The Fight Against COVID-19: Close to Home by Jeff Johnson

In every newscast, in every newspaper, and in countless social media
posts since the beginning of the COVID-19 pandemic, two organizations
have dominated the discussion: The U.S. Centers for Disease Control
and Prevention (CDC) and the World Health Organization (WHO). But
a name more familiar to those of us in East Texas has consistently
been on the lips and crossing the desks of COVID-19 researchers
worldwide: The University of Texas Health Science Center at Tyler.

UTHealth Science Center at Tyler has been at the
forefront of our local and regional efforts to slow
the spread of the disease and to “flatten the curve,”
slowing the rate of spread to prevent overwhelming our health care
resources. But the institution’s efforts haven’t stopped there.


Researchers with the university’s School of Medical and Biological
Sciences have been actively working on diagnostic tools to identify
people with the virus, treatments to help those who already have
the disease, and a vaccine to prevent the spread of COVID–19 in
the future.


Public health experts with the university’s School of Community
and Rural Health have also worked to get healthcare providers and
first responders the resources they need to safely help those who
may have the disease. In addition, these community, environmental
and occupational health specialists have developed practical
resources to help employers and workers better understand how
COVID–19 spreads, along with decision-making tools to make
the process of reopening after quarantine safer.

UT Health Science Center at Tyler is led by President Kirk A.
Calhoun, MD, FACP. He says he is extremely proud of how the
various components of the institution have stepped up in response
to the pandemic. “This university is sometimes referred to as one of
the best kept secrets in East Texas,” Dr. Calhoun said. “Of course,
we are not happy about COVID–19 being here, or anywhere for
that matter. But the fact is, it is here,” he continued, “and the many
ways our team has responded quickly and creatively to address the
unique needs of our region has made our value significantly more
obvious to many more people.”


Two groups–biomedical researchers and community health
professionals–have led the UT Health Science Center at Tyler
response to COVID–19.


IDENTIFYING THOSE INFECTED
WITH THE VIRUS

Guohua Yi, PhD, is investigating the development of a COVID–19
diagnostic test that could be conducted faster, more efficiently
and with greater accuracy than current methods being used. This
project will identify an optimal fragment of a protein that binds
COVID–19 and will be added to the structure of a carrier protein
developed by Dr. Yi. The protein incorporating the virus-binding
fragment will be used to build a new test that has the advantages
of requiring small amounts of samples, potentially greater accuracy
and being adaptable for high throughput.


Dr. Yi is a National Institutes of Health (NIH)-funded virologist
who previously used gene-editing techniques to develop more
effective treatments of multiple diseases and infections, including
cancer and HIV.

NOVEL TREATMENT OPTIONS
FOR A NOVEL VIRUS

Physicians and professors from The University of Texas Health
Science Center at Tyler and UT Health East Texas have joined
forces to research several treatment options to help prevent
the spread of and speed recovery from COVID–19. Leading
these research efforts are Julie Philley, MD, and Megan
Devine, MD. Both doctors are pulmonologists and serve on
the teaching faculty in the institution’s Graduate Medical
Education (GME) programs. In addition to research
into the use of convalescent plasma, or plasma received
from those who have recovered from COVID–19, these
physician-researchers are leading one of only 100 teams in
the country investigating a new antiviral drug called REGNCOV-2. “This medication could not only slow the spread
of the virus, but accelerate the healing process,” Dr. Philley
explained, “and it could be available much more quickly
than any vaccine.” Dr. Devine noted that the development
strategy for REGN-COV-2 is the same as that used to
develop a treatment for Ebola that is currently under review
by the Food and Drug Administration (FDA). “We were the
first in Tyler to start with convalescent plasma,” Dr. Devine
added. “Now, we are one of only 100 sites in the entire U.S.
participating in this study.”

The researchers note that convalescent plasma is an important
therapy, but it is only a small piece of the treatment puzzle.
“The REG-COV-2 study offers a much more sophisticated
and directed method for targeting the virus within the human
body,” Devine said.

REPURPOSING EXISTING
TREATMENTS TO ADDRESS
COVID-19

Steven Idell, MD, PhD, is the senior vice president for
research and dean of the university’s School of Medical
Biological Sciences. Professor Sreerama Shetty, PhD, and
Idell are researching the prospect of repurposing one of their
previous developments for use in treating severe lung injuries
associated with COVID–19 infections. They identified
the treatment as a lung-scarring preventive in preclinical
testing. The compound, called LTI-03, is the outcome of
collaborative research spanning 15 years by Dr. Shetty and
Dr. Idell in prevention and treatment measures for patients
suffering from acute lung diseases and lung scarring. LTI-03
is now in phase I of clinical trial testing. If successful, their
work could provide a pathway back to good health for lung
injury patients, including those affected by COVID–19.


UT HEALTH SCIENCE CENTER’S
INTERNATIONAL IMPACT

Research conducted in the university’s Department of
Cellular and Molecular Biology is gaining recognition from
international scientists conducting clinical trials into an agent to
treat COVID–19. Anna K. Kurdowska, PhD, MS, joined the
institution nearly three decades ago. She serves as the associate
dean for research operations and compliance, the director
of research, and is a full professor in the department. Her
research focuses on the development of acute lung injury/acute
respiratory distress syndrome (ALI/ARDS).


This published and patented research could soon provide an
additional weapon to use in the battle against COVID–19.
Originally, this research into an inhibitor of the Bruton’s tyrosine
kinase (BTK) molecule was developed as a treatment for other
types of lung injuries, including those caused by influenza. It now
serves as a strong foundation for a possible treatment to protect
against pulmonary injuries triggered by novel coronaviruses.

RESEARCHING A
COVID-19 VACCINE

Collaborating with researchers in El Paso, Dr. Yi is also
working to prevent the spread of the virus and save lives with
the development of a vaccine. The joint effort hopes to deliver
a vaccine that works by boosting the body’s natural immune
protective response to COVID–19. Based on a new platform,
their proposed vaccination will utilize antiviral antibodies that
activate T-cell immunity. Should Dr. Yi’s work prove successful,
his COVID–19 vaccine could advance the fight to manage the
sweeping COVID–19 pandemic.


GUIDING THE COMMUNITY
RESPONSE TO COVID-19

The School of Community and Rural Health is particularly
well positioned to respond to a pandemic like COVID–19. In
addition to offering master’s degrees in public health and health
administration, the school is staffed by a team of physicians and
educators with expertise in all aspects of community health.


Paul McGaha, DO, MPH, is an associate professor at UT
Health Science Center at Tyler and serves as chair of the
Department of Community Health. He uses the acronym
PAT–for People, Airflow and Time–to help explain factors that
contribute to the spread of COVID–19. “Individuals who are
in outdoor settings, casually going by each other, in a grocery
store for example, or anywhere where there’s good ventilation,
where it’s not a crowded room and not a lot of people there,
they’re much less likely to contract the illness in that setting,”

Dr. McGaha said. “But, if there’s any setting where there
are just tons of people, it’s crowded, the air is kind of stale
or not well ventilated, and you’re there for a long time,” he
continued, “you’re much more likely to contract the illness.”
Dr. McGaha says the importance of minimizing the time
spent with groups of people in poorly ventilated environments
becomes clear when you realize how easy this virus is to spread.
“An individual who has the illness can spread 200 million
particles in a cough or a sneeze,” he explained. “But it only takes
about 1,000 particles to get sick if you inhale it.”

GETTING EAST TEXAS SAFELY
BACK TO WORK

Members of the School of Community and Rural Health
faculty have been proactive in creating tools to help
business owners and workers in East Texas make better
decisions about how to respond to COVID–19. The
university’s COVID–19 Resources Portal–located at uthct.
edu/COVID–19 – is just one of those assets. In addition
to linking to information from national and international
health authorities, the page includes tools to help the people
of our region stay safe while returning to work. The “Getting
East Texans Safely Back to Work” page includes videos
to help the public better understand how COVID–19 is
spread and how to use available tools, like social distancing
and wearing a mask, to protect yourself and others.


The UT Health Science Center at Tyler’s Department
of Occupational & Environmental Health Sciences has
developed resources that help East Texas employers determine
what groups of employees should be allowed to return to
work and when. Flowcharts for “Return to Work Screening”
and “Employee Risk Stratification” give business owners
and managers the easy-to-use tools they need to make quick
decisions to protect their employees, their customers and
themselves during and after the pandemic.

PROTECTING THE PROTECTORS

While some people and institutions responded to the shortage
of N95 respirators for healthcare workers and first responders
with consternation, The University of Texas Health Science
Center at Tyler responded with action. The institution
located more than 60,000 of these medical-grade masks, but
discovered they were out of date and, therefore, unsafe to use.
Working with federal regulators, the School of Community
and Rural Health faculty developed a process to bring these
much-needed masks back into compliance, greatly reducing
the risk of a shortage in our region.


TREATING THE WHOLE PERSON

Staying home to slow the spread of COVID–19 has presented
an entirely new set of stresses for people who are accustomed
to going to work or school for at least eight hours a day. Even
for those who are considered “essential workers” or who have
returned to work as the state of Texas reopens, requirements
for social distancing and wearing masks have made the
beginning of the return to normal seem anything but.

Ushimbra Buford, MD, is a psychiatry residency program
director and an assistant professor of medicine at UT Health
Science Center at Tyler. He says that, while these preventive
measures are still necessary, he understands they can be hard
on a person’s state of mind. “It appears to be that we have
flattened the curve in a way, but we have to stay vigilant and
stay on task with it,” Dr. Buford said. “This is a time to still keep
a schedule. With children out of school, it’s still very important
to make sure that some kind of schedule is being maintained.”


At a time when business owners are hit hard, Dr. Buford says
they should stay proactive despite the circumstances. “Part of it is
realizing this could not have been avoided, that this was something
external. It was outside of their control,” he explained. “But they
still can gain whatever mastery they can over the situation.” Dr.
Buford says the best way to do that is by being proactive. “Call
in and talk with your bank, your creditors and the vendors who
serve you,” he suggested. “Explain the situation and try to work
out deals where you pay a smaller amount now or defer payments
going forward in the future.”

Dr. Buford anticipates that things will get better as society slowly
returns to familiar patterns and habits, to whatever extent that can
safely be done over time. In the meantime, he suggests staying in
touch with those around you to pick up on signs of stress. “Do
you become more irritable around family and friends? Do you
become more depressed and withdrawn? Understand that is part
of your response to stress,” Dr. Buford explained. “And so you are
recognizing it, working on it, admitting to yourself, ‘Okay, I’m
being irritable. Let me not snap at people.’”


IT’S NOT OVER UNTIL IT’S OVER

UT Health Science Center President Dr. Kirk Calhoun warns
against being lulled into a false sense of security just because
businesses are reopening and things seem to be getting back to
normal. “COVID–19 is still with us and we’re going to have to
continue a number of different actions to make sure that we all
stay safe,” he warned. “Work from home if you can. Do not go in
to work if you’ve been ill. If you have a fever, if you have a cough,
if you’re sick, stay home.”

Dr. Calhoun stressed that the most effective ways to slow the
spread of COVID-19 are the simplest, including:

• Maintain a six-foot distance in public between you and
people with whom you do not live.
• Wear a mask when in public so that you don’t
unintentionally spread the disease if you have it and don’t
know it.
• Wash your hands frequently and vigorously for about 20
seconds each time.
• If you need to cough or sneeze, do that into the crook of
your elbow rather than onto your hands.
• Avoid close contact with people who are sick.

“As we begin to get back into a more normal pace,” Dr. Calhoun
concluded, “let’s not forget to keep doing those things that have
allowed us to open back up in the first place.”

Calhoun also noted that the COVID–19 pandemic has brought
renewed interest in medicine and community health as a career
option. The University of Texas Health Science Center at Tyler
offers master’s degrees in biotechnology, public health and health
administration for those seeking to advance or change their careers.
Medical school graduates seeking to complete their training can
enter residencies at the university in family medicine, general
surgery, internal medicine, occupational medicine, rural family
medicine, general psychiatry and rural psychiatry. Psychology
internships and fellowships are also available.

The University of Texas Health Science Center at Tyler has also
been approved by The University of Texas System Board of
Regents to create a medical school in Tyler and is currently in the
planning and fundraising stages of that next step in the institution’s
contributions to East Texas.

Visit uthct.edu for more information about The University of
Texas Health Science Center at Tyler.