A Travel Epidemiologist Charts New Territory

COVID-19 Corps member Karuna Mary Bollam is one of a select few public-health professionals who has the power to turn a plane around in mid-flight—and she’s done it before, in concert with her colleagues at the Centers for Disease Control and Prevention (CDC). Serving as the statewide travel epidemiologist for the Oregon COVID-19 Response and Recovery Unit (CRRU), Bollam is tasked with tracking those with confirmed and presumptive cases of COVID-19, along with their close contacts, who might have plans to travel out of the state by air.

“Whenever the local health department notifies me that a COVID case or contact has imminent travel plans, I gather the facts about the person and their plans to travel either domestically or internationally, and I'll send that information to CDC’s Division of Global Migration and Quarantine.”

Otherwise known as DGMQ, the division’s 20 quarantine offices are staffed with medical and public health officers from CDC who conduct screenings of air passengers flying into the United States. Those passengers numbered some 766,044 from January through September of 2020. And that’s just one of DGMQ’s many duties. They’re also responsible for establishing, maintaining and distributing up-to-date travel guidance and recommendations, while staying in constant contact with local, territorial and state health departments.

A Quarantine Public Health Officer with CDC conducts a training exercise at Minneapolis-St. Paul International Airport. (Photo Credit: CDC/Arnold Vang)

Karuna Mary Bollam, travel epidemiologist

Once Bollam notifies DGMQ about a specific situation involving air travel in the state, a consult call is scheduled with division officers, local health officials and Bollam, representing the Oregon Health Authority (OHA), to decide whether to add the individual to the Do Not Board list, which prevents them from getting on a plane. “That’s always the last resort,” explained Bollam. Following that decision, she’ll very likely reach out to that potential traveler personally with information and support.

In some cases, that phone call may be the first time the person is hearing about their positive or presumptive status. Bollam, a certified health educator as well as an epidemiologist, has expertise in this kind of communication. “We take a trauma-informed approach to the notification process,” which emphasizes safety, transparency, collaboration and empowerment. “Still, to begin with, the conversation can be rough,” she says. “Of course, they’re not expecting to hear they’ve tested positive, so they’re dealing with a lot of emotions. I understand their reaction.”

Bollam addresses their concerns by offering wraparound services, which involve working with local public health authorities and others who can provide food and shelter to help them wait out isolation or quarantine. That extra dose of compassionate support is welcomed. “By the time they are taken off the Do Not Board, they are really thankful for our help.”

We take a trauma-informed approach to the notification process. They’re not expecting to hear they’ve tested positive, so they’re dealing with a lot of emotions.

Bollam has found her niche at the Oregon Health Authority, and they are thrilled to have her: “Karuna has had to deal with situations that were complex, time-sensitive and stressful and even in these scenarios, she lends compassion, grace and composure to her work,” says her supervisor, Surveillance Epidemiologist Lee R. Peters. “She is a wonderful contribution to the team.”

It’s a natural fit for Bollam. “The area of travel, it drew me,” she explains. “Being an international myself, I can understand coming from a different culture.”

A native of India, she was working as a registered nurse in a cardiothoracic pre-operative setting, when she realized the importance of public health. “There isn’t enough education about preventing heart attacks and strokes. Until a couple of years ago, exercising and going to a gym was a stigma in India.” That realization spurred her to move to America to pursue her master’s degree in public health.

She graduated in 2018, joined the COVID-19 Corps in 2020, and has since had many memorable interactions, including that earlier case in which an international traveler who hadn’t been cleared managed to board a flight to Central America. After an emergency call with DGMQ, the pilot was notified and turned the plane around.

Bollam has also managed COVID-19 outbreaks among cargo ship crew members, and during this recent surge, she’s been receiving several alerts a week about possible travel cases. Like her colleagues at the CDC Foundation, DGMQ and elsewhere, she takes the threat to the community very seriously. As she said with a smile, “If you’re infectious and in quarantine, don’t try to break the rules. Even if it’s my family, if you’re not compliant with public-health recommendations, you will be added to the Do Not Board list.”

 


 

This article is supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $68,939,536 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS or the U.S. Government.

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