Dr. Thespina “Nina” Yamanis, associate professor at the School of International Service (SIS), holds a PhD and a master’s in public health, and focuses on understanding health behavior related to infectious diseases. Her research areas include HIV prevention and immigrant health. Dr. Yamanis also conducted research during the 2014-15 Ebola outbreak in Sierra Leone, giving her the opportunity to observe community perceptions to the government’s response efforts at the time. She has recently been featured in the media regarding the COVID-19 (coronavirus) outbreak, and we [virtually] sat down with her to hear her perspective.
How can non-public health experts better understand COVID-19?
I think this is the “perfect” virus, in the sense that it’s easy to transmit and it only kills around 6% of known cases. That means it’s going to stick around in our community for a long time—for as long as we have people interacting and spreading the virus. That’s why we hear so much about physical distancing, otherwise known as social distancing; the only way to really stop the spread of it is on a population level is to stay away from each other.
How is this different from other infectious diseases, such as Ebola?Unfortunately, there have been several studies that have shown that even people who are not experiencing symptoms can spread the coronavirus. That was not true during Ebola—with Ebola, it was more that people who were experiencing symptoms (and were likely visibly sick) who could spread it. To me, it’s quite scary that someone could not know they have [COVID-19] and be spreading it to others.
Are methods like widespread testing and contact tracing effective in combatting COVID-19?
We’ve seen from a few countries that have been able to contain outbreaks—like Singapore, Hong Kong, Taiwan, South Korea—that widespread testing and contact tracing can help reduce the spread of transmission. Once you know that someone has it, you contact everyone around them and let them know, and they also isolate. But those countries also have had access to more testing and better hospital systems than we have. For example, Singapore hospitalizes every person who is infected and has symptoms, and isolates them. Those who were in contact with those patients must stay home, and they are monitored on their phones to make sure that they are complying with quarantine. In Singapore, Hong Kong or South Korea, they tell you specifics about the cases in your area, such as: “Case 120. This person lives at such and such place; this person went to this market.” Unfortunately, we have nothing like that in any state in the US. New York has posted some information on particular neighborhoods where there were infections, but not specific locations such as markets and apartment buildings. Without widespread testing, the virus has continued to spread in the U.S., and people aren’t notified they were in contact with a case, and that means everyone is at risk.
What is the most important thing to do now?
In addition to maintaining our physical/social distancing, we must keep pushing for better testing. Massachusetts just announced they’re going to do contact tracing (contacting people who have had contacts with a known case), as we’ve seen in Singapore and elsewhere, but that’s going to depend on their ability to test everyone. Testing doesn’t just require having the physical kits—it requires laboratory capacity to process the tests. Unfortunately, there’s been a disinvestment in public health labs in the US over the last four years, and we don’t have that capacity at our public health labs. So, we’re going to have to rely on private firms and labs to do widespread testing in the U.S.
We also need to consider economic support—other countries have provided more economic relief to citizens who are affected by the outbreak. There are ramifications of the outbreak beyond illness and death—people are out of work and are really suffering, and that suffering could lead to even greater virus spread. In the U.S., we’ve seen unbelievable lines at food banks and we have reached 6.6 million unemployment claims. Some people won’t receive their federal government stimulus checks for weeks because they don’t have a direct deposit account set up with the IRS. If people can’t maintain physical distance because they need to work, because they need to feed their families, we will continue to transmit the virus. I would like to see even more response by the government to provide economic relief, food relief, and health care relief to those who are low income and lack access to those things.
What can regular citizens do to help?
Comply with physical distancing and wear a mask in public. If you are doing a good job on those fronts and want to do more—and not everyone can—provide relief to those who are suffering, such as low-income workers. For example, donate to a food bank or a community health center that provides health care to low-income people. Health care workers are really on the front lines of this, so whatever we can do to support them, be it sending food, calling our representatives to get them more ventilators, donating to personal protective equipment (PPE), donating supplies if you have them. If you bought masks for yourself, put on a cloth one and give the medical masks to your health care workers. Health care workers are critical; if we lose them, we lose this fight.
Are you planning any research to contribute to the response?
I am going to offer a practicum this summer for SIS Master’s students to work with La Clínica Del Pueblo—a federally qualified health center that primarily serves Latinx immigrants—to help them with their response. We may end up doing interviews with their clients or explore how this pandemic has affected them and what can be done to help. It’s still coming together, but we are working with La Clínica on what they need to reach their clients, who are particularly vulnerable to losing their jobs [right now]. La Clínica is based in DC and Prince George’s County, MD—they serve about 4,000 Latinx immigrants in the DC metro area. They also crucially serve people living with conditions such as HIV and diabetes, and these are populations that, right now, are not going to be able to access in-person health care or even their normal support systems.