"The Epicenter of an Epidemic is the Best Field": The Diary of China FETP Fellow Wang Senlu on Three Anti-Epidemic Missions
My name is Wang Senlu. I am a staff member of the Xinjiang Center for Disease Control and Prevention and an 18th-cohort fellow of the Chinese Field Epidemiology Training Program (CFETP).
2020 is an unforgettable year for me. The COVID-19 epidemic caught us all by surprise. As a member of CFETP, I know my duty and calling is in the field, and I believe in the power of epidemiological investigation to control the epidemic. With my fervent heart for public health and tools learned in CFETP, I yearn to contribute to combating the epidemic. Therefore, I applied and was included in three major domestic and international field investigations. Those 208 days of fighting started on the eve of Chinese New Year.
It was January 24, 2020, the day I said goodbye to my parents, my wife, and my daughter, who had just learned to walk. I boarded the train heading north from Korla, in southern Xinjiang, to Urumchi. The train looked empty and desolate, but my destination was clear; that is, to the epidemic’s center. I still clearly remember that, during a session of the CFETP core course, public health veteran Dr. Zeng Guang said, “All epidemiologists are trained and developed in the field.” So after witnessing the unforeseeable spread of the epidemic from behind the desk at Xinjiang CDC, I voluntarily applied to my supervisor, hoping to go to the epicenter of the epidemic and participate in epidemic prevention and control in the worst-hit prefectures. On January 27, I had the honor to go to Yili Prefecture, together with a provincial experts’ team from Xinjiang, to fight against the epidemic on the front lines.
In the field, my main task was to locate the infectious agent and to conduct contact tracing as early as possible with epidemiological investigation. The day and night seemed to blur in the COVID-19 designated hospital and department for high fever, where most of my interviewees were. On average, a case investigation took around two hours. To make the most use of the one-time-use PPE, my teammates and I did not stop until almost all of our strength left our bodies. Due to the varying states of the interviewees, on good days, I could complete over five case investigations. If I was unlucky, the information of three cases was all I could gather before total burnout. I still remember the sweat dripping down my back and the seemingly permanent mask marks on my face. At that time, my knowing of my duty carried me on.
In those 46 days and nights of struggle, I participated in a study of four family clusters, carried out field epidemiologic investigations of returnees from abroad in the red zone, traced and identified four epidemiological transmission routes, and put forward several public health response recommendations that were adopted by the local authorities. I was anxious, stressed and flustered. However, the spirt of CFETP inspired me; I made it through and grew up. The experience I gained during this fight laid a foundation for my subsequent participation in the epidemic control campaign in Kyrgyzstan.
On April 27, the day after my son's birthday, I boarded a plane to Manas International Airport, Kyrgyzstan, to participate in an international humanitarian assistance mission against COVID-19. As Chinese public health experts sent to Kyrgyzstan, my team members and I participated in the fight against the epidemic in Bishkek, the capital of Kyrgyzstan, and the Chuy Region. We visited several hospitals, laboratories of the local disease control bureau and medical centers, and shared our experience in epidemic response with Kyrgyzstan government officials and professionals at health facilities and CDCs, communities, etc. We participated in more than 20 on-site mentoring sessions and seminars, provided training to experts at the National College for Continuing Medical Education, health workers, and community workers. China's experience in fighting the epidemic was shared with those who needed it most. Dozens of localized recommendations proposed by our team were adopted by the locals.
Later in July, the city of Urumchi was forced to press the “pause button” due to a local outbreak. During this battle near my home base, the support from my family encouraged me to work day and night to carry out epidemiological investigations, to participate in the study and analysis of the epidemic, and to contribute as a member of a "think tank" for our governmental epidemic response. After a month of fighting, the epidemic was eradicated there.
During the 30 days and nights after cases were identified there, I combed through the epidemiological investigation findings, assisted the epidemiological analysis team to identify the transmission routes and time series of more than 100 cases, assisted with epidemiological investigation into (and management of) more than 100 cases, developed four analysis reports, and helped develop six technical guidelines to provide the technical basis for source tracing and epidemic response. On this mission, I became more sober and calmer than I was on the mission before.
Following three frontline battles against the epidemic, I realize why Dr. Luo of CFETP said, “The epicenter of an epidemic is the best field. Every time I went to the epicenter, I felt full of passion to end the outbreak. I believe field epidemiology is the right direction.” For my personal development, in the 208 days of field investigation, I grew from my greener self in my first combat to a foreign expert who received the “Medal for Outstanding Contribution to Public Health in Kyrgyzstan” from the local Ministry of Health in my second combat. I contributed as a member of a “think tank” for our governmental epidemic response as an experienced expert. Three battles with COVID-19 in three different fields were chances of nirvana for me and millions of public health workers like me. With all the struggling and striving I experienced, my belief strengthened that “it is the duty and mission of public health workers to guard the health and safety of the people from disease.” And I will continue to pass on the “learning by doing” spirit of CFETP and to contribute all I can to strengthening our field epidemiology workforce.