A few years ago, while I was supervising HIV surveillance data for a city of more than two million people, we had a conversation about whether our case records had “enough” demographic detail to say anything meaningful about disparities. The answer depended entirely on decisions made long before anyone asked: which fields existed on the […]
What HIV Cluster Detection Looks Like From the Inside
When people hear “disease surveillance,” they tend to picture dashboards, case counts, maybe a map with dots. They don’t picture the work itself: a small team of epidemiologists and data analysts going through case reports every week, looking for patterns that don’t announce themselves. That work is called Cluster Detection and Response (CDR). It’s a […]
Why Most Public Health Dashboards Stop Getting Used
Every health department I’ve worked in has had at least one dashboard nobody looks at anymore. It probably looked great at launch, with clean charts, live data feeds, maybe a demo for leadership. Six months later it’s a browser tab nobody opens. The technology is rarely the problem. The design is, and it’s one of […]
What COVID-19 and Monkeypox Taught Me About Emergency Operations
Running two emergency responses at once is its own kind of stress. While I was on a municipal COVID-19 response team, there was a stretch when we managed pandemic operations and an emerging Monkeypox outbreak at the same time. Each had its own case definitions, reporting lines, and partners, and one team had to keep […]
Why Public Health Programs Need People Who Speak Both Data and Budget
Public health has plenty of people who can read an epidemic curve. It has far fewer who can also read a budget, write a grant proposal that survives review, and get a project through government procurement without losing a year. In my experience, that gap is one of the most common reasons a good idea […]
What Rural Surgery in Benin Taught Me About Public Health Infrastructure
Before I worked on surveillance systems and dashboards, I worked in the operating room of a district hospital in Bassila, Benin, as a general surgeon for a rural population with little access to specialist care. That is about as far from a KPI framework as clinical work gets. It is also where I learned what […]
From the Operating Room to the Epidemiology Desk
I spent the first part of my career as a physician in Benin, first in an emergency department and then as a general surgeon in a district hospital. I now lead epidemiologic surveillance and data programs at health departments in the United States. On paper those are two different careers. Most days they feel like […]