Q&A: Colorado State Epidemiologist Dr. Rachel Herlihy on Covid-19 and meeting Coloradans where they are

For many Coloradans wanting to know what the next week or month is going to look like during the Covid-19 pandemic, they flock to Facebook for live state government updates from Gov. Jared Polis and his entourage of experts.

Standing with the governor in her white lab coat is Colorado State Epidemiologist Dr. Rachel Herlihy, a scientist and public health expert who has been leading Colorado’s response to the pandemic. Herlihy breaks down the current week’s science and data, often taking questions from the press.

When Herlihy stepped to the podium during the latest press conference on Nov. 30, she expressed concern over the potential impact of the new Omicron variant in Colorado. “I think the takeaway here is that individuals who are unvaccinated, whether they’ve been previously infected or not, are going to continue to be at high risk… Probably higher risk than they have been since the beginning of the pandemic.” 

But what exactly does a state epidemiologist do on a day-to-day basis, and how has the job changed during the Covid-19 pandemic? We spoke with Herlihy about her role and its challenges, along with her own personal journey to science and public health.  

Can you remember what first sparked your interest in science and medicine that led to where you are now?

Yes. I remember very distinctly. I was a high school student, and I was taking an advanced biology class that I was really enjoying, and I really liked the teacher. At the same time, I had signed up for this speed-reading class that was a sort of goofy class, and I thought it would be interesting to learn how to read faster and comprehend faster. A lot of what we needed to do was practice reading. I had to read a ton of books. One of the books my biology teacher recommended was And the Band Played On, which is the story of the HIV epidemic. It was honestly the first time I’d ever heard the term “epidemiology.” 

I had always been interested in science and medicine, but what I liked about epidemiology was this combination of disease detective work — investigation work, plus policy and global health, plus medicine and science. It was really this interesting combination for me, which was very appealing. 

Can you talk about the role of the Colorado state epidemiologist during “normal” times and during the times of Covid-19? How have you and your team had to switch gears since the start of the pandemic?

The role itself hasn’t changed dramatically — the volume of work and the scope has changed. My position is much more public facing than it had been previously because the pandemic is so much of what is on Coloradoans’ minds right now. And so that role of a spokesperson, or translator to the public of what the science is saying and what the data is saying, that has been a much more prominent part of my position than it typically would be. 

I serve as Colorado’s representative to a national organization called the Council of State and Territorial Epidemiologists. What we do in that organization is determine which diseases should be investigated by public health and reported to CDC. And in doing that, we also figure out what data we need to collect [and] how we define those diseases. 

My job is to work with our team to figure out how we investigate those diseases and set up systems so that we are looking for cases of those diseases. We are looking for clusters or outbreaks, unusual increases in those cases. And when we identify those, our job is to investigate what might be causing them and then implement strategies to really control transmissions and stop those outbreaks from occurring. 

The other important role I play is spokesperson or translator. A big part of public health is public messaging and public education, and what I’m trying to do is use the data and the science we are gathering to inform Coloradoans to help them make decisions for themselves and their families — to try and decrease their risk of infectious diseases and exposures, and promote vaccinations. Those types of things are all activities I typically do on a day-to-day basis, but on a much larger scale when it comes to Covid-19.

With science and medicine being at the forefront of our day-to-day lives for almost two years now, how do you think Coloradans’ perception of public health operations and initiatives have been affected?

Before the pandemic, most people weren’t aware of the important role our public health system played — not just about the state public health department, but local public health agencies. These agencies have been dedicated to helping prevent communicable diseases. They are also responsible for protecting air and water quality, and working on a variety of programs to reduce chronic diseases like diabetes and heart disease. There’s a really broad spectrum of work that public health is doing. With public health now at the forefront of the pandemic, for two years almost, it’s been helpful for people to understand the role we play and the importance of public health. 

One of the challenges public health has had in the last couple of decades is this continued decrease in funding, and that has been really difficult. The focus of public health is prevention. When public health is effective, we prevent things from happening. People don’t notice things that don’t happen, right? So, we are sometimes a victim of our own success in that when we are successful, we prevent diseases from happening. The public doesn’t see those diseases happening, and they don’t [always] recognize the important work we’re doing. 

Covid has certainly been a really challenging two years for us, but it has also given public health the opportunity to talk a little more about what we do and the importance of what we are doing — not just for Covid-19, but for other diseases as well.

What has the Covid-19 pandemic taught you about the communities you serve?

I knew going into the pandemic that Colorado was a diverse state with diverse viewpoints, diverse political opinions and diverse levels of beliefs in science or understanding of science. I think this has also played out across the country. There are people coming to decisions for themselves and their families, who all come from very different places. And I think we have some individuals who feel comfortable interpreting,  understanding or trusting the science we are presenting to them and the guidance we are giving folks to make decisions, but there are others who don’t. 

And I think among that population who question public health, science, data and government, there are lots of reasons for that — diversity of opinions, beliefs and personal experiences that have led people to where they are. We’ve learned that we need multiple strategies. We need to meet people where they are. We really need to understand the community we’re serving. 

That’s really an important part of the work we do — and our agency in general: making sure we reflect the people we are serving, and that we have that diverse representation among our staff in trying to do the best service to Colorado we can.

Editor’s Note: This interview has been edited for length and clarity.