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Bears on the Front Line By Jennifer Meininger Wolfe

As COVID-19 swept across the country, prompting stay-at-home orders and shortages on food, masks and disinfecting wipes, Ursinus Bears answered the call to care for those infected, provide protection and support for frontline workers, and raise funds to secure Personal Protective Equipment (PPE) or, when they had the tools and know-how, just create it themselves.

Here, they share their stories from the first days of the pandemic to the work that has continued, such as testing and treating the ill, and working to find a cure.

The Doctors: Responding to a Pandemic

“You carry the moral distress of your patients ... I feel so strongly that no one should die alone.”

Zeba Hussaini M.D. ’14 was nearly two years into her residency in internal medicine at Thomas Jefferson University Hospital in Philadelphia when COVID-19 gripped the region.

Zeba Hussaini M.D. ’14

“The first couple of days in the ICU, I was totally distraught … exhausted, mentally and emotionally,” said Hussaini, who graduated from Sidney Kimmel Medical College in 2018. Seeing how sick the patients got—and how fast it happened—was shocking. “But even more shocking than that was seeing people who are so experienced, doctors who are so intelligent, not know the right thing to do and struggle with it themselves,” she said.

“We had the highest percentage of patients on ventilators in the ICU at any given time in the history of Jefferson and took care of the most COVID-19 patients in Philadelphia,” said Hussaini. Restrictions placed on visitors in the ICU made an already difficult and heartbreaking situation even worse.

“You carry the moral distress of your patients,” said Hussaini, who added that one of the toughest parts for her was the implementation of end-of-life policies: how to support a patient at the end of life, but minimize exposure to family members. “I feel so strongly that no one should die alone.”

She asked herself a familiar question: What will I do? To bring comfort to the patients, their families and even herself, Hussaini made it her “mission” not only to call the families once or twice a day to provide updates, but also to offer them opportunities to connect with their loved ones via phone calls or FaceTime sessions.

“It’s all hard … there was no right or wrong in this,” said Hussaini. “There was just: How can we provide the best care?”

As an emergency medicine doctor, Ashley Panicker M.D. ’09 has been treating patients with COVID-19 in one of the busiest emergency departments on the east coast that serves most of Delaware and parts of Pennsylvania, New Jersey and Maryland.

Seeing people of color disproportionately affected by COVID-19 really brings health disparity to the forefront and shows how unequal the health-care system can be for our patients. The pandemic coinciding with the Black Lives Matter movement has really allowed us to take a much closer look at the health of our patients and look at racism as a systemic issue.”

“It was a scary time to practice medicine,” said the assistant director of emergency medicine ultrasound at Christiana Care Health System in Newark, Del. “We knew so little about what was happening while at the same time were being looked at as the experts amongst our patients, friends and family.”

As he watched cases rise in China, then Italy and New York, he felt that frontline workers were in the tough position of not only knowing very little about the disease process, but also possessing scarce resources to be properly protected against it.

When asked how Ursinus prepared the onetime biology major and president of the pre-med society for the work he’s doing today, he turned to CIE. “Having a liberal arts experience really brought social issues like racism, sexism and classism to the forefront for me as someone who did not have much education on those topics before college,” said Panicker.

Now serving as mentor for his residency program’s diversity, equity and inclusion committee, Panicker said another big challenge related to the pandemic coincides with his work within health equity. “Seeing people of color disproportionately affected by COVID-19 really brings health disparity to the forefront and shows how unequal the health-care system can be for our patients. The pandemic coinciding with the Black Lives Matter movement has really allowed us to take a much closer look at the health of our patients and look at racism as a systemic issue.”

“Having job security, food security, housing, a good education system, health insurance, and a community all factor into the health of our patients,” he said.

Though typically not a superstitious person, Leslie Strickler D.O. ’99 vividly remembers the day she realized COVID-19 was going to have a significant impact in the U.S.: Friday, March 13. That’s the day she got word that her children’s public school in New Mexico was extending a one-week spring break by two weeks.

Leslie Strickler D.O. ’99

“Two weeks has now been 6 months,” said Strickler, the only board-certified child abuse pediatrician at the University of New Mexico Children’s Hospital—and in the state. “I've spent much of my time since then concerned for the physical safety, emotional well-being, and education of children in New Mexico.”

“The collateral damage from COVID-19 has destabilized the economy, education system, and social support networks that are integral to child well-being,” said Strickler, who is also a professor of pediatrics at the hospital. “It is well established that risk for child abuse and neglect increases as stressors in families and communities increase.”

This is compounded by the limited access to child-care and educational settings that provide not only a physical safe space for children at risk, but also an avenue for recognition of harm to children.

“As many pediatric practices shuttered to minimize exposure risk and direct medical resources to the adult COVID-19 front line, my programs continued to see patients, and became one of our busiest pediatric services, which is a sobering reality for my team and the patients we serve,” said Strickler. “It is overwhelming to try to conceptualize how this time of hardship has further marginalized so many children and families who were already struggling to get by.”

First on the Scene

The simple act of holding the patient's hand and verbally comforting them during the trip to the hospital during COVID times clearly made an impression.”

In 1992, Scott C. Savett Ph.D. ’94 and fellow Trappe Ambulance volunteer Craig Overpeck ’94 joined together with two other Ursinus sophomores—Victor Gill and Joe MacDonald—to form SERV (Student Emergency Response Volunteers), a student-run emergency medical team on campus that went on to become known as UC EMS. While home in Lafayette Hill, Pa., during school breaks, Savett volunteered with Whitemarsh Community Ambulance Association (WCAA).

He returned to WCAA in 2004 and rode a steady shift as a volunteer EMT until 2017. “I realized that I was more valuable to the organization in an administrative capacity rather than being on the ambulance,” said Savett, who’s now in his third year of serving as WCAA's chairperson of the board of directors.

“Our biggest challenge has been keeping our EMTs and paramedics safe. PPE and cleaning supplies have sometimes been difficult to obtain, and we're using them at an amazing rate.” It adds up to an extra $1,000 per week in costs, which is equivalent to the salary of a full-time paramedic. To get by, they traded some PPE with neighboring ambulance squads, and were the fortunate recipient of PPE from local businesses.

The area suffered a disproportionate wave of cases and deaths early in the pandemic, largely due to its high number of nursing homes and assisted-care facilities. “This certainly did have an impact on our crews,” said Savett. Free mental-health counseling was offered, leadership endeavored to boost morale, and one of the paramedics served as a peer counselor to help the crews decompress. Appreciation for a job well done helps too. Savett recalls one patient who, despite having only a minor issue, took the time to write a letter to recognize the confidence and compassion the paramedic exuded. “The simple act of holding the patient's hand and verbally comforting them during the trip to the hospital during COVID times clearly made an impression.”

Healthcare Administration: Supporting Doctors

“COVID-19 has impacted health care in ways that none of us could have ever imagined, and health care will never be the same again,” says Andrea McCoy M.D. ’82. “How it's going to look on the other side, I'm not 100% sure.”

Now chief medical officer at Cape Regional Medical Center in New Jersey, McCoy’s career began as a pediatrician. The experience affords her a broader perspective of the field of medicine, which she considers a team sport.

The pandemic has caused McCoy, as an administrator, to rethink everything she does, such as how to keep employees safe—something she’s always done, but it’s been taken to a new level; how to care for patients when resources are strained; and how to determine which routine medical procedures should continue. “Things that were part of our everyday business are just sitting on a shelf,” she said. “Decisions we made two months ago are now 90 degrees from where we were.”

Conversely, things that weren’t commonplace before the pandemic are now happening more often. “The whole notion that we can diagnose and treat patients by telemedicine is one of those things that I always knew was going to take a greater role,” said McCoy, who notes it has gone from being 10% of what her physicians do to 80% of what they do; though she expects the pendulum to swing back to some degree.

Frontline workers are making decisions they never thought they would have to. “We often talk about second victims: people who respond to any kind of a trauma,” said McCoy. Being aware of the support they need “is something that everybody in our organization, across the country and the world is working on.”

Testing: A Look in the Lab

With a decades-long career resulting in expertise in anatomic and clinical pathology, as well as toxicology, Benjamin Gerson M.D. ’69 humbly describes himself as “a laboratory person.” He now serves as either medical director or laboratory director for a number of companies that provide laboratory and other support services.

When COVID-19 hit and people stopped seeking routine care at doctors’ offices and hospitals, the clinical laboratory industry felt the change. But while anatomic pathology and clinical lab tests diminished, the demand for on-site and centralized COVID-19 testing increased, and laboratories responded.

“In COVID-19 testing, there are three types of tests: PCR (polymerase chain reaction), a nasopharyngeal swab, which is the most reliable; it actually measures nucleic acid of the coronavirus,” said Gerson, who is the director of two laboratories performing PCR testing. “Next is antigen testing, which is also usually a nasal swab, but is the kind of test that is done at point of care, meaning you have a result within 30 minutes. The third kind of testing is antibody testing, where you are looking not for the virus, but for antibodies—evidence of prior infection.”

Gerson cautions that people should not confuse the three because they measure different things and are therefore not interchangeable. Another common mistake involves antibody testing, which does not reveal if a person is currently infected or infectious. “It only tells you if you were exposed in the past,” said Gerson.

But doesn’t having antibodies mean you’re protected in the future? “That’s what people had hoped, but as a practical matter it does not mean that,” said Gerson. “The only way to know if you have antibodies that are really protective is to do a test called antibody neutralization, but that test is not commercially available. It’s only used by research laboratories supporting the work on vaccines.”

Providing Urgent Care

Vybe Urgent Care is network of 11 urgent-care centers in the Philadelphia region. In early March, its founder and CEO, Peter Hotz ’82, was having a conversation with an industry contact who operates urgent-care centers in New York City.

Peter Hotz ’82

“He was describing how intense the situation was and it seemed inevitable to me that it would spread,” said Hotz. “Then over the course of the next three to four days, everything changed. Travel bans were announced, the stay-at-home orders were instituted and things accelerated from that point.”

Vybe centers went from averaging fewer than 400 patients per day to more than double that, with many days handling 1,000 patients in total.

In addition to providing walk-in medical care to patients, Vybe has “been very active in testing and treating COVID-19 patients from the very beginning of the pandemic,” said Hotz. “We're providing PCR and antibody testing, and also rapid tests.”

The Volunteers: Racing to Help

In the City of Brotherly Love, Medical Students for Masks (MSFM) was formed by a group of medical students who used fund-raising to provide supplies for Philadelphia hospitals facing severe shortages of PPE. Avery Perez ’17 had just wrapped up the anatomy and physiology block in medical school and moved onto cardiology when he learned about the initiative started by his fellow students at the Philadelphia College of Osteopathic Medicine (PCOM).

“After following the [COVID-19] situation closely in New York City, which is where my family is located, I understood that hospitals were going to be in dire need of resources here in Philadelphia,” said Perez.

He took to social media to fund-raise and joined a subcommittee tasked with collecting video baby monitors, which are used to help manage patients in the hospital.

“We were able to get creative with our ability to fund-raise by applying for grants, reaching Instagram influencers to promote our mission, and enlisting trainer Vince Terry ’17 to host Move for Masks,” said Perez, who personally delivered some of the PPE shipments to hospitals.

MSFM went on to raise more than $76,000 and purchase PPE for 50 local programs. It’s an impressive outcome for the student-led grassroots effort, but Perez didn’t stop there.

Among his fellow MSFM volunteers was Chris Howard ’12, also a first-year student at PCOM. Howard—who focused on contacting local hospitals and other health-care centers to first assess their PPE and medical-device supplies and then schedule deliveries of essential medical equipment—introduced Perez to another organization that needed volunteers: the Black Doctors COVID-19 Consortium (BDCC).

Chris Howard ’12, BDCC founder Dr. Ala Stanford and Avery Perez ’17

BDCC, which is an initiative of It Takes Philly, Inc., aims to provide education and advocacy for African Americans to reduce the incidence of coronavirus-related disease and death, in part via a mobile COVID-19 testing operation. Both Howard and Perez volunteered every other day to register patients and assist the licensed physicians with specimen collection to ensure quality control.

On the Ursinus campus, history major Tiffini Eckenrod ’20 enjoyed learning about new digital tools as a Digital Liberal Arts Fellow for the library. She had been experimenting with the 3D printers at the U-Imagine Center: testing their limits and printing some rather intricate creations that required multiple pieces that needed to be sanded down and then assembled.

As COVID-19 hit, news of PPE shortages began to spread, and with it, stories of people who were using 3D printers to create equipment for frontline workers. Entrepreneur-in-Residence Maureen Cumpstone ’79 thought of UC’s 3D printers and knew there was a student who could help. Maureen located an FDA-approved file for headbands (which are adjustable head pieces that are used to keep plastic face shields in place), and Eckenrod confirmed that the UC printers could make them. The printers were moved to Eckenrod’s Collegeville home, where she set up a maker space and got to work.

Around the same time, Assistant Professor of Physics Casey Schwarz learned about the Berks PPE Resource Network, a group focused on producing, collecting and distributing 3D-printed face shields to help protect those who need it, such as health-care providers, grocery stores and police departments. She reached out to Cumpstone—as well as Instructor of Mathematics Lisa Grossbauer, since one of the printers belonged to the math and computer science department—to form a pipeline to Berks PPE Resource Network.

Every week, Eckenrod would set a batch of headbands, and occasionally ear guards, outside by her mailbox, where Cumpstone, Schwarz or Grossbauer would pick them up and deliver them to the drop-off site. She estimates that she made more than 500 headbands over a two-month period.

Finding a Cure

The Pilot Bioproduction Facility (PBF) at the Walter Reed Army Institute of Research (WRAIR) has been manufacturing phase one and phase two vaccine materials for clinical trials for 23 years. It has produced more than 1,600 lots of vaccine material for government, nonprofit and private entities in that time, and has had vaccines placed in well over 100 clinical trials. After producing a highly effective Zika vaccine, the facility shut down in 2016 for a complete renovation.

What happened next is something Rick Millward ’80 describes as “the perfect storm.”

The purpose of the renovation was to “modernize the building and expand its capabilities in order to be able to assist with this exact type of situation: a national health emergency that requires vaccine production capability,” said Millward, who holds the civilian position of associate director of the PBF. A new director had come aboard, the staff was learning a new documentation system and new equipment, and “we were in the final stages of validation—and not quite ready for production yet—when the COVID-19 pandemic hit.”

“This has been by far the biggest challenge in my career,” said Millward, who has worked at the PBF in Silver Spring, Md., for nearly 20 years.

Rick Millward ’80

Despite the hurdles, the group began work in March to develop and produce a ferritin spiked nanoparticle vaccine, which the Army believes through its research will be an effective COVID-19 vaccine.

Currently in production at the PBF is a vaccine to prevent COVID-19, though scientists ultimately hope to pivot to a pan-coronavirus vaccine. "This vaccine will be able to cover all coronaviruses," said Millward, "so that if there is a new coronavirus that is also causing a problem, the Army believes what they have come up with will be effective."

There are approximately 70 different vaccine candidates in various phases of development, production and clinical trials, and many are further ahead than the PBF’s version, explained Millward, whose focus is not so much the science of vaccines, but the science of putting together products for the public in a way that is safe, effective and approved by the FDA. Still, for his outstanding efforts toward a COVID-19 solution, Millward was among those who received a specially made COVID-19 coin from the Army.

“On a national level, there is Operational Warp Speed for this vaccine,” said Millward. “I am hoping that we will have something available, at least in limited quantities, by March of next year. It could be even sooner, but nobody knows. It's going to be really hard to live with this for another year and a half.”

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