Dr. Emily Smith

By Kathleen Seaman

Your Friendly Neighbor Epidemiologist

Epidemiology is the method used to find the causes of health outcomes and diseases in populations. In epidemiology, the patient is the community and individuals are viewed collectively.” – Centers for Disease Control and Prevention

At the beginning of 2020 Emily Smith’s family and friends started coming to her with questions about the coronavirus pandemic. Dr. Smith is an epidemiologist, an assistant professor in the Department of Public Health at the Robbins College of Health and Human Sciences at Baylor University and an adjunct assistant professor in the Duke Global Health Institute (DGHI) at Duke University. Her research includes areas of global health, health economics, global surgery and pediatric health care in in low-income countries.

When she realized she could help explain and cut through the flood of information found on the news, internet and social media, she created a Facebook page to talk about COVID-19.

“I started it to be friendly to my neighbors,” she said. Hence the name, Friendly Neighbor Epidemiologist.”

The name could also be attributed to Smith’s faith. Today she has more than 60,000 followers, and posts on all things COVID related, like masks, vaccines, the economy, myths and misinformation, and she explains all the scientific jargon and data that might be over some of our heads. But she also shares her perspective on the pandemic as a Christian and a pastor’s wife, encouraging others to wear masks, social distance and make sacrifices as a way to love our neighbors.

“As an epidemiologist, I am acutely aware that my actions can affect others in significant ways. We, as Christians, now have an immense opportunity to be the good Samaritan to the most vulnerable and in need regarding COVID,” Smith said.

WACOAN: When did you create your page, Friendly Neighbor Epidemiologist?

Smith: I started it in March at the very beginning of all of this. I was getting lots of questions from friends and family on, ‘Hey, I’m hearing about this pandemic, and I think this is what you do as an epidemiologist.’ They were just wanting to know should they freak out or not. People were asking questions of, ‘Is this going to be bad? What does flatten the curve mean?’ I just started it to be helpful, and then it kind of caught on.

WACOAN: You have over 57,000 followers now.

Smith: Yeah, and about 4 million per month in reach. Who would have thought?

WACOAN: Was it a steady growth, or was there a tipping point where you woke up one morning and the page had blown up?

Smith: I think it was more steady in the Waco and Texas area. I started writing about faith, the perspective of this whole thing on faith and loving our neighbor and what that means as a Christian. My husband, [Mike], is a pastor. I saw the first uptick when I started talking about the faith aspect. Then when the conspiracy theories started coming out, some of the first ones in the summer, and that’s when another big uptick came. It seems like it was when the election got crazy and everything got loud. The biggest uptick happened when I started talking about masking, and the first smatterings of conspiracy theories emerged that masking is an issue of socialism or, ‘It’ll make it where you can’t breathe.’ Those things started coming out, and I just started combating it, going, ‘No, it’s actually not oppression. It’s not taking away your freedom.’ I saw a big uptick then.

WACOAN: What topics do you try to cover? Is there anything you avoid, or does anything pandemic related go?

Smith: I try to be helpful on anything pandemic related, but I’m an epidemiologist, not a [medical doctor]. We look at the population health, not clinical guidelines, so [if] people are asking, ‘Should I take Tylenol for a headache?’ I’m like, ‘I don’t know. Talk to your doctor.’ I shy away from that, but pretty much everything else, I try to find the answer if I don’t know. And there’s a lot that none of us know, but I try to make sense of it. The big things we’re talking about [include] masking, this whole push for vaccines, how to stay safe when the positivity rates are so high. I try to cover most of it.

WACOAN: As you said, you’re an epidemiologist, not a medical doctor or a physician. Can you explain your background?

Smith: Yeah, it’s like, ‘My friendly neighbor what?’

I think epidemiology was not a known term prior to 2020. People thought we were skin doctors, like ‘epidermis.’ My grandma would ask, ‘Will you look at this mole?’ And I’m like, ‘I’m not a skin doctor, Grandma.’ Now they know it’s a study of epidemics.

I’m actually a global health epidemiologist. I do all of my research on children who need health care in really low-income countries, like Somaliland and Ghana. My whole work is international, not domestic. I do a lot of poverty-type work and work on hunger issues on a global scale for Africa and, in fact, went to the United Nations to present on that work.

There’s some interesting segues of how the hardships of poverty and hunger and job security and keeping our children safe — what I usually see in Africa — is what we’re seeing now, here in the States. People in poverty have just been slammed because of the pandemic in the U.S. Unfortunately there is a lot of overlap between what I did pre-COVID, and what I’m doing now.

WACOAN: I understand you’re affiliated both with Baylor University and Duke University. What are your roles at each?

Smith: I got my Ph.D. at [The University of North Carolina at Chapel Hill], and then after that I went to the other blue. I bleed both blues, which if you’re familiar with North Carolina football, it’s a huge rivalry between UNC and Duke.

I got a job as a research associate at the Duke Global Health Institute for a few years before we came here to Texas and I started at Baylor. I’ve kept my affiliation [at DGHI] as a professor of global health. A lot of my work hasn’t stopped. I was doing the same global health work there that I’m still doing now with the same partners. I’ve just changed my physical location. So pretty much doing the same thing.

WACOAN: On your Facebook page you have a really helpful pinned post of frequently asked questions and popular topics you’ve covered, including some myths. What are some of the biggest myths you try to bust with your information?

Smith: I think masking continues to be [surrounded by] weird myths. I can’t figure out why, other than it just got politicized early on. So just reminding people about the importance of it, the correct usage of it, that you can still breathe through it.

It’s an act of solidarity of loving our neighbors. It’s one of the best ways to protect ourselves, but really, masks are to protect others. There just continues to be some weird myth about [masking] affecting freedom, when in reality it’s actually showing freedom. I’m a Christian, so according to what I believe, that freedom is through Jesus, so then that mask is one of the best things we can wear.

The same thing with vaccines. It’s an act of protecting ourselves and protecting others too.

‘To me, my neighbors are the most vulnerable in our city. And this affects all decisions I make of where I go or do not go.

As a person under the age of 65, I change my behavior for those over the age of 65.

As a person with no underlying health conditions, I change my behavior for those with underlying conditions.

As a person with insurance and relative wealth, I change my behavior for those without.

So, as Christians, please ask yourself if your actions affect those that are vulnerable and if we are using our freedom in Christ according to the Cross through self-less love. Yes, I’m living and loving my life and not living in fear. I’m also praying deeply that I don’t just walk by.’ – ‘Who was the Neighbor?’ (June 14, 2020)

The misconception that COVID is the same as the flu, that it’s being misdiagnosed as the flu, that it’s not as severe as the flu, that only 1% are dying of COVID. All of those are misconceptions that grossly underestimate what COVID is and what it does.

And it’s not just about dying. It’s about long-term implications on people’s bodies. So that’s a big one.

Another big one is that if something is fake news about anything pandemic related, it spreads like wildfire. By the time I can get on to debunk it or others can debunk it (there’s several others doing this work), some of the damage has already been done, and we’re playing defense. That has been hard to keep up with. I’ll post something, and then somebody will send a message, ‘Did you see this other post about X, Y and Z?’ And I’m like, ‘Oh man, I have to tackle that now.’ That’s been difficult.

I really try to just express to people to have patience in what you believe and what you share, and if it doesn’t align with what our experts are saying, like Dr. Fauci, then it’s probably not true and don’t share it. Because of social media, the middle of this pandemic looks very different than it would have back in the ‘80s or than it did back in [1918], when another big pandemic happened.

WACOAN: Another topic on your page I’ve seen you address is attending church and the reopening of churches. I even saw that you helped with some reopening plans. How did you get involved with that?

Smith: We’re a ministry family. We’ve been in some form of ministry for nearly 20 years now. I understand, as a pastor’s wife, what it means to make decisions and the feedback that pastoral staffs usually get. If you change the color of the church carpet to blue, everybody is going to have an opinion on that, one way or another. Well-meaning people. I’m just trying to help pastors navigate what they can do for their own communities. I think they are very uniquely positioned to lead the way out. Let’s lead the way out of this, meaning let’s go over and beyond what we’re being asked.

An example is if we [are allowed to] open to 50%, then maybe we should just open at 30% and make sure everybody is masked. Regardless of feelings around masking, we do it as a way to show people we are loving our neighbor in the Cross. In Galatians 5 in the Bible, it talks about how the entire law can be summed up in one phrase: ‘Love your neighbor as yourself.’ The whole Bible. I try to remind Christians to redirect to that.

‘What if we used our freedom in Christ to show mercy through wearing a mask? What if we let it be a statement of faith not fear? What if it’s not an infringement of our freedom, but rather a statement of freedom through the Cross? What if wearing a mask can become an overflow of mercy displayed on the Cross because it loves and protects my neighbor?’ – ‘What if Christians led the way out of this? Redefining our freedom according to the Cross’ (July 11, 2020)

It’s not about our personal individual lives. It’s actually showing something different. And as a church we have an opportunity, probably more than ever, at least in our lifetime, to show the witness of Jesus through what we do in the churches.

[Working with churches on reopening plans] has been really fun because I worked with an Episcopal priest in South Texas, some nondenominational churches in California, some in Oregon and New York, Baptist and Methodist, megachurches and tiny churches. I’ve loved doing that because there are pastors who understand the value of meeting in person, but they also understand what it means to love your neighbor, and they want to do it well. I’ve worked with several in the Waco area to figure out how to do this responsibly. It’s been varied on how churches have responded, just like it has been for Christians, but I’ve enjoyed talking about that. I think people can trust what I say because I’m a pastor’s wife. If I’m telling you to shut your doors, I understand what that means, even from a financial perspective. I think that has helped give some empathy.

WACOAN: What are some of the recent questions and myths you’ve addressed around vaccines?

Smith: I have a whole vaccine series now that’s maybe 15 posts at this point, and it’s to help people understand and cut through the noise of all the information. [Questions like] ‘Were these made too quick? Are they unsafe?’

These were not made super quick. They’ve done years and years of startup for a time just like this, to get these vaccines out. They’re not made near as quick as it probably seems, with warp speed. And when we hear that mRNA vaccines are 95% effective, what does it mean? That means that they’re really awesome. You will be protected so much better than just trying to stay away from it right now.

And then I’m also cutting through the trials and reading the scientific jargon. I think the Pfizer FDA review is 95 pages long, and I read it all, and then put it in a post to summarize it for people, that the safety profile of these vaccines is so good, and it works really well, and these are the people that were in the trial. Just bullet point it out, so people don’t have to go read it. That’s what I’m trying to do now.

Our next frontier is getting people to take the vaccine and trust it. The more people who can get vaccinated, there will be more of a collective sigh. I have a lot of friends that are getting it, and they were surprised at how emotional the experience was. I think there’s a lot of worry that we don’t recognize we have about this [pandemic]. We are always watching our back or making these mental decisions on where to go or where not to go. The vaccines will help alleviate that a lot.

WACOAN: You said other people are ‘doing this work,’ and I’ve seen you mention a sister page, Your Local Epidemiologist, which is run by Dr. Katelyn Jetelina.

Smith: There’s hers, and there’s another big group on Facebook called Dear Pandemic. We all have probably the equivalent followers, give or take, but all of us are women scientists. I love the sisterhood of that because if one of them posts something, then I’ll reshare it and vice versa. I just love that it is a sisterhood of we’re all moms, and we’re all trying to get through this pandemic and help people at the same time. And we all have a pretty good following of people listening to us.

I’m just a huge advocate for women in science and women to be who they are. In science, there’s not a lot of us, and it’s changing, but there’s kind of a misconception that women have to be a certain way to be in leadership or be an M.D. or a Ph.D. or something. And that’s just not the case. And I think more and more women are coming out saying, ‘No, I can be friendly, and I can still be a badass.’

I did a post [called To the Drs., in a response to a Wall Street Journal op-ed]:

‘Being a woman in science/academics/medicine/leadership does not mean we have to prove we are better by going the extra mile. We do not have to be loud, aggressive, meek, weak, kind, bossy, generous, or stingy. Let’s just be us. That is enough. That is success.

We also have nothing to lose — so, let’s take some awesome risks. We can elevate one another, promote each another, cheer on one another.’ – ‘To the Drs.’ (December 16, 2020)

WACOAN: How has your family chosen to do schooling through the pandemic?

Smith: We decided to go virtual. What I’ve talked about on the page from the beginning is loving your neighbor, and a lot of that means sacrificing for people who can’t. If we can do our part in lowering the risk of a potential COVID infection, then we chose that as our route.

That’s been hard sometimes when talking to people about the pandemic. It is so individually specific. There are some families where everybody works from home and the kids stay home. That’s different than a family where both parents are essential workers, and the kids have to go to school. I know [my family has] a choice, and a lot of families don’t.

WACOAN: How old are your kids?

Smith: We have a 12-year-old girl, Bella, and a 9-year-old boy, Jonathan.

WACOAN: Do your kids like being virtual?

Smith: We’ve talked with the kids, ‘Do you want to go back?’ We have family conversations, and they’re fine with being here. They understand the concept of loving your neighbor from even a perspective of school. We’re still virtual. They’re loving it. They’re good buds anyways, and we take family walks, so we’ve just kind of made the best of it. They haven’t seemed to miss a beat.

WACOAN: What are some other activities you’ve done as a family during the pandemic?

Smith: Well, at the beginning — when we all thought it was going to last a month, right? — we would do family scavenger hunts with other families in the neighborhood. People would put up stuff in their windows, and you would find it. That was kind of fun.

As this has gone into 10 months we’ve just tried to do as much normalcy as possible. We’ll have movie nights. We’ll go walking. We watch ‘America’s Funniest Home Videos’ and have a pizza picnic. So trying to find new traditions when we can’t get out and do the traditional things has been a mixed blessing. It’s been really interesting to see what is actually needed or not to make a family happy, but it’s also just been hard because you can’t go and do what you used to. But we are outside a lot. Thank goodness for Texas weather.

WACOAN: Do you do anything or have any suggestions for fighting pandemic fatigue?

Smith: Man, bless ‘em. If I could say one thing to America, it would be that. Just bless ‘em. I’m so sorry, but just hang in there. Because in 2021 we have vaccines coming out.

I don’t want to get political. It’s very hard to say anything about the pandemic right now without it sounding political. But from a federal standpoint of how to combat a pandemic, we have a playbook to do that. It was not followed, which is the mess that we’re kind of in right now.

So I think the vaccine distribution pipeline, the uptake, is about to be fixed pretty soon. It’s just going to look better. It’s going to look a lot better. In fact I talked to my kids about this this morning because one of them said it feels like this is going to keep going on forever. [I reminded them of] the hope of what’s coming. That we’ve got vaccines. We’re going to see our grandparents again. We’re going to go on a vacation. We started making a list of things that we’re hoping for, and that helped redirect the fatigue. If we can just keep moving forward.

WACOAN: What are some of those things on your list that you’re hoping for?

Smith: They want to go camping in Oklahoma. That was one of our favorite vacations. Seeing grandparents is a huge deal, and then we’re going to have one big party for birthdays, Christmas, Thanksgiving, anniversaries. We [celebrated] here at home, but it just wasn’t the same. So that’s on the list. And my son put Chuck E. Cheese or something, which we’ve actually never even gone to.

And their friends. We’ve done porch-sits with their friends, and I’ve done that with mine too, to have some sort of connection, but it’s different than when you have eight girlfriends over, and you’re all sitting on one couch and not worried. That will be nice. Hugging will be nice.

WACOAN: How did your family celebrate the holidays?

Smith: Well, we knew that it was just going to be us. We were going to be home. We just tried to make it as normal as possible, but I’m big on open meetings with the family — Smith team family meetings and talking to the kids about expectations that we’re not going to be able to see Grandma and Grandpa, that we’re going to do Zoom, which was so much fun. And then just recognizing that it would feel uncomfortable because it wasn’t normal. We’re used to chaos and lots of people in the house, and that was not the case. I cooked for an army like we usually do and then we just watched movies and tried to make it as normal as possible, but there were times where it was hard. There was just a loss there when you can’t be with your other family.

So for the kids, just catching those moments. If they have a hard moment and they need to cry, then we’ll just sit with them and cry with them and talk about it, and we move on.

We did the normal traditions that we do for Santa and the reindeer, but we made some new traditions specifically for 2020 that I hope they remember. Just trying to reframe it. They know just as well as I do that we’re doing what we’re doing to protect our neighbors. That includes the neighbors across the city and in the state.

WACOAN: Are there any traditions you’ve started this year, holiday related or not, that you plan to continue?

Smith: When things start over, when we are able to get out and go back to normal, I don’t want the old normal. What I like about 2020 is it forced everybody to really focus on what matters. And for us it was family, and it was friendships. At least with my friends and family, there’s a level of solidarity and deep empathy for one another. Almost like a rawness in how you feel and that being OK and redefining priorities. I hope that that continues going forward. I don’t want the old normal. I want a new normal.

And for the kids, I really want to keep up the family walks that we do in the neighborhood. We’ve always had a movie night, but we have upped those and tried to make them even more fun. And a ton of talking. The kids are home all day long, and so I see them all day long. I’m able to engage in conversations they have at school as they happen. I hope I don’t forget to do that when they go back in person.

WACOAN: What are some of your favorite places in Waco from 2020 or before?

Smith: We always love the Baylor campus. It’s just pretty, and we like to go walking out there.

Another plus about 2020 is I’ve gained a whole new community here in Waco through the Facebook site. I haven’t met them actually in person, but I’ve met more people this year through the site than I did in prior years. I’m very thankful for that. I didn’t even know about some of the East Waco markets and the summertime events that happen. I’m looking forward to going to those places in person when we are able to get out of here. It’s opened up this whole new world, this Waco community that I just wasn’t exposed to prior to this.

We’ve done takeout from the get-go. I do some health economics as well in my global work. So I knew that this was going to affect the economy, and it did here in Waco. We try to do takeout one or two times a week, just to support our neighbors that way. My kids are huge fans of Rosa’s [Café and Tortilla Factory], but Leal’s [Mexican Restaurant] is another we love. We love Slow Rise [Slice House].

WACOAN: Along those lines, my husband and I started tipping even though we’re just doing curbside. Pre-pandemic, we’d only tip if we ate inside.

Smith: Yes. I did a Love Your Neighbor challenge a few months ago where I tried to offer tips just like that. And if you’re doing takeout, then tip or find a place like a food truck or something that may not be nearly as accessible as a Rosa’s. All of those little things matter. There are little things that we can do step-by-step to help our neighbors, but tipping is a huge thing. Someone told me early on, ‘Don’t forget to tip,’ and I appreciated that.

At the beginning [of the pandemic] we had those parades and big things to say thank you to our health care workers. And those have kind of gone away now. So [the Love Your Neighbor challenge] was to send health care workers a note or a text.

WACOAN: How do you stay active on your page and respond to questions but not let it take up your whole day? Because obviously you still have your actual day job.

Smith: Yeah, you could be on there all day long responding. It seems like every time it hits another 10,000-mark there are new boundaries that need to be put in place. I do try to get back to some comments on every post, but certainly not all. When it was 200 people, I could have conversations with people and actually get back in a timely manner, but not anymore, and that’s OK.

Yesterday I think I had 500 comments, and I just can’t answer all those questions, and that’s different for me. My personality is I’d love to have them over for coffee, all of them, and answer all of it. So I think just learning the boundaries of what I can or can’t do, and then trying to figure out how to monitor for harassment or conspiracy websites that are thrown on me.

WACOAN: Will you continue posting even after we get through this pandemic?

Smith: I’m going to keep doing it until it just gets to be too much. That’s where the boundaries come in. I’m reading these things anyway as an epidemiologist, the current news and the current science, so I might as well just write it out and post it for people.

And I think when all of this is over, you know, in June and July when things look much better, not over but better, it is not hard to segue what I’m doing and talking about here to what I’m already doing in Africa. The pandemic has hit the continent there as much as it has over here. It’s probably just not being talked about near as much, but these issues of hunger and poverty and [people who are] marginalized are the same here as they are over in Africa. I’m going to talk more and more about that in the days to come.

Because even when the vaccine comes and less people are getting sick, there will be an economic recovery period from the local to the state and federal level. I think we’ll see that in Waco. There’s going to be a recovery period, especially for people who were already on the margins of poverty. It’s going to take them a little bit longer to recover.

Loving our neighbors means our proximal neighbors, but also neighbors across the city and community. Solidarity is key to end this pandemic with equity. The issue of love your neighbor will keep going, and that’s how I see it extending. People get their vaccines, things look good, hospitals look better, now what can we do to help those that were really hit hard?

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