The former Rose at the front line of US Covid-19 fight

Californian epidemiologist with Irish roots has helped Native American tribe deal with crisis

Maureen Bartee has seen a lot during her two decades with the Centers for Disease Prevention and Control (CDC) in the United States, but when news started to emerge about Covid-19 late last year it felt different. "We knew something was going to happen. I think when you know and you're preparing sometimes you aren't sure 'is this really it?'. . . [But] it was pretty clear pretty soon after we heard about what was happening in China that this was going to be a big issue."

Bartee is associate director for global health security within the Center for Global Health at the CDC. She has been involved in the agency's response to outbreaks of polio, Sars and Ebola and worked in public health in Africa and Central Asia. In her current role she is focused on implementing the Global Health Security Agenda, a group of 69 countries, NGOs and international companies working to improve capacity to deal with infectious diseases around the world.

The group works to build up countries’ capabilities in disease detection, laboratory capacity, surveillance and emergency management so that there are people in place who are trained if there is an infectious disease emergency.

Control measures

One of the ways the CDC looks to do this is through the Field Epidemiology Training Programme which it says has helped train more than 18,000 “disease detectives” in more than 80 countries since 1980. Bartee established the Kenyan branch of the programme in the early 2000s, which teaches the process of investigating an unknown disease.

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“They would learn things like . . . what kind of samples should be collected, what are the ethical issues around doing the investigation, how do you analyse the data and then make sense of the data to make good decisions about control measures that should be put in place. Is this an infectious disease where you need to warn other people or is it maybe an environmental contaminant and you need to check the water, check the food?”

While Bartee stresses “we haven’t seen something like this for 100 years”, she believes the Covid-19 pandemic is a good example of the challenges caused by how hard it is to “convince people to really take prevention seriously”.

“It’s a lot harder to convince the people who fund activities to fund activities for prevention. When you don’t have a sick child to say ‘look if you give the money, you’re going to save this child’. It’s all about not having things happen in the first place. And I think it’s difficult for the ministries for finance to really understand how much it matters to put money towards prevention versus just response.”

Bartee's mother is from Moate in Co Westmeath. The eldest of nine children, she settled in San Francisco in the 1960s, working there as a nurse for years. Bartee is also a second cousin of golfer Shane Lowry. "His grandfather and my grandmother were brother and sister . . . we've met but I don't really know him." However, she says she's "really excited for him and we do watch all of his matches and everything".

The California native is "proud of [her] Irish heritage" and says it was an "honour" to be selected as the San Francisco Rose in 1997. "I had an amazing time and it was such a special opportunity, but I think even more so for my family to be able to participate. Lots of them came down to the festivities and stayed for the week and celebrated and enjoyed everything, it was really great for them. What was memorable for me was my escort was actually German. I had thought I would be paired with a nice Irish boy, but I was paired with a German guy, who was lovely and we kept in touch for a long time afterwards."

At that stage she was already on the path to becoming an epidemiologist. “When I was in the Rose of Tralee I was in my Master’s programme in epidemiology and biostatistics. So, I was just starting my career. I was doing some research on HIV. I think why I chose epidemiology was I really wanted to think about and see how we could prevent people from getting sick in the first place as opposed to just treating individuals with disease. I was thinking I would do medicine and be a medical doctor but then I came across public health and epidemiology as something where you could make an even greater impact.”

She says two years working with detainees who had HIV at Cook County jail in Chicago had a big influence on her. "Many of them had not really had a regular doctor, they had not had an opportunity to get social services so we connected with them to try to get drivers' licences or some kind of ID and ways that they could get connect to social services that were available to them being HIV positive that they weren't really connected to before."

She was the deputy director of the CDC's Central Asia Regional Office in Kazakhstan for three years, where she worked with governments across the region to improve preparedness for outbreaks. She also met her husband there, who now works in public health too.

Her current job normally involves a lot of travelling overseas and meeting with ministries of health in different countries but as that was no longer possible, when Covid-19 hit the US she redeployed to help a Native American tribe in South Dakota with their response to the crisis.

“A lot of the tribes have more poverty, they have less resources than the rest of the country so it can be challenging when a new disease hits,” says Bartee, but “they were doing a great job already responding to the challenges they were facing. They have a big Pow Wow every year where members of the tribe who don’t necessarily live on the reservation come back. They weren’t able to do that this year.”

She linked them to the expertise at CDC and helped them with things such as how to arrange school reopenings while adhering to distancing guidelines. She found it a “pretty incredible” experience.

There has been some research to suggest countries led by women have dealt with Covid-19 better than those led by men and Bartee says “it’s never bad to have more women at the table”. But she says it is more important to make sure “you have diverse voices at the table. When you think about diseases and populations that are most impacted you want to make sure that the decision-makers represent the broadest group of individuals so you can get all the perspectives.”

She has been impressed by the passion and commitment of her colleagues in tackling the crisis. “Everyone at CDC is coming together to work hard to fight this. People are up all hours of the day, working through the weekends, really focused on trying to get the right science and the right information out to people to make the best decisions to hopefully get this finished as quickly as possible.”

Missed opportunity

Bartee says the hardest part of the current situation has been family related, working from her home in Atlanta, Georgia, while trying to keep her three children up to date in school. "We were supposed to go [back to Ireland] for a family reunion this summer, and all the cousins were supposed to be coming, some live in South Africa, some were in the States, some were in England, but unfortunately because of Covid we weren't able to have it. This year, two of my mom's siblings passed away so we just missed the opportunity to see them again."

However, Bartee is hopeful about the next phase of the pandemic.

“There’s a lot of good things happening in terms of vaccine development, obviously that’s been moving forward very quickly and I’m hopeful we’re all going to be using the lessons that we’ve learned in order to prevent people getting infected.

“How long it’s going to take and all that I think it’s really difficult to know. But we’re learning new science every day about what’s effective [and] as we’re learning more and we’re implementing prevention measures, we’ll be making a difference.”