already in the vet school\nstream, it was really nice and it was a good bit of care, frankly, for them to\nsay – hey, we’re going to meet you where you are, and we’re going to talk about\nhow to do this thing alongside you. The path we ended up taking is a couple of\nextra classes along the way, some summer courses, and then a semester after the\ncurriculum ended to focus on MPH classes to finish everything up. We also got to\nuse our—with the public/corporate track our fourth year of seventeen three-week\nblocks, that’s how fourth year goes, for us at the time at least, we had a lot\nof flexibility. I spent about half of the year outside of Blacksburg because a\nlot of the rotations I was looking to do—we did basic ones that everyone has to\ndo— of surgery, and anesthesiology, and large animal medicine, and community\npractice, and a few others I’m blanking on at the moment, and those have to be\ndone at the vet school. But to get the public/corporate experience, you’re\nfrankly not going to get it in Blacksburg.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=7.0,7.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/46","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I was able to get some local agricultural, local animal health experience at an\noutpost of the state Ag [Agricultural] department, but otherwise I was in\nRichmond, Virginia at the state health department, I was up in Middletown, New\nYork, Newburg, New York, for that import center where very expensive horses come\nthrough. I was in Fort Collins, Colorado working in a cubicle for a couple of\nweeks. I was down in Atlanta, Georgia doing the CDC epidemiology elective for\nsix weeks. Six weeks for that one, which ended up being another kind of fun EIS\nconnection because I was looking at housing at Atlanta, they have a housing\nboard that helps set things up, and the person who I ended up staying with, Dr.\nDanielle [M.] Tack and her husband Dr. Paul Hollier, these are both\nveterinarians, they both were in the military, and at least Dr. Tack, if not\n[also] Dr. Hollier, were EIS alums. They happened to have a room at a good rate,\nand they were helping that student kind of find a place to live for two months\nin Atlanta. I saw Danielle at a conference a month ago, and we’re still in\ntouch, and she’s connected me again somewhat incidentally to some of her EIS\nclassmates, and some other folks, and the network—again, this is as a\nfourth-year vet student who’s telling everyone who will listen he’s going to do\nEIS, people are excited about that. I remember talking to Dr. Jennie [Jennifer\nH.] McQuiston about EIS kind of in general. We were there because we were doing\na fourth year—we were getting ready to do a fourth-year rotation project on the\nSan Carlos Apache Nation in Globe, Arizona. Which, as I came to learn later,\ncurrent at the time EIS officer Dr. Laura Adams, also a veterinarian, was\nrunning this project, and this was to do some spay/neuter work on the\nreservation because of Colorado Tick Fever—nope. RMSF Rodeo, Rocky Mountain\nSpotted Fever. Colorado Tick Fever was an EIS experience.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=7.0,8.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/47","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And we’re talking to Dr. McQuiston about some of the plans and we’re like— Oh\nhey, by the way, I have some questions about EIS, and she just cut me off and\nsaid, apply. Well, I want to kind of—she’s like, you should apply. So, it’s\nthe—you should apply. Message received. She was right. I think she knew enough\nabout me at that point and frankly why I was there. This was at CDC’s vet\nstudent day. For a variety of reasons, I think the answer was obvious and in\nfront of her. Frankly she could have spent some time talking about the details,\nreally going into it, but the thing I needed to hear from her was the story that\nstuck with me, which was apply.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=8.0,8.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/48","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: What year was that?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=8.0,8.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/49","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: That would have been I think January or so of 2012.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=8.0,8.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/50","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: This was before you graduated.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=8.0,8.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/51","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, the project in Arizona was actually one of my rotations where\nwe—again, this is one of these chances to be game and solve the problem, we were\nat a spay and neuter clinic at the Boys and Girls Club on the reservation out\nthere. Which one of my favorite pictures from that is I’m wearing gloves, and\nI’ve got my surgical equipment, and I’ve got a mask on, but I’ve got an old\nbaseball cap with a little work light attached to it. That’s my surgical light\nand you can see that it’s not a typical veterinarian surgery suite around me,\nbut we were there to do some work. It was a really good experience. I got a ton\nof surgery experience in the way that we really didn’t get at that school, but I\nreally enjoyed. Later that year, during my fourth year, again we had those\nseventeen blocks, and I used it to get a variety of experience, to do my MPH\nproject on rabies post-exposure prophylaxis with Dr. Julia Murphy, the state\npublic health vet in Virginia, and also to see what her job was like in the wide\nvariety of things that came in the door for her.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=8.0,8.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/52","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But one of our seventeen blocks is vacation, three weeks of vacation. I had just\nbeen basically saving it trying to make sure I had space in case a travel plan\nwent wrong, or something like that, so if I had to take it in October then I\ncould take that trip I was supposed to take in October in April toward the end\nof the year. Fortunately, none of those hiccups happened and I had my vacation\nblock as my last block. Right in the middle of that block was the EIS conference\nthat year. It’s a six-ish hour drive from Blacksburg to Atlanta and EIS\nconference is free to attend. I just had to figure out where to stay and I\nwanted to go. I actually reached back out to Danielle, Dr. Tack, who introduced\nme to Dr. Amy Peterson, another veterinarian, another EIS alum, who was renting\na house for a week, and it had an extra room, so I ended up staying with Dr.\nPeterson for that week, and attending conference, and attending Dr. Adams’ talk\nabout the project I had done out in Arizona. Just kind of seeing that I—similar\nto my experience at UVA where maybe I was a little bit less sold on it at the\ntime, but I was there, and I kind of felt like yes, this feels good, and\ncomfortable, and I like these people. I went to the EIS conference, I knew at\nthat point I wasn’t going to apply right then, I still had intended to, but was\ngoing to finish up the MPH and apply following that. It was just a good time. I\nenjoyed going to the talks, I went to skit night which was kind of fascinating\nto see. But again, after going to a week of really professional and impressive\ntalks to see, oh, these are real people too, was a great reminder for me. I\nstill have a very grainy video of them doing the Thriller dance and I think they\ndid the Harlem Shake, which again, it was the spring of 2013, so some things\nhave come and gone since then. Yes, it was really neat to get to go see that and\nit only kind of strengthened my resolve that that was going to be on my path.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=8.0,9.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/53","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Excellent. Then you graduate with your MPH and where are you now? Where are\nyou going now?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=9.0,9.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/54","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I mentioned when I met Dr. Jason Baldwin up at Cornell, part of that\nprogram, part of that week-long summer experience was going to Plum Island. The\nPlum Island Animal Disease Center, which is a USDA and DHS [Department of\nHomeland Security] run research lab off of Long Island in New York. I had gone\nup there and got experience, and by that point my friends knew me as the foreign\nanimal disease guy. When stuff came up, they’re like oh, Steve, you should take\na look at this. There was an ORISE scholarship, Oak Ridge Institute for Science\nand Education, or Science Education, I forget, an ORISE opportunity at Plum\nIsland. This is one of the great thing about ORISE is that you get that access,\nyou get that exposure that you wouldn’t have gotten, not as a fresh out of vet\nschool, even with an MPH person interested in that kind of thing, I was not\ngoing to get a federal job at Plum Island. Those are tougher to come by. But I\ncan get an ORISE fellowship and I can get up to Plum and do some interesting\nwork right away, right out of school, not have to get some more experience before.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=9.0,9.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/55","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I was hired to this position with USDA ARS, the Agricultural Research Service,\nin the Foreign Animal Disease Research Unit. My project was effectively to\ndetermine whether or not an infrared camera was an effective tool at diagnosing\nFoot and Mouth Disease. One of the things that was a pretty big limiting factor\nin the UK [United Kingdom] when they had an outbreak of Foot and Mouth Disease\nin 2001 is that veterinarians would go on to an infected farm and they’d have to\nsit on the bench for five days after that. You couldn’t go to the next farm, you\ncouldn’t investigate the next farm because—this is complicated and somewhat\ndebatable, perhaps, but you were a risk of spreading disease to that farm if you\nwent to the next one. But it took a veterinarian to diagnose it, you had to do a\nclinical exam on the cattle, on the sheep, whatever it was, to determine if they\nhad Foot and Mouth Disease on the premises, so you had to do that. The idea of\nthe infrared camera was what if you could sit at the fence line, you could sit\noutside, or you could even use someone who was specially trained in this, or\nfrankly wasn’t as focused as a veterinarian might be as far as the training\nexperience, and you could get at least get a sense, you could get a screen of\njust shooting an infrared camera looking for—frankly look for hot feet and hot\ncows, and say, hey, we didn’t do a physical exam, but we suspect diseases here,\nso we’re going to do all the quarantine, we’re going to do our intervention\nhere, and really help stem the potential spread a bit more quickly.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=9.0,9.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/56","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I was hired for that project, I did a bunch more when I was at Plum. The\ninfrared camera is affected by surface textures and it’s doing surface\ntemperatures so one of the things that happens in the room with the cattle is\nthey get washed down every day, which is great, and helpful, and very important\nfor a variety of reasons, but if you’re going in with an infrared camera and\nyou’re taking a picture of wet cattle, they’re going to look artificially cold,\nso your project is not really that helpful. I would take the boat to work\nbecause Plum Island is an island. Take the boat to work—I guess I would take\nDramamine and then take the boat to work every day for two and a half years. I’d\nget to the animal rooms early, take my infrared pictures, and then help the\ntechnicians with some of the prep because we had to do the cleaning before we\ndid the other experiments where we did nasal and oral swabs for Foot and Mouth\nDisease, where we did physical exams, and that kind of thing. My mornings were\noften go and take some pictures, put the camera in the pack, and then help out\nwith the experiment for that day. Then in the afternoon come back to the lab and\nprocess the samples, run the assays. I ran, I guess it’s technically not\ncountless because I have my logs and can tell you how many I did, but\neffectively countless ELISA [enzyme-linked immunoassay] test samples to\nunderstand some of the cytokine profiles, and I was doing that for basically two\nand a half years. The ORISE program is a one-year program, or one year at a time\nrather, but at the end of one year you and your supervisor have the option to\nmutually renew.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=9.0,10.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/57","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There are a couple other projects, I went up to the University of Vermont to use\nthe infrared camera in the field, which was really interesting to work on the\ndairy for, gosh, I was there for three weeks I think, and then back for another\nweek later. The whole time being very worried that I was going to spread Foot\nand Mouth Disease to domestic cattle. I guess I should note, Foot and Mouth\nDisease, which is what we study there, has not been detected in this country\nsince 1929. It is genetically similar, it’s related to Hand, Foot, and Mouth\nDisease that children often get, but it’s a different virus specifically for\nlivestock, and some other assorted species, but mostly for livestock. It’s not\nzoonotic, so would not really affect us directly, but it’s a really important\nOne Health pathogen because of what it does to food security. It’s not great for\nthe cattle. It doesn’t often kill the cattle, it sometimes is fatal to young animals.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=10.0,10.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/58","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Virus or bacteria?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=10.0,10.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/59","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Virus. Yes, it causes production losses. It makes production animals\nless productive. They produce less milk, they produce less meat, they gain less\nweight, and that has the knock-on effects of making the animal products more\nexpensive because there’s less of it, so there’s some scarcity, but then the\npeople that are producing them are producing less, so their economic\nremuneration is lower, and it really causes some knock-on effects that can have\nsome serious problems. Even though humans won’t get sick from this virus,\ninfections can still cause serious health problems to humans indirectly. It’s a\ndisease of economic importance. When I was going to the farm up in Vermont, we\nmade sure that I had a cool down period outside the lab for a couple of days to\nmeet guidance, and again, we’re just very careful to not frankly torpedo my\ncareer in veterinary medicine if I was the person that brought Foot and Mouth\nDisease back to the US. There’s a special dispensation to have the virus on Plum\nIsland and that is the only place in the country, I believe, where it exists.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=10.0,10.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/60","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: That’s only used in the lab there on Plum Island.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=10.0,10.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/61","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=10.0,10.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/62","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: So—go ahead.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=10.0,10.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/63","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: No, I was going to say EIS was the next step in my plan. I had actually\ngotten my materials together and had applied, I’m trying to get my timing right,\nI had applied to the class of 2016, so I was up at Plum from fall of 2013, as I\nwas actually finishing my MPH from afar, and I actually went back to Virginia to\ndo one last test and presentation in December, and I was there [at Plum] again\nfor two and a half years. I was applying to the [EIS] class of 2016. I actually\ndid not get in, I did not get an interview, which was disappointing. I had\ntalked to some folks in the program, people had been mentors of mine along the\nway like Dr. Tracy Dutcher, who is at USDA, who is an alum, and I did a rotation\nwith her in [vet] school, Dr. Stacey Bosch, who I think is just now leaving the\nprogram, but was a veterinarian with the EIS program for a while. I had done my\nepi-elective with her in DFWED, Division of Foodborne, Waterborne, and\nEnvironmental Diseases. That was my first actual CDC experience looking into\nsalmonella and pet turtles and learning how many people will hug and kiss their\nturtle goodnight and then maybe get sick with salmonella. I talked to Dr.\nDutcher, Dr. Bosch, again some folks that had been helpful along the way, and\njust thinking about what I might do if EIS was not going to happen, at least not\nat this point. I took the somewhat typical approach of applying to everything on\nUSA Jobs trying to figure out what the next step might be. Fortunately, I found\na job with the Select Agent program, which is a program that is co-run by USDA\nand CDC to inspect high containment labs frankly like Plum Island, like other\nplaces, and in this case my high containment lab experience had served me quite\nwell because it was experience that a lot of folks didn’t have.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=10.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/64","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Plum, we talk about being worried about taking the virus back with you, there\nare some interesting ways in which that manifests. For one is you shower out of\nwork every day, every time you leave an animal room you shower, so some of those\ndays when I was going in early to take my infrared pictures and helping with the\nexperiments, and actually would for one set of experiments came back in the\nafternoon to take pictures again, I was taking five showers a day at work.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/65","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Dry skin.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/66","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, it’s funny the conversations you have with some folks when you get\nup there, they give you recommendations on the best lotion. We have health\ntechnicians who do a ton more going in and out of the rooms, you see some guys\nshow up with I guess really any hair is the important thing, and pretty quickly\nthere’s a lot of buzz cuts that happen, a lot of just making that part easier\nbecause you’re showering, again, a lot more than I was even, every day it’s part\nof your job, anything to make it easier, make it quicker, was the way to go. But\nsome of those other funny ways are I remember being out at a bookstore in\nConnecticut where I lived and at some point, turned around, an outdoor mostly\nbookstore, and they had a goat on the premises. Well, I had left work two days\nprior, because this was a Saturday or a Sunday, and I had been in the lab, and\ngoats are susceptible, and my quarantine period was five days. I very quickly I\nwas like, I have to go. I was there with someone, we had to leave very quickly\nonce I realized that. Or the time I ran into a petting zoo at the mall, and I\njust turned around and did my shopping elsewhere that day.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/67","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Wow. I can’t imagine being with someone and them saying – We’ve got to go,\nthere’s a goat here.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/68","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I actually took a vacation with friends of mine, we went to Chicago for\na week, and we did a bunch of interesting stuff that was a lot of fun, but we\ncouldn’t go to the zoo because I wasn’t allowed to be there. Another kind of\nfunny quirk, to help, if nothing else, maintain my sanity the whole way through\nI played in band, I played the horn. I learned through—actually when I was here\nin college, no, when I was here in vet school rather, I brought my horn with me,\nI played with the community band for the month and a half just because it was\nfun to get out and play. I had played with community bands in Charlottesville\nwhen I moved back there, I was playing with one in Blacksburg when I was in vet\nschool, and when I moved to Connecticut, I played with the Old Lyme Town Band up\nthere. At some point it just kind of came up that I worked at Plum Island, and\nthe conspiracy theories are fun about that place, and quite well known. When I\nmentioned that everyone around me just like moved their chairs a little bit\nfurther away.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/69","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But this was actually it was in service of getting the band there. I, in kind of\nan effort of—I think part of it because I thought it was entertaining to have\nthat reaction but to help demystify it, to do some public health outreach and\ncommunication, I worked with our folks, the public communication people at Plum\nIsland often had people come visit the island. It was the Garden Club and\nwhoever else, and this was a great chance for me. I was like, if the band is\ninterested, we should bring them out there, and really kind of help demystify\nthis place. It was great, to get my timing right it was probably in 2015, so I\nthink it was seven years ago last week that the band came out to visit Plum, and\nI have my picture reminder of that the other day.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/70","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Oh, did it come up on your phone?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/71","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes. Just exciting to get folks out there. But again, to help take this\nreally secretive work, it’s not secretive by nature, it just has that\nreputation, and help show folks. I talked about Foot and Mouth Disease and\npeople didn’t know what it was. Understanding why it was important to do that\nwork out there I think was important for me to help understand that. I don’t\nknow if I knew it at the time that’s what I was doing but it was nice to kind of\nconnect that work to the broader public, for me another part of my life in\nplaying with bands, but also just another set of the public to understand kind\nof what we do, to help tell more folks that veterinarians are not just in the\nclinic sometimes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/72","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Then you demystify the whole Plum Island thing, and they can go and tell\ntheir friends that oh no, it’s not aliens.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/73","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Right. You joke about that, that’s a—the Montauk Monster is a fun\nconspiracy theory.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/74","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Wait, what’s Montauk Monster?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/75","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Montauk is a mostly resort community on the end of Long Island. Plum\nIsland is actually closer to the north fork of Long Island than anything else,\nalthough the boat ride I took from Connecticut was a bit longer, there was just\nmore to do in Connecticut than that part of New York, so that’s where I lived.\nThe Montauk Monster is, I believe it was a raccoon. It was some unfortunate\nanimal that drowned and washed up on the shores of Montauk but because it had\nbeen in the water for so long really just started to look kind of weird and a\nbit different, and because it was close to Plum was very quickly tagged as some\nescaped biological project. Just again, fed into that Plum Island created Lyme\nDisease and used it as a bio-terror weapon, which is a good bit of nonsense,\nthere are a bunch of reasons to know that’s not the case. It did lead to a very\nawkward lunch actually when I caught up with a friend from college who had since\ngotten a job at a Lyme Disease non-profit and herself believed that conspiracy\ntheory when I was working at Plum. It made that lunch a little bit awkward to\ntalk through that.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/76","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Yes, I just looked it up on Wikipedia.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/77","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, not an alien but maybe closer than folks might expect.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/78","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: It’s a gruesome picture.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/79","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I got the Select Agent job and was inspecting labs for a couple of\nyears. USDA, specifically Veterinarian Services, every so often will sponsor an\nEIS officer. In the spring of 2017 there was an educational webinar, there was\nan advertisement for this, and again I had been thinking about it, had been\nthinking about getting my application back together, but really wasn’t sure. I\nhad kind of frankly by not getting an interview, not getting in, I was a little\nbit unmoored from my plan in trying to figure out what to do. When this\nopportunity came along, I took a quick moment to think, well, it’s a training\nprogram, EIS is—I’m already a federal employee, I’ve got some training since I\napplied last time, is it really something that’s going to benefit me, and I very\nquickly dismissed that as nonsense because yes, of course it will. I applied to\nthe sponsored position and was fortunately enough to be accepted. Through the\nlong process of applying to EIS, again, I applied in—I applied to USDA in the\nspring of 2017 with the intention of starting EIS in the summer of 2018 because\nthat’s how the timeline goes. Fortunately, I was picked as the USDA sponsored candidate.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/80","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It’s funny I was telling someone just yesterday— it wasn’t entirely clear to me\nif I was guaranteed a spot in EIS because of that [USDA sponsorship]. I still\nwent through the CDC application portal, and I did interviews, and that kind of\nthing. I was pretty confident that I was in because of the sponsored nature, so\nI perhaps was a little more relaxed during my interview than I might have\notherwise been, which I think worked out great. Again, fortunately was accepted.\nFinished up my Select Agent work and again the timeline is pretty—it’s a long\ntale on that application, but still was able to do inspections with Select\nAgent, and was glad to then start the next thing, to get I don’t know if back on\ntrack is quite the right word, we’ve talked a bit about how the path is not\nreally set out, but to get back to the way point I was really hoping would be\npart of my path.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/81","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: This is something that you’ve been, I don’t want to say dreaming of, but\nreally wanting to do since early 2000s, mid 2000s, and now you’re there.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/82","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, since talking to Dr. Walters in 2008 and learning that EIS existed.\nThen talking to people during that school because I was at CDC for the\nepi-elective, Dr. Bosch herself is an alum, and there were other folks in DFWED\n[Division of Foodborne, Waterborne, and Environmental Diseases] who were alumni,\nand they connected me to other EIS alumni, and it’s a great network, and it did\nvery little to slow the momentum of me wanting to go that way. Come winter—or I\nguess fall of 2017, I believe when Jenn Wright called me and let me know. Dr.\nJenn Wright who was also frankly in DFWED when I was there as a student for five\nyears prior. It was really exciting still to get that call in the fall of 2017\nand start to plan for what was going to be next.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/83","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: They usually call in October and then you don’t go to EIS until April?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,11.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/84","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, the EIS conference is when everyone matches. For mine it was in\nApril, it’s pushing into—I think this past year was in May, the next year is\ngoing to be in the kind of end of April beginning of May timeframe. This is a\nthing I didn’t realize when I was a vet student attending an EIS conference, I\nwas just going to talks. A lot of people are just going to talks. But the\nincoming officers are spending their entire week in this weird week-long speed\ndate experience of talking to prospective sites and just trying to figure out\nthe best match. I got some really good advice during that process, kind of\nleading up to it, specifically I remember hearing it from Dr. Casey [E.] Barton\nBehravesh, who was also in DFWED at the time when I was a student, so we kept in\ntouch, but she is now and I believe at the time then even, was director of the\nOne Health office, and in a nice bit of symmetry is someone that I work with on\nan at least weekly basis now at my current job. Casey told me it’s in order, if\nyou can, it’s people, then projects, and then place. When you’re trying to match\nwith an EIS spot, the most important thing is that you get along with\nsupervisors, that you’re going to mesh well. EIS, the program does a nice thing\nof connecting you with an EIS big sib [sibling], a current officer to help just\nkind of answer questions. I remember mine in particular saying he’s got family\nnear where his assignment was and he really felt the work was interesting, but\nsometimes he didn’t have quite the same— style, same work style, as his\nsupervisors, and it made the experience not great at times. Which again, he\nchecked the place box, he checked the projects box, and I don’t know if he knew\nthis coming into it, but the people part really can be overriding.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=11.0,12.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/85","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"With that in mind, I went to go match. I knew coming into EIS—I should back up a\nlittle bit. With the USDA program, with the sponsored position, you remain a\nUSDA the whole time. I was a USDA employee effectively on loan, on detail, with\nCDC for two years, which comes with a continuous service agreement. I was going\nback to USDA when I was done [with EIS], I’m in the middle of that [obligation]\nnow. But one of the really nice things, because I know other entities will\nsponsor positions sometimes for foreign health ministries, and the military will\nsponsor officers sometimes, and I think sometimes the—I think the plan can be a\nlittle bit more laid out for them. When I was talking with the program folks at\nUSDA I asked should I go somewhere in particular, we’re going to do a lot of\nfoodborne work at USDA, should I go to DFWED? And what they said was go where\nyou want to go. We want you to get the EIS experience and we don’t want any\nrestrictions on it. Which was great. I was glad to have that flexibility. I\nstill used that coming back to VS [veterinary science] perspective to help\ninform my choices but for me EIS was always going to be—not always, after a bit,\nat least to kind of crystalize in the years coming up to it, but it was going to\nbe a field experience.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=12.0,12.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/86","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I think I would have been happy at headquarters, there’s interesting work to do,\nbut stemming a lot from my experience with Dr. Murphy at the Virginia Department\nof Health and seeing just the variety of stuff that came in, working on issues\nwith local shelters and unowned cats, looking at rabies in livestock, look at\ndisease disaster response teams, and studying for that training over the course\nof a week, when I think back to working in that clinic it wasn’t ten-percent\nvariety and ninety-percent kind of routine things, it was seventy-five,\neighty-percent variety, and the rest of it was routine things, so that kind of\npace, that variety really appealed to me, so I was going to be out in the state.\nThe way EIS conference is set up, the state and local departments that are\nmatching up are in their own room and then the different—I think it’s organized\nby center, the headquarters positions are in other rooms. I walked around a\nlittle bit, I went to some of the center-based rooms, but I spent most of my EIS\nweek as an incoming officer in the state room, and just talking to folks. It’s\nsuch an interesting experience where you have your spiel, you have your\nquestions, and you sit down with supervisors in Oregon, and you have a five to\nfifteen minute conversation about those things, and you get up, and you walk ten\nfeet to the table for Minnesota, and you have the same conversation, sometimes\nwithin earshot of the previous table, and you get up and you talk to Washington,\nand you get up and you talk to Arizona, and you do that kind of day after day.\nIt’s not the same thing, but if you like a position, you go back the next day\nand you just—again because I had that lens, that framework of the people part,\nreally focusing on that, I just wanted to talk to folks. I wanted to get a sense\nof what it might be like to work with them. I remember very distinctly the two\nsupervisors who were there for Oregon, we talked about playing cards, we talked\nabout one of the supervisors is from effectively the same part of Jersey that I\nam, but she and her husband had been in Oregon for a while, and we talked about\nthe food that we missed from home. Talked about work of course as well, but it\nwas really nice to get a more human picture of these folks.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=12.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/87","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I got that sense from other people as well, other states, but Oregon sticks out\nbecause that’s where I ended up going. One of the things, and to this day I\npoint it out to incoming officers, and really it was one of those things that’s\nimportant, it’s not necessary, and it wasn’t on its own going to be enough, but\nin the Oregon position description I believe the phrase they have is “excellent\nsoup club”.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/88","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: What does that mean?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/89","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: On Tuesdays through the winter the Oregon Health Department, the Oregon\nHealth Authority, specifically through Acute and Communicable Disease\nPrevention, where I was stationed, runs a soup club. Which is there are three\nsoups each day and everyone signs up over the course of the season, and you\nbring in a crockpot full of soup on your day, and that’s your ticket. If you’ve\nsigned up, then you get to show up next Tuesday and just eat soup that someone\nelse brought. There’s a vegetarian option, there’s a meat option, there’s a more\nflexible like chef’s choice option there, so everyone has got something\npotentially. Over the course it’s really a nice way to talk to folks, it’s a\nkind of fun thing for people to participate in.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/90","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Do you swap the soups? Do you get to take them home?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/91","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I think you’re supposed to take yours home at the end. There’s not\nusually that much in the way of leftovers. But it was also, it’s funny to think\nabout this, because when you’re at EIS conference as well, you’re getting along\nwith your colleagues, you’re meeting your classmates often for the first time.\nYou met some folks during interviews and all that, but that was nine months ago.\nMy colleague and a good friend of mine, Michelle Holshue, who was the officer\nwho matched to Washington, gave me great advice as far as this question as kind\nof a proxy for the social environment at the department was to ask about where\npeople eat lunch.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/92","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Were people at their desk, are they going out to lunch together, are they\nmeeting in a cafeteria, and again, soup club—did I eat lunch at my desk most\ndays at Oregon? Yes, probably. But every Tuesday in the winter was I having\nsoup? Every Tuesday in the summer it became salad club because soup is not a\ngreat summer food. Was I having soup in the winter and salad in the summer every\nTuesday? You bet. Spending that whole time getting to know my colleagues, the\nfolks in Oregon who really became good close friends. I know we’ll touch on a\nbit with the pandemic response, but having friends, being able to walk into a\nroom and see my friends, who happen to be smart talented people as well, and\ndoing good work, and dedicated to it, really made stuff a good bit, frankly, easier.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/93","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Sounds like a wise decision to do people, project, and place.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/94","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: It worked out great and it’s the advice I give anyone and everyone who’s\nwilling to listen.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/95","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: [laughs] That’s great. Did you move from Virginia to Oregon?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/96","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I feel compelled as someone who didn’t know coming up there, but now\ndoes know, it’s not Oregon, it’s Oregon.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/97","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Thank you, Oregon.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/98","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yeah, Oregon is actually full of shibboleths.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/99","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: What?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/100","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Shibboleth.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/101","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: You’re going to have to spell that later.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/102","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I don’t know that I can. I can try. It’s actually a biblical story. It’s\na word—it’s pronouncing a word to kind of show the people that you belong. In\nthis case, I forget what the story actually was, but because of the dialect of\none of the groups at war, they couldn’t pronounce—they didn’t pronounce\nshibboleth in the same way, so you could actually tell who was trying to maybe\nbe a spy and get through, or that kind of thing. In Oregon, if you say Oregon,\nif you mispronounce the name of the river, which is the Willamette River, there\nis Couch Street, which is spelled like couch. These are all these little\nshibboleths. Some of these things that are—I think shibboleth is by definition a\nspoken thing, but I learned really quickly there were a lot of markers for\nOregonians that you’re not a local. If, for example, you use an umbrella when\nit’s raining because true locals, they have the rain gear that they need, and\nyou know what, sometimes it’s just kind of a light rain and you don’t need\nanything. I say that kind of jokingly, but I really came to adopt that over\ntime. I still have an umbrella in my car just in case. I mentioned going for a\nwalk at the end of the day and we don’t really get a light drizzle in Atlanta,\nso it’s not borne out the same way, but if we had one of those, I would\nsometimes just keep walking, don’t need a coat, don’t need an umbrella, it\nshould be all right.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/103","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Until you reach that place where they have incredible air conditioning and\nyou’re wet and damp.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/104","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, definitely coming in from that was important. From Connecticut I\nmoved to Virginia for the Select Agent job because that was my first experience\nwith remote work. That job is based out of your home except when you are\ntraveling. I traveled forty, fifty percent of the time, and when I wasn’t\ntraveling I was at home writing reports from where I had just been, preparing\nfor the next experience.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/105","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: That’s a lot of traveling.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/106","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: It’s a lot of traveling. It was really good experience as a veterinarian\nlooking to become a federal employee. That was my first federal job, it was a\nkind of neat flexible way to do it. There are other more common ways that folks\nget their federal stamp, as it were, that are probably a bit less fun, and\nfrankly I don’t think I would have taken to quite as well. It was a good way to\ndo that and to see different parts of the country. I actually was in Atlanta a\nlot. The CDC was inspected a couple of times and we had trainings here a good\nbit. But I was living in Virginia partially because it was closer to my friends,\nI went to undergrad at UVA and vet school at Virginia Tech, and a lot of people\nmoved to DC, and partially just because it was, I don’t know, a place I wanted\nto be.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/107","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I was living there, and I got into EIS. I came down to Atlanta for a summer\ncourse—[coughs] excuse me. I came down to Atlanta for a summer course, me, and\nmy cat, and then I drove out to Oregon. I had never been to Oregon before this\nexperience. I had visited family in California before, I had been to Seattle for\na bit of training when I was in vet school, but I missed a state in between.\nAgain, I think—not again, I don’t think I’ve said this at this point, but I\nviewed EIS as two years of adventure. I could do kind of whatever it was. I was\nnot necessarily up for traveling so much in my kind of general constitution but\none of the reasons I worked the public/corporate track in vet school, not just\nbecause the work suited me, is I kind of wanted EIS training, I wanted to spend\nthree weeks in upstate New York, or middle New York, and then travel somewhere\nelse, I wanted to kind of desensitize myself to being asked to get up and go\nquickly and adapt to a new place.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/108","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: That is EIS.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,13.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/109","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Exactly, and I knew that, I knew I wasn’t, frankly, good at that. I had\ntrouble going down to Virginia initially when I went to school for undergrad, I\nhad trouble going from undergrad to vet school, just kind of adapting to the new\nplace. I knew that about myself, and it was a weakness I wanted to address. So,\nI tell—traveling and that I think really helped open up when I was looking at\nstates to apply to for EIS to try and match with, I think everything was west of\nthe Mississippi, at least high up on my list. I’m someone who kind of, I think\nmy running joke for a bit, was I had never received mail outside of the Eastern\nTime Zone before this experience. I went up and down the coast for school, and\nfor work, and that kind of thing, but I was an east coaster, and still am an\neast coaster through and through, but I’d never been to Oregon. I left Atlanta\nthe day after summer course ended, I picked up my sister in Nashville,\nTennessee, she flew down to meet me along the way, and the three of us, me,\nJulie, and Zeke the cat, spent the next week driving across the country. It\nreally was an incredible experience— it was a ton of fun. My sister is seven\nyears younger than I am and we were close growing up, but at this point she had\ngone off and become a bit of an adult, and we got to connect in a different way.\nShe was, I think at that point—I’m trying to think if she was in grad school at\nthat point. I think she was in grad school at that point in a combined physical\ntherapy/PhD program. We, in addition to having a lot of shared experiences\ngrowing up, we got to kind of talk shop about science a little bit. It really\nwas a great experience.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=13.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/110","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Got out to Oregon and my first day was August 13. That was the Monday\nafter—again, I had the week in the car, and settled into my temporary quarters.\nI was in temporary quarters for the first couple of weeks out there.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/111","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Are those assigned to you?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/112","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: No. This part will make any other EIS officers maybe a little bit\njealous. The sponsored position with USDA is a GS13 position, whereas most EIS\nofficers come in as a Title 42 GS12. I believe starting with my class, people\ncame in as a GS12 step three because CDC—[coughs] excuse me. Because CDC was no\nlonger paying for relocation. USDA not only gave me a GS13, but also paid for my\nrelocation. I found an Air BnB for, I was there for I think two weeks, and was\nscouting out apartment in the meantime, and found one that I ended up being\nquite happy with that was actually a walk from PSOB, from the Portland State\nOffice Building where I worked, which was really nice. The location was nice,\nthe apartment was fine.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/113","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It was not assigned, that was a place that I found when I got out there and was\nable to get some advice from people at the office, and from the small handful of\nfriends in Oregon I had coming into it, into Portland, about where to look, and\nthat kind of thing.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/114","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: It’s expensive?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/115","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, coming from DC I kind of expected that I wouldn’t get so much\nsticker shock, but it was—it was also a bit more urban, I guess, for lack of a\nbetter—it was more downtown than I’ve ever been. I lived in Virginia outside DC,\nbut I was in the suburbs of Northern Virginia, I wasn’t like in the city. When I\nwas in Connecticut, I was in rural shoreline Connecticut. Undergrad, vet school\nare kind of more out there parts, so that was the—going to Portland living a\nblock away from where the Trailblazers play, that was a bit more built up, and\ntherefore more expensive than I think I was maybe expecting, ready for. Like I\nsaid, I was being well-compensated for work, and it worked out fine.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/116","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: And you could walk to work.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/117","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: And you could walk to work. Yes, that was, again, one of those lessons I\nthink I got from my time in Virginia where I was working from home and I would\nkind of get to the end of a day like, oh, I haven’t talked to a person or gone\noutside today, and I don’t feel good, so I started to learn a couple things\nthere. Having that—I mean, walking to work was just great in general but also it\nwas a nice signal to me physically like work is starting and then work is ending.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/118","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Bookended.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/119","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/120","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Assigned to Oregon Health Authority, is that correct?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/121","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/122","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: What does that entail? What does that mean? What is your day like? Going to\nthe—you walk to work.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/123","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Walk into work.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/124","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Coffee?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,14.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/125","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: No, actually that’s a whole other thing. Put me on the outs with Oregon\nfolks because I do enjoy coffee, but it was not part of my day to day.\nFortunately, sometimes the walk into work was enough to get things going. It\ndepended. There were some days that were kind of more regular in that they\nlooked like the day before and the day after. But I got to participate in a\nvariety of things. One of the great lessons I learned, and I think one of the\nthings that made Oregon a great spot, a lot of EIS positions are like this, is\nthat they’re supposed to be able to function with or without you. Your presence\nthere doesn’t keep the lights on, doesn’t keep kind of the regular machine\nrunning. You get to be there to help as special projects come up, but you’re\nthere to train, it really is a training program. I was glad to have the\nflexibility and the latitude to focus on that. Projects would come up and I\njoined our Cluster Buster’s team where we looked at foodborne disease illnesses,\ndisease clusters, and kind of investigated those. I was on call for taking phone\ncalls during the day, which led to just some great stories and fun interactions\nwith the public. Not all of them fun, of course, but really interesting, and in\na way that was kind of new to me, or at least not since I worked in a clinic,\nthat feedback loop, that the work I’m doing and understanding how it impacts\npeople was so much tighter, was so much closer working at the state health\ndepartment than it was at a researcher at Plum Island, than it was an inspector\ngoing to research labs, where sure, I understood the feedback loop of the lab,\nand writing up the report, and that kind of thing, that was close. But the\nactual impact of protecting the public, knowing that biosecurity was good to\nprevent release, or helping the research forward, those are really long feedback\nloops, and it’s sometimes tough to stay motivated when you’re not getting that\nreinforcement. One of the nice things about being at the state is you did get\nthat. You got really into it a good bit. My first day within literally half hour\nof walking in the door I was part of an outbreak investigation. This is where\nbeing game becomes an important part of it, this was about measles, and I\nlearned very little about measles in veterinary school. It’s a human pathogen.\nThere are diseases like it in animals, but you don’t really learn so much about it.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=14.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/126","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This was a great lesson for me because not only was it about something I didn’t\nknow so much about physiologically, but I could still learn to apply some of the\nepi principles I learned. It was a great lesson in the importance of\nrelationships, which became a theme through all my time at EIS, and frankly as\npart of a lot of my job now. In this particular case, people knew how to\ninvestigate measles outbreaks. They knew someone had this—in this case someone\nhad been at a wedding, so they knew how to do contact tracing from the wedding,\nfrom the nail salon, from the rehearsal dinner. But this person took\nride-sharing services around town as well, and when I get an Uber, or more\nimportantly when I get out of an Uber, I see a receipt that says, oh, your\ndriver was Chris. When the health department calls me up as someone with measles\nand says, who have you been in contact with in the past four days, like Chris\nfrom Uber. The relationship we had to, in this case build, this was totally new\nfor them, was to go to these companies and say, we need you to give us\ninformation so we can do public health. This was a bit new to them in some ways.\nPeople hung up on us.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/127","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Because when we call up a company that is in the public eye for having a lot of\ndata, and tells its users we protect your information, and the health department\nsays, we need to know who drove Steve on this ride, and we need to know how to\ncontact them. [coughs] Excuse me. If you don’t understand the public health\nimportance of this, your knee-jerk reaction is no, we protect our users’ data,\nthank you, goodbye. It was really interesting to get that experience to learn\nthat the companies we were working with had physical offices in the Portland\narea, so we could go in person and talk to someone, and really for that\nparticular relationship it was important to show we were serious about this and\nhere’s how we can help answer questions for someone who is ready to hear our\nquestions. Part of that was really helpful too, both for me, because I got to\nshow the folks in Oregon that I’m willing to dive in, I was just game for this,\nbut also when it came time to do COVID-19 contact tracing, and we called up the\npeople at [ridesharing companies], they had worked on this, they had figured out\nhow to do this data sharing, and we could do that contact tracing a lot more\neasily than two years prior when it was a totally new experience to them. That\nreally came back. It was interesting.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/128","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Something new that public health has never had to—yes. But also coming up\nwill also be important when we get to COVID, yes. Other things that you were\nassigned to besides measles, there was shigellosis, am I saying that right?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/129","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: You are, yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/130","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Outbreak at a wedding.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/131","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, my first day of work was the measles outbreak. My second day of\nwork we got notified of this Shigella outbreak associated with a wedding.\nActually, those two outbreaks followed me through my EIS career. I presented\nthem both at [EIS] conference. I keep presenting them actually when it’s time to\ntalk about my time in Oregon.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/132","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Is it because they’re classic outbreaks or?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/133","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: They aren’t actually, which is I think part of why. With\nmeasles—measles, that part is a classic outbreak to investigate, but the\nride-sharing part was new. That was what made it more interesting. That’s what\ncaused someone at CSTE [Council of State and Territorial Epidemiologists]\nConference a year and a half later to call it “nightmare fuel” because we hadn’t\nreally thought about this, this contact tracing, these exposures with a disease\nlike measles maybe a bit less so because it spreads so easily, but something\nlike SARS-CoV-2, with COVID-19, you know who your contacts are. I know generally\nwho I spent time around. But I don’t know my Uber driver, I don’t know my Lyft\ndriver, and trying to follow it up, if you called me up and asked me to do\ncontact tracing, I could tell you here’s my fiancé, here’s her phone number, I\nwas talking to the neighbor, here’s their phone number, I was at work talking to\nthese folks, here’s how to contact them.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/134","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But I couldn’t tell you how to contact the folks that were giving me a ride\nsomewhere because we talk about fifteen minutes within six feet, that’s usually\nthinking about in buildings, and we think about measles exposure kind of the\nsame way, but if you’re in the car with someone that’s definitely close enough\nto transmit. That was what made that one a bit new. With the Shigella outbreak\nit was classic in that it was a foodborne outbreak, it was a wedding, we had\nfrankly really good data, good cooperation from the local—the health department\ndid great work working with the bridal party, but Shigella is kind of a weird\none. It’s not typically foodborne. Oregon actually experienced an outbreak of\nshigellosis of people experiencing homelessness. Shigella is a waterborne\nbacterium so often after big rains we would see disease spikes and without\naccess to clean water, it became a real risk. But for foodborne outbreak, that\nwas really something uncommon. It was the second largest foodborne outbreak of\nthis kind of Shigella ever reported in the US.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/135","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Where was it found?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/136","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I’m laughing because of one of my favorite slides that says –It was\nprobably the asparagus. But we did a little bit of environmental sampling, we\ntested food, and we couldn’t—we never found it in a person that was working the\nevent, or we never found it in the food, or the water, or that kind of thing at\nthe event. This was a really important lesson for me too because we didn’t have\nlab evidence—we had lab evidence of the connection of the outbreak, but not the\nsource. We didn’t have environmental evidence of the source but we had epi\nevidence. I did extensive food questionnaires, food exposure questionnaires, and\nwe had pretty good data on that. We were able to say hey, we don’t have this\npart, we don’t have this part, but with this information we can say pretty\nconfidentially what the cause was, what the culprit was here. Which was a good\nbit of training for me because in school you’re like you need the three parts,\nand in practice it’s like it’s great to have the three parts, but one of the\ngreat lessons I learned in Oregon, and again at the pace of a state department\nin particular, or even a local, is work’s got to get done. It’s great to have\nall of our data, and you can analyze all day long, but it’s important to make\ndecisions, to kind of come to conclusions that are hopefully supported by the\ndata, but really have to be put into practice.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/137","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This came back in a big way with COVID-19 because we did a lot of decision\nmaking, I wouldn’t say in an information vacuum, but without the answers, had to\nkind of come up with guidance without really knowing the answer sometimes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/138","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: You mentioned COVID, which is the elephant in the room here. How did you\nstart hearing about COVID?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/139","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: When I was getting ready for EIS and just kind of in general, I was\npaying more attention to ProMED, which is a daily email from the International\nSociety for Infectious Diseases, I believe. It’s a daily digest of, it can be\nzoonotic focused, it can be plant focused, it can be human focused, it can be\nregional. I was getting the broad digest because it was really helpful for me to\nprepare for preventative medicine board exams. I was just in the habit of\nreading ProMED, just scanning, looking through. At the very end of December 2019\nand in early January there started to be some of these messages, these new\nstories that were captured there about unexplained flu-like illness in China,\nand that’s kind of where it started. That’s why I first became aware of any of\nthis. Within a couple of weeks of that Oregon started to spin up our response.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/140","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Did that include cruise ships? Did you have cruise ships coming in?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/141","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes. There are ports in Oregon that are big cruise ship destinations.\nFrankly are pretty important parts of local economy in some of those cities.\nThere were cruise ships, later on there were fishing vessels that go out are out\nthere, this kind of self-contained little city for two, three weeks at a time,\nwhich is something I had very little experience with. No experience with. But we\nstarted to hear about it, we started to hear about the repatriation efforts to\nget some of the American folks out of China. One of my first memories from the\nresponse, so we spun up the response with I think there are mid-teens to twenty\npeople on that first set of paperwork, the incident action plan.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/142","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: These are all people from the Department of Health or are you working with\nother organizations?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/143","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: This is all from the—yes, this is all the State Health Department at\nthis point. We organized our incident management team for information management\nat this point. There weren’t cases—we had not detected cases in Oregon. But\nthere was a lot of chatter about it, and there was a lot of work going on,\nagain, with repatriation, and like screening at the airports was a big part as\nwell, so a lot of my work early on I remember going to, it ended up being a\ndisused men’s shelter, because we were looking for a place to potentially house\npeople coming in from China. People coming in on the airplanes to have to—both\nthey had to quarantine for some time, and we had to house the people who were\nresponding to take case of them. Scouting out a potential location to house the\nfolks. We ended up not receiving those people who were repatriated, so it ended\nup not being an issue, but having that experience, going out and kind of being\nready for that, was one of the first kind of oh this is going to be potentially\nreal, a potentially big thing that’s going to impact our work in a broader way.\nThere was a bit of that.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/144","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"There was a lot of our work early on was getting lists from CDC of people who\nhad been on planes and who had transited China or some of the other areas where\nearly cases were detected. We weren’t doing the calling necessarily, a lot of\nthis was—Oregon is a home rule state, so the local department is in charge, and\nthe state helps coordinate. But the list came to us, and we had to come up with\nways to tell Washington County, Multnomah County, Wallowa County—Wallowa is a\nbad example because the state—they don’t have a local health department and the\nstate runs that one. Harney County, Clatsop, all of these places we had to tell\nthem— Hey, you had some residents, so we would like you to follow up with these\npeople and ask them to quarantine, check for clinical signs, add them to your list.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/145","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Quarantine was how we handled it first on, so there was no testing at this\npoint in time. It was just let’s isolate these people and see what happens.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/146","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I think for a little bit there Oregon was able to run—through our state\npublic health lab, working with CDC, I think we were able to run one plate of\ntests per day, which was I believe eighty samples, probably fewer than that\nbecause they were probably controls, but it was one set of test results. Which\nwas interesting because we got into a cadence early on that was not the most\nhelpful. It was fine when there were no positives, but because they had one to\nrun, because it took time to get the samples in because they wanted to make sure\nthat they most efficiently, that they were—Oregon is a pretty rural state in\nsome places, and to get a sample in from Southeastern Oregon up to Portland in\nthe opposite corner takes some time. We want to provide good service to all\nOregonians, so it makes sense to wait a little bit for that sample to come in to\nthen run the assay a little later in the day, make sure we’ve gotten theirs.\nThat meant if we were getting positives when a positive—when a single case was\nreally the big news, that news came in between five and six PM. Which is not\nreally the ideal time to start doing a lot more work, to say hey, we’ve got our\nfirst case, what do we want to do, after everyone has been there all day long\ndoing communications, doing the airplane lists, and whatever else. We got into a\nbetter cadence eventually but at that point testing was really limited to at the\npublic health lab.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/147","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Another kind of really important lesson I learned there, with the restricted,\nwith the kind of limited resource that we had to be careful. We couldn’t just\nsay you get a test, you get a test, like sure you want a test, cool, do it. We\ngot into this kind of weird or unfortunate, I don’t know what the right word is\nnecessarily for this place where the people who were most likely to spread\nCOVID-19, when there were cases—I think we knew this at the time, at least a\nlittle bit, these were not people in the hospitals because you know who’s not\ngoing out in the community? Someone who is hospitalized. But we need some\ncriteria to use as a screen to say hey, this is serious enough to use our\nlimited test resource to test you. We set up a system early on that was\nbasically limited testing to hospitalized people. One of the important lessons I\ngot from that too was it wasn’t just – are we testing the wrong people? Because\nthey’re not going to spread it, they’re in the hospital. It’s important to\nunderstand too so the hospitals know what protections that can use for their\nworkers definitely. But the question we were looking to answer there was kind of\na different. It wasn’t how do we stop the spread, it was is this here, if it’s\nhere, how much is here.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/148","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"What we did there is we focused our approach on testing those highest risk\npeople. People with clinical signs that made sense, that had potentially no\nexposure, eventually that was an important part of it, but because the question\nwe were trying to answer was is the virus here, are people getting sick, if so\nhow many? We had to kind of adjust our approach in a way that from the outside\nmight not make sense because our goal was to stop the spread, and the people\nwe’re testing are not spreading it. But our approach really was to answer, at\nthat point, a different question. Testing was limited, that was really\nimportant. It also helped hone I think some of our messaging in that testing is\nnot the only way to show people that we are responding, not the only way to show\npeople that we care. I think testing became a very visible way for people to see\nthat they were being cared for, that that was something they were being\nacknowledged, and it’s really important. But it’s also important to spin up\nother response mechanisms that are not just testing.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/149","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Where were you getting your info on how to respond? Was CDC helping you with\nguidance? Where were you getting your information about COVID? Because it’s so\nfast coming in and of course since it’s a virus, it will be changing.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,15.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/150","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I don’t remember when these started, but there were some regular calls\nfrom CDC, so the CDC was giving at some point a daily brief, a daily kind of\ndigest to the state health departments about here’s what’s going on, here are\nour procedures too, this is how we’re supposed to handle, how we’re supposed to\nrespond to these. A good bit of that was—what’s everyone else doing, or what are\nwe being told to do, how do we do this in a coordinated way across the country?\nThen it shifted a little bit over time where it became more of a—again with\nOregon being a home rule state, our local health departments are really in touch\nwith their constituencies, and we would hear stories from folks about hey, we’re\ndoing this thing, this is the guidance, but what we’re seeing in our county\nreally doesn’t square with this, either the clinical signs are different, or\nwhen we do our investigations we’re just not getting traction this way, but we\nthink there are other ways to do this to help answer these questions. Then it\nbecame kind of a hybrid from the guidance from CDC, of the stories from our\nhealthcare community and local health departments, and the good old shadow\nnetwork, which is what I like to refer to the group chats as. We stood one up\nrecently as well for the Monkeypox response. Among EIS current officers and some\nrecent alumni, we just have a group chat to kind of help share stories, to\nunderstand what questions are coming up, to understand what resources are out\nthere as well. That was really important to know who to look to and how to make\nconnections, where we talked a bit about quarantining people who had traveled.\nWell, some people come to Oregon and they keep going. Sorry.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=15.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/151","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: I’m sorry. These are the, when you say the shadow network, you’re talking\nabout your EIS class and people you know through EIS? Is that the shadow network?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/152","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes. My EIS class was the most active one, and we use this for social\nreasons as well, but when it came time for response like this, like the broader\nmeasles responses prior to that, the vaping-associated lung outbreak, we use\nthese group chats to keep up with folks. When additional classes got integrated\ninto, consumed by, the COVID response, then the group chat membership got a bit\nmore broad.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/153","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Wow. That’s kind of what EIS is there for. You use each other as a network.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/154","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I would be remiss to not mention it was EIS and also LLS [Leadership Lab Services].","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/155","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In my class and in the other classes because there are often a lot of diagnostic\nquestions and the lab part it’s really important to nail that as well, so we\noften found ourselves asking questions back and forth of each other with that expertise.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/156","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: What’s LLS stand for?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/157","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Laboratory Leadership Service? I think.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/158","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Yes, I think that is right. We talked earlier and you were—the coordination\nof efforts through the Department of Health, but then you became this guidance\nanswer guy, can you describe that role?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/159","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Oregon has what we call investigative guidelines. For every disease on\nour reportable list, and some more catch-all ones, we have a document that is\ntwo, to twelve, to in the case of COVID-19, I think we’re pushing fifty now,\npages long, and it’s basically a primer on how to be insert disease epi. How to\nresponse to measles, how to response to Legionnaires Disease, how to respond to\nsalmonella, how to respond to COVID-19.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/160","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Protocol.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/161","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Exactly. It’s great because one of the things that I came to learn is\nthe problem of decision fatigue. Making decisions can be tough and having to\nmake decisions over and over, and frankly having to make the same decision\nmultiple times, is draining. Having worked together often before response, but\nin this case during response, to come up with the answer to questions that were\ngoing to come up, and especially for us at the state to help our local folks to\nknow that maybe the local health department just gets one of these questions,\nbut each local department is getting that one question, so giving them the\nanswers, giving them the help to help answer those questions when it comes up,\nwas really important. My role pretty quickly became to wrangle that guidance, to\ntake in the responses from CDC, to take in the guidance from CSTE about case\ndefinitions, and again, to take the feedback from the folks in Oregon about how\nour local situation did and didn’t square with the national picture. Part of my\nrole became to keep the guidance up to date. You can go back and check those\nguidelines, have a history on them. I remember very distinctly when before we\nhad cases in Oregon, I and a colleague, Amanda Faulkner, we were charged with\ngoing into a room—taking a step away from the airplane quarantine calls, from\nmonitoring the Johns Hopkins dashboard with global cases—just a quick tangent on\nthat. I gave a talk to an MPH program the day before our first case was detected\nin Oregon. I remember showing a screenshot of that dashboard with a big like\nthere are no cases in Oregon. I guess I jinxed it.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/162","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: When was that talk?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/163","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: That was whenever—I forget the number day, but it was the Wednesday in\nlate February. Thursday, we announced our first case, and Friday I picked up the\nnight call phone, which was a very hectic—it ended up just being for me the week\nwas only into Sunday because I got so many calls that they just had to have\nsomebody pick up the phone after a bit. I was on the phone more or less\nconstantly Friday night, all day Saturday, and all-day Sunday until someone\nhelped. I say that they were helping along the way.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/164","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: What were you doing on phone calls?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/165","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Mostly answering provider questions or local health department\nquestions. This is a 24/7 line.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/166","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Anybody can call?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/167","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Anybody can call. We certainly encourage folks to call their local\ndepartment who is supposed to have a mechanism to handle calls 24/7 as well, and\nthey get to help filter things up to us. A lot of the questions were either\nfrom—frankly often from Portland Metro area healthcare providers who maybe knew\nto contact us or knew how to contact us more directly, but also from local\ndepartments with questions about how to handle whatever it was. I’d take a call\nand while I was taking that one call, I’d miss two more. I’d call one of those\nback and I’d miss two more. It just kept going.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/168","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: February you get your first case in Portland and then from there how many\nmore came after that? Did it evolve quickly? Are you getting imported cases from\npeople coming back on their cruise ships? Where are the cases coming? It’s a\nlong question, sorry.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,16.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/169","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Our cases were mostly local early on. I remember I think the fourth case\nnationally, I think it was the second California case, maybe it was the second\nCalifornia case, was described as community acquired and that really sent up\nalarm bells because we’re like so it’s in the community, so who gave it to this\nfirst person, where did this come from. That really sparked a lot more focus\non—we were still doing, of course, the work with people traveling on planes, and\ncoming from other states, and that kind of thing, but as far as we knew the\nhotspots were elsewhere. Then we started to have cases come in. I can’t recall\nactually— I think our second case was a close contact of our first case. I\nremember our third case distinctly, that was a couple of days later, and this is\nsomeone who had attended a high school event over the weekend, I believe, and\ncollapsed at the event, was taken to a hospital, and a day or two later was\ndiagnosed with COVID-19. We were still in that cadence of getting the lab\nresults kind of late in the day, so we had to scramble a bit. I remember talking\nto a couple people that night, I think this was the first time I ever had a\nmeeting invitation for midnight before, but this was at a school event, and the\nprincipal and folks in that school district needed the kind of care and support,\nwe needed to talk through these questions. Because we didn’t know. This is the\ntime where people are still buying all of the hand sanitizer, and clean wipes,\nand that kind of thing, and there’s no toilet paper on the shelves and all that.\nThey’re like, can we open the gym tomorrow.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=16.0,17.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/170","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Fortunately, it was— I think it was ahead of a weekend, I don’t know if I have\nmy timing right, I might not. But this was an auxiliary part of the school, and\nit was, can we open it, how do we clean it, how do we protect the people there\ncleaning it. This is what I kind of alluded to earlier about making decisions\nwhen there aren’t answers is someone has got to do this tomorrow, we’ve got to\ntalk and think rationally about what to do. We had that meeting. We talked about\nit, we worked with them on communications because that was an essential part of\nany part of the response. I also remember the next day or two talking with the\nlocal, I think it was the fire chief, because our guidance at the time was to\nstrictly quarantine contacts of cases. Well, this person collapsed at a public\nevent, two EMTs attended this event—attended him and took him to the hospital.\nThis was a smaller county and if we quarantined two EMTs for two weeks, that was\na third of the workforce. There were a lot of people who were going to need\nsupport from those EMTs, and we had to think about how do we provide services.\nCOVID-19 is not the only thing out there. At that there was more than I’m sure\nwe realized, but still not that much, and what’s the balance of public health\nhere? Should we take these two people out of the rotation for two weeks and\ncompromise the care in that community for that whole time? Or do we find ways to\nmaybe not follow the guidance explicitly and say here, you can do some work, you\ncan do it safely, here’s how to mitigate the risk, here’s how to—it’s not, I\ndon’t think, the classical use of the term harm reduction, but in looking at the\noptions, in this case when the options were bad or worse, you go with bad, and\nstuff’s got to get done. People still need to, in this case, receive care. We\ntalked a lot with—I met with, over the phone, many more fire chiefs and things\nlike that then I ever expected because we had to talk through this. They were\nhelped with the EMTs, and especially in these rural areas, how do we provide the\nbest care given the situation. That was a really big part of it.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=17.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/171","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Then cases started to pop up more and more. I remember very distinctly there had\nbeen the outbreak at the nursing home in Seattle, which understandably got a lot\nof attention. There was a lot of illness, there were sadly a lot of deaths from\nthat. The first retirement home cases in Oregon I remember very clearly. I was\nliterally talking with a colleague in Oregon about this yesterday, about my\nexperience there. It was a full-on approach. We had seen what had happened\nelsewhere. Like I said, testing is not the only way to show that you care, but I\nthink it was a very clear signal people were associating with at the time as\ntesting became a little bit more available, you saw—it’s perhaps not appropriate\nto say abuse of that testing capacity, but you saw people in prominent places\ndoing a lot of testing, kind of trying to use that as care for themselves in\nways that it might not be available folks more broadly. Then people see that\nsignal and wonder why other folks are getting special treatment.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/172","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: And they’re not, yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/173","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: And they’re not. I remember going to the— I think it’s out in the news,\nI think it’s okay to say the name, the Oregon Veterans Home in Lebanon, another\nshibboleth by the way, not Lebanon, Lebanon. Working with the folks there,\ntalking with them about how they provide care for the folks there. This is the\nveteran’s home. These are people the community is committed to care for and with\ngood reason. But is it good care to keep everyone in their rooms for however\nlong this outbreak is going to go? At that point, because of how scary the\ndisease was, maybe it is. We talked about they brought in enrichment at all\ntimes, they had pets come in, they had demonstrations, they had talks, they had\nmusicians. How do we keep these people living rich lives without compromising\nthe health of them or the folks who are potentially going to come into the\nspace? Then also we did a lot of testing. We mobilized one of Oregon’s disaster\nresponse teams to go and help us with this particular effort. Which was interesting.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/174","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: In February the CDC was pretty much—when local health departments were the\nplace to get your testing results. Then the tests that came out of CDC were not\naccurate for a while there.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/175","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, the issues with the different targets that I think—admittedly I’m\nnot as familiar with and this was a place where I did turn to that shadow\nnetwork, and talked to my LLS colleagues, and asked hey, what does this mean,\nhow do I actually put this information into practice. Yes, testing was\nreally—was slow to roll out for a bit because of some of those issues.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/176","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Testing was important because that was pretty much the only way to figure\nwhere an outbreak was happening or, as you were saying, how to show care.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/177","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, it was an important place—I mean, in practice definitely. You had\nto know where disease was because at that point, we were still operating on kind\nof stratified risk profiles, of looking at a place and saying, hey, Hubei\nProvince and Wuhan, cities in China, highest risk. If you’re transiting there,\nwe’ve got to worry about you. Over time you started to see there was a cluster\nof cases in Chicago, so is Chicago a risk, is Illinois as a state a risk?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/178","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"You start to stratify some of these places where there had been cases. We think\nabout now, we look at the map of the country, and we see areas of high, medium,\nand low transmission. Well, the, I can’t think of the word, the conceit there is\nthat the disease is everywhere. Even in low transmission there are sick people.\nThere are people that are getting infected, there are people getting ill, there\nare people that are dying with COVID-19, it’s just the transmission rate is low.\nBut for a while there the risk was just based on did we find disease here. The\nway to find disease somewhere is to certainly to test. That is the way to kind\nof answer that. Again, when we had restricted testing to hospitalized folks, the\nquestion wasn’t necessarily how to prevent disease, because testing wasn’t going\nto do that for us. We had other responses, other tools to do that. The question\nwe wanted to answer was is there disease and where is it. That was what we\nthought was the best use of limited testing resources at the time.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/179","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: By this time now, you’re probably into March, March is pretty much everybody,\nthe whole world locks down.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/180","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, I referenced those daily CDC briefings and I remember, again,\ndistinctly—I’ll find a different phrase than I remember distinctly, but I keep\nsaying it—walking into the AOC, the Agency Operations Center, where we all were\nworking. Pretty quickly in Oregon we moved from our desks down to the AOC where\nwe’d all be working. For us the epi is the ten, the twelve, thirteen, fourteen\nof us that were all working together all day every day, sat around this\nhorseshoe table, and that’s just where we were. I was going to say where we\nlived and that’s maybe more true than it should have been, but we were there,\nthat’s where we were. I remember walking into the building, I was listening to\nthe call on my phone, walking in and hearing Dr. Nancy Messonnier on the\nspeakers and say—effectively sounding the alarm saying hey, this is serious, and\nthings have changed. It wasn’t necessarily that things had changed, it was just\nthings had gotten to a point where we could no longer say that things weren’t as\nserious as they were. That tonal shift kind of chilled a couple of us and it\ntook a couple of moments to think like, we knew what our response was, and we\nhad a sense of how much disease there was here, but we need to project forward a\nlittle bit more and think about frankly how bad this could get, the kind of\nrange of outcomes here, the bottom here, the lower end of outcomes has gotten\nlower, and we need to account for that.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/181","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: This is really— just a matter of weeks we’re talking here. It was so fast but\nfelt like forever when you’re in it.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/182","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: It felt like forever when you’re in it. One of the things that’s still\nmind blowing to me, as part of my current job I look at kind of a broader view\nover time of what cases were, and just remembering how hectic it was, how much\neach individual case felt like its own little, crisis is maybe too strong, but\nevery case had a lot of work associated with it. Even when there weren’t\nnecessarily cases, there was a ton of work associated with keeping care around\nthe state. I remember a lot of meetings about hey, who’s got this retirement\nhome, for example, there are cases there, how do we keep caring for people? Or\nwe’ve got someone, and this is a thing I learned about this system, someone who\nworks part-time at four or five, or maybe two or three, different homes.\nWell—Can they go to work now? How do we help keep that afloat? And if they can’t\ngo, well someone’s got to work there, do we have the resources, can we bring\npeople in, or are we going to ask people that are already stretched to stretch\nfurther because we can’t have this other person come into work. Then a lot of\ndiscussions about that, even when there wasn’t necessarily a lot of disease,\nthere was still a lot of, frankly, work, and understandable worry around each\ncase, and each potential case. But to look back at the epi-curve now, and see\nwhat the numbers were, and how busy things were, I almost have to laugh a little\nbit because there was so much work.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/183","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"And compared to some of the surges there were so few cases. Part of it was we\nhad a small team and things staffed up, it’s very well documented and well\ndiscussed how under supported public health generally has been, and we\nfortunately were able to bring a lot of new people into public health but are\nstill, I’m sure, well, well below where we need to be to be able to respond to\nthis. Because I guess part of the reason it felt like weeks, or the weeks felt\nlike they took quite a long time, is there were just a couple of us. There were\na lot of us working really longer, harder than we probably ever had. I reflect\non some of the days in vet school where we’re at school all day long, go to lab\nin the evening, studying, reading, and that was tiring, and I might have spent\nmore time at vet school on some of those long days, but never concentrated like\nthis. The intensity of those days was just so much more that it weighed on you.\nIt was just tough.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/184","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Was the intensity because there was an unknown?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/185","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, I think the—I referenced the decision fatigue and having to think\nrationally kind of in the absence of information to point to takes some work. I\nthink – I didn’t touch on but I can certainly circle back to this now, we had\nour investigative guidelines, but depending on the week we had three, to four,\nto six, to seven hours of calls with our local health departments where we would\noften give updates from the state about new policies for schools, and new\nupdates for what’s happening in the correctional settings, and whatever else was\nhappening at different parts around the state, but a lot of those calls turned\ninto, and some of those calls were dedicated to, here’s what the guidance says,\nwhat are your questions. I remember this really clearly, so Paul [R] Cieslak was\nmy primary supervisor in Oregon, and he was and is still looked to from people\naround the state as someone who can just help make decisions, who can think\nrationally. We’d be in this room with twelve, fifteen people, we’d go to a\ndifferent room for this call depending on who was updating, and a question would\ncome, and we’d realize immediately there was not an answer, there isn’t a known\nanswer to this. Pretty quickly people would look to Paul. Like Paul, What do you\ngot? He’s comfortable in this space so he would start to talk.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,18.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/186","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We would go back after and kind of talk about some of the decisions because\nagain, I had to fold some of these interpretations into the investigative\nguidelines, both the questions that came up, and then help refine our answer.\nThen over time that moment became me and Paul looking at each other, and looking\nokay, who’s going to move first, who’s going to move towards the microphone to\nanswer first, and in just an incredible—one of the things when I was going to\nEIS, I was very clear about wanting good supervision, good mentorship, partially\nbecause I don’t believe I had had that before. I had had that kind of here and\nthere, but especially a professional capacity, I really hadn’t had it. I had\npeople help me through with school, I had people I could turn to. I forget if it\nwas Paul, it might have also been Scott Lindquist, Dr. Lindquist in Washington,\nwho at match week asked me, what does that look like to you. I didn’t have an\nanswer. I got my answers in Oregon. I got to see what it looked like. In this\nreally empowering move for me, Paul would start deferring to me. He would see\nthe wheels turning, he would see me start to lean towards the microphone, and\nhe’d lean back. He’d let me answer. Over time those calls kind of became—I don’t\nthink this is too self-aggrandizing, people would describe it this way as well,\nthey kind of became Q\u0026A with Steve. I would get questions then and it was my job\nto know the guidance. For one to say like, this guidance exists, here’s your\nanswer. But to also recognize when hey, this guidance doesn’t exist, here’s your\nanswer. It was my job to think rationally. It was incredible training. I felt\nprofessional growth on an almost daily basis because of my ability to think\nthrough some of these issues, but also my confidence to trust my public health\nsense. I felt that sense kind of growing. One of the great things about my time\nat EIS was learning to trust it, was learning to know just like when I started\ntalking during those MPH negotiations with faculty at vet school, to know that\nthe thoughts that are coming out of my brain are ones that are valid, are ones\nthat I should share with people, that can be helpful.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=18.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/187","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Plus, he allowed you to do that.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/188","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Sorry?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/189","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Plus, he allowed you to do that. Recognized that and let you—","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/190","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: That was exactly it because it wasn’t just here is the space to do it,\nit was someone I trust and respect telling me that they trusted and respected me\nenough to do it, help me find that within myself and build on that. Again that’s\nhow I mentioned the mentorship part because that’s obviously a lesson that stuck\nwith me and a thing that I really hope to be able to do, as I mentioned I picked\nup a mentee just the other day, something that I hope to be able to do to help\nfolks, and that I hope continues as I myself grow, and kind of learn spaces I\nmight move into. That’s really important to help empower people to trust themselves.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/191","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: You were collecting all this guidance and giving guidance, did you share this\nguidance with other people besides the phone calls? Did you post this or—?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/192","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, the investigative guidelines were updated sometimes weekly. This\nwas also an interesting place where you had to kind of know what the right\ncadence was. Sometimes there were some small questions and really niche things\nthat do we need to publish new guidance here? No. Can we provide interpretation\nof people on the phone so the local department knows what to do until we publish\nnew guidance in two weeks? Yes, I think that’s the way to go here. We’d update\nthe investigative guidelines with some regularity.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/193","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Did your horseshoe group, did that stay together? Or again, as it got more\nand more into it, did you all go home?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/194","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes— the USDA sponsored spot comes with that return to USDA, so I have a\ncommitment to come back. EIS was scheduled to end at the end of June of 2020.\nUSDA and I had not figured out the right landing spot for me at the time, so I\nactually signed an extension to stay in Oregon through September, another couple\nof months.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/195","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: You’re in Portland?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/196","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I was in Portland on the response up until September of 2020, through\nSeptember 2020.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/197","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: That makes you—you were there for The Battle of Portland?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/198","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/199","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Which is a whole other part of this—COVID.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/200","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: It really is. What’s kind of real interesting to me about that too is\nlike—Portland is divided, as I mentioned, by the Willamette River. The health\ndepartment is on the east side of the river and downtown is on the west side.\nThere’s some neat bridges, there’s some great stuff downtown, but I feel like\nsometimes the river is a psychological barrier for folks to just like bike over,\ndrive over, so I wasn’t downtown really all that often. We did see one protest\ncome by the state health department and I walked through another one on my way\nhome one day, but this was not the intensity of what was happening downtown\naround the courthouse, around the—oh gosh, I forget what the—","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/201","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Black Lives Matter?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/202","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, no, there was a particular government official who talked about\ncriminals, and miscreants, and whatever else kinds of issues.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/203","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Antifa?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/204","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, and I remember people, myself included, using that as kind of a\nguide to help figure out how much to donate to the causes that were doing the\ngood work. But it wasn’t—while that was going on I was not geographically that\nfar from it, but it really wasn’t part of my thoughts day to day. Partially\nbecause we were just so busy.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/205","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The way it did work its way into my thoughts is an issue in guidance. We had\nquestions about guidance to give protesters because we don’t want people to\ncongregate, we don’t want people to gather, we don’t want people to be yelling\nand spreading droplets around other people. But at the same time, like I said\nbefore, COVID-19 is not the only thing out there. It wasn’t infectious disease\nhere but there are real problems that we at public health can provide input on,\ncan really address, but can also importantly keep in our mind to have that care\nis really important. One part of this is just kind of the general optics of the\ngovernment coming out and saying, hey, you shouldn’t protest. That obviously\ndoesn’t resonate well for good reason. But for us to kind of give some kind of\nchilling effect to the protests in the name of COVID-19 safety, under the guise\nof COVID-19 safety, I think depending on what the guidance might have been,\nreally isn’t what we wanted to do, is not the way we wanted to provide the best\ncare. We did provide some messaging around protesting, but never did we say, at\nleast as far as I can recall, never was it don’t protest, it was how to do this\nsafely, how to take care of yourself, how to take care of others, because the\npeople there, their goal wasn’t to spread COVID-19. There were perhaps some\npeople who were trying to do some of that nonsense, but in general the people\nthat were there protesting were not looking to do that, they were looking to\nsolve ills, they were looking to address issues, and issues that we in public\nhealth care about, that we have to care about.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,19.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/206","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"CSTEI think I was glad to be able to attend the CSTE [annual meeting] conference\nabout a month ago, and one of the resolutions that was passed was defining, and\nexamining, and really kind of in a cooperative coordinated way across the state\nhealth departments to look at violence related to law enforcement. Individuals\naffected—I forget the acronym they ended up using was, but violence, and\ninjuries, and death related to encounters with law enforcement. It’s a very\nclear, to me, public health issue and one that we can’t sideline because there’s\nalso a disease. It’s one that we have to keep all these things in mind. Again,\nthat was also happening, that was helping shape some of the guidance, and\nfrankly some of the messaging too. I think that was good for us to be able to\ntalk to folks in governmental leadership about what our goals were. I don’t want\nto characterize them as not understanding how to do public health, but their\ngoals were different than ours sometimes. That’s fine, that’s what their role\nis, and the government works together when it works well to help achieve as many\nof those different roles as we can. It also put me in an interesting situation\nas the sponsored officer as someone who knew I couldn’t stay in Oregon. As we\ntouched on earlier, I loved my time there, it was an incredible experience, my\nfamily is back east, my girlfriend, now fiancé, was actually working at CDC\nheadquarters for most of it. She was an EIS officer as well in the class ahead\nme assigned to Wisconsin. Prior to the pandemic we would fly back and forth to\nsee each other. Then we went about five months without seeing each other and\nrunning this hectic schedule because first off, the time difference is tough to\nnavigate in the first place, but she’s at CDC headquarters, and she was\nresponding at the EOC [Emergency Operations Center] here in Atlanta. Finding\nthat time to keep each other sane, to just catch up, and again, kind of provide\ncare, was tough at times. I found some kind of curious and funny, silly\nmechanisms, I think, to work on staying sane early on. Like I said, seeing my\nfriends every day was an incredible part of it. I don’t have this right now—I\nhave the outline on my second screen.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=19.0,20.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/207","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"But we have a bunch of TVs around the EOC, and on your second screen you do this\nas well, we would watch these nature cams. We had the bears at the park in\nAlaska, which became a really fun theme for us. We’d have that on in the\nbackground. You’re not focusing on it, you’re not seeing what bear is catching\nwhat, or who is Jacuzzi-ing, who is fighting, whatever else, but it was just\nthis little bit of care for each other that we could do to have that. Sometimes\nit was a live cam of puppies at a shelter, or cats playing at a shelter, or\nbirds eating fruit at a nature preserve, whatever it was, that was a neat bit of\ncare for us. Fruit is a segue I’ll take too because I started having what I call\nmy sanity citrus where I would bring an orange to work. One of the things about\nthe job we talked about is it was constant. You were always sending an email,\nanswering a phone, whatever it was, using your hands to do stuff. It turns out\nwhen you’re eating an orange by hand, you can’t pick up the phone without\ngetting it dirty, you can’t type an email. For me it was a way to enforce just a\nfew minutes of break. It’s important for me to take care of myself, which is a\nlesson I learned directly and indirectly from folks in Oregon from early\nresponses as well, but for me it was a way to just take a step back, to step out\nof the response for just a moment and check in with how I was doing.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=20.0,20.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/208","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One of the other things, Oregon was great, especially early on, in providing\nfood for us. Like I said, we were at work, and some of the places that provide\nfood around the state office building closed down so we couldn’t necessarily go\nget lunch easily, and the state provided lunch for us for the first couple of\nmonths. There are two staircases in the building to get down to where the\ncafeteria was, and I took the wrong one intentionally because the wrong one put\nme outside. The wrong one in the middle of the day it was an extra, I don’t\nknow, ninety seconds of walking, but I got outside. I also often used that time\noutside to send Amy, my partner, a note, just to say hi. But that was part of\nthe—I had to engineer that into my days to help stay sane, frankly.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=20.0,20.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/209","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: It doesn’t sound like you were teleworking, you were actually going into the office.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=20.0,20.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/210","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I lost that bit for a moment. I left Oregon in September of 2020, at the\nend of the month, we did not telework up until that point. We were going into\nthe office all day every day, that horseshoe of a dozen or so of us, it was the\nsame team the whole time. We started to bring some more people on a little later\nin that time when the state was able to step up a bit and expand the team, which\nitself was interesting. It was good, it was great to have more people on, but we\nran into this issue of the pace being so fast sometimes that it would be great\nto train three more people that in a week could make this easier, but we can’t\nbe anything but short-sighted, we’ve got something in front of us right now, and\nwe can’t take that time. It took some more support, some good leadership from a\nbunch of folks, to find that space for us, to really make it clear to leadership\nin our group, leadership well above us in state government, how important this\nwas, and why some of the things they might have become accustomed to, like a\ndaily report, was going to take some time, was going to be delayed, or was going\nto have less information, that kind of thing. We started to expand the group a\nlittle bit and it was great to grow the team as we had capacity to do so.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=20.0,20.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/211","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: We mentioned just briefly COVID, and care, and health equity. Were there\npopulations within Portland that needed a little bit more care in that respect?\nBecause really— COVID has really shown a light on the importance of health\nequity, the importance of listening, and the importance of really—care.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=20.0,20.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/212","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: There definitely were. Some of that was in Portland, some of that was\nacross the rest of the state. That part of Oregon in particular, lots of parts\nof Oregon, have pretty strong agriculture, and that means a workforce that\nsometimes is a little more transient or just in general is not as connected, is\nnot as supported as other groups might have been. We did a lot of work reaching\nout to the federally qualified health centers, to some of these organizations\nthat specifically provide care, in this particular instance to migrant workers,\nand try to connect specific resources, and say, hey, what we don’t want is\npeople to be sick, of course, but we also don’t want these products to—fruit\nrotting on the vine, and grains going unprocessed, and whatever else. We want\nthings to keep moving because those are really important economic-wise for folks\nto keep getting paid so they can keep the lights on and buy groceries, but also\nto make these things available. We all feel the crunch now of supply chain\nissues and that was another way that we were able to hopefully mitigate that a bit.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=20.0,20.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/213","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We focused a bit on some of those. I remember in particular there was a—I\nshouldn’t laugh, it’s not funny, but there was a testing event, and we were\nworking hard to organize it. The focus was on agricultural workers, but because\nthe resources we were able to mobilize to support this, I think testing was\navailable Tuesday, Wednesday, Thursday of that week from eleven to three. Well,\nthe population we’re looking to reach is not available then, so we had to\nrethink how we were going to do that. That approach we got a lot of testing, but\nnot who we were trying to support directly. We had to really kind of consider\nwhere people were, had to meet them there. Again, provide that care, show that\ntesting was available, but as something that’s not the only mechanism to show\ncare. One of the things that I was taking part in, but not the biggest part of\nmy response because it was happening a lot as I was starting to wind down and\nget ready to come back to USDA, was working with some of these cultural-focused\norganization, not about testing, but about how to disperse funds. One of the\ntoughest things throughout this whole thing, and one of the talking points that\nI think has been said so many times and still not enough, has been how to enable\npeople to make good decisions. We can give guidance all day long, but if they\ncan’t follow it, for whatever reason, it doesn’t matter. If someone can’t\nquarantine because they have to go to work, for example, quarantine does no\ngood, so how do we support them? How do we use—in this case it was purely\nfinancial sometimes. How do we support them to make good decisions. One of the\nways to do that is to ask the people who know, to ask these culturally focused\norganizations how to support them, how to come to them, how to give these answers.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=20.0,21.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/214","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One of the things I’ve really come to appreciate. I long ago subscribed to the\nOregon Health Authority You Tube channel. Every couple of weeks there’s a new\nset of messaging in a dozen languages, I think, in a variety of languages that\nsome I had frankly never heard of before I went to Oregon, but these are\npopulations that are present, these are folks that need our support. One of the\nways to enable people to make good decisions is to give them good information. I\ncan have the best scientific paper with the most answers in it, but if you can’t\nread it, you can’t use that information. If we can’t translate it into Karen,\nand Mam, and a whole bunch of other languages that I frankly don’t know or\nhadn’t heard of, people can’t use this information. I had actually learned this\na bit in a clear way a year prior. There was a measles outbreak in Clark County\nWashington, right across the border, which was, at least in that area initially,\nlargely contained within the Russian-speaking population of which there are\nplenty in that area. Which was, again, a surprise to me not knowing Oregon too much.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=21.0,21.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/215","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"When I went to Oregon I remember I looked up the census page to see what was\nthere and that’s what I knew about the state, which was not much. But\nunderstanding how to get out there, how to kind of find people where they can\nhear this messaging, where they can receive it, how we can support them to make\ngood decisions, is really important. One of the things we are working on as a\ngroup here in the One Health coordination office is getting some behavioral\nscience expertise on the team. Whether or not that’s an individual person for\nus, or access to others, we talk a lot about One Health and the connection\nbetween humans, animals, and their shared environment, which is One Health.\nWe’ve had a good, comprehensive, US government definition of One Health. But as\nwe think about this triangle, as I think about this triangle, especially of\nthose three elements, they’re all happening in the context of humans making\ndecisions. Of humans making choices and spreading diseases sometimes. You can\nprovide whatever guidance, but someone’s got to make a choice.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=21.0,21.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/216","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One of the important benefits of our society is that freedom to make those\nchoices. If we’re not enabling people to make good decisions, they’re not going\nto be able to follow—they’re not going to follow those and then the impacts that\nwe want to have are going to be tougher to follow through. They’re really not\ngoing to manifest, and they’ll cause some additional problems. Working with\nthose culturally focused organizations, working with the translators to—Oregon\nhas a great push for something called REALD which is to have the data on race,\nethnicity, language, and disability, to integrate that into everything we do.\nThere actually was an executive order, I think, that was passed during the\npandemic that said if you are receiving, I think it was the vaccine eventually\nbecause vaccines weren’t available at that time, but if you’re getting testing\nthrough a state sponsored program, you have to collect REALD information. One of\nthe interesting things I learned about REALD in particular, one of the big\ntenets is its self-reported. You can look at me and say, oh, Steve is probably\nof this heritage, and you would be right because I think mine is pretty straight\nforward. But there are some people when you look and you’re like, we can make a\nguess, and the problems that come with that are really important.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=21.0,21.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/217","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"My colleague Dr. Alex Wu, who, I get to say this officially, was assigned to the\nNorthwest Portland Area Indian Health Board Tribal Epidemiology Center, which\nwas across the water in Oregon. It was in Portland and Alex came over to work\nwith us a couple times for taking calls, which is a bunch of incredible stories\nnot for this conversation really with stuff that came in, and with our response\nas well. But [before the pandemic] one of Alex’s big projects working with the\nNative populations was to take the tribal registries, and take the disease\nreporting, and match things up, and look at where the race and ethnicity data\nwas just wrong to better understand what the risks for his community, for the\ncommunity he was supporting, and by getting that—having seen that work and\nfrankly having seen Alex get very passionate about that work was quite moving. I\nknow the importance of that was something I got to carry through with the rest\nof my time with EIS and is less so when we talk about animals. Certainly, in\nagriculture we don’t think about race and ethnicity in the same way, but again\nunderstanding the context of where people are. In addition to REALD, when I was\ngetting ready to leave Oregon, one of the additional pushes for data collection\nwas what are called SOGI data, which is short for Sexual Orientation and Gender\nIdentity. REALD was, I think, a paradigm shift for people doing public health\nwork and SOGI data was another step for a lot of people who just weren’t—just\nlike myself, weren’t familiar with both how to collect that information, but how\nimportant it is to collect that information. We’re also, of course, seeing that\nplay out in a big way currently with the Monkeypox outbreak and how important it\nis to understand who we’re trying to support and how to support them.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=21.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/218","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: After leaving Portland, you went back to USDA, you went to Atlanta?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/219","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, so my official duty station up until about eight months ago was\nRiverdale, Maryland. But while in Oregon we were all going into the office,\nsince spring of 2020 USDA was, when possible, fully remote. There is a lot of\nUSDA work that cannot be done remotely, a lot of people have to go in and face\nadditional risks, but fortunately with a job like mine, I need a computer. Kind\nof end of list. With my partner at CDC headquarters and the flexibility to be in\nAtlanta with her, I came here. Fortunately, I’ve gotten to stay. But really one\nof the big challenges I had for a long time here was this kind of second level\nmeta question of the uncertainty where we didn’t really know where the pandemic\nwas going. When I was leaving Oregon, I was confident that USDA wouldn’t call me\nback to Maryland for three months. I had a good feeling, not a good feeling, I\nhad some confidence that they wouldn’t call me back for a bit after that, but I\nwasn’t so confident that I was going to sign a year-long lease. I ended up in\nthe situation of going—over the course of a year I lived in three apartment\ncomplexes and an extended stay hotel based on what was available and what kind\nof suited my needs because I had to go kind of month to month or two or three\nmonths at a time because I didn’t know. I wasn’t sure that I could stay.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/220","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I also was without a lot of my things. A lot of the things on my walls and are\nin my background now were in a storage unit because when I left Oregon, again\nfortunately USDA paid for the move, but I thought I might get the stuff back in\ntwo or three months, so it was going to stay in storage for a little bit. I left\nOregon with—it was me and the cat, again, and whatever else I could fit in the\ncar, and that was it. That uncertainty of not kind of knowing where I was going\nto be, not knowing if I could stay, it was great to get to be in the same place\nas my partner, and we were soaking that up for as much as we could, but over it\nall was this obviously cloud of the pandemic, and we were in this kind of odd\nsituation of it would have been incredible if the pandemic just ended. But it\nwas going to continue on, and it meant that we had the flexibility for me to be\nhere, and the eventually USDA did a reevaluation, and my position has been\nreclassified as fully remote. My duty station is what you see.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/221","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Wherever you are.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/222","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Wherever I am","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/223","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Another wonderful lucky destiny and fate thing.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/224","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/225","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: You are now working at USDA on One Health. Can you explain to me what One\nHealth is?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/226","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I do feel I should pull up the official definition to make sure I get it\nright. I won’t do that now. But it is the understanding that humans, animals,\nand their shared environment all interact and influence each other, to know that\nthat work is not contained with any specific sector, that that work has to be\ndone at different levels of local, and regional, and national, and global. It’s\nbeen interesting to be on some calls talking about planetary health and the use\nof earth-observing satellites to do public health work, has really helped expand\nmy understanding of what this work can even be. Being a veterinarian focusing on\ninfectious disease a lot of the work is in animals with zoonotic diseases, but\nwe really try to make sure the focus stays pretty broad and accounts for the\nenvironmental impact, environmental factors, and as I’ve touched on a little\nbit, the sociological parts of this. People making decisions underpin a lot of\nwhat we do.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/227","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: When you were in Oregon you were also—I said it wrong, Oregon. When you were\nin Oregon, didn’t you also coordinate care of people coming back from an Ebola\noutbreak in DRC [Democratic Republic of Congo]?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/228","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I did. That was some new training for me as, again, to kind of learn a\nbit about contact tracing and what that work might be like. There was an\noutbreak of Ebola in the Democratic Republic of Congo. And Rwanda? I forgot\nwhere else it was. Oregon, we were not officially sending people, but there were\nsome non-profits, some non-governmental organizations, some Good Samaritan\norganizations, that were sending people to respond to help provide care and\nsupport for the response that was happening, and then they came home. Some of\nthose people came home to Oregon.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/229","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: During the pandemic?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/230","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: That was actually before. Fortunately, this was between measles and\nvaping, I think. It was in 2019.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/231","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: End of the year? November?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/232","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: It might have been kind of later in the year but not quite pandemic\ntime. A lot of my job was working with the local health departments who were\ngoing to do this monitoring, so quarantine for someone coming back from an Ebola\ninfected area was to do daily temperature checks to really be on the lookout for\nfever and other clinical signs because of how severe one case could be. We had\nto be especially vigilant. It wasn’t just coordinating that check in, it was\ncoming up with a plan of okay, what happens if they have a fever, what happens\nif they have clinical signs, and working with the local health departments about\npeople who were planning to travel in that time, and kind of passing off the\nmonitoring in that time, and passing off the time as well, especially in some of\nthese rural areas, to get someone, a potential Ebola patient, safely to a place\nthat can help treat them, care for them. Actually, really the answer is that\nthere are, I think, ten regional hospitals that are equipped to care for someone\nfor more than seventy-two hours. The nearest one I think to anyone in Oregon is\nin Spokane, Washington, which is a bit of a hike. But there are some areas in\nPortland, around Portland, and I think in other parts of the state, there’s one\nin southern Oregon as well, that can help support someone for up to seventy-two hours.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/233","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I was fortunate enough to know one of the nursing faculty at a hospital there, a\nplace where I’d actually given some lectures to nursing students for his class,\nwho had access to the Ebola ward, the area prepared for people. I got to go\ntour, actually again with my colleague Dr. Wu, we got to go tour the facility\nand see what it was like to actually work in that temporary facility where you\nwould care for someone potentially with Ebola for up to seventy-two hours.\nFortunately, it was empty at the time. But to see that process—","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/234","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Did it stay empty?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/235","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: It did stay empty. Yes, fortunately as far as I know there were not any\ndomestic cases from that outbreak.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/236","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: But this is kind of preparing you for what’s going to happen in a couple of\nmonths because you’re also—it’s like setting you up for COVID.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/237","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: It is. One of the lessons, and a phrase I’ve taken from Dr. Murphy in\nVirginia, is about the importance of peacetime relations. In this case when you\nsee someone, when you call someone, they’re not a stranger. Yes, there were\npeople in southern Oregon that we talked to a bunch because some of the\nvolunteers were coming back there, well they knew who I was. After we had a\ncouple of conversations about what their questions were, about what monitoring\nwould look like, so when they heard me on calls giving guidance answers about\nCOVID-19 a couple months later they knew who I was. They didn’t necessarily take\nit on faith like oh, Steve knows what we’re talking about, we’re good. But they\nwere at least willing to kind of accept that might be the case and willing to\nwork with me, willing to say we had questions before and Steve was responsive to\nour local concerns and context, so we have confidence now we can bring our\nconcerns to him, to the state, to help get those answers addressed.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/238","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Building relations, yes, that’s key. I want to return back to the present\nessentially and working with USDA and One Health. Where you are now, at least\nwhen we were talking before, you were working with SARS-CoV-2 in animals.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/239","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/240","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Is that still an ongoing—","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/241","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, that is still the majority of my work. I was even just yesterday\ndoing some reporting on a new case of a dog that was confirmed as infected. Cats\nand dogs have been most of the cases, but a bit of that is the epidemiology, not\nnecessarily the virus, but so much of the infection, so much of the virus, the\nreservoir as it were, is humans. In order to get exposed to the virus you have\nto be exposed to someone with it, and if there’s so much in the human population\nthan cats and dogs get more exposed than whales and sea otters.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/242","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Makes sense.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/243","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: That said, not whales or actually sea otters—well, I don’t know where\nAsian small-clawed otters live, but we have also seen cases in zoos and other\nwildlife—other facilities with animals under human care like zoos and aquariums.\nOne of the things that’s been very exciting and takes up a lot of my time now is\nsomething that we’re calling the Zoo and Aquarium Serology Study, which is a\nproject funded by the American Rescue Plan Act where USDA received $300 million\nto do surveillance for SARS-CoV-2 in susceptible animals. This is one of those\nprojects that I helped dream up with one of my colleagues in USDA APHIS [Animal\n\u0026 Plant Health Inspection Service] Animal Care that we are now sending people\nout to go do this work. They are taking—we’re using banked serum samples from\nthese zoo and aquarium animals from before the pandemic, from within the\npandemic, intra-pandemic, and when animals have been vaccinated following\nvaccination, with the idea of being able to say if they’re serologically\npositive then there’s at least evidence that there was an exposure there before.\nWe’ve identified cases at a lot of facilities, but it’s less than half of the\nfacilities in our study where we’ve found PCR positive, active cases, in the\nlions, and tigers, and snow leopards, and Asian small-clawed otters, and\ngorillas, and coatimundis, and binturong, and fishing cats, and squirrel\nmonkeys, and cougars, I think that’s the whole list.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/244","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Sounds like all mammals.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,22.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/245","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: All mammals, yes. That’s part of with the study and one of the things\nwe’ve been working on recently actually when the zoo or aquarium reaches out to\nus they say—hey, we’ve got these serum samples, what works for your study? We’ve\nbeen saying, mammals. Listen, this virus keeps surprising us, keeps showing that\nit’s going to infect maybe another animal. Manatees were recently diagnosed as\ninfected in Brazil, and hippos were confirmed infected in Amsterdam at a zoo, so\nit’s just we want to get that breadth there. Seeing the species list from some\nof these facilities and seeing that just like us, you do an annual exam, and you\nget blood taken. Because the zoo community is really invested in answering\nquestions about their animals and working together across the community, they\noften save these samples, and will work together to do some of these studies.\nOne of the things that’s really exciting is we as USDA, who frankly our\nrelationship with these facilities is usually as their regulator, we’re coming\nto them in a different capacity here. We’re working together to answer questions\nthat we think with this financial support and with our national coordination,\nwe’re able to help answer questions that we have, but also that they have as a\ncommunity. We are testing serum samples to look for history of exposure, we’re\ngoing onsite to talk about biosecurity and practices that did, and frankly\nsometimes didn’t work or didn’t help. Which was interesting feedback from the\nzoos when we did a pilot with them, they said they spent a lot of time and\neffort doing barriers, and putting up signs, and masking for guests, and a whole\nbunch of other things. They’re like if those work, great, that’s really helpful\nto know. If those don’t work, we really want to know that too so next time we\ndon’t have to spend the time, and effort, and just agita, of putting the stuff\ntogether. We’re doing that and we also have an arm of this which is testing\nwildlife because in addition to the animals I listed off, and then of course\ncats, dogs, ferrets, and not in this country but elsewhere hamsters that have\ntested positive.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=22.0,23.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/246","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Guinea pigs?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=23.0,23.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/247","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Not confirmed. I think in the lab maybe but not natural infection. We’ve\nidentified a lot of places where white-tailed deer, wild white-tailed deer are\ninfected. USDA did—Wildlife Services did a serological survey early on, this was\na little over a year ago, and found a decent amount of serum positivity in the\ndeer and have since taken a project across much of the country to look for\nactive infection, and frankly has found it. There are a lot of questions about\nthe role that wildlife might or might not play in this response. Alongside the\nzoo project we’re going to facilities, and we’re doing biosecurity evaluation,\nwe’re testing samples. We’re also, where the facility is amenable to it,\ntrapping and testing wildlife on and around the grounds, because maybe that\nsquirrel monkey that tests serologically positive from a sample from August of\n2020, the white-tailed deer we find positive outside of the facility in July of\n2022, didn’t infect that monkey, but that positive deer could be basically a\nproxy for what disease pressure was coming from wildlife. We, at this point,\nmore or less expect, and I think are somewhat confident in the fact that when an\nanimal in a zoo or aquarium gets infected, it’s likely from a human caretaker.\nLikely not from a guest, but not impossible. But for a variety of reasons, we’re\nnot definitely set up to answer that questions in a lot of these places, so\nwe’re helping to understand what works.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=23.0,23.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/248","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Again, you’re coming back to the lesson from Oregon of what decisions we can\nmake with the information we have and what decisions we have to make with\ninformation we don’t have. We’re not going to get a perfect answer, especially\nnot for the range of species, but we’re hoping that while we might not be\nprecise, that we’ll be accurate, we’ll be helpful with the answers that we get\nfrom the study. We can give them back to the zoos, of course, because we’re\nplanning on working with them all to answer these questions, to say— How do we\nuse this information? How do we apply this across the community? We have upwards\nof fifty facilities participating in this, but there are many more in this\ncountry that are not. There are zoos and aquaria all around the world that can\nuse this information. How do we use our specific study that can be used by a zoo\nthat’s participating, how they can take that and apply that to themselves, but\nhow can we help others make these decisions and protect the animals and people there.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=23.0,23.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/249","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Are the animals affected the same as humans? Do they come down with the same\nsymptoms? Is there a mortality rate here?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=23.0,23.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/250","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Some do. A lot of the—it’s an interesting question to try and answer\nbecause the surveillance system—testing is not as broadly available, not as\nbroadly done, as what’s happening in humans. It is available, I think people\ndon’t necessarily avail themselves of it, but it’s also relatively tough to get\nthese samples sometimes. When I tested positive for COVID-19 now, oh gosh, two\nweeks ago, more than two weeks ago, I walked downstairs, I stuck a swab up my\nnose, I put it in the home test kit, and found my answer. The snow leopard is\nnot necessarily so amenable to you sticking a swab up its nose or down its\nthroat. We’ve actually confirmed a lot of the animals in zoos and aquariums by\nfecal testing. Coronavirus while not—it does have some gastrointestinal effects,\nbut coronaviruses do tend to go to the gut, and that means we’re able to find it\nin rectal swabs and in fecal samples from animals sometimes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=23.0,23.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/251","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Then can it spread that way too?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=23.0,23.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/252","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Unclear. One of the things we are honestly trying to figure out is kind\nof what transmission dynamics are in animals generally. We think in general\nfecal samples have less virus, so if you take nasal swab and a fecal sample from\nthe same animal, you are likely to find a lot more virus in the nasal swab. That\nmeans that the fecal samples are less likely to be an issue. Then also, there is\nsome capacity for aerosol spread with SARS-CoV-2, so just that it is in feces,\nand even if there is viable virus in feces, you still have to get exposed to it,\nyou still have to have it infect you.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=23.0,23.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/253","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It’s not just that it’s there, it’s that it’s also infected and then affected\nyou. We’re frankly working on those kinds of questions. We’ve had some of these\nfacilities that have actually sent us serial samples over time. They’ll take\nfecal samples for, gosh, that one zoo I think was four or five months and\nsending us samples—they’re not positive the whole time, but they are, just like\nsome humans test positive for quite a while on PCR, they are positive for more\nthan the duration of the illness. There have been a few animals that have died.\nIt’s not entirely clear, and we’re still looking into this, it’s not entirely\nclear if these are animals that died from SARS-CoV-2 or animals that died with\nSARS-CoV-2. Unfortunately, I had good training in this kind of messaging and the\nproblem of this with my time in Oregon because we had experience with that a\nwhole bunch. One of the things that became, this might have to come out of the\ntranscript, one of the things that became kind of a sticking point for the folks\non the epi team, and a bit of just a point of friction with our upper\nleadership, outside of the health department further up, is the level of detail\nthat Oregon published about each death. There’s an important thing I learned in\npublic health about what information the public benefits from. There’s some\ninformation, some level of regularity, that we need to give people so that they\ncan use the information.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=23.0,23.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/254","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Somewhere along that spectrum we compromise an individual’s privacy in a way\nthat doesn’t benefit the public more broadly. It’s not helpful to know in a\npublic setting, for example, someone has a sexually transmitted infection, to\nput my name out in public as that person. That doesn’t do anyone any good except\nfor my contacts and we have other public health mechanisms to follow up within\nthat and to keep that private. But is it helpful to know how much disease is out\nthere and what that risk might mean to other people generally? Yes. That’s kind\nof an extreme example, but for someone to feel seen I think in the numbers can\nbe important, but we also don’t want people to be able to see themselves when\nit’s compromising. In Oregon we spent a lot of time messaging around some of\nthese deaths. I remember one story in particular where it was known in the\ncommunity that someone had, I believe, fallen off of a ladder and died, and they\nhappened to test positive for COVID-19 after. We establish case definition, CSTE\nestablished national ones, and we adapt as necessary to the local context, and\nwe have a case definition, and it’s a feature of public practice that the case\ndefinitions don’t always align perfectly with medical diagnoses. I think that’s\na tough thing for folks to understand, frankly it’s a tough thing for me to\nunderstand early on. Because in this particular case, even as a general example,\nif someone falls off a ladder and dies, and tests positive for COVID-19, did\nthey die from COVID-19? Probably not. Nosology, assigning cause of death, is an\nincredibly complicated science sometimes, and really can be a bit of an issue,\ncan take a long time. Is it helpful for that individual to dig really deeply and\nunderstand the cause of death there? Yes. We’ve got clinical providers who can\nhelp with the family, can help provide that information. But at the public\nhealth level, it’s not our charge in the same way. What we have to do is take\nthe information across the population. Epidemiology is literally the study of\ndisease upon the people, epidemos, so we need use this at the population level.\nIt’s important to work with our clinical community and marry that up, of course,\nbut we have to take our context and apply that to the breadth. That’s a thing\nwhere, again, bringing you back to the animals, we see the signal sometimes\nwhen—in this particularly there have just been a bunch of reports of snow\nleopards that have died and tested positive.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=23.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/255","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"From SARS-CoV-2, because of SARS-CoV-2, or with SARS-CoV-2 is unclear in some of\nthese cases, but we work with our academic labs, we work with the zoo community\nto study this the best we can and if and when there is broader surveillance\ntesting to understand are these just the highlights, are these the cases that\nexist, or is this the tip of the iceberg? What truly is the risk for these\nspecies? Especially when we start talking about some of the ones that are in\nzoos for conservation reasons, these provide a real threat to the population of\nthat species potentially, and that’s why the zoo community works together often\nto answer these questions. They have Taxon[omic] Advisory Groups, TAGs, that\nfocus on reptiles, and large felids, and apes, and whoever else it is, whatever\ngroup that frankly there’s enough interest in. With this particular outbreak,\nbecause of the importance of cats, the susceptibility of the cats and the\nimportance thereof, our project team we’ve worked with the felid TAG to both\nunderstand the kind of work and also if they’re doing a study as well,\nunderstand how our studies can and do potentially interact, and how they\ncomplement each other, and also how not to step on each other’s toes. When we\ntalk about these samples that are stored, the blood sample from that cougar from\nlast May, you can’t get another one, that’s it, you can’t recreate that. What is\nthe balance of using an irreplaceable sample to answer a question or holding\nonto it for the next question? Or can we use a little bit now and a little bit\nlater? Working with the community, again, really asking them how we can help\nthem answer those questions have been a big part of the zoo project.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/256","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I talked about Wildlife Services and their work on white-tailed deer, that is\nongoing. Also, in mule deer and also wildlife work. We are starting to dip our\ntoe into the companion animal realm as well. Cats and dogs, for example, are not\nspecies that—there are parts of USDA that do interact with companion animals\nwith our Center for Biologics in particular, talking about veterinary vaccines,\nand testing, protocols, and equipment for that kind of thing, testing the tests.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/257","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Do you work with sanctuaries and rehabs [rehabilitation] and things like that?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/258","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: That’s the kind of thing we’re trying to figure out is—I used this\nbefore, this idea of the “ur” question. I mentioned veterinary student day where\n[Dr.] Jennie McQuiston just told me to apply to EIS. My other big memory from\nthat day was hearing then CDC director [Dr.] Tom Frieden give a talk where the\nthesis of the talk was basically that it’s important to ask the question so what\nwith some frequency. We’ve gotten some information, so what, what do we do with\nthis, what can someone else do with this. The best—it might not be the most\nprecise but one of my favorite, I think my favorite definition of the word\nsurveillance is data for action. Sorry, I just heard my cat.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/259","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: I hear your cat too.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/260","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: He is pretty vocal sometimes. Data for action. Well, we can collect\ndata, but if you don’t know what you’re going to do with it, what are you doing,\nwhy are you doing that, because data collection is not free in a sense, it takes\nwork, it takes time, it takes the people you’re collecting data from for as many\nsurveys, spam calls as we get to answer a survey, right? It’s work. And if\nsomeone can justify why to answer, [coughs] excuse me. Someone can justify why\nit is worth my time to answer their survey, then I’ll answer it. That’s the so\nwhat, that’s the action you’re going to do with this. We’re thinking about, in\nthis case it’s SARS-CoV-2, but keeping an eye on whatever the next one might be,\nand preventing that, or mitigating it coming with an early warning system, and\nthinking about where those places might be, where can we find those early\ndetections. Dogs and cats are imported all the time in this country, is that a\nplace we can maybe do some surveillance to affect a change. We just referenced\nmy cat, is there benefit to testing my cat for some things, or is he kind of—he\nis indoor only, like many, many cats should be. He’s not spreading disease probably.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/261","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: But you are.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/262","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: But I might and who is out in the world? It’s me. If he’s going to sick,\nand as fortunately he did not as far as we can tell, but I got COVID-19 because\nI was out. Because I was out doing some things and admittedly took a calculated\nrisk. I knew this was a potential outcome. Unfortunately, I was exposed and got\ninfected, but fortunately when I came back, I had the support both with my\npartner, and—","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/263","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Your cat.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/264","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: No, I know. I can hear him through the headphones. He hears me talking\nand not paying attention to him and that causes much consternation. But\nfortunately, we are in a position where I could isolate, it seems like\neffectively, to protect both my partner and my cat from getting infected. Like\nwe talked about earlier with enabling people to make good decisions, I couldn’t\nhave done that some places that I lived, I couldn’t have done that without this\njob that lets me be remote, that lets me take sick leave, and that lets me not\nhave to go in an office when I am well enough to work but maybe still infectious.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/265","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Right, and earlier when you were more of a vagabond and you didn’t have a\nplace to live, you were out there, and could have been potentially spreading it.\nThis, I think, is a really good time to turn a little bit to your personal life.\nI know we’ve gone way over our time, but this is fascinating and you’re doing\nsuch good work.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/266","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Thank you.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/267","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Let’s just turn to personal life. In your own personal life, what has COVID\ndone? How has it navigated through your life? You have family and they’ve come\ndown with it as well?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/268","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Fortunately, as far as I can tell, at least within my immediate family,\nso my brother who himself has a somewhat—he has an autoimmune condition which we\nthink might compromise him somewhat, he fortunately has not gotten infected,\nneither him nor his wife. My parents, who again fortunately as far as we can\ntell have not tested positive, have not gotten sick. My sister, who works as a\nphysical therapist in a hospital, she has tested positive, she has gotten quite\nsick, because again, this is a risk that our frontline healthcare workers are in\nsome ways choosing and in some ways being forced to shoulder. Mercifully no, not\nthat many people in my life have gotten at least known infected.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/269","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Everybody is vaccinated in your family?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/270","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Almost everyone is vaccinated in my family. In my immediate family, yes,\nand I say the almost. One of the ways in which my personal and professional\nlives kind of bleed together is when it was at least potentially safe enough to\ngather, I alluded to family in New Jersey, and the siblings are spread around a\nlittle bit, we’ve got some family, some aunts and uncles, and my grandmother\nalso spread around, but close enough to gather for holidays as we do with some\nfrequency, or as we did with some frequency. When it came time to think about\nthat again, I’m the only epidemiologist in the family, at least by training, I’m\nworking on them. So when it came time for questions about whether to gather and\nhow to gather safely, those came to me. I got to consult on those questions\nbecause I referenced my grandmother who is vaccinated, but is certainly old\nenough, has health conditions that might open her up to potentially more severe\ndisease if she were to get exposed, if she were to get infected. Very long\ncomplicated story about someone who was married to my aunt and no longer is, but\nthey have a child, and he has influenced their child, my cousin, to resist\ngetting vaccines. She actually has gotten infected with COVID-19 and so I\nbelieve has her mother. This is my dad’s sister. As the three of them, his\nbrother as well, as they’re navigating who’s going to help take care of their\nmother, my grandmother, that kind of came into play, when it is safe for my aunt\nto get back in the mix there for just taking care.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/271","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Then when it’s time to gather for Thanksgiving or for Passover, I think those\nwere the main ones that our family was looking to gather for, can our cousin\nsafely attend? This was one of these things were fortunately a lot of the group\nrealized, a lot of the family group, that I’m taking care of myself, but I’m\ndoing this to take care of my community, and in this case that’s my family,\nthat’s who I want to see. That perspective, I don’t know that she shared that\nperspective, and it’s an interesting thing that we think about a good bit. One\nof the things that I really appreciate about my upbringing is I do know my\ncousins. This is on my father’s side, but on my mother’s side I know my cousins\nquite well because we grew up going to holidays together. They were close enough\nto get to see them with some frequency. We’re not in regular communication now\nbut we see each other at holidays, we catch up, and we get along. This cousin\nthat’s not vaccinated is a good bit younger than the rest of the cohort of\ncousins and we kind of wonder, we kind of worry what her connection is going to\nbe the family more broadly if she’s not part of these gatherings, if she doesn’t\nsee her grandmother. But if we think that she is putting her grandmother at risk\nfor a serious health outcome for a way that frankly is very easy for her to\naddress, and is unquestionably in folks that are medically able, the smart\ndecision, at some point your choice to prioritize yourself or your own needs\nover the group is going to have some consequences here.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,24.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/272","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"In this particular case we came up with a plan. This is also someone who is in\nschool, so is not able to quarantine. She is in her teens so is going to school\nevery day. We know that the masking protocols maybe are not adhered to as\nclosely as they should be, so not only is this someone that we can’t—we can’t\nsay, hey, you should cloister for two weeks before Passover, and then it will be\nsafe. This is someone who is consistently being potentially exposed, and how do\nwe find, again, if not the safe way necessarily, but the safest way to\naccomplish what we want to accomplish. In the case of Passover this past\nyear—with Thanksgiving rather the year—in this past year, I don’t think she\nattended. I think we talked about it enough and she was feeling put upon in a\nway we perhaps disagree with, but so it goes, that she didn’t attend the\nThanksgiving. With Passover we put together a plan, again because she was having\nin-person school, and was still choosing not to get vaccinated, that all right,\nwe’re going to test, and we’re going to stick with the test results. This was\nanother issue that my partner and I ran into for Christmas this past year where\nher parents live a few hours away, we wanted to go visit them for the holiday.\nI’ve referenced Jewish and Christian holidays, I am Jewish, and she celebrates\nChristmas. But it’s one I’ve really come to appreciate and it’s not for them a\nreligious holiday, but it’s really important to get the family together. I’ve\nalluded to kind of the five of us, my siblings, and my parents, and I, and\ncousins, and aunts, and uncles, and I have a relatively big family. My partner\nmostly grew up with her cousins, aunts, and uncles, but mostly it’s the three of\nthem, she and her parents. Not being able to get together for holidays for a\nwhile was pretty tough. When it came time to go up for Christmas, we had to have\nthis conversation a couple of times and say, we’re all going to test, and if\nsomeone is positive, we’re not going to spend time together. I think enabling\npeople to make a good decision, a good public health decision, is sometimes at\nodds with making a, frankly, good mental health decision about how nice it would\nbe to see people. Trying to keep that in mind, trying to keep that\nconsideration, as we’re literally in their garage waiting for our fifteen\nminutes to elapse, looking at our little COVID lollipops, the card with the\nstick in it, and kind of thinking if this is positive, we are going home.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=24.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/273","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"We might not want to, it’s going to be tough, but we know that the risk here is\nsuch that we should not stay. Fortunately, everyone was negative and it worked\nout, but it was really important for us to come to that decision ahead of time,\nto really think about okay, what are we going to do, what is the important thing\nto do here. That was a bit tough. There were some things early on in the\npandemic, sadly each of my grandfathers passed away over the course of 2020. I\nthink my maternal was the very end of 2019, but we all—the one day that I took\noff of the COVID response for the first couple of months was because it took an\nextra day because I was flying from Oregon back to New York for my grandfather’s\nfuneral. Then at the end of the year my paternal step-grandfather, I guess, but\nthe grandfather I knew. My biological grandfather died when my dad was young,\nand my grandmother’s second husband died when I was very young, and she married\nagain, Mickey is the grandfather that I knew. He passed away in late 2020 and\nthe whole thing was conducted—some people were local and able to go, but I\nZoomed in. I called into the services, I called into the little bit of family\ngathering that could happen. Those were things that would have been great to be\nable to be there to comfort folks and to just kind of be with each other.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/274","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: What was that like to Zoom into something? I wanted to ask a reflective\nquestion about that but it kind of got there.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/275","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, it was tough in that—","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/276","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Did you feel isolated?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/277","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, I felt isolated. It didn’t feel real in the same way. I felt like I\nwas apart from what was going on. I knew that I was doing what I could, and I\nknew that the decision I was making to not drive or fly up from Georgia for this\nevening of services and a long weekend or so of talking to people, of being\naround folks, I knew that was a good decision from a disease transmission\nstandpoint, and I still felt like I was apart from it. Fortunately, like I said,\na lot of folks are local enough there to feel that kind of connection and as\nmuch as I’ve been up for the adventure of going up to Connecticut, going down\nfor work, going down to Virginia for school, back to Virginia for work, out to\nOregon for a couple of years, and being down here, I know there are reasons it’s\nimportant, and I would make those same decisions again. But even when I was in\nvet school, really quite busy, I’d go home, I’d see my folks a couple of times a\nyear. There’s a bit of this that I’m sure is just growing up, and becoming an\nadult, and spreading out, whatever else, but I think it’s been exacerbated a bit\nby not being able to get home, to not be able to have that same connection to a\nplace that’s still important to me. I’m not going out around South Brunswick but\nthat house, and those people, and all that, really do still resonate with me.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/278","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: How do you think this pandemic will resonate into future generations? As you\nmentioned there was the missed time at a funeral where you usually get together\nwith family members you haven’t see in a long time, and wedding, or funerals, or\nthose types of things where they all come together, you can reunite, and share\nthe experience together. But there’s these lost milestones that are going to\nreverberate perhaps into the future.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/279","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, and actually my calculated choice when I did get COVID was going to\na vet school wedding. One of my classmates from vet school who her herself was\nliving in New Zealand for a while and I just hadn’t seen her or a lot of my\nclassmates since our five-year vet school reunion, which was when I got to\nOregon basically. It was about a month later. It’s been years. These are people\nthat are really important to me. I don’t talk with all that regularly, but one\nof the things I have strong feelings about Meyers-Briggs, and\nintrovert/extrovert, and very strong scales about that and whatever else, but\nit’s an important framework I think to use sometimes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/280","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"One of the things I really truly value which was great in Oregon, which was\ngreat in Virginia and part of the reason I moved there for that Select Agent\njob, is to be around people who know me, to be around people who like—not that I\nfeel like I have to perform around new people or whatever else I’m getting more\ncomfortable just kind of with my own thing, but these are people that I’ve\nforged really strong bonds, really strong memories with, and I mean the moment\nyou see that friend walking up to the wedding venue for this thing, it’s just\nright back to it. These are people that know me and know my experience, know\nwhat I went through because they went through it, in a way that a lot of people\ndon’t. I expect the same thing will happen next time I get to go visit my\nfriends in Oregon if I go out there for a trip or if I see—I saw one at a\nconference recently and you connect in a different way. In a way that was more\nfrequent when I could just drive to a wedding. I felt really pretty bad actually\nbecause I did specifically not go to one of my vet school friend’s weddings\nabout a year ago because we had planned our first family vacation in about a\nyear and I didn’t want to—we all wanted to go, we were all being very careful in\nthe two weeks leading up to the vacation, and I just couldn’t have that week at\nthe beach with the family, and be worried that I was going to bringing disease\nbecause of a decision I made right before it.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/281","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I had a long really heartfelt conversation with my friend and I still to this\nday feel bad about not being able to go. Choosing not to go. I think that’s also\na tough thing to reckon with. I could have gone, and it might have been fine, it\nmight have been safe. Like I said, I went to the wedding now a couple weeks ago,\nand I would make the same decision again. For me I was fortunate enough to be\nable to make that choice, but to choose not to do these things have been tough\nfor a lot of the time.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/282","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: A lot of missed opportunity.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,25.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/283","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: A lot of missed opportunity and there’s part of it that I know are\noutside of my experience. I think about the vet students I talked to and how\nimportant it was for me to literally go in and see people doing this work. I\nhave met vet students, I think now they’ve gone back in, but for the first year\nor so, they hadn’t ever been in the same room with their whole class. I don’t\nthink I could have gotten through vet school that way. But there’s one story\nthat just I can’t shake that has me a little bit worried. One of my supervisors\nin Oregon, her son, she tells a story about seeing his best friend around the\nneighborhood and like running to him, just like running, running, and then with\nabout ten feet left, stops. These friends would normally just like have the most\nadorable four-year-old hug possible, but now he doesn’t know if his friend is\nsafe to be around. I’m not a child psychologist, I don’t know this in a kind of\nparticular—but that’s an important developmental time. It’s really important to\nknow how to interact with people, to learn those things, especially that. That\nstory still just breaks my heart for the moment and then the worry about what\npotentially comes from that. Again, I talk about introvert, extrovert, and\nwhatever else, it’s good for me to be around people and to feel comfortable\naround them, for whatever the reason, and when that’s not the case—that’s not\nthe case even now sometimes. Most of my friends in Atlanta or friends at CDC are\nfrankly the EIS classmates that have come here. We meet for dinner, and we go\noutside, and that kind of thing, or we go to the drive-in movie theater, which\nis great, and has been a lot of fun, but we know that we’re—there’s still this\nbit of knowing we’re there because we don’t feel comfortable going to the movie\ntheater inside or don’t feel comfortable getting together and going into a\nrestaurant. You kind of have to retrain into some of those things, I think. I\nremember someone I know from when I was in college put something up, he lives\ninternationally, and there was a time when the country was living in it really\nwas in a lull.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=25.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/284","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It really was for the case rates and the amount of testing being done, as far as\nwe can tell, safe to go outside, to be indoors, perhaps even without masks, and\nhe recalled looking at people being uncomfortable at the restaurant, at the club\nhe was at or something, and it’s like people aren’t ready, and it’s time now,\nand maybe that was a bit premature, so it might have been more pressure than\nthey thought, well that’s a thing I worry about a bunch is when is it time, when\nit truly safe to do the things we used to do. It’s going to take a bit, I think,\nto readjust to that, to choose to do those things that didn’t feel safe for so long.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/285","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Right, to hug someone. You have to turn and make sure—very social hug.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/286","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Hugs are probably okay. There was a New York Times article early on\nabout how to safely hug or is hugging okay. This was also an important thing for\nmy friends in Oregon. After some of these long days, a hug feels pretty good,\nand it helps you kind of keep going, and reminds you of a whole bunch of things.\nFor some people, it doesn’t do it for everyone. I remember very clearly talking\nto one of my co-workers, Meagan McLafferty, outside of the building one day and\njust like, I forget if I said it or she said it, but like man, I need a hug.\nLike hugs are safe, right? I think hugs are safe and also right now, whatever\nthe risk is, it’s outweighed by the benefit of a hug.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/287","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: It’s wonderful, yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/288","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: But it’s also a tough place to get to. I think we needed that hug\nbecause we spent the whole day working on calls or hearing about people getting\nsick and dying.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/289","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Yes, early on the interactions were so—there were these strange rituals that\nyou would go through. When you came home some people would be wiping down their\neverything, groceries they bought before they came in. People would take their\nclothes off before they would go see their—change their clothes and see their\nfamily. It was a crazy ritual. You’d go for a walk, and you’d avoid people when\nyou would walk. Everybody was so separate. You tried to form pods but then\nsomebody would break the pod.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/290","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Some of those articles looks into the idea that your bubble is a lot\nbigger than you think it is, really eye opening. Partially because of what\ncontrol you do or don’t have, but also that reminder—I don’t know if this is\nexactly the right thing but as you can, I think, see in the background, I like\nputting together Legos, and off in the corner is 123 Sesame Street, which is a\nlovely set. But the reminder of people that you meet each day, that feels very\nweird to use the Sesame Street theme song in this interview, but these are the\npeople in your neighborhood. In order to live your life, you’re going to run\ninto people, you’re going to see folks. This was again, part of the lesson I\nlearned about telework when I had the job in Virginia is when you don’t do that,\nwhen I go three or four days and the only in-person conversation I had was the\ncashier at the grocery store, that’s not good.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/291","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: [laughs] It’s true.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/292","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: And it caused me some serious mental distress over time before I kind of\nnamed it and realized what it was going to be, how to help address it.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/293","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: You have those tools to do that but not everybody has that.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/294","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I didn’t then, so it took that learning experience. This was a\ndiscussion with my partner and with the folks at work, when I had the—my job got\nreclassified as fully remote, that wasn’t the decision, my job got reclassified\nas it could be fully remote if I want. That’s how flexible I can be if I want\nto. I know that I benefit from the structure of going to work, of being around\npeople, of coming home, but I also know the benefit from the flexibility of\nliving with my partner. I can’t necessarily do both of those things, so the\nchoice that I made, that again I would make thousands times out of a thousand,\nis to be here, and I have to engineer some of the other things around it\nbecause—sometimes the hard way, sometimes I more practically went out and sought\nit, but I’ve learned those lessons.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/295","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I figured hey, this doesn’t work or this does work, this can be a problem if I\ndon’t do certain things.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/296","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: What do you think will permanently change after the pandemic? If the pandemic\nis ever over? Or are we just going to slide into an endemic kind of situation?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/297","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: There are some places that are already declaring endemicity, which is\ninteresting. Yes, I don’t know if it’s so established and so changing that\nthere’s a fully past this. I think some of the flexibility that has been opened\nup are really quite nice. One of the reasons that USDA was so proactive, I\nthink, in doing this reevaluation is that prior to this if you wanted to move up\nin USDA you could start in the field, but if you wanted to keep moving up you\nhad to go to a couple of places, a couple of locations for headquarters.\nObviously with CDC, if you want to work at CDC, you more or less have to be in\nAtlanta. There are a couple of other locations, of course. That’s not a great\nway to retain or attract talent. There are some really smart people who look at\nthis like I have this set of skills, and I can do this job for USDA, maybe I\nwant to do this job for USDA. I get if you’re someone like me, for example, you\njust get fulfillment out of public service, it just is part of it. But if you’re\ngoing to tell me I have to go to, I mean no ill will to Minneapolis, but\nMinneapolis, Minnesota where there’s a USDA headquarters, and I don’t want to go\nthere because I want to be close to my family in New Jersey? Maybe I’m not\nstaying with USDA, maybe I’m going to go get less fulfillment from work, but\nI’ll get my fulfillment from being close to family.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,26.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/298","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"The analogy that I came to, I think I came up with it, although I’m sure others\nhave, about fulfillment and something that my time in Virginia kind of caused a\nbit of a—spurred on this discovery, I don’t know what the word quite is, for me,\nthe idea of this fulfillment dog sled. You’ve got the different dogs that are\npulling the thing along. For a long time for me work or school, the work or\nschool dog, was doing the pulling, was doing almost all of it, and the\nfriendship, and the relationship, and the hobbies, and those kinds of dogs were\ndoing some work as well, but without that big dog up front, the thing wasn’t\ngoing. The extension of that, and I kind of knew this, and wanted to keep things\nmoving, so to torture the metaphor a little bit, that’s the dog that got fed. My\ntime was maybe disproportionately spent on work or school in a way that it\nperhaps could have been spent on friends, and family, and relationships, and\nhobbies, but it was in the service of keeping that fulfillment sled moving\nforward. Whenever I ran into, in my case it was the job when I was in Virginia\nwith Select Agent where it just wasn’t fulfilling in the same way that previous\nwork, and school, and stuff like that would be, and I didn’t know how to\nredistribute my care and feeding of the different dogs, I guess. I had a bit of\na crisis, I had to kind of build those things into my routine because some of\nthose things weren’t moving forward in the same way they were before. Learning\nto, in this case, like I said, could work feel a bit better for me, could it\nmove forward a bit, by going into an office? Yes, maybe. But would that impact\nthe other things negatively? Yes, without question. I think the flexibility\nreally is nice. Our team at One Health, there are five of us in our small group.\nThere happens to be someone else at CDC at Atlanta, so you’re actually imbedded\nat CDC headquarters, but the other three people we’ve got someone in Raleigh,\nNorth Carolina, someone in Riverdale, Maryland, someone in Fort Collins,\nColorado. If I went into the office, I would be on Teams calls from the office.\nI think that the flexibility and the access, I’ve done a whole lot more\ninternational work involved in that kind of thing than I would have ever done.\nThat is great, that has opened up things, to get access to people that just\nweren’t going to be part of this before. What we’ve lost is the interstitial stuff.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=26.0,27.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/299","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Right, that’s what I was going to ask you about, do you miss the parts\nwhere—I was going to say your soup club type things?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=27.0,27.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/300","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Definitely. I remember walking back from meetings sometimes and just\nstopping by a friend’s cube and talking for a few minutes. Sometimes about work\nbut sometimes not because part of it is in service to that peacetime relations\nthing, it’s important to know who you work with. Part of it is you can’t, some\npeople can, I can’t focus on work eight straight hours and just work. Got to\nhave the mental refresh. It’s really good for that kind of thing. It’s nice that\nour group chat on Teams has kind of become a place for that. It’s not always the\nmost professional place, we kind of tell jokes, and send a GIF here and there.\nIt’s always safe for work consumption but there will be a reference to\nsomething, and you realize, okay, I’ll go for a joke here. It’s nice to have\nthat kind of thing. I think it’s made interactions intentionally in a way that I\nhope can be less so. If you want to talk to someone, you can’t just, in my case,\njust stand up and look over the cube wall, or even just like shout, hey Mike, I\nwant to talk, got a second. You have to send them a Teams calls, they have to\naccept it, so it’s an intentional way. It’s not hard to do that, but it’s harder\nthan it was, and it’s just that little extra bit of motivation to take that step\nlike is it worth it to make this call, I don’t know.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=27.0,27.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/301","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Those kind of things and again the interstitial stuff where it’s one thing for\nme to be working and look at my Teams chats and see oh, some people look at\nSkype, as I did before, see a bunch of green dots, so oh, other people are\nworking. That’s not the same as seeing someone else in the office like okay, I’m\non this team and I’m not doing this alone. The flexibility is worth that\ntrade-off, but I think as this becomes a more real part of the work, trying to\nengineer in those touch points, trying to have—one of the things I’d love, I\nfeel bad because we haven’t done it for a while because other things have come\nup, but within our team we have a small group working on a project. We had,\nsometimes multiple times a week, but we for a while stuck with weekly calls that\nit wasn’t about work, it was just how are you doing, just checking in, making\nsure. Because it’s also tough to see, I guess kind of an extreme example would\nbe if I broke my leg while I was out walking yesterday, you don’t know that. You\nsee me from the shoulders up. Maybe I’m not so willing to go check it out, get\nit checked out, but if I was in the office you’d say, Steve, you look horrible,\nyou should go get that checked out. Or even just the hey, how’s it going. Is\nthat worth the cost of a Teams call? Maybe not. Some of those conversations,\nsome of those little bits of checking in I think are lost. It’s important to do,\nI think it’s incumbent upon managers in particular, but also upon just\nindividual people to try and engineer those things back in. I don’t think we\nhave the best tools for that just yet.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=27.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/302","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Then this isolation, you have your partner, and then you also have Zeke, so\nthere’s that. Then there’s the people who went and got pandemic animals and now\nare returning them. Mental health has become another one of these huge themes\nthat has been brought to light because of the pandemic and that’s going to be an\nongoing topic for many years to come along with the whole missed opportunities,\nfunerals, wedding, coming together. Empathy seems to have really become a\ndifficult topic for a lot of people.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/303","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I want to start to wrap up here because we’ve gone on a long time, but it’s been\ngreat. I wanted to ask you if you had anything that has been on your mind\nthroughout the pandemic. That’s the question.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/304","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I’m thinking about the conversation that I had with that student earlier\nthis week that one of the most important lessons I learned, I don’t know how to\nfix this, but it helps set my expectation, like there’s the work, there’s the\nwork that you’re doing, and there’s all the other stuff you have to do to\nsupport that work to make it possible. I often find that the second stuff, the\nsupport stuff, that’s what’s tough, that’s what is really difficult, and\nsometimes necessarily so. One of the things about the pandemic that just rankled\nme the whole time is that second stuff, the stuff to make it to the work, to\ntake the work out into the world and make it actually do stuff, was made so much\nmore difficult than it had to be, that was intentionally done, and it makes it\nreally tough to come back and do the thing when you know that people are pulling\nagainst you. When you look at—","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/305","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Can you describe what you’re talking about?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/306","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, I think in general I mentioned the time when Dr. Messonnier talked\nabout how serious this was, and we took that to heart, and our responses\nfollowed. But when there’s conflicting messaging about how serious this is and\nwhat our priorities are. Conflicting priorities are a reality, that’s important,\nit’s important to understand and acknowledge those. But I alluded to the access\nof testing, one of the things that we saw often, or we had to deal with a little\nbit with some of our hospitals, is we’re doing screening testing, or our CEOs\nwant—I take that back, they ended up being pretty good about that kind of thing.\nPeople had to get the message about testing, and why I’ve talked about testing\nnot being the only form of caring so much, is because it was talked about in a\nlot of circles as far up as the president about either the importance of not\ntesting, which was also maddening, but to see people testing with a lot of\nfrequency frankly above and beyond what the science was maybe saying, and to\nalso look at the hierarchy of controls, the approach that looks at what is\nclosest, what is the most approximate way to prevent this, is that often the\nleast effective and the most work, how do we step back, how do we go up this\nhierarchy and mitigate the hazard, how do we remove the hazard, how do we\nreplace it. Looking at people not taking an approach like that and choosing to\nmake it tougher for other people when it didn’t impact the person making the\nchoose was tough.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/307","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Are you talking about the federal government and leadership at the beginning\nof the pandemic? And misinformation that would sometimes come out.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/308","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I am. My public health side pandemic experience doesn’t stop in October\n2020, but I really go to the animal side then. When I talk about the effects on\nhumans and that kind of thing it’s mostly focused there. The work spent chasing\ndown all the nonsense about hydroxychloroquine, and ivermectin, and bleach, and\nwhatever else, there was some science behind some of these conversations, but\nthey were taken and intentionally for often the gain of limited sets of folks,\nmanipulated and misrepresented in a way that was causing serious illness,\nserious problems for people, but also on the public health side it was causing a\nlot of work that was unnecessary, was really making people clear out some of the\nstuff, some of the other stuff, to get to the work that’s got to be done. That\nwas tough. Again, I touched on the different motivations. Truly, and I wrote\nthis in my EIS essay, I’ve written this in other things when it is appropriate,\nservice is important to me, it just resonates. I know it doesn’t resonate with\neveryone in the same way and that’s fine, that’s how the world is supposed to\nbe, but it makes it really tough to understand peoples’ motivations when they’re\nexplicitly pulling against that, when they’re not all rowing the boat in the\nsame direction.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/309","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Tough to navigate the boat.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/310","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/311","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: I’ll ask my last question, well, not my last question. What’s been the\nbiggest personal challenge you’ve faced during this pandemic? If you had one.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/312","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Yes, for me it has been the uncertainty and frankly the—this is a very\npersonally focused response, but the come down. Yes, like I said, there are a\nbunch of decisions that I’ve made for non-work reasons that I would make over\nand over again. I’ve been thinking about EIS for a long time, and then I got\nthere, and it’s a cliché, but it’s everything I had wanted and so much more. I\nhad no idea what it was going to be. I had an incredible experience. I sometimes\nfeel when I am talking to prospective EIS officers that I have to tone it down\nbecause I am selling them on the goods, they are not going to have as good of an\nexperience as I did. I had an incredible experience. Some of those times, yes, I\nwas working far too many hours, far too many days in a row, compromising other\nparts of my life sometimes, but I felt like fully optimized in a professional\ncapacity in a way that was particular to the moment. I know this that I can’t\nrecapture the feeling of professional growth on a literally daily basis, but\nthat’s also tough. That fulfillment sled in some ways was really moving along. I\nmight have been falling asleep at the wheel because I was too tired to direct\nit, but it was moving forward.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,28.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/313","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Another thing I touched on like feedback loops and the pace of things, the\nfederal government is slower, it just is. It’s the cruise ship that’s going to\ncarry a lot of people real far and takes a long time to turn. You can be more\nnimble at the state level. I really fell into—not fell, I really kind of took to\nthat pace. I knew I couldn’t stay. Like I said, I had the USDA commitment, and\nit’s the work I want to do, but having seen some other parts of sometimes it’s\nwork, sometimes it’s even stuff outside, having seen those things that are not\nrecapturable has been tough sometimes. Even though they’re for good reasons. I\nnever want to work how many ever hours in a pay period I was working again. If\nthat’s happening something has gone terribly horribly wrong. That’s not good for\nobviously the broader world, but also for me, the people close to me. At the\nsame time I knew what I was supposed to be doing and I felt really good about\nthat. I felt very fulfilled by that work. I knew when that weekly LPHA call came\non, Local Public Health Authority, I knew what I was there for, I knew what I\ncould do, I knew that I was helping people, and it was really clear that I could\nget that done. Again, we talked about confidence, I was confident. It wasn’t\njust the feedback of like oh, thanks Steve, that was helpful, it was just the\ncomfort of knowing without that response that I’m good at this, I’m helping, and\nthis is just a great combination of my particular skills and approach and what\nthe need is in this particular moment. There are other ways I’m trying to find\nthat and really find it in kind of a different perspective, but it was clear and\neasy for some times there. Not the whole time in Oregon definitely, but some of\nthe time having seen what that looks like after having not seen it before, has\nmade it sometimes a little bit tough.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=28.0,29.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/314","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Tough in what ways?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=29.0,29.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/315","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: I think to stay motivated. It’s really easy to come in and do hopefully\ngood work, to work really hard, when you have that confidence, when you know\nwhere this all fits. Sometimes when you don’t have either the perspective to\nknow it or the feedback to get that perspective, you kind of worry that you’re—I\nkind of worry that I’m going down a path that isn’t going to be helpful in some\nways with a particular project or whatever else, where it’s a thing that’s\nimportant to me, but without the connection to the broader group in the same\nway, and without knowing that it’s also a priority for other people because—oh\nman, I’m going to invoke that again, I feel like I’ve done this a couple of days\nthis week. [laughs] There’s a, I forget from what country, a proverb, I know it\nbecause the UVA basketball coach has used it a bunch, but this idea that if you\nwant to go fast, go alone, and if you want to go far, go together. The problem I\nthink I face sometimes is I see where I think we should go and the pace of not\ngoing fast can be kind of tough. Not only do I feel like I have to get momentum\nbut sometimes people don’t know where—sometimes people don’t agree that’s where\nwe’re supposed to go as an agency. Part of it is being able to make my case and\nbe clear about hey, no, I think we should, and let’s talk about it. Part of it\nis accepting no, that’s not where we’re going to go as an agency and trying to\nfigure out what that means for me personally, and finding the same kind of\nfulfillment knowing, even for often justifiable reasons, that we’re going to go\nin a slightly different direction. How does that resonate with me, how do I get\nthe same fulfillment from the work part of it. Sometimes, and this is a thing\nthat has been a good learning experience, sometimes the answer is not that sled\ndog that’s going to do the pulling this time. You’ve got to put some resources\nelsewhere and that’s how to move forward through this part.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=29.0,30.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/316","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Well, good.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=30.0,30.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/317","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: Thanks.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=30.0,30.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/318","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: We’ve come to the end of a very interesting conversation. I just wanted to\nask the last question which is—","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=30.0,30.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/319","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"what else haven’t we covered that you would like to share. Which sled dog is\npulling your sled today?","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=30.0,30.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/320","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"REKANT: There’s literally Legos off to my screen here so I’ll just hang out with\nthe cat and get him away from the instructions a little bit, have some nice\nfood. Yes, I’m not sure that there’s anything that’s really trying to push its\nway to the front that we haven’t talked about.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=30.0,30.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/321","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Q: Well, then thank you for your time and your stories.","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=30.0,30.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/transcript/69860/annotation/322","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"12 ","format":"text/plain"},"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=30.0,30.0"}]},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/index/85345","type":"AnnotationPage","label":{"en":["content172466200620240826-2043719-spa75.xml [English] [Index]"]},"items":[{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/index/85345/annotation/323","type":"Annotation","motivation":"supplementing","body":[{"type":"TextualBody","value":"Background","format":"text/plain","label":{"en":["Title"]}}],"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=44.0,470.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/index/85345/annotation/324","type":"Annotation","motivation":"supplementing","body":[{"type":"TextualBody","value":"Dr. Steven Rekant describes his early childhood, interest in nature, and educational background.","format":"text/plain","label":{"en":["Synopsis"]}}],"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=44.0,470.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/index/85345/annotation/325","type":"Annotation","motivation":"supplementing","body":[{"type":"TextualBody","value":"Thank you. Before we dive into the details here about CDC [Centers for Disease Control], and COVID-19, and EIS [Epidemic Intelligence Service], could you tell me a little bit about your family background and the community where you grew up? ","format":"text/plain","label":{"en":["Partial Transcript"]}}],"target":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548#t=44.0,470.0"},{"id":"https://globalhealthchronicles.aviaryplatform.com/collections/2849/collection_resources/134497/file/249548/index/85345/annotation/326","type":"Annotation","motivation":"supplementing","body":[{"type":"TextualBody","value":"New Jersey","format":"text/plain","label":{"en":["Subjects"]}},{"type":"TextualBody","value":"Virginia","format":"text/plain","label":{"en":["Subjects"]}},{"type":"TextualBody","value":"Washington, 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