Working in Clark County: Madison Riethman, epidemiologist, Clark County Public Health

The COVID-19 pandemic has put public health front and center in the world’s issues.

Prior to the virus, epidemiologists like Madison Riethman, an employee of Clark County Public Health’s Communicable Disease department, had trouble with people even understanding what she does for a living.

“What’s interesting about COVID-19 is that it has raised the awareness of epidemiology,” Riethman said. “I have fewer people asking if I’m a bug scientist or skin doctor.”

The 28-year-old Ohio native is one of four epidemiologists employed by the agency, which plans to hire more. The Centers for Disease Control and Prevention defines epidemiology as the “study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems.”

Riethman said she looks at the public health issue facing our community and gives the five basic points: who?, what?, when?, where? and why? “We look at if someone’s being disproportionately impacted by a disease or health condition,” she said. “We look at why that’s happening. Then we look at data collected to fix them. It’s really trying to get to the bottom of what is happening.”

Riethman, who lives in Southeast Portland, has been working long hours at home since the pandemic started back in March, though she occasionally visits her office at the public health building on East Fourth Plain Boulevard.

The Columbian caught up with Riethman to learn more about her and her work.

Tell me about yourself. How’d you land in this job?

I originally got my bachelor’s degree in chemistry, and thought I was going to go work in a lab somewhere or maybe do environmental work out in the field. I realized I needed to work with people. I started my master’s of public health program. After that I got a fellowship position that placed me with Clark County Public Health, where I’ve been since 2016. If I’m being honest I don’t think I knew what an epidemiologist was until I was applying for my master’s program. My mom is a registered nurse, so I was always exposed to the world of health care. Generally that was always the line I kind of toed. I’m very grateful I ended up where I did.

So you were an epidemiologist before the pandemic. Did your job duties change drastically once the pandemic actually started?

You know, in Clark County we were weirdly a little fortunate. We had a pretty sizable measles outbreak in 2019. Which was obviously a terrible thing and a very stressful experience and something I’d never wish on this community again, but it did give us the practice to work on a larger outbreak. We had a year there where my job was really post-measles outbreak, it was trying to get back to our normal job of routine activities of data analysis and reports. We were like, “We need to be prepared for these kind of things.” COVID-19 is definitely different than a measles outbreak, but the principles are the same.

Is a pandemic something you ever expected to happen?

I want to say yes and no. It’s definitely something that, especially getting my master’s in public health in epidemiology, it’s something we always talked about — when that big pandemic hits, kind of like in this area when people talk about “The Big One” (earthquake). It was like an inevitability. But it was off the horizon, not like this big looming threat. That changed a bit when we had a measles outbreak last year. Did we expect the biggest outbreak in 100 years? No we did not expect that.

What are you observing here locally? How does that compare nationally?

A lot of what we’ve seen in the community has been pretty reflective of Washington state and nationwide at different periods of the outbreak. The biggest thing I’ve been coming back to is how our communities of color are impacted disproportionately. That’s reflected in Washington state and across the country. There are a lot of reasons for that; I think there are other factors going on, such as the need for essential workers, and those workers are the ones more on the front lines and at the highest risk for contracting COVID-19. Regardless of those reasons, it’s important to acknowledge that it’s happening and come up with strategies to address those.

There is a lot of debate in America right now about how scared we should be of the disease. Some seem to not care about wearing masks, for instance. What are your thoughts?

It’s actually pretty reflective of how we are as a culture in America broadly. We had this debate about vaccines last year with the (measles) outbreak. We have this debate with about every political issue in this country. There’s always going to be people who have a different experience. Part of that is having conversations with people who think it’s not important to wear a mask, and coming to a place and acknowledge each other’s experiences and sharing the data about what’s happening. Because you know I think that we can get caught in this trap of us versus them, and that’s just going to make this more challenging. I think that the information is there, the data is there, the stories are there if you’re not a data-minded person. It’s important to keep sharing those accounts and that data, so we can come up with a better plan as a community and not as a small group of individuals.

What are your feelings on the likelihood of a vaccine being developed by the end of this year, as some have projected?

I’ll be completely honest, I’m not super involved in that world of tracking the vaccinations. From what I know about other vaccine development, I know it’s a pretty rigorous process. We don’t have a lot of information about how this disease can change. We’re still learning things about this disease and if you can get it more than once. There are a lot of unknowns. I trust the hard work going into vaccine development, but also know that we can’t rely on hope that it will be developed by the end of this year.

How are you coping in this pandemic personally?

It’s very difficult. I’m kind of a naturally extroverted person. I get my energy spending time with other people. So having to work all day at home not with the company of people and not being able to unwind with friends and family, that’s definitely a stressor. I’ve been finding ways to take care of that at home. I’ve been doing a lot of yard work, getting to books on my bookshelf that I’ve been saying I’d read for years. Just taking the time to do things in life that maybe I’ve been neglecting but that make me feel good about myself. I cannot advocate enough for a warm bath and a glass of whisky at the end of a very long day.