By Jasmine Stole Weiss
Dr. Ann Pobutsky, Guam’s territorial epidemiologist, is in the virtual spotlight every Thursday, providing updates on the Covid-19 situation on island during the Department of Public Health and Social Services’ weekly briefings.
Flashed on the screen are tables, charts and graphs, which Pobutsky interprets for the media and other Zoom viewers. People watch and listen, with heightened interest and occasional skepticism. Pobutsky’s job involves analyzing data, presenting processed information and fighting misinformation.
The numbers and the pattern of lines showing their crests and troughs shape the government’s pandemic-related mandates and determine the size of our social gatherings. We now understand that these infographics, which are otherwise obscure to most of us, determine how we must live in the time of coronavirus.
Nearly two years since Covid-19 became the staple of news, the study of virus transmission has loomed large in our struggle to understand and subdue this invisible enemy.
“Examining the patterns of diseases is interesting because data or disease statistics constitute evidence of where problems are, and point to where public health needs to do interventions,” said Pobutsky, who has been investigating sick populations for decades.
Pobutsky obtained her PhD in medical sociology and social epidemiology from the University of Hawaii and has served different roles in the public health field over the years. She is now Guam’s sole territorial epidemiologist, a role has brought with it the most challenging chapter of her career, she said.
Pobutsky returned to Guam in November 2018 after working at the Hawaii State Department of Health for 14 years.
While she wasn’t born on Guam, she has spent many years on the island. She first came back in 1979 with her then-husband who was in the U.S. Air Force.
From then on, her path to becoming the island’s only territorial epidemiologist was something she said she evolved into.
In the 1980s, Pobutsky worked on population-based health surveys on Guam. In the mid-1980s the first telephone survey was done on Guam for risk factors associated with HIV/AIDS, a survey which Pobutsky said has since morphed into the CDC’s Behavioral Risk Factor Surveillance System.
In the late-1980s, she worked on a survey focused on Guam residents and the prevalence of Lytico and Bodig diseases, or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s Disease) and Parkinson’s disease dementia.
Her work eventually carried her across the Pacific Ocean to Hawaii, where she was posted with the state’s health department as an epidemiologist. She worked on cancer prevention and control, tobacco, diabetes, heart disease, and health disparities among Hawaii residents.
“I also did work with communicable disease programs, such as TB/Hansen’s, related to the Filipino and Micronesian migrant populations in Hawaii, as well as maternal and child health,” Pobutsky said.
Nowadays, her days on the job involve examining morbidity case reports from clinics and hospitals regularly. She summarizes the data patterns and reports on them.
Over the years, Pobutsky monitored the SARS outbreak and MERS outbreaks. She said she knew it was possible that in her lifetime she’d be working as an epidemiologist during a global pandemic, “particularly, since there is plenty of evidence of emerging infectious diseases, even prior to SARS-CoV-2/Covid-19.”
“In addition, we know that global warming is already having an impact of human health via heat-related disease, changes in vector ecology, increasing allergens, environmental degradation and water quality issues, to name a few,” she added.
Prior to Covid-19, Pobutsky said Guam has had to address outbreaks of Shigella, and dengue fever.
The job generally brings challenges because public health has been underfunded for decades. “One of the biggest challenges throughout the U.S. for public health in the past 40 years has been underfunding by both local and federal governments,” she said. “Although this has changed recently with a huge influx of federal monies for Covid-19 response.”
With a lack of funding comes a lack of personnel. Pobutsky said Guam should ideally have more than one epidemiologist. “An epidemiologist’s role is to track the incidence, and/or prevalence of diseases that affect populations, and examine the patterns and causes of such communicable and non-communicable diseases,” she said.
During the past year, Covid-19 data revealed a segment of the community that needed public health intervention, she said. “We can see from the data that Micronesians are disproportionately affected by Covid-19 mortality, compared to what we would expect, based on their numbers in the Guam population.”
The result was the rollout of door-to-door Covid-19 testing and a simultaneous awareness campaign targeting the Micronesian communities on the island. When vaccines became available, officials worked to bring the shots to Micronesian residents, too.
“Public health is community health,” Pobutsky said. “People on Guam have a great sense of community and pulling together. During this pandemic, the reasons for wearing masks, social distancing and limiting social gatherings, and getting vaccinated are to protect all of us, the entire community.”