8 Ways Yale Doctors and Researchers Helped Us Through the COVID-19 Pandemic
BY COLLEEN MORIARTY December 1, 2020
2020—a year unlike any other
Credit: Anthony DeCarloIf you’re looking forward to ringing in the new year, you’re not alone. Even if you’ve been lucky enough to avoid getting sick, the COVID-19 pandemic has affected everyone’s life. Many have lost loved ones. Others have lost their jobs or their health care. Many of us are just getting by, but with a growing—and deepening—anxiety.
We’ve tried to keep ourselves and others safe by wearing masks, staying home, and avoiding social situations—even missing important milestones like birthdays, graduations, weddings, and holidays with our families and friends. But our health care workers across the country—and the world—have sacrificed much more.
That’s true here at Yale, where our frontline health care workers—physicians, nurses, as well as clinic and laboratory staff—cared for more than 5,000 COVID-19 patients since the pandemic began.
But, as an academic medical center, we have a different mandate. Not only do we treat the patients who come to us for care, our doctors are also here to study, innovate, and advance the practice of medicine, which Yale has a long history of doing. From developing new ways to share research earlier, to innovations in testing, treatments, and technology, to identifying and acting on ways to reduce health disparities and improve on cultural sensitivity in the community response to the pandemic, Yale doctors have risen to the challenge and felt grateful for the opportunity to make an impact in a situation where so many feel so helpless.
From the earliest days of the pandemic, they not only provided around-the-clock care to patients on the frontlines, they also pivoted to revamp laboratories overnight, embarked on numerous studies and clinical trials for treatments, and dug deep into the science behind SARS-CoV-2, the virus that causes COVID-19, to help us find our way to 2021.Here is a look back at some key contributions Yale experts made during the pandemic.
[Pictured: The Study at Yale hotel in New Haven lights up windows in a heart shape in support of health care workers during the COVID-19 pandemic.]
1. A Yale expert was tapped to co-chair the presidential COVID-19 transition team and chair a federal COVID-19 Equity Task Force
Credit: Robert A. LisakIn November, Marcella Nunez-Smith, MD, an internal medicine physician and epidemiologist, was tapped to co-chair president-elect Joe Biden’s transition team on his COVID-19 Advisory Board. In early December, it was announced that she will serve as a senior advisor in the Biden-Harris White House as the inaugural chair of a federal COVID-19 Equity Task Force. Dr. Nunez-Smith is also associate dean of health equity research at Yale School of Medicine and has a long history of conducting research focused on promoting health and health care equity for marginalized populations.
"It is an honor to go to work with colleagues and partners who center on science and equity. The COVID-19 pandemic makes societal inequities visible to everyone. This is an historic moment,” she says. “It is our societal obligation to ensure equitable access to testing, treatments, and vaccines during the pandemic. And to ensure equitable access to educational and economic opportunity in our recovery."
[Pictured: Marcella Nunez-Smith, MD]
2. Yale led clinical trials for new treatments and vaccines
Credit: Anthony DeCarloYale participated in Phase 2 and 3 clinical trials of the Pfizer-BioNTech vaccine, which will be given to health care workers and residents of nursing homes in the first tranche of vaccine delivery. “Having a highly effective vaccine will help us achieve herd immunity, and if we have enough people who receive the vaccine and are protected against the virus, this really could be the beginning of the end of the pandemic,” says Onyema Ogbuagu, MBBCh, a Yale Medicine infectious diseases specialist and principal investigator of the vaccine trial at Yale Center for Clinical Investigation (YCCI).
Our doctors have trialed many compounds and devices in hopes of addressing the effects of COVID-19, including severe respiratory problems. One of those medications—remdesivir—received approval from the Food and Drug Administration (FDA). “We trialed remdesivir for patients with both severe and moderate COVID-19, and based on the results of the trials, it has received approval by the FDA,” says Dr. Ogbuagu, who also led that trial at Yale. “It remains the only antiviral medication approved for hospitalized COVID-positive patients to date.”
[Pictured: Onyema Ogbuagu, MBBCh]
3. Yale experts helped speed up the sharing of scientific research
Credit: Robert A. Lisak“This platform [medRxiv] was designed to provide faster communication among the scientific community, which has been essential during this global pandemic,” says Harlan Krumholz, MD, SM, Harold H. Hines, Jr. Professor of Medicine. He and Joseph S. Ross, MD, are Yale’s co-founders of medRxiv, a “free online archive and distribution server for complete but unpublished manuscripts (preprints) in the medical, clinical, and related health sciences,” according to the site.
They also co-lead the Yale Open Data Access (YODA) project. “With medRxiv, scientists didn’t have to wait months on peer review to share their findings on COVID-19 or on any other research topic—it has been a game changer for scientific communication,” says Dr. Ross.
[Pictured: Harlan Krumholz, MD (left), and Joseph S. Ross, MD]
4. Yale experts developed SalivaDirect, which makes COVID-19 testing more accessible
Testing helps monitor transmission of SARS-CoV-2, the virus that causes COVID-19. But, nasopharyngeal swabs can be uncomfortable, which discourages people from getting tested. SalivaDirectTM is a new method developed at Yale for testing people suspected of SARS-CoV-2 infection. While it still relies on a similar molecular process as earlier tests (called RT-qPCR), Yale researchers made it simpler and cheaper. SalivaDirect was issued an Emergency Use Authorization (EUA) from the FDA in August 2020. So far, over 50 labs from 25 states have been designated by Yale to use SalivaDirect.
[Pictured: The schematic for SalivaDirectTM. Created with BioRender.com. Courtesy of the SalivaDirect team.]
5. Yale monitored wastewater to predict community COVID-19 outbreaks
Credit: Harold ShapiroYale found that viral RNA levels in sewage sludge can be an early indicator of not only the presence of COVID-19 in communities, but of a worsening crisis. This gives hospitals a jump-start with a three- to five-day warning that more patients with severe disease are predicted to need hospitalization.
An important element of a predictive process often called “nowcasting,” this methodology is now being used in multiple locations to plan for upcoming health care needs. “SARS-CoV-2 RNA in wastewater can be a leading indicator for changes in the incidence of COVID-19 even when there are gaps in clinical testing,” says Saad Omer, MBBS, director, Yale Institute for Global Health. The effort was in collaboration with Jordan Peccia, PhD, the Thomas E. Golden, Jr. Professor of Chemical & Environmental Engineering.
Wastewater testing efforts are being expanded in Connecticut and are being planned abroad. “It can be particularly useful for low-income countries,” notes Dr. Omer.
[Pictured: Saad Omer, MBBS]
6. Yale doctors pioneered a methodology to clean and repurpose N95 respirators during supply shortages
Early in the pandemic, demand for N95 respirators, an important type of personal protective equipment (PPE), skyrocketed. “In early 2020, the Centers for Disease Control and Prevention [CDC] issued crisis guidance saying that scarves or bandanas could be used when hospitals ran out of N95s, which was a very real concern at many centers,” says Patrick Kenney, MD, medical director of supply chain for Yale New Haven Health and interim chair of Yale Urology.
Feeling like that wasn’t enough to keep nurses and doctors safe, he and colleagues conducted a study that established efficacy for a scalable method to reprocess used respirators. (They reprocessed used respirators with vaporized hydrogen peroxide using a machine that area hospitals already had on hand.)
“We were able to demonstrate that respirators that had been inoculated with aerosolized viruses were able to be sterilized with vaporized hydrogen peroxide,” says Dr. Kenney. “Although we would normally discard a used respirator, once reprocessed, it is as protective as a new N95.”
This work led Yale New Haven Health to build a high throughput reprocessing facility and was an essential component in providing PPE to health care workers.
[Pictured: N95 respirator, an important PPE for health care workers]
7. A Yale expert was tapped to co-lead the governor’s Reopen Connecticut Advisory Group
Credit: Robert A. LisakWhen Connecticut Governor Ned Lamont put together a group of experts to advise him on the public health response to COVID-19, he selected Albert Ko, MD, a Yale Medicine infectious diseases specialist and epidemiologist, who is also the department chair at the Yale School of Public Health, to co-chair the Reopen Connecticut Advisory Group.
“It is a privilege for any infectious disease epidemiologist to be called upon by the governor to serve during the pandemic. I also had the immense privilege of working with Indra Nooyi (YSOM ‘80), the co-chair, and an advisory group that included colleagues at Yale, such as Harlan Krumholz, Carrie Redlich, Marcella Nunez-Smith, Linda Lorimer, and Rick Levin,” he says. “The advisory group worked around the clock during the height of the pandemic to provide recommendations that enabled the state to control the initial surge and safely reopen its businesses and education and social institutions.”
[Pictured: Albert Ko, MD]
8. Yale started the first multidisciplinary post-COVID-19 recovery clinic in Connecticut
Credit: Anthony DeCarloDuring the first surge, Yale pulmonary and critical care physicians were caring for patients with acute COVID-19 on the front lines of the ICU and the hospital wards, but were also being referred patients whose symptoms seemed to linger.
“People were struggling with severe shortness of breath, ongoing chest pain, profound fatigue, and sometimes difficulty concentrating,” says Jennifer Possick, MD, a Yale Medicine pulmonologist and the medical director of the Winchester Center for Lung Disease. “Though the symptoms of acute illness—such as fever and cough—had resolved, these other symptoms were preventing people from returning to their normal lives. We reached out to specialists in different areas to create the Post-COVID-19 Recovery Program, which could help us understand the reasons for these symptoms and support people through their recovery.”
Staffed by pulmonologists, physical therapists, and social workers, this clinic—the first of its kind in Connecticut—formally launched in July and partners closely with collaborators in other specialties to ensure a comprehensive evaluation of patients and the creation of personalized care plans for them.
“Though the path back to health may be a long one, we are committed to supporting our patients while they are on this journey,” says Dr. Possick.
[Pictured: Jennifer Possick, MD]
Here’s to all the health care workers who helped us this year, and we look forward to more breakthroughs in the year ahead.
