Health Administration and COVID: Interview with Epidemiologist Earnest Clayton

Within our current state of the pandemic, we see many perspectives. Mainly from those affected and politicians referencing it to try to make a point. Something we see largely ignored and arguably one of the most important points of view is those that actually worked behind the scenes with it.

Epidemiology is the study of diseases within a population and these scientists gather information on people and are able to analyze disease spread. Earnest Clayton has worked with several diseases including the recent COVID 19.

This interview is to look into his past work as well as to see what his job entails and his work with COVID.

Interview Conducted By Anthony Rodriguez.

To start off tell me a little bit about yourself.

Oh man about myself let’s see. So you want my educational background.

Yes.

I did my undergraduate degree in biology and chemistry and I minored in physics at Texas Southern University. I got my masters in health education at Texas southern university with a concentration on epidemiology. Then I went on to Baylor University where I got my masters in public health where I did a lot of focus in epidemiology as well more so with special populations. From then I worked in public health for the last 10-12 years and that’s when I became an educator. I still teach but I still work in epidemiology.

You got all the sciences covered there, kind of got that whole background.

I do. Yep. I covered all the sciences. When it comes to biology or chemistry I can relate to it because I touched aspects with it.

How long did you want to do what you wanted to do?

Initially, when I started school I was prepared to go to medical school so during my undergraduate year I was an intern at Baylor college of medicine in the genetics department. When it got closer to my senior year I studied in Tokyo, Japan in infectious disease so when I came back I actually had my mind more so to the public health side of it. But I still had my mind set on going to medical school. I applied to a medical school here in texas but for my demographic, they don’t really cater to African American males so I had to actually apply outside of texas because I didn’t get any interviews here. I actually got accepted into tufts university but I had to defer my seat because my dad was diagnosed with cancer and at that point, I was like alright let me explore my options so that’s how I actually got into my role.

I guess you can say destiny kind of pushed you in that direction

Yeah, you can say that especially if you align yourself with all those different tools that you set yourself up for. Cause it could of went in any direction I could’ve gone to medical school or I could’ve studied epidemiology of infectious disease but one thing of epidemiology that you don’t focus just on covid you focus on other things related to public health such as food desserts and pretty much everything you can think of that affects certain demographics.

Can you give me a general description of what epidemiologists do?

Epidemiologists generally focus on everything that has to do with any disease so it just depends on projects that you’re working on. So take me for instance I have a disease science background I’m the type of epidemiologist where they call me for things such as HIV syphilis different types of disease and virus cause I understand the different type of code for it and a typical day usually consists of collecting data well um getting your task because being an epidemiologist means your working on it one day at a time because it never really ends since the disease doesn’t really have an endpoint. I think the only disease I have never really worked with is ebola because it was stopped ahead of time before it really reached much of the united states and I have a strong idea on why.

Epidemiological Triangle

What reason was that?

The reason being is because Ebola is communicable and noncommunicable meaning that you can get it from touching a surface or coming in contact with contaminated clothes. Rather than a person covid 19 positive you can use their shirt and not get covid 19 because covid doesn’t live on surfaces for long periods of time but ebola stays there. It means that the epidemic would have been really tough to control they would have had to shut everything down.

It was basically more aggressive.

Yeah a person that has Ebola can infect every 10 persons around them while covid is 1-3.

What are some of the things you work with as an epidemiologist… basically some of the more specific things?

Typically I work a lot with HIV and syphilis. Also done a lot of work with understanding mental health with parents that abuse their child and most recently Houston and its food deserts. Houston has a lot of those. For instance, look at third ward Houston you go to the sunny side and see taco bell, and burger king, and jack in the box but you don’t see a grocery store. These groups of people have health issues such as diabetes.

I understand that - not a single grocery store near me so we have to shop at the dollar general...

That means you live in a food desert so whenever there isn’t a grocery store within a 10-mile radius you’re most likely in a food desert but I bet you can find a McDonalds right down the street. And then a burger king and a taco bell or pizza place. Without gentrifying areas how do we get past these issues?

You have done work with covid correct?

Yeah, I’m currently working with covid 19.

Can you tell me about your work on that?

I get a Covid 19 caseload daily. I typically call them and see how they’re doing with their health and see who they’ve come across or where they've been and I collect the data and I pass it on. My job is also revealing death cases so when a person dies amidst covid outbreak or had covid 19 when they died - I go inside their medical records and see when they were born to when they died and I see when they were in the hospital to their end date. I have to paint this picture as if I’m telling a story (hypothetically) this patient is a 69-year-old female and she arrived on this date 2020 and then I tell the whole story.I have to diagnose whether she died of covid 19 related issues or of cancer, old age, or natural causes. Usually, when I get the case they died because of covid 19 the most difficult part about it is when I talked to them before and they say I’m fine and I call them back and the family members say they died and it's wakening because I worked with them actively.

Working with these types of diseases, has it shaped your view on diseases as a whole?

I've always viewed diseases as well so working with covid has opened up my eyes that an epidemic can definitely spread to a pandemic if it’s not controlled properly even before when data was releases you didn't have to wear a mask I was thinking more on the scale of air vapors and can a person get it from inhaling and I was thinking maybe face masks were not necessary but as more data came in face masks were necessary and gloves were necessary they put me in a bubble because even though I understood disease and viruses it kinda scared me because I really didn't understand what the next steps were even when I studied abroad I worked with sars before so I knew what it could be just not large scale.

The Purpose of Public Healthcare Surveillance

I guess you could say you were skeptical?

I was never skeptical I just didn’t think the rate of transmission wasn’t what it is now. I thought it was more close contact and hands-on.

So just harder to spread?

Yeah, I thought it was harder to spread.

Have you seen things when working with covid 19 that you don’t think people really know much about?

A person that has cancer they don’t get covid 19 related symptoms they actually are asymptomatic it’s because of the cytokines when the body is doing too many things at once they don’t recognize what’s going on so even if the body is recognizing a covid 19 reaction the body is more worried about the cancer so they don’t get sick they might have the sniffles. Also with teenagers, you guys don’t get sick as bad it might last 2-3 days. Even at class I know if you guys returned it would be fine the thing is when you go back to your parents they will get sick but you as a whole y’all won’t get sick.

I never knew about the cancer so that’s actually really interesting, it’s not something you really hear about

You only know if you collect the data and I collect the data and the crazy part about it is people who test HIV positive and they’re undetectable they don’t have symptoms that’s because the body is fighting other things the body doesn’t have time to figure out what’s going on with covid cancer patients and HIV patients and I believe HIV patients because they’re taking anti retral virals.

What are your thoughts on herd immunity whether it is through natural means or through vaccines?

It is going to have to be both because vaccines are totally necessary due to the fact that your body has to build some type of an immune response because the thing is with covid 19 those antibodies we don’t have a lot of them so you probably have antibodies for 3-6 months because after that’s I’ve seen people get reinfected.

In terms of that though when it comes to vaccinations do you think we are at the current stage to where it’s safe or do you think more testing still needs to get done?

As far as vaccinations I think they’re safe because the sequence of sars has been completely synthesized so it’s easy to go inside something where the whole DNA has been mapped out and take out the parts that don’t work. It’s the same thing with humans scientists can make the perfect human since our whole genomes are out there. But it’s unethical they can’t just go and remove oh I’m going to remove scoliosis. But with viruses, it doesn’t take away anything it just makes them non-active. So I think vaccinations are safe to take and I’m scheduled to get my second dosage tomorrow.

There are two vaccinations right one done by Pfizer and one done by…

Moderna.

Do you have a preference of which is better or do you think they’re both good?

I can tell you based on data I collected that Moderna is better. they both have the same effectiveness Pfizer is 96 percent and Moderna is 98 percent but people are getting more negative reactions from Pfizer. Moderna you’re getting a boost of energy but Pfizer you’re getting covid related symptoms even people getting Moderna may have fever or chills for a day then it goes away Moderna has data that says if you get covid it won’t transfer to someone else Pfizer doesn’t have that data yet. That’s why when Moderna rolled out that’s the vaccine I wanted to get.

Do you think we are currently in a state of overreaction or underreaction?

Underreaction because if it was an overreaction I think people wouldn’t have issues with wearing masks and I think more priority would be given to closing down bars and pubs and I think stores should be done in phases meaning if you live downtown you can only shop from 1-3. But I think a hard shutdown for 2 weeks would help a lot.

Is there a certain state or country that you think is handling is the best?

Aw man what’s the name of that.. Norway is handling it I think they have zero transmissions for the past 2-3 months.

In your opinion what’s the best thing about your job?

To look in everyone’s business. Take for instance a celebrity - I can’t release that information to the public but I can see their whole medical record. The Houston rockets - I had a case connected to one of them and it pulled up the whole team and without disclosing their diagnoses I was able to see everything and I can actually call them and say hey so um... How you doing type of deal. I did speak to a celebrity recently that was kind of cool I think that’s the best part nothing is off limits except the president when it comes to public information Beyonce, Oprah everyone.

Something you didn’t know about the job until you were actually working within it?

The numbers I suck at math I literally count with my fingers but being an epidemiologist you deal a lot with biostatistics and looking at the data in graphs and everything is going that’s the part I don’t like.

What do you think is cool about being an epidemiologist that no one knows about other than the celebrity thing?

One thing that’s cool about it is that you actually know more than… something a lot of people don’t realize is that you know a lot more than doctors so currently, I’m getting my doctorate of public health but a lot of epidemiologists know more than physicians and we have a couple of nurses on our staff and I can literally sequence a whole bacteria nurse cant do that and a physician probably hasn’t done that in grad school. Epidemiologist, you’re constantly working in that position so you focus on everything coming across the table.

Have you ever had the covid 19 virus?

No, I haven’t and I think I have a strong idea why because I definitely took precautions one thing I definitely knew was how long it stayed on certain surfaces. I know how long it lasted in air and on clothing that’s the point I adhered to before they said to wear masks. I was already doing it. I didn’t have to go to the grocery store or gas station and I used gloves and also once put my mask on I didn't touch my face.

I have gotten the virus before so I wish I could say the same but I was asymptomatic. We went out once that month before mask mandates and she was wearing a mask and we were out for 10 minutes and I got it.

Cause of that age demographic. Did your mom get it?

No.

Ground zero was definitely there in that close proximity. If she didn't have a mask I would say she was ground zero and you didn't have any symptoms did you stay isolated?

I was in my room for 2 weeks my whole family kind of got it more than once.

Multiple family members or people getting reinfected?

Reinfection.

What are you like Hispanic or white?

Hispanic.

I can tell you right now within the Hispanic community and Mexican Americans and Latinx covid is really bad and the reason being is that a lot of time it comes with mistrust within the community because take, for instance, one person tests positive there can be 10 people in the household so 5 might be undocumented and say that person doesn’t live here and give me false information then they go uh and spread it and that’s an issue we deal with in the Hispanic community and trying to gain that trust to better assist.

I think it's a stereotype that we are big on parties they are bigger families I have all these cousins I can't name and we have all these 7-year-old children without a mask.

That contributes a whole lost same way in the black communist I have my mask on and everyone is maskless and it's a culture thing within the African American community and Hispanic communities it's because culturally we are big on family, parties, and trust/mistrust.

What are the dangers of being an epidemiologist?

There is really no danger unless you have to go into the field. If I have to go into the field and get first-hand insight or make sure a person is going through treatment that can be iffy. We work in the back end and you don't go into the demographic but typically it's pretty safe.

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As far as epidemiologists go it is because of them we know these things related to covid and get these statistics that are valued. Their job is the reason we know so much about certain diseases as well as things pertaining to demographics. Their work is very important and without it, many more people would be uneducated on the danger and information relating to public health. Even today with COVID 19 still amongst us this is possibly one of the most important jobs. Often not acknowledging the people that work around it we just look a the statistics and go on but it is people such as this that need more appreciation. If one wants to talk to a professional about COVID epidemiology is the best choice to get the most accurate answers.