BENTON TOWNSHIP — Tucked away in the Berrien County Health Department is an essential employee whose job it is to prepare for and respond to the spread of diseases.
Guy Miller, the health department’s epidemiologist, has recently put in many hours following the spread of COVID-19 in Berrien County and trying to get ahead of it.
But that’s only just part of his job.
Herald-Palladium Staff Writer Alexandra Newman practiced social distancing and did a phone interview with Miller to learn about what an epidemiologist does, how he got into the field, and how we can best protect ourselves and others from getting COVID-19.
How would you describe epidemiology to a person on the street?
The one thing I always get, and maybe it’ll change after a global pandemic, but people always think we’re skin doctors. They hear “epi” and think skin, but it refers to epidemic. We, as epidemiologists, are scientists who study diseases and how they spread. It’s the study of how often diseases occur in groups of people, why they’re occurring and where they’re occurring.
We do a lot of mapping and tracking of the disease, trying to understand it and get ahead of it to try to stop it before it spreads across the community. We are like the disease detectives, that’s what people refer to us as, but we do a lot more than that too. There’s a clinical side of epidemiology, a research side and your public health epidemiologist who does a little bit of both.
What has it been like during the COVID-19 pandemic so far?
We are responsible in public health to follow up with anyone who has suspect COVID-19 or a positive laboratory case of COVID-19, so me and our public health nurses are working really hard to do contract tracing. We ask them to self-isolate and ask them who they’ve been in contact with.
One person could have five to 10 contacts if they’re super popular, and we go call all of those people. If they have any symptoms, we tell them to stay at home and stay away from everyone. Obviously, before the executive orders were put into place, we were finding the average person might have 10-15 contacts, but now that more people are staying home, we’re finding people are having fewer contacts, which makes our job a little easier.
Right now, we’re working really closely with Spectrum Health Lakeland. They send us lab results and up-to-date information. They let us know how people are doing in the hospital so we can track that and monitor that really really well, and so we can report that back to the public about what’s going on.
I’m in a lot of contact with the doctors and nurses at the hospital, as well as different community partners, like long-term care facilities. I’m in charge of following up with them and providing guidance on ways we can help control and contain COVID-19.
How did you get into epidemiology?
I graduated from St. Joseph High School in 2008. I’m a local, so I grew up here. After I graduated I was thinking health care. My mom had a bit of an influence on that because she’s a surgical nurse.
I was pursing pre-med while I was at Grand Valley State University, and that was the route I wanted to take to get into med school and some kind of medicine. My types of medicine that I wanted to do slowly evolved from something that was hyper-focused on one area, like surgery, to like, how can I help the broader sense of the community?
I wanted to keep people healthy, not just save lives; keeping people from getting sick in the first place. Eventually I found the door of public health. The whole idea of public health is like being a physician for the entire community.
After completing my pre-med curriculum, I found myself in a masters program at Walden University pretty quickly. I was working in a hospital as a phlebotomist full time while I was completing my masters course work. It taught me a lot of really good lessons about patient care and laboratory testing. It’s almost like disease surveillance. It taught me a lot about the clinical side of epidemiology, like the tests we’re ordering and different kinds of tests. It also taught me about how to prevent infections, because you’re washing your hands constantly to prevent spreading infection person to person.
During the last six months of my masters work, I worked at the Kent County Health Department under their epidemiologist, and that really got me fired up for not only a career in public health, but a career in epidemiology. Two months after that internship, the position opened at the Berrien County Health Department and I took that. That was in 2016.
What is your work like when there isn’t a global pandemic happening?
I work with our food team to monitor for food-borne outbreaks and infectious diseases that are spreading that way. I was very involved in Eastern Equine Encephalitis when we had that going on.
We’re constantly surveying for lyme disease and West Nile virus. Salmonella and campylobacter are the two most common food-borne illnesses that we’re constantly following up with people about.
I do a lot of work with our public health nurses on following up with actual sick people to figure out where they’ve been exposed and what they’re sick with. I also make recommendations for travelers and people coming back to the country.
I work with nursing homes and adult daycare facilities, following up with them if they ever get one person in their facility that has flu-like illness. We help them lock that facility down, so none of that flu-like illness can spread. So, already having those community partners in place and developed, it’s been a pretty good spot for what we’re doing right now because COVID-19 presents with respiratory symptoms like the flu.
There’s also the public health epidemiology. I work with Lakeland’s population health department trying to get community data on obesity, exercise, access to health care providers and access to good foods.
The health department runs a farmer’s market as well and I’ve been very active with that, trying to bring food access to Benton Harbor. There really are no big stores in the city that sell a lot of fresh fruits and vegetables, so we coordinate food for people because we know what you eat can determine a lot of what your health outcomes are. It’s important for a public health and an epidemiologist perspective that people are getting access to good food.
Epidemiology is kind of the backbone of public health because we provide a lot of the data and decisions that drive a lot of the policies made in public health.
There’s a lot of advice and information flying around right now. What is most important for you, as an epidemiologist, that you’d want to let people know?
Right now we’re in the mitigation phase of a pandemic. We know we can’t stop the spread of coronavirus in our communities. It’s widespread.
The lockdown orders, and people coming into contact with less people, are going to directly impact how the curve bends. Now that people are coming into less close personal contact with others, there’s less risk. But I can’t say there’s no risk.
Your risk is directly dependent on your own behaviors. Coronavirus doesn’t go through the skin in our hands, it needs to enter our eyes, nose or our mouth. So if I completely refrain from ever connecting whatever that virus was to my eyes, nose and mouth, I’m very unlikely to get it.
But, if I touch something gross, then pick up a sandwich and contaminate the sandwich, and eat it, that could be my disease transmission. So one of the best recommendations we have to stop this is: wash your hands.
The second most important thing is social distancing. If you did decide to do this interview in my office, and we were in close proximity for more than two minutes, it’d be possible that the particles of spit that I’m putting into the air while I’m talking to you can hit your eyes, nose and mouth. That’s the droplet spread we’re concerned about.
If I’m an infected person, a good way to mitigate that if we’re going to be in close personal contact, is to put a mask on me. I know I can’t hit you with my droplets if I have a mask on. That’s still our recommendation – we’re masking the sick people.
Now that we’re moving into knowing there are people that are a-symptomatic transmitters, I very well could have a virus and could spread it to you. So, if you’re going to be having contact with strangers, which no one should be right now, you should wear a mask to protect the stranger from whatever you might be carrying around.
There are people in their homes right now watching movies about pandemics, do any of them get it right?
I’ve seen a few of them, because as an epidemiologist I was interested in them when they first came out, but a lot of them are like the CSI’s of epidemiology.
In those shows, the police officer is doing all of the work. That’d be awesome if I was the field epidemiologist going in with my hazmat suit trying to find patient zero, but a lot of it happens at a computer desk, trying to figure out, based on statistical analysis or simple contract tracing, who’s exposed and where this is coming from.
Do you have pets or family members you’ve been spending a lot of time with?
I have a roommate that I’ve known since I was 3 years old. So that’s really where I’ve been spending my time, other than work. I have awesome colleagues. I see these people much more often than I see my family. We’re considering everyone here at the health department close personal contacts. We are like a family here.
My birthday was March 27; my 30th birthday. We celebrated here at the health department. Everybody brought in cupcakes and cookies, so I was able to have somewhat of a celebration with my close contacts here.
Is there anything else you’d like to make sure I include about you or that you want people to know?
I can’t emphasize enough how lucky, I think, Berrien County is to have the partnerships we do, especially Spectrum Health Lakeland. They’ve stepped up in a huge way in their ability to get results for tests faster than the state can. Their turn-around time is about 24 hours, while the state takes about seven days. That makes a huge difference when we’re contact tracing.
Another message for the public, a positive COVID-19 test does not change the way you’ll be treated. A positive test simply tells public health that we need to get ahold of you, start doing a contact investigation and tell you to stay home.
Even before COVID-19, that is our recommendation. If you’re sick, don’t go to work because you’re going to spread that illness around, whether it’s flu, COVID-19 or something else. I can’t stress that enough; people need to listen to that advice. You’re doing a great thing for your coworkers and their family members who they might be going home to. People need to take this seriously.
Not everybody needs to be tested. We’re really saving these tests for how we’re going to triage people in the hospital when they need critical care, like if they need to go to the COVID-19 unit. We don’t want to put them at any more risk if we know they don’t have COVID by admitting them to the hospital.
We don’t have enough tests in Berrien County and even if we did test everyone in Berrien County today, your risk will change by next week. You’d have to be tested again because you could be re-exposed. Getting a negative test is not a clean bill of health.
It’s about minimizing your exposure, and if you’re symptomatic stay home, stay away from people.