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              <text>&lt;strong&gt;Q:&lt;/strong&gt; Was contact tracing something you'd had experience in before? &lt;br /&gt;&lt;br /&gt;&lt;strong&gt;ALIABADI:&lt;/strong&gt; No. &lt;br /&gt;&lt;br /&gt;&lt;strong&gt;Q:&lt;/strong&gt; What was that like then--just starting to pick that up?&lt;br /&gt;&lt;br /&gt;&lt;strong&gt;ALIABADI:&lt;/strong&gt; It's a pretty straightforward concept, but it's not necessarily easy to execute because, again, there's people letting you talk to them, people being suspicious, and all that stuff plays into it. The theory is simple, but the execution isn't. I always, just for me, especially with that first appointment, when we'd be out talking to people in the field it would just be really hard for me not to immediately try to assume a doctor-patient relationship with people just because that's my training and where I'd been from. It's hard to push that away and not want to examine someone or like--you know. &lt;br /&gt;&lt;br /&gt;There was an incident in that first deployment as well when I was with the same WHO person who was doing contact tracing with me where he was like oh, there's been a death in a prison and it's unexplained and we need to go investigate. We went up to the prison, and this was not in Conakry, this was in the next prefecture a couple of hours away. We go there, and talking to the prison warden or whatever they're called, I'm like, who did the person share a cell with? Can we examine them--or I wasn't asking, can we examine them. I'm like, "Who's the doctor or the nurse here?" They brought that person in, and I'm like, "Tell me the symptoms, give me some history that I can say yeah, this person probably had Ebola versus they didn't." The story was all over the place. It was hard to understand what really had happened, but I was like, "Did you examine the people around this person?" He was like no, they hadn't. My instinct at that moment was like, bring them in. Someone needs to examine them. I want to do it, but we're not supposed to do that. They told us no exceptions, we're not supposed to handle patients and touch patients and care for them in a clinical way. That was hard for me to let go of. But when I saw that it wasn't being done, it was just frustrating. What ended up happening is we just called MSF and were like, just please come, somebody needs to actually lay hands on these patients. [laughs] Not lay hands, but look at them, observe them, examine them. They did, and it ended up being fine. &lt;br /&gt;&lt;br /&gt;&lt;strong&gt;Q:&lt;/strong&gt; But when you look back, how do you feel about that? The prohibition on having that more doctor-patient relationship? &lt;br /&gt;&lt;br /&gt;&lt;strong&gt;ALIABADI:&lt;/strong&gt; I think it's probably appropriate. We're there as epidemiologists, not as physicians. I think if there was a mechanism for us to have been able to provide direct care, I think a lot of us--some of the EIS officers that I know I'm sure would've taken on that role. But I can also understand that CDC wouldn't want to get involved in potential exposure of its staff to Ebola. I can understand.</text>
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              <text>The one thing, the thing that I think I would want to--the message I would want to convey most of all about what it was like working in the red zone, is not how impersonal the PPE made it, but actually how personal it made it. Because Ebola is very isolating illness. The moment the Ebola box is opened, you leave your kids. You don't touch your children. You don't touch a dead body. You cannot touch, you cannot go near a sick person. One of the most instinctive things is to care for someone who's really sick. Just to even hold the hand, or to mop their brow, all that, you cannot do. Someone's got Ebola, you cannot go near them. And PPE, the only people in the world who could crouch down and clean up someone who was having profuse, like, ten liters of diarrhea every day, uncontrollable water coming out of them, the only people who could crouch down and clean the sheets and change their clothes and wipe them down and wipe their brow and give them a sip of water were the people wearing the PPE. So actually, it felt really privileged, and it felt really close. It was the most intimate patient care experience I've ever had. It was crouching down with a--this fantastic Sierra Leonean hygienist called Princess who--she did not take any shit. [laughter] If she wanted to spray your shoes, even if someone's like, "Why are you spraying my shoes here, Princess?" She's like, "No, Charles, stop! Shoes!" It's like, okay, whatever, whatever. But because she cared about the people she was in there with, she cared about keeping things clean, she cared about doing things right. We did a ward round together, and we did it efficiently, we did it well, and we were going well. I think the second- or third-last patient we had was a fourteen-year-old girl who was dying, and she had just been cleaned like half an hour earlier, and she was already horrendously soiled. She was lying on her mattress on the floor, that she'd put her mattress onto the floor as many of our patients did. We saw her, we did the kind of clinical bit, and then I wanted to move on. And Princess was like, "Are you leaving her?" I was like, "No, we're going to see our next two, and then we'll come back, because we've got enough time." You're only meant to be in the red zone for an hour, but we had probably been there for forty-five minutes at that point. It's like, we've got two more people--no, it must have been one, because we would have been about the forty-five minute--we had one more person who needed a proper review. Then we had three or four people in the convalescent tent. They were all well. They were getting better, their blood tests were just still positive. I said, "What we're going to do is we're going to see this one more person, we're going to sack it off, convalescent tank can wait for another time, and then we're going to come back and clean this girl up." Princess was very happy about that. We did that, came back, and together, Princess on one side of the mattress, me the other side, we crouched down. You're wearing this big PPE with these heavy aprons and gumboots and the hood, and your goggles are steaming up, you've been there an hour. It's really, really hot. Your clothes, the scrubs you've got on under your PPE is absolutely saturated, like you have jumped in a swimming pool, saturated with water. I have one photo of me, before-and-after photos getting on scales. I'd gotten on scales before I went in, and then when I came out, I didn't drink any water, I just went and changed my scrubs into dry scrubs and got back on the scales before I had water. I'd lost 1.3 kilos [kilograms] in an hour. And you hear stories of people losing more. Anyway, so we were crouching down, sopping wet, and got new bedsheets, got new clothes, cleaned her up, made her comfortable, gave her some water. She would have only been clean until the next people came past, I'm sure, and they would have done the same. But that was the most intimate patient care experience I've ever had in my career. No question about it.</text>
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              <text>&lt;p&gt;&lt;strong&gt;ALPREN:&lt;/strong&gt; The main projects I've been involved in, the main theme of my work over the last year, has been semen. [laughter] Because Ebola was found to persist in bodily fluids, particularly immune privileged sites--the sites that don't get much blood supply, much immune cell supply--for far longer than we initially thought when the outbreak started. When I was discharging men from ETC in Aspen, we would say to them, "Look, Ebola has been found in semen for longer than other bodily fluids, and we think probably about three months, so you should use condoms." That's the kind of advice, that was the basic advice. I could have probably put it in a slightly more articulate, official way, but that's kind of how it was said. It quickly became evident that it was potentially present for a lot longer than three months, but probably the chances of actually causing sexual transmission were low. That's really where we're at now. We've had examples of sexual transmission from survivors well over a year, well over fourteen, fifteen months from the time of their infection, but they are very isolated cases and very rare. However, when you've got three, four thousand, however many survivors we've got in Sierra Leone, forty-odd percent of whom are men, most of them are men of sexually active age. They all need testing, they all need counseling, they all need to change their behavior because you don't know which one person--we don't know for sure if having cleared Ebola RNA [ribonucleic acid] from your semen, it stays away. We don't really know what negative means, what not detecting Ebola RNA in semen means. One of the things that I say when I'm teaching about Ebola is--I don't know, do you know how many people work in this campus of CDC?&lt;/p&gt;&#13;
&lt;p&gt;&lt;strong&gt;Q:&lt;/strong&gt; I have no idea. [laughs]&lt;/p&gt;&#13;
&lt;p&gt;&lt;strong&gt;ALPREN:&lt;/strong&gt; No? I use the example of Melbourne University, where I teach, where there are about forty thousand undergraduate students. It's a big--it's a big--&lt;/p&gt;&#13;
&lt;p&gt;&lt;strong&gt;Q:&lt;/strong&gt; We have a large college campus next door with Emory [University], too.&lt;/p&gt;&#13;
&lt;p&gt;&lt;strong&gt;ALPREN:&lt;/strong&gt; Exactly. So a big university campus, a few tens of thousands of people. Probably most of them, if not all of them--not all of them, ninety-odd percent have had chicken pox, a very common infectious disease. But everyone kind of knows it. We know a lot about chicken pox, but there's stuff we don't know, and there's problems we have with it still. We can't treat it very well. Shingles comes along. Sorry, this is a bit of a longwinded explanation. However, before this Ebola outbreak, there had been just over two thousand recorded cases of Ebola ever. And there have now been less than thirty thousand cases of Ebola recorded. So less Ebola than there has been chicken pox at Melbourne Uni now. We know nothing about this condition. Our level of understanding is low, but accelerating very fast. And that's been reflected in--so many times, the uncertainty about the counseling, even that the politicians or the public health people should be giving the politicians early in the outbreak, and the confusion that happened, not just in West Africa but also in America, in Australia, in Europe, when there were cases. I do think we've learned a lot about communicating uncertainty. That's one thing I do think we've learned a lot about. The speed at which the information is changing, we've gone from saying to male survivors, three months, to six months, to a year, to [shrugs]. [laughs] To a year? Well, there's no RNA in your semen, and that sounds great. Keep in touch. We're not totally sure what that means, but you've had a couple of negative tests, so whoopee. Which is kind of where we're at, at the moment.&lt;/p&gt;</text>
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              <text>[T]he huge success was the spread of Ebola into Nigeria that had occurred a month earlier. In Nigeria, we were fortunate that we had several collaborations in place. The introduction into Nigeria was a single person ill on an airplane and introduced it into Lagos, and secondary and tertiary transmission occurred in Lagos and then it also spread to Port Harcourt, a second city. When I joined the International Task Force, besides leading the response in Senegal, my team picked up the Nigerian response although it was well in its--it was quite a mature response. I led the lingering activities that were in Nigeria, and I learned a lot from that Nigeria experience because what Nigeria showed us was how vitally important it is to rapidly identify all of the controls and to monitor them and prevent secondary transmission. But in order to do that, the success story in Nigeria was that there was a Field Epidemiology Training Program, an FETP, that was very robust, in particular because of the polio resources. Polio's resources that were provided to the FETP in Nigeria led to well-trained field epidemiologists that were used to being in the field and finding cases. In some of the polio trace-backs, they found cases, even in the most difficult settings, and knew how to do contact tracing in a very robust way and to monitor the contacts. That EIS-matured program, experienced EIS program, was just phenomenal. They immediately went to the field in the Ebola outbreak and broke the chains of transmission. &lt;br /&gt;&lt;br /&gt;The second thing was because of the polio effort, there was an emergency operations center concept and program in Nigeria, so that when Ebola was introduced, they immediately set up an emergency operations center to coordinate and make all the decisions rapidly. These decisions, which sound simplistic, but the emergency operations center for example had the ability to immediately allocate resources, small resources. In some of our other countries' responses, paying for the taxis, which was a minimal expense, would take a week to get the necessary signatures to pay for. But here in the EOC in Nigeria, they were able to immediately allocate funds. Although they did get some of the funds from private partners, so in some instances, even going through the government was not quick enough, they got additional resources added. But nonetheless, they had a mechanism to make decisions rapidly to, how do we respond? So the FETP, the EOC, and then they had a robust laboratory program network because of the polio. All those pieces were in place mainly because of our--in large part because of CDC country office partnership with the Ministry of Health, and we had their trusted relationship with the Ministry of Health. All those programs together allowed CDC to contribute to quite a robust response in Nigeria and rapidly contain the introduction. &lt;br /&gt;&lt;br /&gt;We learned a lot from that in our team as we were starting up this Unaffected Countries Team, we called it, in the third week of August. I remember that we were fortunate that on my first or second day, Frank Mahoney had returned from Nigeria and came to the EOC, and I sat down with him and debriefed him, and he shared all these stories about the success in Nigeria, and we learned from that, that those are the things we needed to focus on for our responses in the other countries. We began to focus our energy on controlling Senegal, but rapid concerns about well okay, if this could happen in Senegal and happened just a month earlier in Nigeria, what about Côte d'Ivoire or any immediately neighboring country? And also, any country. Like Nigeria demonstrated, it doesn't have to be an adjacent country. Any other country that has connections, flight connections, there could be transmission. What can we do to strengthen the neighboring countries so that it does not spread out of these heavily affected countries?</text>
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              <text>&lt;p&gt;&lt;strong&gt;&lt;span class="speaker"&gt;Q:&lt;/span&gt;&lt;/strong&gt; So you go to Anniston with all of these strangers.&lt;o:p&gt;&lt;/o:p&gt;&lt;/p&gt;&#13;
&lt;p&gt;&lt;span class="speaker"&gt;&lt;/span&gt;&lt;strong&gt;&lt;span id="line_265"&gt;BORNEMANN:&lt;/span&gt;&lt;/strong&gt; All these strangers. All these strangers. It's almost surreal as I &lt;span class="transcript-line"&gt;&lt;span id="line_266"&gt;look back. We recently had our two-year anniversary of returning home earlier&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_267"&gt;this month, and in looking at the pictures and the reminders, in some ways it&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_268"&gt;seems like a million years ago and in some ways it seems like yesterday.&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_269"&gt;Anniston is such a blur in so many ways. I feel like I was a child then. The&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_270"&gt;highlight for me of Anniston was because of my dad's familiarity with the&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_271"&gt;country of Liberia, his passion for the country and its people, his knowledge of&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_272"&gt;the current state there and, of course, his service as a corps officer himself,&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_273"&gt;I asked for him to come and give sort of the cultural awareness piece. He drove&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_274"&gt;down to Anniston and gave us a brief on Liberia, and he got to meet some of my&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_275"&gt;brand-new friends. I felt very lucky to have had that opportunity. I wish other&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_276"&gt;teams were able to hear him, because again, his passion and his knowledge around&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_277"&gt;the country. But for me, I got that extra squeeze before I left.&lt;/span&gt;&lt;/span&gt;&lt;o:p&gt;&lt;/o:p&gt;&lt;/p&gt;&#13;
&lt;p&gt;&lt;span class="speaker"&gt;&lt;/span&gt;&lt;strong&gt;&lt;span id="line_279"&gt;Q:&lt;/span&gt;&lt;/strong&gt; Were there some important messages of cultural sensitivity and understanding &lt;span class="transcript-line"&gt;&lt;span id="line_280"&gt;what it's like to live in Liberia that you felt were especially important that&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_281"&gt;you brought with you?&lt;/span&gt;&lt;/span&gt;&lt;o:p&gt;&lt;/o:p&gt;&lt;/p&gt;&#13;
&lt;p&gt;&lt;span class="speaker"&gt;&lt;/span&gt;&lt;strong&gt;&lt;span id="line_283"&gt;BORNEMANN:&lt;/span&gt;&lt;/strong&gt; Yes, very important, and ones that I was aware of, but I was worried &lt;span class="transcript-line"&gt;&lt;span id="line_284"&gt;about others. Not necessarily our group but just in general. I worry that a lot&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_285"&gt;of people tend to think of Africa as a "land of savages," and I think in very&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_286"&gt;narrow viewpoints it's "why do we care about a bunch of savages," if you will.&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_287"&gt;That saddens me to my core because they are human beings just like each and&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_288"&gt;every one of us and they happen to not have the resources that we have, and&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_289"&gt;people were getting very, very sick. What my dad brought to it was certainly the&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_290"&gt;sense of humanity. Even besides the savagery reputation, misinformation, that I&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_291"&gt;think some people have, it also should be noted that Liberia had recently in the&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_292"&gt;past thirty years been through two civil wars. That's pretty scary stuff.&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_293"&gt;There's a lot of security concerns there. Based on those headline-type areas,&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_294"&gt;people could assume one way about Liberia and its people. But the reality is&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_295"&gt;they're actually very warm, they're very loving. For a culture that is like&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_296"&gt;that, and they have a special handshake when they greet each other, to not be&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_297"&gt;able to touch was huge and certainly worth noting, so that when we did enter, we&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_298"&gt;had that awareness of the importance of physical human interaction to the people&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_299"&gt;of Liberia. Of course, that's a generalization, but that's just in terms of the&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_300"&gt;cultural piece. That was something, again, that humanity piece that I'm so&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_301"&gt;grateful my dad certainly brought to me but also to our entire team before we left.&lt;/span&gt;&lt;/span&gt;&lt;o:p&gt;&lt;/o:p&gt;&lt;/p&gt;&#13;
&lt;p&gt;&lt;span class="speaker"&gt;&lt;/span&gt;&lt;strong&gt;&lt;span id="line_303"&gt;Q:&lt;/span&gt;&lt;/strong&gt; Were there other parts of Anniston that you found particularly helpful for &lt;span class="transcript-line"&gt;&lt;span id="line_304"&gt;preparation? Going in?&lt;/span&gt;&lt;/span&gt;&lt;o:p&gt;&lt;/o:p&gt;&lt;/p&gt;&#13;
&lt;p&gt;&lt;span class="speaker"&gt;&lt;/span&gt;&lt;strong&gt;&lt;span id="line_306"&gt;BORNEMANN:&lt;/span&gt;&lt;/strong&gt; Sure. I think we had the look of having a tremendous training cadre &lt;span class="transcript-line"&gt;&lt;span id="line_307"&gt;of I think primarily CDC folks. The woman who sticks out the most for me is&lt;/span&gt;&lt;/span&gt; &lt;span class="transcript-line"&gt;&lt;span id="line_308"&gt;Captain Holly Williams, who is here at CDC.&lt;/span&gt;&lt;/span&gt;&lt;o:p&gt;&lt;/o:p&gt;&lt;/p&gt;</text>
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              <text>[A]ll the way really through June, even parts of July, it was a pretty calm reaction.&#13;
&#13;
We had noticed that in Conakry, in the capital, they were starting to make some public health responses to it, in the sense of if you went to some of the fancier restaurants, they would make you wash your hands before you went in. Because soap and water aren't exactly the most ubiquitous out there, they would actually just have really chlorinated water, and so everyone was walking around with really dry hands [laughter] or just over-using hand sanitizer. But they also started implementing the--[laughs] they would just call it, it was like a fist bump for Ebola, instead of shaking hands. Small public health interventions and recommendations to help slow the spread of disease. We were starting to notice those things, but again, they didn't have a great impact on my day. I didn't really--it didn't really change what I was doing.&#13;
&#13;
It wasn't until closer to June and July that we started hearing about more cases, and there was more in Conakry, and more in other places and in other smaller villages in Guinea. Because again, someone would either be a patient or someone who had just passed away from Ebola, would be transported back to that village to be buried, and then funeral rites usually involve a lot of touching and a lot of handling of the body, and it spreads again. We saw those problems throughout the entire response. But this was just the beginnings of it, and we had just heard about these things. It wasn't through any news source, it was just through Peace Corps a little bit […]</text>
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              <text>Micro-cerclage being mini quarantine. In French, it just means mini circling. It was this quarantine-lite that we had determined would be most appropriate for a Guinean neighborhood or Guinean community. Because as we saw in Liberia, in Monrovia, a straight quarantine to a neighborhood is a death sentence, almost. Obviously, we couldn't have that, but at the same time you're trying to limit the transmission and limit movement, and so you've got to meet them halfway. That's where the micro-cerclage came from, and with that comes a whole breadth of activities. Because not only do you have to provide--you want to provide food, proper sustenance to those families who aren't supposed to move. You'd have a social mobilization component to it, a rapid assessment component to it. You'd have to provide health, you have to provide doctors. You can't just identify a problem then walk away from it.</text>
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              <text>&lt;strong&gt;Q:&lt;/strong&gt; I know that your experience with Ebola continues as deputy IM, etcetera. Maybe we should transition into that. &lt;br /&gt;&lt;br /&gt;&lt;strong&gt;CACERES:&lt;/strong&gt; Sure, so that was a great experience, too, because I felt like I had seen the Ebola response from the ground level, in the ring countries, so not the immediate countries that--of course, that would have been an entirely different experience. I really think that people that went there were doing heroic things, and kudos to those folks who were there in the midst of all of that. I didn't have the experience of the Ebola countries themselves, and I also didn't have the experience of the EOC central operations.&lt;br /&gt;&lt;br /&gt;So I was asked to volunteer for that. And I thought, at that point, when I volunteered, I thought I would be doing it--taking time away from FETP. But at the time, I was also in transition, or was about to find out that I was going to move out of FETP and into this new position. And so I asked my supervisor in the new position, whether I could honor that commitment. And they were all for it because the EOC just happens to be in the center where my new position is, so it was again, a nice segue. &lt;br /&gt;&lt;br /&gt;And really, the deputy IM position, at that point, I felt like I was helpful, but really, I was back-up. I would do things that were needed, and I enjoyed working with Barb [Barbara J.] Marston and Oliver [W. Morgan] and seeing the interactions that they had with Tom [Thomas R.] Frieden, with the folks on the [National] Security Council. We'd have those security-cleared meetings in the top-secret room, and give those briefings. I think I gained much more than I actually contributed there. But I was grateful for that experience. &lt;br /&gt;&lt;br /&gt;That was at the time when the countdowns were occurring, the initial countdowns. On the day that you'd have that twenty-one-day period or forty-two-day period, we would get another case, or another--and that was kind of frustrating. I think we were all in an atmosphere where we didn't want to talk about countdowns because of the jinx.</text>
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              <text>&lt;p&gt;&lt;span&gt;&lt;strong&gt;CALLIS:&lt;/strong&gt; It was such a dynamic time, things were changing daily, that you&lt;/span&gt; &lt;span&gt;just never really knew what the day was going to look like. We hadn't launched&lt;/span&gt; &lt;span&gt;yet, we were really working hard to get--I mean, a clinical trial can take years&lt;/span&gt; &lt;span&gt;of planning. We were working really hard to get all of the pieces in place from&lt;/span&gt; &lt;span&gt;even the buildings. We had to refurbish some buildings. It was logistically a&lt;/span&gt; &lt;span&gt;really heavy lift. It took us a long time to get it off the ground and actually&lt;/span&gt; &lt;span&gt;launch. Prior to that, from a communications and social mobilization standpoint,&lt;/span&gt; &lt;span&gt;Sierra Leone had never seen a [vaccine] clinical trial. Nobody had ever done&lt;/span&gt; &lt;span&gt;one. We were in the midst of a horrific emergency. We needed to be able to talk&lt;/span&gt; &lt;span&gt;to the potential participants in a way that gave them the information so they&lt;/span&gt; &lt;span&gt;could make an informed decision, but didn't promise. People were so desperate&lt;/span&gt; &lt;span&gt;for a solution. We wanted to really be clear, this was a trial, we didn't know.&lt;/span&gt; &lt;span&gt;We had a good sense that it would probably work [but] we didn't know. We didn't&lt;/span&gt; &lt;span&gt;want to hold out hope in the middle of this emergency, and so it was a&lt;/span&gt; &lt;span&gt;delicate--it was a bit of a tightrope, trying to talk to people about the trial&lt;/span&gt; &lt;span&gt;and their participation in it.&lt;/span&gt;&lt;/p&gt;&#13;
&lt;strong&gt;Q:&lt;/strong&gt; Can you talk more about, so what that communication work really entailed in &lt;span&gt;the beginning?&lt;/span&gt;&#13;
&lt;p&gt;&lt;strong&gt;CALLIS:&lt;/strong&gt; Before I came, there were folks who literally mapped out every single &lt;span&gt;hospital, every single Ebola treatment unit, every single Ebola holding unit,&lt;/span&gt; &lt;span&gt;everything, so that we knew where all of the potential participants were. The&lt;/span&gt; &lt;span&gt;trial was only open to healthcare workers and frontline workers, burial workers,&lt;/span&gt; &lt;span&gt;people who swabbed out the ambulances, things like that, and the reason why was&lt;/span&gt; &lt;span&gt;because they were at highest risk. They were dying by the numbers. I remember&lt;/span&gt; &lt;span&gt;when I got to Sierra Leone in February, I went to Connaught Hospital, and I had&lt;/span&gt; &lt;span&gt;been there years before, and when I walked in, every wall was plastered with&lt;/span&gt; &lt;span&gt;obituaries. Photos of all the nurses and doctors who had died, and it really hit&lt;/span&gt; &lt;span&gt;me. I think there's a great responsibility that comes with that. This country&lt;/span&gt; &lt;span&gt;had a fragile healthcare system to begin with. And then they lost so many of&lt;/span&gt; &lt;span&gt;their best and brightest. And we, I felt a deep responsibility to both honor the&lt;/span&gt; &lt;span&gt;risk that these people were taking, but also make sure that we provided them all&lt;/span&gt; &lt;span&gt;the right facts, so that they could really decide if they wanted to participate&lt;/span&gt; &lt;span&gt;or not.&lt;/span&gt;&lt;/p&gt;&#13;
&lt;span&gt;Once we had done this enumeration of all of those hospitals and everything, we literally went to every single hospital and we sat down and gave an information session where we talked about everything from the science that had come before this trial, what we knew, what they could expect, what we felt that some of the side effects would be. All of these things. After, we opened it up to questions, and everybody was able to ask their questions and everything. We did this in hundreds of places. And probably talked to, unfortunately we don't have great records, but I would guess that it was upwards of one thousand to two thousand at least. Then, if they decided they wanted to participate, when they came to the actual vaccination center, we again did a smaller information session and allowed them to ask questions. Then they did an informed consent one-on-one where they would sit down with someone who spoke Krio or Temne, or whatever it was that their native language was. Often cases, it was English. They would go through the informed consent step by step by step, and allow them to ask any additional questions at that point. It was a very high touch and in-depth process, but from an ethical standpoint, I feel very strongly that we did it exactly the way it should have been done. &lt;/span&gt;&#13;
&lt;p&gt;&lt;strong&gt;Q:&lt;/strong&gt; What makes you think that?&lt;/p&gt;&#13;
&lt;p&gt;&lt;strong&gt;CALLIS:&lt;/strong&gt; Well, we--first of all, the response was amazing. We never had backlash, &lt;span&gt;we never had any big rumors or backlash against the trial. I think a lot of that&lt;/span&gt; &lt;span&gt;was due to the fact that we one, worked so hard to provide the right information&lt;/span&gt; &lt;span&gt;to the participants. But we also worked with the community. I sat down with&lt;/span&gt; &lt;span&gt;chiefs in the area that we were working in, and would sit and talk with them,&lt;/span&gt; &lt;span&gt;and I would go back every six weeks, or part of my team would go back every six&lt;/span&gt; &lt;span&gt;weeks and update them and the mayors and the city council and hospital&lt;/span&gt; &lt;span&gt;administrators. We really made it a priority to continually communicate with&lt;/span&gt; &lt;span&gt;these people and make sure that they felt a part of this process, and that they&lt;/span&gt; &lt;span&gt;could talk to us if they had concerns. Because we knew that they were people&lt;/span&gt; &lt;span&gt;that the community was going to talk to, and say hey, we heard about this&lt;/span&gt; &lt;span&gt;vaccine, what's going on? I think that was really important. It's ethical, it's&lt;/span&gt; &lt;span&gt;respectful when you're in a country to sit down and talk with the stakeholders&lt;/span&gt; &lt;span&gt;and the leaders. But it also helped our trial. We had hoped to enroll six&lt;/span&gt; &lt;span&gt;thousand people--we enrolled over [eight] thousand. There was a lot of support&lt;/span&gt; &lt;span&gt;for this. A lot of hopes hung on it.&lt;/span&gt;&lt;/p&gt;</text>
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              <text>We were really working hard, and it was frustrating because we hadn't opened. It's just hard when you see the need is so great and you're not getting anywhere. We really needed some good news, and I remember the day they reopened the schools. The schools had been closed for nine months--there were no children on the streets at all. It was weirdly quiet. I remember the day they opened the schools, driving out to Connaught Hospital and seeing all these kids in their school uniforms marching off to school. I just thought, oh my God, we're on the back end of this. Things are going to start to get normal again. It took a really long time for that to happen. We still had cases and clusters, and even after we got to zero, we got another case, but that to me signaled like we're on the back end of this. It's contained, if not controlled entirely. But it's contained, and we're on the back end. This is a country that had lost so much that just seeing the kids walking to school was just this vision of normalcy that there hadn't been any of it for months.</text>
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                <text>Callis Normalcy Transcript</text>
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