2020: Year of the Epidemiologist!

Mary-Louise McLaws, UNSW

I joined UNSW Sydney in 1992 as a lecturer and over the years I was promoted to Professor of Epidemiology, Hospital Infection and Infectious Diseases Control. I have been privileged to represent Medicine on the Academic Board and have held the role of Deputy President for the last 2 years.

I am also the Water-Health Leader of the UNSW Global Water Institute. I was very fortunate to have the choice of free university education. My mother was a single parent and my brother and I were the first to attend university since my mother’s family arrived from Europe where her grandfather was a professor of music. So the privilege of a free university education was a highly treasured opportunity that sadly is no longer available to Australians.

My research career began during my Masters of Public Health at the University of Sydney in clinical epidemiology under the guidance of eminent Professors Geoffrey Berry and Les Irwig; both were exceptional biostatisticians and clinical epidemiologists and generous mentors while I performed the first surveillance study of surgical sites and other infection complications in Australian hospitals.

An opportunity of a life time came up when I was offered a position with Professor David Cooper at UNSW as a PhD candidate in Australia’s first HIV research centre. Professor Cooper was a generous and innovative mentor encouraging me to think big and along with Professors Berry and Irwig, I was mentored across two universities and given the skills to become an all-round academic focusing on teaching, research and social responsibility.

I returned to researching patient safety associated with hospital associated infections and developed the first automated surveillance system for public hospitals as a pilot for the NSW Ministry of Health. The World Health Organization (WHO) offered me a position as WHO Advisor to China and Malaysia for short missions over several years and UNSW, with its strong support of social responsibility, enabled me to undertake this role. I have focused on this aspect of mentorship and translational research with WHO as opposed to grant supported research over a long association with WHO as an expert advisor to several of their patient safety projects.

The Sudden Acute Respiratory Syndrome (SARS) outbreak in 2003 in China and Hong Kong was an outbreak that transfixed the world, although from a safe distance, be- lieving these outbreaks would never leave the shores of Asia. With a team of Beijing experts, we reviewed the response to SARS and the response for the safety of healthcare workers in Hong Kong. I learnt that their approach to a novel disease with unproven control strategies was world’s best practice and included mental well being of healthcare workers and the role of humans in the spread of SARS. I see today during our COVID-19 approach that failing to account for human behav- iour is our failure.

Staff are also suffering anxiety from the years of declining research funding and general support of universities in Australia and this is now heightened by the financial pressures from COVID-19.

The arrival of COVID-19 outside of Asia was received with surprise yet many parts of the world had expe- rienced other zoonoses diseases such as Ebola and MERS, that had jumped from animal to humans with help from human behaviour and poor public hygiene practices. I was invited to a WHO meeting in February 2020 along with 400 other scientists to discuss a roadmap for COVID and was appointed to a WHO Health Emergencies group and have the privilege of working in a group of dedicated scientists for infection prevention and control.

My passion is mentoring the next generation of researchers and have enjoyed the opportunity to supervise many talented research candidates through their training who have returned to Asia, the Middle East or remained here to become our future leaders in patient safety. I am fortu- nate to be in contact with most of them through Facebook (yes, it is for old people) and Instagram. I some- times work with my former students in building capacity in their countries.

COVID-19 has impacted academics on many fronts – working off cam- pus and adapting to web teaching and online mentoring and research meetings. For academics working from home has advantages (no traffic, easy access to the fridge) and disadvantages (absence of the serendipitous chats with our lovely colleagues, the expense associated with home offices, poor internet connections and a strain on our IT expertise). We are now teaching mostly online and this mode of teaching requires far more hours than face-to-face teaching. Staff are also suffering anxiety from the years of declining research funding and general support of universities in Australia and this is now heightened by the financial pressures from COVID-19.

Future online learning must have increased funding to enable coteaching with two academics or an academic and a professional staff to respond to the reasonable expectations of our students of a value-for-money education experience.

Students pay for tuition and have the right to expect faster return of their work, more detailed responses, and improved teacher to student ratios. My experience teaching our postgraduate program Health Services Management offshore in Hong Kong gave us the opportunity to co-teach courses with the academics who were at the offshore residential schools, giving students a wider perspective of the subject matter. As a consequence, I adopted the same approach to Outbreak Investigation, teaching it with a colleague who had a very different fieldwork experience. It also allowed one of us to answer written Q&A while the other continued to interact with the students and we would swap around our roles. It was a very enjoyable teaching experience.

A COVID-forced online mode of delivery would have been a great opportunity to mentor junior academics through co-teaching, but reduced funding may mean this is unlikely as all staff will be stretched for time. Future online learning must have increased funding to enable co-teaching with two academics or an academic and a professional staff member to respond to the reasonable expectations of our students of a value-for-money education experience. This is especially true for postgraduate students who usually learn after hours and on the weekend.

The erosion of university funding has been pernicious and resulted in further reductions to professional and academic staffing. The public may not be mindful of the value that university education provides. Imagine a COVID pandemic without a sound investment in education? Without university training there would be no designers, scientists and engineers to produce life-saving facemasks, alcohol-based hand rub and environmental cleaning products. There would be no engineers to ensure the airflow is safe in hospitals to clean air of COVID, or trained frontline nurses, doctors, and allied healthcare workers. Education is one of Australia’s top export products and our international students are invaluable for the cultural and intellectual value-add to our society. We love them.

The last 5 months has highlighted to me the additional burden academics with childcare and carer responsibilities have associated with working from home during COVID. COVID has also exposed the unacceptable inequities in society. Examining hotspots for COVID has highlighted that in the same suburbs there is poverty living alongside the more fortunate in society. Those with poorer opportunities for education and earning power have also been at a greater risk of infection with COVID. It is my hope that post-COVID we will redress all these inequities in our society. It is also my hope that university education never becomes an opportunity only for the financially privileged.