Responding to Ebola in West Africa
After time as an Epidemic Intelligence Service officer at the CDC, which included her stint in New York City and many other response efforts to acute public health events, MacDonald was recruited to the Epidemiology Department at the UNC Gillings School of Global Public Health. She went on to spend a decade as a faculty member at Gillings before eventually settling at RTI.
“Literally the day I arrived at RTI, my colleagues said, ‘Hey, we talked about you over the weekend, here is a request for applications with a one-week turnaround that might be interesting.’ And I looked at it and it was related to the Ebola response in West Africa,” MacDonald recalls. “It was daunting to arrive at a new job and immediately begin discussing work in a place I had never been. But I knew I could not pass up the chance to try.”
MacDonald and her team scrambled to put together an application for the work, which involved serving as an on-the-ground implementing partner funded by the CDC to support the national government in Guinea in responding to the Ebola outbreak and helping reconstruct the region’s public health infrastructure in the outbreak’s aftermath. A few months later, they were notified their application had been selected and MacDonald would be the lead investigator.
Before they knew it, MacDonald and her RTI colleagues were in Guinea — the epicenter of the outbreak — where their work focused on supporting the ongoing public health response: integrating data, training responders on Ebola contact tracing, setting up screening areas that would triage Ebola patients, and much more.
“The infrastructure building afterward was very much focused on the prevent, detect, respond paradigm for global health security, where you’re building up your system to detect outbreaks faster and make sure they get reported and responded to before they get very large or expand to other countries,” MacDonald says.
The work paid off. MacDonald points to Guinea’s swift response to the threat of another Ebola outbreak in early 2021. They were able to detect cases early and limit spread — a textbook response to a deadly disease.
A (Hopefully) Once-in-a-Lifetime Crisis
Few people or countries were prepared for the emergence of coronavirus, also known as SARS-CoV-2 — though MacDonald proudly notes Guinea’s national government was ahead of the curve on that one, too, having commenced preparations months before it took hold globally.
“I remember thinking we were headed for a once-in-a-lifetime global public health crisis,” MacDonald says. “SARS-CoV-2 was a new, highly contagious pathogen that caused a disease we had no experience treating, and for which we had no vaccine. When you put all that together, you realize there’s a big storm coming. With all the naysayers early on, I kept asking myself, ‘Am I overreacting?’”
Amid the pandemic, MacDonald has pivoted, as she has become accustomed to doing across her time in public health and epidemiology.
She has worked with the state of Louisiana on contact-tracing efforts and supported work to model the spread of COVID-19 in North Carolina. She has also played an integral role in the development of a COVID-19 epidemiological data insights tool designed to help federal, state, and local public health officials and key stakeholders make informed decisions on how to prioritize response efforts, including contact tracing, placement of testing sites, and vaccine distribution.
MacDonald has also shared her expertise with community groups, teachers, high school and college students, lawyers, and local and national media during the pandemic to help keep the public abreast of the latest guidance and epidemiological research.
With an undoubtedly busy schedule, she still finds time to ponder the future of public health, where she hopes to “revolutionize” public health surveillance, and mentor women in science to become more visible and recognized for their contributions.
“Investment in public health surveillance has languished for many years. It needs a complete overhaul and modernization immediately and for the future. We need to leverage enormous advances in data science and analytics, machine learning, and genomic sequencing, at a minimum,” MacDonald says.
As for supporting other women, MacDonald says making time to be a mentor to other women in the field is a priority because it is something she had little of as an aspiring scientist. Naturally, she is attacking it like a response to an infectious disease: using data, detecting the issues and responding, with the hope of building a stronger, more inclusive future.