College Helps Curtail Kent State Ebola Concerns with Science, Calm

Dean Sonia Alemagno got the phone call mid-morning on October 15.  Provost Todd Diacon was on the line.  The college’s expertise was needed – now!  A second nurse who had cared for Thomas Eric Duncan, the first U.S. Ebola patient, was diagnosed as infected with the highly contagious, deadly virus.  The nurse visited Ohio just days before, and three of her relatives work in administration at the university.

Public Health Joins the Crisis Management Team

Alemagno reached for biorisk containment expert Christopher J. Woolverton, PhD, Environmental Health Sciences professor, alerting him there was an infectious disease emergency on campus.  “You can well imagine the immediate adrenalin squeeze,” Woolverton recalls.  He alerted Associate Professor Tara C. Smith, PhD, an infectious disease scholar who’s written a book on Ebola, and they headed to the dean’s office, where she filled them in on the limited information she had.  “All we knew at the time was that an employee was related to a Texas nurse and Kent State alumna, Amber Vinson, BS ’06, BSN ’08, who had been diagnosed,” he says.  There would be a meeting in the president’s office at 11:00 a.m.  Woolverton would attend to advise the crisis communication team.

Kabir Bhatia © 2014 WKSU
While packing up to go, he heard from Angela DeJulius, MD, chief physician and director of University Health Services, who had been apprised as well and would be at the meeting.  “She said, ‘Let’s get together, so we’re on the same page,’ and I went right to her office,” Woolverton says.  “Minutes after I arrived, we got a call to ‘come now,’ so we rushed over to the president’s office.”
The crisis communication team was already assembled, and President Beverly Warren, PhD, convened the meeting.  “She shared with us all the information she had, and I educated the team about the disease, transmission routes, infectivity and epidemiology.  President Warren’s staff was able to call the employee to find out firsthand how Amber was doing and whether she was sick while in Ohio.  We obtained information the media didn’t have at that point and felt we were in a safe situation.  Amber knew she was at a higher level of risk.  She was told many times that unless she was showing symptoms, there was nothing to worry about.  We were told that only one day while in Ohio did she feel out of sorts, but didn’t have a fever.  She checked in with the Centers for Disease Control (CDC) and was told not worry about it.  She became sick when she arrived back in Dallas.  She hadn’t been on campus.  What we obtained from Amber through her relative was in conflict with what the media were quoting CDC and other sources as saying.  We started working on a press release to clarify the facts,” Woolverton retells.  DeJulius, who has an MPH degree and is on the faculty of the College of Public Health, was named the point person for presenting the university’s response, alongside President Warren.
Woolverton, who is a member of the City of Kent Board of Health, served as a liaison to the board for the university and dialed the health commissioner at the president’s request.  “When I got to the meeting, I learned that the university had been attempting to call the CDC.  No one was responding, which is the right protocol, he explains.  “The CDC can’t have just anyone calling them.  It must start with the local health department – they have the bat phone.  It goes from the local health department to the county and state, then to the CDC.  I alerted the health commissioner to what was already known and what we knew about what was going on in Summit County, which was handling all the work.  The CDC was in an advisory-only capacity throughout.” 

Viral Misinformation Goes Viral

Meanwhile, Smith was back at her office monitoring news and social media in real time.  She e-mailed Woolverton with an urgent update:  A local TV station was erroneously reporting that someone at Kent State had been quarantined.  “This was picked up by a number of outlets without being verified, and it scared a whole lot of people on campus and off,” Woolverton says.  “The situation quickly devolved into a crisis management ordeal because of information that was incorrect,” he says.  “We went from preparing a regular press release laying out what we knew to one that refuted misinformation, and a press conference was scheduled for 4:00 p.m.,” to give news outlets time to assemble.
“The misinformation essentially developed from confusion between the definitions of true mandated quarantine, recommended social distance and self-monitoring,” Woolverton observes.  “The media doesn’t understand the differences and was and still is using the wrong language,” he adds.
Before addressing the media, President Warren wanted to calm the campus community, so she convened a 1:30 p.m. emergency meeting of the President’s Administrative Council (PAC), which includes the deans, department chairs, program directors and senior members of the administrative staff.  “Once the president reassured the PAC, Angela and I explained the science and medicine behind Ebola and shared that, as best we could tell, no one was at risk.  Amber had not set foot in Portage County.  Her relatives hadn’t interacted with a symptomatic patient and had no symptoms of their own.  There was no real concern,” Woolverton explains.  “It was as close to no real risk as you can get.”
The press conference was held, and “we got the message out that there was little to no risk on campus,” he says.  But that didn’t stop parents from boiling over with concern.  “The university activated an emergency hotline, and university staff, along with local nurses, came over to volunteer,” Woolverton recalls.  “There were confused and irate parents who threatened legal action and visits to campus to extract their children,” he says.  “The next day, there were a large number of contractors and vendors who were very skittish and cancelled appointments, partly because of all the misinformation released through the media,” he observes.
Throughout the evening, while Vinson was flown to Atlanta for treatment, Woolverton, Smith and DeJulius were in constant contact electronically, scouring news reports to brief the president the next morning.
For several days, Woolverton and Smith “were on it 24/7,” he recalls.  Friday, October 17, the president heard that staff members who worked in proximity to Vinson’s relatives were still upset and concerned they were at risk.  “We visited their workplaces to help them understand that their potential risk was zero.  I repeated our visit on Monday afternoon to catch some employees not in the office the first time,” he says.
Smith was vigorously tweeting and blogging on scientific media outlets, conveying what was going on and dissuading that there was an infectious disease outbreak at Kent State, helping the scientific media counteract the mainstream media.  “Throughout, she helped the crisis communication team to recognize the gravity of misinformation and the importance of refuting it as quickly as possible,” observes Woolverton. 

Involvement by the College Spreads

“Chris and Tara, because of their unique expertise, stepped up to the plate very quickly and represented the college very well,” says Mark A. James, PhD, professor and chair of their department, Biostatistics, Environmental Health Sciences and Epidemiology.  But he and other faculty were also involved.  James, a tropical disease authority and executive director of the college’s global health programs, says he was “concerned about our numerous international students, a good number of whom are from Africa.  I spoke to them, giving assurance that if they were faced with any bias or stigma, we would help them deal with it.”  He likewise conferred with the director of the Office of Global Education, who alerted his advising staff.  Madhav Bhatta, PhD, assistant professor and specialist in infectious disease epidemiology, counseled the Department of Pan-African Studies about the relevance of the situation to faculty and students.
Assistant Professor Heather Beaird, PhD, epidemiology chief of Summit County Public Health, worked on the public health front lines a dozen or more hours a day assisting with contact tracing and agency response, while maintaining a teaching load in undergraduate and graduate epidemiology.
In their classes, faculty across the college took the pulse of the student population and gave them as much information as they could, reassuring them they were not at risk and there was no cause for alarm.  “I deputized my students as public health ambassadors to get the truth out.  The students were very concerned about the misinformation out there and excited to be asked to help fix it.  Many went right to social media, explaining there was no risk to students or faculty members regarding Ebola,” Woolverton recalls.  “Once students were told by another student, they were over with Ebola and on to Homecoming,” observes Alemagno.  No students presented at the university health center concerned that they had Ebola symptoms, according to DeJulius.
The following week, Woolverton was scheduled to speak to a new student organization, Hungry for Health, about the flu on college campuses, but his appearance was repurposed to additionally discuss Ebola.  He found the room packed, including substantial representation from the local community.  Woolverton subsequently provided training on Ebola infection control to University Health Services staff and did a two-hour training session for the first-responder community of the City of Kent regarding Ebola history, infectivity, epidemiology and disease information.  Similar training was later held for the Suffield Township first responders. 

Lessons Learned for the Benefit of Future Response Situations

“The biggest lesson we’re learning nationally is that in the absence of hard facts, don’t speculate and draw conclusions that lead to hysteria,” sums up Woolverton.  “We should all learn the truth, share the truth and dispel information as best as possible.  Knowledge is power, to quote an old cliché.  President Warren integrated science into her talks and calming messages, keeping a level head and being a good leader in the campus response, because she understands the science.  That’s what saved the day, in my opinion,” Woolverton says.
“The president demonstrated that she is very capable of assimilating scientific information and very articulate in transmitting the information in a forthright, but calming, way,” agrees James.  “This was evident when she spoke at the October 15 PAC meeting and the press conference, as well as the following day, when she coincidentally addressed the Akron Roundtable, where she spent time talking about the situation at Kent State.  Her comments were stellar.  She talked about the value of public health and what we’re doing here,” James says.
President Warren repaid these compliments in an October 24 message to the university, saying, “Through the competent and caring expertise of our medical staff and faculty in the College of Public Health, we were able to respond immediately with the latest information and an explanation of the potential risks and the precautions … I am especially grateful for the support and expertise of Dr. Angela DeJulius and Dr. Chris Woolverton, and I know the university is indeed fortunate that we have such competent experts to help guide us.”
“Having an expert like Dr. Woolverton gave us a scientific perspective that deepened our credibility, with his expertise in the microbiology of organisms like Ebola,” DeJulius says.  “The college now has a reputation for responding quickly, calmly and with correct information as leaders in these types of emergencies,” adds Alemagno