The Ohio State University graduate signed on for a medical school rotation in epidemiology—and found herself working at the forefront of a pandemic.
When fourth-year Ohio State medical student Amy Xie arrived on Jan. 13 at the Centers for Disease Control and Prevention in Atlanta for an elective rotation in epidemiology, the term COVID-19 was not yet in use and few Americans were worried about the novel coronavirus that was wreaking havoc in Wuhan, China. Xie had applied to the selective program the prior fall, hoping to gain insight into the field of public health.
She had no idea how much she would learn.
Less than two weeks into her rotation, Xie got the unexpected news that she was being sent into the field. There was a case of novel coronavirus infection in Phoenix—the fifth confirmed case in the U.S.—and she was needed to join the investigative team. “The lab result got flagged on a Sunday morning,” she says. “I got the call by 4 p.m. that day to get my N95 mask and get my supplies, with a plane ticket to be expected in my email inbox soon.”Like what you’re reading? Subscribe to our weekly newsletters.
Of the 25 students in her program, Xie was one of five sent to investigate coronavirus cases. She thinks she was selected because she is fluent in Mandarin Chinese. Xie was born and raised in upstate New York, but her Chinese grandmother lived with her family for half of each year and Xie learned to speak Mandarin at home. The Arizona patient, like several other early cases, was someone who had recently traveled to Wuhan, China, and so it was expected that some of the patient’s contacts would speak Chinese.
Xie’s job in Phoenix was to interview contacts of the patient, then stay in touch with them to help them quarantine and track whether they developed symptoms. She was assigned a phone line that rang constantly each morning as contacts checked in.
Now, of course, we know what signs to watch for, such as fever, a dry cough and sometimes loss of smell and taste, and that they are maddeningly inconsistent. But in January and February, investigators knew much less about the disease. As Xie and others interviewed patients and their contacts, she was able to see how a profile of a new ailment emerges.
The experience, she says, reinforced what she had learned in med school classes: “If you don’t know, ask. Patients will teach you what you need to know. That reflected what I had learned as a third-year medical student on the wards, which is to go in with an open mind and open-ended questions and be open to say, ‘Oh, you have this new symptom, one that’s not respiratory? Let me write that down.’”
Her work called for empathy, as well. Many of the contacts who had been instructed to self-quarantine were experiencing two layers of stigma: one, from being suspected of carrying a potentially deadly virus, and the second from being Chinese. “The [Chinese] restaurants weren’t getting any business; hateful words were being circulated,” says Xie. “That was a nuanced piece, I think, that was felt very strongly at that point in the pandemic.”
Xie was inspired by the excitement, urgency and collaborative nature of the work in Phoenix. She sat in on phone consultations with doctors and others experienced in SARS, MERS, HIV and influenza. “This experience has opened my eyes to the importance of the role physicians can have to protect the health of the public,” she says.
Xie graduated from Ohio State this spring and recently began a residency in internal medicine at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. But she’s not writing off a future in epidemiology or public health. After her residency, she’d like to do a fellowship with the CDC’s Epidemic Intelligence Service—an interdisciplinary investigative unit that includes doctors, nurses, Ph.D.s, even veterinarians. “It’s really the premier boots-on-the-ground experience for academic investigations,” she says.
Throughout her time in Arizona, Xie had very little close contact with COVID-19 patients, and she remained healthy. It was only when she returned to Columbus that she caught the virus. “One of my housemates had it,” she says. “I had symptoms, but luckily I did not have to go to the hospital for treatment.”
“I’ve been better for months, but I still have the mentality that I could pass it on,” she says. “The key is prevention.”