‘COVID was the greatest trial in my career’

If you ask Professor Alison M. Nicholson, the outgoing head of the Department of Microbiology at the University of the West Indies (UWI), Mona campus, she would say, “COVID was the worst time of my career!”

When the first COVID  case surfaced in Jamaica, Nicholson was the head of the Microbiology Department which houses the Virus Lab at the UWI/UHWI. The first wave of samples was sent to the Virus Lab which was ready, with trained technologists, relentlessly supervised by Professor Monica Smikle, who has since passed away. 

Nicholson continued to provide oversight between the lab and the hospital as the outbreak progressed

“When we started COVID testing, the Ministry of Health [and Wellness] didn’t have everything in place, so the testing started here first. Then as they got their stuff, they took off some of it from us, but the first part of the burden of testing was at the [Department of] Microbiology ... . We were testing for the entire country. It was a new test, so that took doing to get accustomed to what needed to be done,” Nicholson, who will retire this year, told The Gleaner during a recent interview.

“COVID really was the greatest trial I have ever been through in my career as a medical microbiologist, and I don’t think anything can equal that. It was nerve-wracking. It was brutal. It was brutal! I think I went for months without more than two hours sleep per night, and then once you get up and start working, you don’t stop,” she said.

She said the most stressful part – in addition to clearing hundreds of daily cases for testing, prioritising UHWI’s tests to know who must be admitted in the COVID ward and doing due diligence for the country – was her being consistently called on to get reagents into the island while the demand was very high in other parts of the world

“We’re a Third World country. We’re not going to get reagents easily. The First World countries will walk over you to get their reagents. Developed countries were getting reagents we couldn’t get, so sometimes when we put in our order, and a big country comes in, they just bump us down and give the big countries the order, and we had to start over again, and then people quarreling because they don’t understand that it’s not so. You don’t just go in the shop and order reagents. It’s a specialised thing,” Nicholson said while smiling because the situation is now one she can look back on and smile about.

CHALLENGES

“There were times when we were running short on reagents. There were times when the reagent was about to finish, and we had a whole pile of samples to test, and we had no idea when we would get reagents again, so for me, as head of department, it was really very challenging, and there was actually a time when we ran out of reagents and we had about 200 samples to test, and a lot of those samples belonged to our colleagues [doctors and nurses] at this hospital, and tensions were running high. Persons were very unhappy that their samples weren’t tested not understanding that it was completely out of our control,” she said.

The Christian woman said at one point when she had absolutely no reagents in the lab for COVID-19 testing and she was extremely worried, “by divine intervention, we were able to find a source of 200 tests on a cold, rainy night when nobody was supposed to be walking around [during curfew hours]. We had to drive to the place where we knew the source was”.

She said that night, it was a resident, Dr Jerome Walker, who accompanied her to drive through the rain to get the 200 reagents and then work with technologists until around midnight.

For the last 30 years, Nicholson has dedicated her time to working to understand the realities of antimicrobial resistance (AMR), which makes situations more difficult to treat certain infections.

According to the World Health Organization (WHO), antimicrobial resistance “occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness, and death”.

The consultant microbiologist focused heavily on the study of the microorganisms that are capable of infecting and causing diseases in humans.

She earned her Doctor of Medicine (DM) in Medical Microbiology and her Bachelor of Medicine, Bachelor of Surgery (MBBS) at Mona, following which she began her tenure at the UHWI as a resident in 1994.

OVER 20 YEARS IN THE FIELD

Her general area of specialisation is in medical microbiology, and she has spent more than 20 years honing her skills in antimicrobial resistance microbial infections and infection prevention and control, learning best practices that she shares readily with others across the Caribbean.

She joined the university’s teaching staff in 1999 as a lecturer in microbiology and recently completed two terms as head of department, guiding it through the tremendous challenges of the COVID-19 outbreak. She has served as chair of the Infection Control Committee since 2012.

Throughout her academic career, Nicholson has published over 36 peer-reviewed articles, one book chapter, 45 abstracts, and four technical reports. She has also received research grants and led and conducted several training workshops.

Nicholson has supervised research projects for students in the DM Microbiology and Masters in Microbiology programmes. She has delivered numerous training workshops across Jamaica on antimicrobial stewardship and infection prevention and control in the healthcare setting. From 2010 to 2018, she was an internal examiner for the DM in Microbiology and has been a university examiner since 2019. She has also coordinated the DM in Microbiology programme since 2010. In 2021, she developed the Postgraduate Diploma programme in Infection Prevention and Control in the Health Care Environment and is currently the director of this programme in its first year. She is a member of the Governance Team of the UHWI COVID-19 Task Force. Outside The UWI, she holds memberships in professional societies in the Caribbean, the USA, and the UK.

She is co-founder of the Caribbean Association of Clinical Microbiologists (CACM), which was started in 2004 and continues to have an impact on the field of microbiology. Regionally, she has been recognised by the CACM for her work in this area.

Although seasoned in the field, Nicholson told The Gleaner that when she first heard about the coronavirus (COVID-19), her reflex reaction was to panic, but her response became more tempered, given that she had numerous logistical things to overcome, and with more than 20 years of service in the field, she knew it was a God-ordained task for her to take on.

“Entering the field of microbiology [itself], I have to think that this was God-ordained. I had no interest in microbiology. I had actually finished my training and got to work in different areas and then decided to step out into private practice, and I enjoyed private practice ... and it lasted about eight years,” Nicholson told The Gleaner.

Unfortunately, there was an attack on her colleague doctor with whom she shared the practice, so they opted to close the office following which, Prof Nicholson went to work at the Department of Microbiology at the UHWI with the intention of being there for only six months, and now 30 years have passed.

“Circumstances led to me being here, and when I look back, I have to think that God played a hand in that because while I was here, there was the Royal Microbiologists who came here for a limited period,” she said.

The then trained medical doctor said it was their clinical emphasis on microbiology that pulled her into the field, and she sought mentorship from them for clinical microbiology.

“The trajectory of my life just changed after that, and to be honest with you, I don’t feel as if I was working because I’m enjoying what I do so much. .. . Now, it has been 30 years since!” Nicholson told The Gleaner.

After over 25 years of service to the department, she said she had no interest in becoming the head.

“That’s another story. I had no interest in being head, absolutely none. I’m not ambition driven. I tend to be driven more by what I like to do, and if I find things I like to do, you don’t have to drive me. I’ll drive myself,” Nicholson said.

“When the post of head came up, I had no interest. I showed no interest. I actually said to persons that asked me that I wasn’t interested, but in spite of that, the post was offered to me, and I remembered thinking to myself, ‘If it is placed on my plate, I will take it’ ... and it was placed on my plate, so I took it ... and it was placed on my plate just before COVID,” she said.

The post is one that has a three-year term and Nicholson has already done two terms and is now looking forward to her days of retirement.

“[Now] at the end of the two terms, I said this is it. COVID took everything out of me! At the end of two terms, I’ve wanted no more. This was fine. I’ve felt I have made my contributions in that area ... . Even though I was offered the opportunity to continue, I’ve told them not one day past the six years. Not one day, and I meant it,” she said.

“Uneasy lies the head that wears the crown,” she said before the interview ended.

Nicholson, a graduate of Montego Bay High School, credits her family for her success over the years, especially her husband of 45 years, Michael Nicholson.

ainsworth.morris@gleanerjm.com