The Rewards of Being a Public Health Professional Today with Dr. Chantel Sloan-Aagard

Addressing misinformation and economic trade-offs only begins to detail the “complex wrestles” of a public health professional. Join Dr. Chantel Sloan-Aagard as she shares insights from her career as an epidemiologist and considers the rise of RSV and other infectious diseases.

Bio:

Dr. Sloan-Aagard received her Doctorate in genetics from Dartmouth College, following a Bachelor of Science in biology from BYU-Hawaii.  After completing a postdoctoral program at Vanderbilt University Medical Center, she joined the BYU Department of Public Health faculty. As a spatial epidemiologist, her research interests include patterns in pediatric respiratory infectious diseases, such as COVID-19, influenza, respiratory syncytial virus (RSV), and pneumococcal pneumonia.

Recorded, Edited & Produced by Christy Gonzalez, Harper Xinyu Zhang, and Tanya Gale

Transcript

Cougar: [00:00:00] Dr. Chantel Sloan Agar, how are you doing? 

Chantel: I'm good. Thanks for having me on Cougar. It's great to be here. 

Cougar: We've been patient, really wanted to get you on in season one, but a great way to start season two is to have you on Chantel. I wonder if you would just take a moment, introduce yourself. How did you wind up here in this office this morning?

Cougar: You've been at BYU for a minute. 

Chantel: This is my 10th year. 

Cougar: 10th year. 

Chantel: Yeah. Which is crazy. 

Cougar: It is crazy. Give us your background. What's your expertise? Where did you study? 

Chantel: Oh, my background is varied. I always tell students I fell into public health backwards in an ungraceful, somersault, . So, I grew up in Connecticut.

Chantel: I'm a New Englander through and through. And I went to my undergrad actually at, by Hawaii. I went with my twin sister out there for four years, studied biology, loved it, had a fantastic experience. And then I went back east. I went to Dartmouth for a PhD in genetics actually, [00:01:00] because that's what I thought I wanted to do.

Chantel: And about a year to two years in, I realized, mm, This isn't actually what I love, not because I didn't enjoy it at all, I still love the field of genetics, but I was just drawn to these kind of bigger population level questions. So I started doing a lot more genetic epidemiology. I started looking at the influence of water and air on our genetic backgrounds.

Chantel: And that just became really exciting to me. And then I told that to my mentor at the time and he said, well, I don't know how to help you with that. However, I just got a call from someone over in the geography department and they would love to do some work with us, figure out a way to collaborate. I have no idea how to collaborate with geography, but start going to their meetings and figure something out.

Chantel: And so it was really cool. It was a great move on his part because it gave me the [00:02:00] leeway to really find the things that I loved and was passionate about. So I went over to geography. I started learning how to map. I started learning how we use tools to understand the spatial distributions of health and why some places are healthier than others.

Chantel: And I just took it and ran. I worked on a spatial epidemiology project, and then when I graduated…First I took myself to Costa Rica for a month because a PhD is long. 

Cougar: That's a necessity right there. Costa Rica is beautiful. 

Cougar: Yes, good choice. 

Chantel: But then I went to SUNY Stony Brook for six months and just did an intensive kind of post-doctoral internship in disease mapping with an expert there.

Chantel: And that was a great experience. And then I went and did a full postdoc at Vanderbilt in Nashville, Tennessee, where I did more medical geography, and I moved from, what I was previously working in, which was mostly cancer into infectious disease. So I worked with an awesome [00:03:00] pulmonologist there who was studying R S V, which is running rampant and asthma and connections there.

Chantel: I started working with a group that I. Still working with regarding influenza, pneumococcal, pneumonia. I just really got into the infectious disease world and combining my mapping background with infectious diseases, which are so dynamic and move across space in such interesting ways. So I end up now that I'm here, then I got hired by byu back in 2013.

Chantel: And. , which I still feel like I'm brand new, but I've been here a long time. You've been here for a while. You've been been such an amazing addition to the faculty by the way. 

Chantel: Well, thank you. So thank you. I, I love our faculty. I tell people we have the best faculty on campus on a regular basis. Yeah, we're in a good spot.

Chantel: We are . So. when, when I came here, I came with this very diverse background. You know, I had a lot of biology in my undergrad. I did ecology and botany and zoology and all [00:04:00] these different things. And then I've got this genetics, background mapping and infectious diseases, and I've done cancer. So here in the department, I wear a lot of different hats.

Chantel: I teach in the core primarily. I got hired on originally to teach the infectious diseases prevention course. Now our curriculum's changed and I'm teaching. human health and its determinants. I still have a lot of infectious and environmental work that's taught there. And then I teach the specialty class about mapping.

Chantel: Medical geography for, it's usually a small group of seniors and master students who wanna learn how to use the technology. So it's a lot of fun and we have great discussions and I'm so happy to be here. 

Cougar: You really are a jack of all tradesman. Some of this because. , you're kind of in our health science track because mm-hmm.

Cougar: of the medical geography. And of course because of your strong, strong science background

Cougar: right. . Mm-hmm. And yet you've got some epi skills, there's no doubt. Mm-hmm. , and you also have some, some population health and, and health [00:05:00] promotion skills. So you, you kind of find yourself doing a little bit of everything sometimes. I imagine. 

Chantel: I do.

Chantel: I do. When we meet as emphases groups, I'm usually in three of the four of them. . Yeah, . So, which I'm happy to do, I love. , I don't have the attention span to stay in one spot. , I have to jump around. I love, I've always loved all through school. My favorite thing was to connect one class to another. Yeah. So I'd be in a, a biochemistry class and I'd connect it to something from my history class.

Chantel: And you know, that's when light bulbs go off for me is when I'm crossing fields. And so that's, that's still where I'm happiest. . 

Cougar: Well, this is great timing to have an infectious disease expert. That's what I'm gonna refer to as on, on the, on the podcast. I think probably it was four or five years ago, and I was teaching kind of an introductory to public health course.

Cougar: Mm-hmm. and I had a slide in my slide deck that day and. . The gist of the message was we used to die from [00:06:00] infectious communicable diseases, but then there's this shift and because of vaccinations and uptake there, now we die of lifestyle diseases, cardiovascular disease, cancer, stroke, diabetes, and I went through this whole thing and I was pretty convincing.

Cougar: Mm-hmm. that we've really turned the page on. Infectious diseases. Get your flu shot. But you know what? We're moving forward, at least in the developed world. that that message didn't, didn't age well, did it? No. . So, so this is so great because we ha we can talk about sars Cov two. You just mentioned rsv.

Cougar: We're having and, and probably not unrelated to the pandemic is, is some of these other , I'll let you speak to this, but, but RSV is a good example, but we're gonna have a pretty significant flu season as our guest. It's bad, it's bad already. And we have probably a general mistrust of vaccines maybe.

Cougar: That was probably always there, but I think we've galvanized kind of the anti-vax groups. I think I'll let you [00:07:00] speak to that, but those are some of the things that are in my mind as you're talking. 

Chantel: Yeah. So, you know, things might be different at the time this airs than where it is right now. People in the news are calling it the Triple De.

Chantel: Season, right? Yeah. Because RSV respiratory, syncytial virus literally everyone is infected on the planet with it by the age of two, and you're probably infected with it multiple times throughout your life. But it is the number one cause of infant hospitalization in the US and in many countries abroad.

Chantel: So, RSV has been bad news for a long time. However, now we have this cohort of young children that may have not been exposed earlier. Combined with the year where it's probably a bad strain, some RSV years are worse than others. We have strains that PR cause a lot more mucus production, for example, making it much harder for infants to breathe.

Chantel: And so that's why you see so many infants going in, being put on oxygen. I know Primary Children's this winter is already. At the brim. Yeah. And then this, a similar thing with flu. [00:08:00] we had very little flu over the last two years. You will hear people saying, well, that's just because doctors didn't wanna record a flu.

Chantel: Death over covid death. Not true flu surveillance is done using lab tests in selected hospitals. That's how it's been set up for a very long time. It's not based off of billing or coding. So we truly did have very little flu over those two years. And you know, we have again, probably a bad strain that.

Chantel: is coming at a time when our immune systems haven't been challenged with it for a while. And whenever that happens, this isn't the only time in recent history that this has happened. But whenever that happens, we see a lot more illness, especially in the most vulnerable people who are immunocompromised, older adults, young children.

Chantel: So. , I would say that slide was even wrong then Cougar, had I seen it, I would've come at you. I would've come at you. You would've had it with me. I would've said, what about the, you know, between 20 and 60,000 people in the United States that die from flu every year, [00:09:00] they're gonna have a beef with this

Cougar: No, there's no doubt. And, and I'm, I'm probably painting with a broad brush, . I think, I think my point was, that's, That's a bad month with cardiovascular disease. Yeah, it should, when we look at the flu, but, but I do think it's important in public health to, to always keep our foot on the gas. Mm-hmm. , and maybe that's what we're getting at is, yeah, we've all heard of rsv.

Cougar: I've had four kids. It was a, it was a thing we went through and it was tough. Mm-hmm. and challenging and kids were already colicky and now they can't breathe and Yeah. It's awful. It's a real challenge, I think this pandemic has created a situation like you say, where whether it was masking or social distancing or all of those things mm-hmm.

Cougar: we had, we. A bit of a reprieve from some of those other ailments that would hit us kind of annually. Mm-hmm. and now it's like they've stocked up and we are right in the sites for sure. We are. I'm, I'm wondering, for someone who's [00:10:00] listening who does have a young child or as a grandparent of a young child are there some practical things that we can do to address R s V?

Chantel: There are so like you said keeping an infant home more if they're born during RSV season, which I would say starts around October and can go through February and March. Mm-hmm. now typically, RSV Peaks at the same time every year. It's unlike any other infectious disease. It is clockwork where you can say the first two weeks of February, that's when RSV is at its peak.

Chantel: It's this very narrow high peak that dissipates quickly. This year is different. this year, it came much earlier. We have a much wider peak happening. We'll see what happens over the coming weeks and months, but it is, it is more severe right now. So you do wanna watch out for infants. 

Chantel: So the thing about R S V is typically it's like clockwork every year, the first couple weeks in February in many parts of the Northern hemisphere, it usually starts actually in the southeastern United States and spreads north and [00:11:00] west.

Chantel: It's not always true, but that's the overall pattern year to year. Right now we're seeing a much earlier peak, a more severe peak, a wider peak happening than we would in any other year. Normally R S V just shifts around by a couple weeks and what's gonna be really fascinating too is going forward from here in a really bad RSV year.

Chantel: RSV is one of the few known causes of asthma in childhood. So if you have a severe. severe case early in childhood. But we think about 20% of asthma cases later in life are connected to that as causal. Asthma being a very complicated disease. So, you know, are we gonna have worse asthma going forward?

Chantel: Good news about R S V is that there is, for the first time a really promising vaccine going through FDA approval. It's unique, it's a maternal vaccine, so the mother takes it and then passes antibodies through breast milk to the infant. This is a big improvement. There have [00:12:00] been dozens and dozens of RSV vaccines in the works.

Chantel: Decades and it's very challenging. RSV is one of the few infectious diseases that are originated in humans. It didn't come from another animal into us. It's nose. Our immune systems extremely well, and it is just wily in how it's able to get around our immune protection. So it's been very difficult. But this new vaccine is promising, probably about 50% effectiveness.

Chantel: We think maybe we'll see. Things come out. But even then, a lot of times when you hear that, you're like, oh, well it only gives me, it's like a coin flip, whether or not it protects me against the disease. But those types of vaccines also typically reduce the severity if you still get it. So among the 50% of people, of those infants that still get it, they're gonna be much less likely to end up hospitalized.

Chantel: So that's all good news. That's gonna reduce asthma later in life. Reduce burden on hospitals, and of course, just the fear and anxiety. parents go through [00:13:00] watching their infants suffer and force the infant suffering. Oh yeah. So that's great news in the vaccine world. We hope it comes through and as, as promising as it looks right now.

Cougar: Well, as, as someone who's had asthma my entire life, now I'm thinking Hmm. , was it rsv? 

Chantel: maybe. 

Cougar: And asthma's. Not pleasant. No, it's not fun. Mine's. Mine's fairly manageable until I get sick. Mm-hmm. , and then it's just a nightmare. So anyway, all right. 

Chantel: It circles around because R S V and rhinovirus, other two most common causes of then asthma exacerbations are what we call asthma attacks.

Chantel: Yeah. Colloquially is, so it caused the asthma in the first place? Sometimes. Not always. You know, I'm telling about 20%. So there's other things. Dust, maternal, smoking, genetics, all that plays in. But not only does, can it cause it in the first place, but it makes it worse through the rest of your 

Chantel: life.

Cougar: Right. Yeah, that makes a lot of sense. Other infectious diseases that are on your radar. Right. 

Chantel: Ooh, there's always a bunch. You know, I've been, [00:14:00] I've been following the Monkeypox. Yeah. That seems to be fairly under control at this point. I'm always watching what's going on with for example, pneumococcal pneumonia.

Chantel: How is that evading the vaccine? We've got some issues. I'm working on a paper right now actually, where we're looking at antibiotic resistance. among some of these bacterial. Yeah. Respiratory infections, like pneumococcal pneumonia, so those kind of play by a different set of rules. There's, there's a watch list that the World Health Organization has for emerging diseases that we need to keep an eye on and, you know, you just keep your ear to the ground, look at the literature, and hopefully our next covid 19, like pandemic won't be for a while, but, Honestly, we were pretty well overdue for one.

Chantel: They happened at random times because there's a lot of randomness involved in when a disease spills over. But given that random timing, we would have expected to have one earlier and so is the next one coming? Probably, probably sooner than we would like , [00:15:00] so, but now we have a lot more infrastructure built up so we can deal with it better, which is good.

Cougar: So let me ask the, maybe this question makes sense right now. The Harvard Chan school, it's, oh, it's been over a year now. They put out the results of a survey. About 52% of Americans at that time trusted c d c , about 37% trusted nih, fda. It, it does seem that public health could have done a better job with messaging and. Probably we could all improve and not just public health. Right. But I am concerned as we talk about whether it's RSV and a potential vaccine, or whether it's it's the next pandemic. how does public health restore trust? How do we get back to a place, the W H O recently put out a report on? Infos and just misinformation, disinformation, and it seems like this is gonna be a difficult space for us to navigate.

Cougar: Now you're a virologist, but are you concerned about trust? Trust in the public health messaging or in, in [00:16:00] really getting people back to a place where they believe in science? , 

Chantel: Trust right now is huge and it's huge in the public health world. It's huge in the political world. It's everywhere. I've actually been doing the long-term project with people at the law school on trust related to how the election in 2020 correlated with the output of. , the Covid vaccines and how trust was related and all of that.

Chantel: Interesting. And I think, you know, we talk about this politically divisive crisis in the United States a lot, and a big piece of that that isn't discussed enough is that there's a huge growing group of people in the US and and around the world who trust no. , whether it's a government institution, a health institution, a religious institution, and they even have very low trust in people like family and friends.

Chantel: This is a growing group. And it's a diverse group. People [00:17:00] who are from lower socioeconomic levels or are minorities have, they're more represented in that group. But there's still, you know, a lot of people who are wealthy who are for majority populations who are in that group. I think it's a huge issue going forward that across systems where it used to be that the number one predictor of whether or not you got a vaccine was if your doctor recommended it.

Chantel: And I believe that's still true, but there are a lot more people who say they don't trust the medical system at all. And there are unfortunately even clinicians who have spread misinformation about vaccines. Whether actively on the internet or, or within their, their own practice. So trust is huge.

Chantel: We, we did make messaging mistakes during covid, and, and I did too, right? Because what happened was the science [00:18:00] came on and evolved very quickly. , we, this was overlapped with difficulties with supply chains, with hospitals of, around so much uncertainty about how you even treat covid in the hospital.

Chantel: Right. We were putting everybody on ventilators because that's been standard practice for respiratory infectious diseases. But then it turned out we didn't need to put people on ventilators as much. And the information about can you spread it when you're asymptomatic, all of this shifted in real time and public health has.

Chantel: Huge challenge and always has where we have to deal with things in real time and especially in the infectious disease world. And it's also a time it was also a time of fear of political division and all of this interplayed for individuals in very different. I think we can do more to restore trust.

Chantel: I think we need to be extremely active listeners to the population. Find out what it [00:19:00] might take to restore trust. Find out messaging that really helps. , Dr. Pool in biology here does a lot of vaccine hesitancy research, and he's found different tools for messaging to different groups that are really effective in helping people understand the need for vaccination.

Chantel: And we, we just need to be much more aware of that and not think of ourselves as well. Whatever message I give you today, that's the message you're gonna trust, right? We have to to think in long term and. How do I speak to groups in, in language that they're going to take in, right? Yeah. And aligns with their value systems, and that's different for different people.

Chantel: So I think we need to do a much better job. I think we can do a much better job. We've learned a lot through this experience. Lot of successes. I don't wanna say it was all bad public. Professionals did a fantastic job around the country and around the world. It was challenging. There was [00:20:00] burnout there was pushback.

Chantel: And we were still able to have the biggest vaccine campaign in human history come through. So there was a ton of good, but we also are taking lessons forward. Right? Which, as a field, we need to be humble and do in, in some serious, . 

Cougar: I love that answer. There's two things I'm thinking of when you're talking.

Cougar: One, I think that that is what science is, science. , I think, I think people have been critical saying, yeah, well, well the message changed. That's cuz science changed. Cuz that's what we're, we're always asking questions and trying to use data to find out, okay, this is, this is what we need to do right now.

Cougar: And that, and so I think there's a, there's a need to educate the populace of what science really is. It's not something that happened years ago and that's forever in stone. Sometimes the science changes very, very quickly and that's, that doesn't mean that you should begin to mistrust science. that's actually assigned science is doing what it's intended to do.

Cougar: , it's continuing to explore and ask questions and, and prove or disprove [00:21:00] hypotheses. The other thing, I think that public health has done a very good job in the last maybe six months in doing exactly what you described in really listening. I think there's been a, a tremendous display of. , we've even seen CDC do some massive restructuring saying, Hey, we, we, we did some good things and there's things we can do better and we're gonna be responsive.

Cougar: And I think I'm hopeful, I'm mostly hopeful that as we take that approach, that we will not only be more prepared because the infrastructure and the financial resources commitment to being prepared for the next infectious outbreak, but I thi I hope in the hearts and minds of people, there's a regeneration of trust.

Cougar: So I'm very hopeful and I really appreciate Your answer was terrific. 

Chantel: Well, I also, as, as you were talking , I, I wanna add that we also. , we, we need to ask for grace from the public and humility from the public in that there's, there's this take that public health professionals are kind of [00:22:00] these people on the hill.

Chantel: They'll say, well, they said this first and they said this later. It's like, well, who are the, they? They are your neighbors. . They're human beings who are doing their best, who they're, it's not some shadow group. that's making all these decisions and just trying to make money and all this stuff. it's a vaccine for example, that we're gonna take, our children are gonna take, our parents and grandparents are gonna take. We are extremely concerned with issues of safety and, and messaging. Doing things in ways that don't, don't destroy the economy.

Chantel: Sure. Where it's not like we're out to get anybody, it's cuz we're living through the exact same thing that everyone else is. . But we're trying to do our best in the moment to message, to get the right technology, to get the best support to figure out all the medical issues. And oh my gosh, are we gonna be working on long covid for the next 10 years?

Chantel: 2030 , but it's. . It's [00:23:00] something where we all need to give grace and humility to each other and say, yeah, people who are professionals who have studied this are working really, really hard to get it right and they're not always gonna get it right. But that doesn't mean I throw out the baby with the bath water and stop trusting public health or the medical system.

Cougar: Really well said. It feels like. . I was thinking the other day about this and not to bring in, well, I'll just do it. . I was, I was thinking about the Protestant Reformation. . So up until that time, you relied on a priest to. read the holy Words to read the scriptures and then to decipher and to teach and, and and then people literacy increased and access to the scriptures increased.

Cougar: And then suddenly you had people saying, well, I'm interpreting this way and I'm interpreting that way. And that caused some challenges initially. . And then we move forward and, and certainly I think, We've all benefited from those original reformers and then [00:24:00] pushing back. And I've wondered if there's something there for all the world to think about right now.

Cougar: Maybe, maybe a generation ago you really did just look at a physician and you expect them to interpret the, whether that's the scientific literature or the test, and, but things changed with the internet and things changed with social media. and now we have everyone who says, oh, I'll, I'll interpret the science, or I have access to the same things that, you know, those people on the hill have.

Cougar: And I, I feel like it was in so many ways, it's the perfect storm. Everyone feels like they, they can read those scriptures, the holy written for their own. And, but I, I do think that's, that's not a bad thing, but I think that it, there's a transition period to where now we can, because we have the internet, we can access things, but anyone can.

Cougar: whatever they like. And we need to, we need to improve our media literacy and our social media literacy to the point where we can decipher between, okay, this is an authority [00:25:00] figure who really does have the training like yourself. Mm-hmm. Who can help me interpret these results or help me interpret , wh why this particular mandate is essential right now, and where are the lives saved?

Cougar: And so that's probably really in left field. But I've been, I've been thinking about, we, we all feel like, cuz we have a, a phone that can access anything. We all have Google Scholar. . But I think there's gonna be a period, and I hope it's before this next large outbreak, where we recognize that there are limitations within that.

Cougar: and it, it doesn't remove the need for public health authority figures and for, for decision making. That's really, Made by those that have all the information. Anyway, I'm just, I'm all over the place right now, Chantel, but , I thinking all sorts of things, trying to be hopeful and trying to recognize mm-hmm.

Cougar: that there is a path forward 

Cougar: too. 

Chantel: Yeah. I, there is a path forward. There is, and one thing that I try to teach the students to do, and which I try to do, I don't always model it perfectly. [00:26:00] When someone asks me a question, and I did this multiple times over the last couple years, I'd go on Facebook and say, tell, ask me all your questions.

Chantel: I don't care if you think it sounds quote unquote crazy. Or you're just wondering, could this possibly be true? This thing I heard online I'm just gonna look it up in the scientific literature. Fine papers tell you where to go and say, this is what. means this is what the data shows. I'm not gonna call you stupid, I'm not gonna Yeah.

Chantel: Do anything because it's confusing. Right? Yeah. One of the big things we saw around Covid was that came out later was people saying, oh, the vaccine causes infertility. This was a big time rumor spread through the internet. And it turns out it was actually traced to one in particular clinician who was, had a history of being anti-vax who did this very sophisticated disinformation campaign, but it was completely made.

Chantel: completely, but a lot of people had questions about it because it was such wide. , you know, rumor presented as information presented, even in kind of pseudo-scientific context. And so [00:27:00] the idea that everybody's gonna be able to look at that stuff and say, well, let me double check the literature. I'm gonna jump on Google Scholar and find these 10 papers and understand what's going on.

Chantel: It, it takes, it takes background. It takes practice to understand a scientific paper. Yeah. And to be able to differentiate a good one and a bad one and, right. Understand. , all the nuances there. For those of us who have generated those papers, we understand the strengths and weaknesses and how it takes multiple papers and studies together to really reach a conclusion you can move forward with.

Chantel: And, but it's, you know, for the lay public, no matter how smart and educated you are, if you're not in this field, it's really easy. For a disinformation campaign to sow seeds of doubt. . It's much easier to sow seeds of doubt than it is to sow seeds of confidence. And that is a major issue for public health going forward, is how do we sow these seeds of confidence? And I think it's through listening, it's through understanding what people [00:28:00] value making sure that our, our messaging and.

Chantel: Decision making is in line with that. We're gonna continue to have, to make really hard decisions to save lives and damage the economy. Do you let the disease run rampant and a lot of people die, which is also gonna damage the economy it turns out. But or. , keep everything open. I mean, these are trade-offs we've known about and have been talked about in the literature long before Covid.

Chantel: But it is this extreme wrestle that we have in public health because you're asking people oftentimes to limit in some way. I mean, even asking people to wear a seatbelt is limiting in some way. , but there are things like infectious diseases and air pollution and water safety and all of these different things where we're literally all in it together.

Chantel: Either we, we come together and we beat this thing and we all live much better, safer, healthier, longer lives, or it's everybody for [00:29:00] themselves, and, and we cannot beat these things. There are things, and I think. Sometimes I look at it as almost a gift the Lord has given us to make us understand and love our neighbor and, and look outside ourselves and recognize that, hey, that person down the street who has Emphysema or had an organ transplant or HIV or whatever it is, you know, for, or they're 75 years old, their life is as valuable as my life.

Chantel: And it's okay for me to limit myself a little bit by wearing a mask so that they can have the freedom to live without this extreme fear hanging over their heads or having to go to the hospital. You know, we all know people who are still dealing with long covid and. It was pretty much all preventable.

Chantel: And that's really difficult to watch people who still have memory issues, breathing issues have developed diabetes as a result of the virus, which, you know, who would've guessed that that [00:30:00] would be an outcome. But it is, it's definitely a real outcome that, you know, we could have prevented. And, you know, how, how much are we willing to give?

Chantel: to give for each other. . And to keep our planet clean and safe for everybody. You know, it does take some sacrifice and some willingness to limit ourselves for the benefit of others. 

Cougar: 

Cougar: Really well said. I don't think I want to try to add anything to that. , just one thought I have to share. The one thought though, which is you could have chosen an easier career.

Cougar: This is public health is really messy. It is. And so I think. , I think to some of your earlier points, it's like, yeah, this is really hard and there are trade offs and there are consequences and unattended consequences, and there it's just, so thank you for choosing this career and for being a champion for public health, being a champion for, for the population.

Cougar: So thank you Chantel. I'm really just, really touched by your goodness, and by, by the, the commitment that you've [00:31:00] had your entire. To educate yourself to, to put yourself in, in doctoral programs and post-doctoral programs, to develop this expertise and and to then have the humility though to say, I don't know everything, but I'm, I'm working towards good things to help others.

Cougar: So, really cool. Very selfless. I really 

Cougar: appreciate that. 

Chantel: Oh, well, thank you. I, I have to say that every step in my path I. Very helped and given a lot of grace by mentors and people who are much smarter than me. But I, I love being in public health. It's just the best spot for me because we're doing really good work dealing with complex wrestles, , ideas, but you know, we know that our field helps people. It's a great reason to get up and come every morning. 

Cougar: You just took my line, . Here's my last question for you, then I'll let you get on with your day. What is it that gets you up in the morning right now?

Cougar: Is there something you're reading? Is there a paper you're working on? How do you recharge your batteries? Because it, this has been a slog. 

Chantel: [00:32:00] Yeah, it has been a slog and I will say I took the last. and I was on sabbatical actually in El Paso, Texas, working with a great group down there, group of people called the Paso del Norte Health Information Exchange or Fix.

Chantel: And I, I recharged and I learned a ton and I've got lots of new, exciting projects. Some of which are chronic disease related diabetes, others which are covid related. I'm working on this really cool long covid project right now looking at. The effects and the types of hospitalizations. People are coming in for long covid based on what they were originally infected with.

Chantel: Omicron Delta Wild type. I, I mean though, I will say the thing that gets me to work every morning the most is the students. I love the classroom. I love it. I'm an introvert, but I love it . I'd love to come in, put on this like show, interact with the students, hear everything they have to say, and then go back and sit quietly in my introvert.

Chantel: Analyze some data so it's, it's a, it's the perfect balance for me. 

Cougar: It is. And I've, I've seen you in the classroom. You're exceptional. So [00:33:00] you, you're, you keep spitting out amazing research churning out paper after paper and doing good things in the community. And students love you.

Cougar: Well, I have been blessed by being here today and, and listening to you and your passion and your expertise.

Cougar: So Chantel, thank you. I really appreciate your time. 

Chantel: Thanks, Cougar.