After battling on the front lines of the global coronavirus pandemic for nearly a year, Arizona’s health care community paused last Friday to evaluate what we’ve learned about COVID-19, what challenges are yet to come and how best to work together for greater success. Over 300 health care professionals, researchers, policy makers and others gathered virtually for the fourth annual Arizona Wellbeing Commons event, which focused on the coronavirus pandemic.
Arizona Wellbeing Commons brings scientists, clinicians and partners together in a powerful network of researchers to tackle the health issues that impact well-being in the state. This initiative, which includes Arizona State University, University of Arizona and Northern Arizona University, has created a community of collaboration to find successful answers for our most pressing health issues — such as cancer, dementia, mental health and obesity.
Bringing together multiple points of view enables solutions that are as multifaceted as the problems themselves. The current challenge of COVID-19 has highlighted the power of collaboration even more.
Though the scope of the virus’s impact is vast, the research community has answered the call by sharing resources to increase testing, distribute personal protective equipment, understand how the virus works, treat those affected, predict how the virus will react and travel, search for a safe and effective vaccine, evaluate the social and economic effects of social distancing, and help schools and businesses find ways to continue operating.
“The Arizona Wellbeing Commons was created to help researchers in Arizona connect with one another to build collaborations and achieve greater results. Now that COVID-19 has limited our routine interactions, it is more important than ever to come together at this virtual annual conference to learn about what is happening in our community,“ said Joshua LaBaer, conference leader and executive director of the Biodesign Institute at Arizona State University.
LaBaer compared the group to a swarm; just as bees can do more together than they could individually, so it is for scientists working toward a healthier Arizona.
“In order for us to accomplish things, we need to work together,” he said.
What we know about COVID-19
“We are living in the age of epidemics,” noted Tara O’Toole, executive vice president and senior fellow at In-Q-Tel, in the keynote address. “We should not be surprised when epidemics appear, and we should be more prepared to deal with them.”
O’Toole, an expert in epidemic and pandemic response and preparedness, directs B.Next, In-Q-Tel’s initiative devoted to identifying and accelerating biotechnologies that could help detect, manage and quash epidemics of infectious disease. She shared an overview of what the scientific community has learned about COVID-19 in her address.
For example, instances of a large number of people being infected at the same time, which she called superspreading events, play a significant role in the spread of COVID-19. Only 10-20% of those infected cause 80-90% of cases of the disease.
It’s also clear that Black, Hispanic and American Indian populations are disproportionately affected by the virus with higher numbers of infections and hospitalizations.
“Epidemics always cause social, economic and political disruption to various degrees,” she said, in particular by exacerbating existing societal stresses.
Looking toward the future, the public health community’s concerns for the winter include the possibility of a “twindemic” with the flu and increased spread due to holiday travel and gatherings. A vaccine opportunity may be available by next spring, but O’Toole cautioned that it could take years to deliver it throughout the U.S., let alone the world. Further complicating these efforts is a lower confidence in vaccines.
“The intrusion of politics has eroded people’s trust in whether a vaccine will work,” said Complex Adaptive Systems Initiative Regents’ Professor George Poste, who moderated a Q&A with O’Toole.
To earn back that trust and boost vaccine confidence, O’Toole said, the public health community must be extraordinarily transparent about vaccines, increase awareness of misinformation campaigns, work with doctors to communicate with patients and lead a public information campaign.
But an even longer view is needed to be truly proactive, O’Toole argued. COVID-19 will not be the world’s last pandemic. Recent advances in technology, such as data collection, diagnostic tests and vaccine development, can be put to our advantage.
For example, it’s known that pandemics originate when microbes spill over from animals to humans. (A bat or pangolin is suspected as the source of the SARS-CoV-2 virus that causes COVID-19.) The process of animal disease developing and then being introduced to humans is a long one, however. O’Toole suggested using this delay and our available technology to identify as many coronaviruses in the wild as possible, create antibodies for them, and store samples of the viruses and their antibodies so that we have them at the ready if needed.
The state of the state’s coronavirus research
In his address to conference attendees, Arizona Board of Regents Chair Larry Penley praised the efforts of the state’s three public universities to combat COVID-19. He called out UA’s 13 teams working on different aspects of the virus; NAU’s study of its different strains; and ASU’s efforts to model its spread and adaptations. He also lauded their collaboration to offer COVID-19 testing to the public, as well as their dedication to continue providing education despite today’s new obstacles to teaching and learning.
“Thank you for what you’re doing,” Penley said. “Keep at it.”
Throughout the daylong conference, researchers from across Arizona shared their efforts, findings and recommendations in areas ranging from diagnosis, treatment and prevention options to public health policy to healthy lifestyles and mental health.
Efrem Lim, researcher in the Biodesign Institute and assistant professor in the School of Life Sciences, reported that the “viruses, immunity, microbiomes and infectious disease” division of the Wellbeing Commons was the first in the state to sequence the virus’s genome. The group is now monitoring virus mutations across the state.
Brenda Hogue, researcher in the Biodesign Center for Immunotherapy, Vaccines and Virotherapy and professor in the School of Life Sciences, presented on her laboratory’s work to develop a platform that can build vaccine-like particles, which could mimic the virus in a vaccine without introducing the live virus.
Lim noted that there is much concern in the virology community about misinformation about a future vaccine, and that this group could be a resource for the public to find reliable information.
David Sklar, a professor in the College of Health Solutions, praised the public health successes of rapid testing, improved collaboration between hospitals, improvements in telemedicine and citizen activism for measures such as mask mandates. He also noted that the immediacy of the pandemic has taken focus away from other important public health issues. Going forward, he recommended the public health community not only continue their efforts around COVID-19 (including growing recognition of complications related to the disease), but also emphasize other pressing health crises like climate and heat, vulnerable populations, violence and guns, health policy and legal issues, and women’s health issues.
College of Health Solutions professors Stavros Kavouras and Dorothy Sears emphasized that preventing disease is the key to fighting COVID-19 — and a healthy lifestyle plays a significant part in that. One practical step?
“Go outside and walk,” said Kavouras, for socially distant exercise with a vitamin-D benefit.
Sears spoke about how diabetes and obesity are both risk factors for severe forms of the disease; successfully addressing them not only improves well-being but lessens risk of severe COVID-19. Kavouras observed that the ACE-2 receptor, a protein that provides entry for the coronavirus, is expressed in the body more when a person is dehydrated. He said supporting data is still needed, but that it is possible that dehydration could be one factor in catching the disease.
Kelly Cue Davis, associate professor in the Edson College of Nursing and Health Innovation, and William Corbin, professor in the Department of Psychology, reported that mental health has seen a widespread decline since the beginning of the pandemic, and substance abuse has increased.
Athena Aktipis, Biodesign Institute researcher and associate professor in the Department of Psychology, presented her project, “Cooperation in the apocalypse,” a longitudinal study of how cooperation changes during the pandemic. Her team has been collecting data from around the world since early March. So far, she has found an increase in feelings of interdependence — the belief that we rise and fall together — in the general populace, but especially among those with pre-existing medical conditions.
Looking toward the future, Davis and Corbin believe that mental health researchers and practitioners should focus on studying how COVID-19 affects people emotionally, providing mental health services to first responders, and acknowledging other sources of stress, such as social or political stress.
Rita Sattler, associate professor at the Barrow Neurological Institute, and Jason Newbern, associate professor in the School of Life Sciences, said that studying the short- and long-term impacts of COVID-19 on the nervous system is important, but that this research is still in its early days. One important insight is that SARS-CoV-2 affects the central nervous system, causing inflammation that then affects the vascular system. Young people who experience a stroke, they said, should be tested for COVID-19 as a potential cause.
Richard Gerkin, an associate professor in the School of Life Sciences, spoke about his research on smell perception in the brain and how it relates to COVID-19 — a known symptom of which is loss of smell. He conducted a survey to figure out how people’s experience of smell changes specific to COVID-19 versus other illnesses. This allowed him to create a clinical scale, dubbed ODoR-19, that determines the odds ratio of a patient having COVID-19.
“If you want to figure out if it’s COVID-19 or another respiratory illness, check smell loss,” Gerkin said.
Biodesign Institute researchers Professor Karen Anderson and Associate Professor Carlo Maley of the School of Life Sciences gave updates on the latest in cancer research. Cancer expertise, Anderson argued, can also inform our understanding of COVID-19. For example, cancer immunotherapy studies T cells, and scientists could use that information to help understand how T cells recognize mutations of SARS-CoV-2. She also stressed the importance of continuing cancer research, saying that although COVID-19 has become the #3 killer disease in the U.S., it has not surpassed cancer.
In that vein, Maley described his vision of applying agricultural pest management techniques to cancer prevention. Farmers know that some pests are more resistant to pesticides than others, so to keep the resistant ones in check, they help the more sensitive pests outcompete the resistant pests. Then, using minimal pesticide later allows for maximum population control. This method, he proposed, might also work for controlling cancer cells, some of which are more resistant to treatment than others.
Tamara Underiner, associate professor in the School of Film, Dance and Theatre and associate dean in the Graduate College, reported for the Wellbeing Commons’ newest division, “culture, arts, design and humanities in health.” She pointed to the ability of the arts to promote social cohesion, fight isolation, improve mental health, manage chronic illness and even reduce pain. During the pandemic, the arts have become crucial as people seek creative outlets to cope while staying at home. This unique time presents an opportunity to study the impact of digital arts, she said, since much of our consumption of and participation in the arts has moved to a digital medium. She urged that researchers should also study how the arts can specifically support those with COVID-19.
“Especially in COVID-19, really over the past 10 years, we’re beginning to understand how important the arts are to health and well-being, that the arts are no longer just something nice that you add on after taking care of essentials,” Underiner said. “They’re increasingly a necessity.”
Though the conference was centered around finding answers for the coronavirus in Arizona, attendees left with more than fresh ideas and connections for addressing the current crisis. A focus toward the future throughout the event not only emphasized the need to prepare now for the next pandemic, but also renewed the public health community’s resolve to continue their important work in other areas of physical and mental well-being.
“Out of the challenges of this time, what we really need to call on ourselves for is a sense of hope,” Penley said. “To me, the work that we’re doing at our three universities provides a sense of hope. This conference provides a sense of hope. From the work that’s been done by each of you, I derive a sense of hope for Arizona, our country and for the globe.”
Videos produced by Grace Clark Media.
The Arizona Wellbeing Commons conference was sponsored by the Arizona Biomedical Research Centre, a unit of the Arizona Department of Health Services.