Everyone knows that epidemiological investigators are the invisible solders who keep pandemics at bay, but few know the lengths to which these public servants go to protect the nation.
Aside from the more obvious work of contact tracing, these “disease detectives” are asked to do any number of dirty jobs, from climbing up water towers for samples to catching mosquitoes in pig pens.
Lin Chih-hsuan (林治萱), who now works as a long-term-care nurse, served as an epidemiological investigator from 2011 to 2018.
Lin last week recalled her experiences working in a job she said was often difficult and trivial.
“Investigation is the main point of attack for controlling epidemics,” she said.
Each investigator is a soldier in the battle against infectious disease, collecting information for health authorities to ascertain its spread and identify weak points, Lin said.
Knowing this granted her a sense of purpose that kept her going through seven years of difficult work, she said.
Among the most basic of skills required of investigators is learning how to communicate with patients, who must be comfortable enough to answer probing questions honestly.
The key to success is letting people know that “I am here to help,” Lin said.
When first meeting a contact, she said that she identified herself and explained her intention from the beginning, while emphasizing that their conversation would not be disclosed.
However, as it took time to build trust, it would often take several visits to collect all of the information that she needed, Lin added.
At first, most people would only share limited information until they realized that it was not being shared with others, then after a few days, they would begin to reveal more details and contacts, Lin said.
“Whenever I got a call saying: ‘I forgot to tell you something two days ago,’ it was usually a big deal,” she said.
“Therefore, even though we knew we had not asked for some key information, we knew we could just slow down, not be overbearing and perfect the special epidemiological skill of ‘reading the room,’” she added.
Most test results are released in the afternoon, which is also “lottery draw” time for epidemiological investigators, Lin said.
They would only receive basic information about the cases — such as birthdate, gender and occupation — before needing to start work, sometimes without even knowing their detailed test results, she said.
“I was most afraid of encountering a case of dengue fever,” she said.
Every time one was reported, she would need to ask local environmental protection officials to disinfect the area and request that civil affairs officials interview the case, Lin said.
They would also need to ask volunteers to clean the streets and water containers, and remind the infected person’s family to close off aquariums and wrap up other household items, she added.
One time, a restaurant held a promotional sale on lobster so that it could clear out all of its tanks before sanitization, Lin said.
Residents are often upset when their area is disinfected with little warning, leaving investigators to calmly explain that the goal is to fight mosquitoes without singling out the infected person or their family, she added.
As it takes two days to test for dengue fever, Lin said that there were some cases when they carried out all of the disinfecting and contact tracing work just to receive a negative result.
The work is difficult, yet investigators seldom receive thanks, Lin said.
However, every time they put the pieces together to discover the source of an infection, “we would be so happy, we could almost scream,” she added.
Seeing their location of responsibility successfully contain an outbreak was like solving a difficult riddle, Lin said, adding that they were happy to quietly protect public health.
In fighting epidemics, people should remember that every person is like a screw: Although small, each one is indispensable, Lin said.
Investigations are bound to increase in the coming days amid a rise in locally transmitted COVID-19 cases, Lin said, urging people to view the need to report like the act of sharing a travelogue so that everyone can make it through this COVID-19 pandemic together.
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