Until the COVID-19 crisis, we had not experienced a pandemic since the 1918 Spanish flu pandemic. The field of epidemiology aims to prevent and control diseases such as COVID-19. An epidemiologist uses three characteristics — person, place, and time — to develop a case definition of what meets the criteria of the outcome under investigation. This process is similar to the development of a diagnosis using the DSM-5.
The epidemiologist gathers data based on symptoms such as cough, fever, fatigue, and respiratory distress and looks for the most common defining symptoms. The epidemiologist also looks at demographic information (person characteristics) and lab test results. The demographics are important to see if the disease is a burden at a greater level for specific subpopulations such as older people, those with chronic conditions (e.g., asthma, smokers), race/ethnicity (e.g., African Americans), socioeconomic status, and so on. After determining a case definition, the epidemiologist continues to gather place and time data on each case to develop a graph of the outcome. This data can be organized by country, state, county, and city to identify where the disease is occurring. The epidemiologist also wants to know who gets the disease.
All this information leads to establishing population-level interventions in an attempt to “flatten the curve” of the pandemic and ideally bring the cases to zero. We have seen a number of interventions used such as shelter-in-place orders, orders to close nonessential businesses, and shift changes to reduce exposure from one person to another until a vaccine becomes available.
Many of these current interventions are based on behavioral health, which connects epidemiology to the work we do as professional counselors as well as our professional value of prevention. We may view counseling as divorced from the public health, but in reality, we have more to offer the current efforts to control and prevent COVID-19 than just telemental health. Through our skills of rapport building and our understanding of people, empowerment, diversity, and program evaluation, we can engender change.
Author and Guest Blogger: David E. Jones, EdD