By Alexandra Erath, A16
Cassidy Heverling, A16, had planned to study community health
when she arrived at Tufts and eventually, to have a career in
clinical medicine. Her perspective on health and illness was
informed by social science courses she took in her freshman year and
she began to think of ways to fuse these interests. Eventually, she
chose sociology and community health as a double major.
Heverling says she "clicked immediately" with her advisor, Associate Professor of Sociology and Community Health Rosemary Taylor. "We bonded over a shared interest in global health and a similar way of thinking about the world," she adds. After taking both Epidemiology and Taylor's course—Epidemics: Plagues, Peoples and Politics—she became absorbed in the broader factors shaping health and disease. "In Epidemics, we had to locate health problems in a global, international and historical context," says Heverling. "Instead of treating an individual patient, epidemiology looks at larger populations and what might make them more or less susceptible to certain diseases," she explains.
"Cassidy always seemed more interested in the movement of peoples than of atoms and molecules," says Taylor. "This interest in how the world works, in social relations and politics, led naturally to her desire to do research of a social scientific kind."
Taylor invited Heverling to work on her research team that was focusing on what she calls "cross-border health threats." "These are threats to health that are perceived, correctly or not, to come from beyond the borders of a nation, a region or a society," explains Taylor. "Studying the responses to such threats—political, economic, and cultural—provides one with a prism through which to study societies' capacities to mobilize collective resources and generate strategies to cope with disease and illness." Taylor had chosen four initial cases, which crossed borders in the bodies of migrants and travelers: HIV, tuberculosis, the prospect of an avian flu pandemic and H1N1 ("swine flu"). But diseases also entered countries via products and Taylor had become particularly interested in blood and blood products, focusing on how two sources of viral contamination, Hepatitis C and HIV, had entered the global blood supply with tragic results.
When Ebola began to capture national headlines as a cross-border threat in late 2014, Taylor asked members of her research team to work with her on various aspects of the epidemic. Heverling and another research assistant were investigating why global health authorities were recommending that "convalescent serum" (made from Ebola survivors' blood or plasma) be given to patients despite the lack of convincing scientific evidence that this was effective, feasible or safe. This issue fascinated Heverling, as it connected with one of the core intellectual questions in Taylor's research: how is scientific information about health and disease generated and how is it factored or not into policy-making? Heverling seized the opportunity to pursue this question further with regard to Ebola: a fellow research assistant had previously completed the Summer Scholars program, and Heverling realized that this provided an excellent way to explore her newfound interest.
As a Summer Scholar, Heverling proposed to examine the flow of scientific information during the continuing Ebola outbreak in West Africa and whether—and how—it informed policy decisions designed to contain the epidemic. The broader question that interested Heverling was the current state of global health governance and how it shapes the relationship between science and policy in responding to epidemics. "My goal is to explain how and why decisions were made regarding the containment and treatment of Ebola, the scientific basis for these decisions and what then happened in the field," wrote Heverling in her collaborative Summer Scholars proposal with Taylor.
Heverling began by examining the timeline of the response, or how
long it took various countries to recognize that Ebola was a serious
problem. "For example, it took several months before the World
Health Organization said Ebola is something we should be concerned
about," she notes. "So I looked at what took place both before and
after that call to action."
Heverling has also analyzed the broad spectrum of responses and health outcomes among different countries. "Patients being treated in more developed countries receive better care on average because these countries are able to devote more resources to them than the affected countries that are currently spread thin," explains Heverling. While much of what she has found so far has aligned with her expectations based on previous research, she is fascinated by the discrepancies in mortality rates between countries.
"More importantly," she says, "I've realized that the connection between science and policy is not always clear. Information gets lost in translation and can lead to suboptimal outcomes. Ebola vaccines that existed ten years ago didn't progress to Phase II and Phase III trials, and there were discrepancies between the evidence used by donor nations such as the United States, Britain, and France to develop containment strategies and that which informed protocols put in place by international organizations such as Doctors without Borders and the Red Cross."
Heverling's Summer Scholars investigation requires much more independent work than her research during the school year, and she has faced her fair share of challenges. "This type of research involves a lot of reading, and it's hard to predict where you'll end," Heverling explains. She contrasts her research with typical lab "benchwork," in which one completes an experiment and collects raw data. "With my summer research, it's sometimes hard to know when enough is enough, when to switch from reading to analyzing." In addition, she cites occasional difficulties with inconsistencies among sources, in which groups biased one way or the other often publish competing and contradictory claims.
Heverling hopes her Summer Scholars work will become the foundation for a senior thesis. She is planning to attend graduate school, to study control and containment of infectious diseases, and she considers her summer experience extremely helpful in the decisions she's making about her future. Beyond gaining general research and time management skills, Heverling now knows she can handle full-time research, which she considers an important confidence-booster before applying to graduate school.
Taylor believes the Summer Scholars program can foster all these objectives, and more. As a mentor in the program, Taylor says she's seen different modes of participation, learning and results. "I suspect every scholar would say that the program has been a gift that enabled them to enter a serious collaboration with a faculty member," says Taylor. "At the same time, they can find their own voice by grappling with the process of designing research. Many scholars establish significant lines of inquiry that they continue to pursue after the summer has ended."
Related article: Summer Scholars Program Provides Funding and Mentorship for Student Research Projects: Sophie Laing, A16, explores voter opinion and political flip-flopping.