Explosion of Innovation
UF Health community steps up in time of crisis
The novel coronavirus hadn’t even arrived in North America before the wheels began turning at University of Florida Health. UF Health virologist John Lednicky, Ph.D., read the first news reports about the outbreak in China and quickly moved into action.
Would a test he had developed years ago to detect another type of coronavirus in bats work in identifying this new scourge in humans? As soon as the Chinese posted the genetic code of the new virus, Lednicky started work to see if his test would work.
It would. And it did. Weeks later, his molecular test played a crucial role in important UF Health research involving testing of asymptomatic people for COVID-19, the disease caused by the coronavirus. The work provided crucial understanding about how the virus moves through a community of vulnerable adults.
“We already had something here we could use right away,” said Lednicky, a professor in the UF College of Public Health and Health Professions and a member of the UF Emerging Pathogens Institute. “It was just stored in my freezer. You’ll be surprised at what researchers have hidden away in their laboratories.”
Lednicky’s case is one of numerous examples of how people throughout UF Health have turned their intellectual firepower to battle the most-serious national public health emergency in a century. The result has been an explosion of innovation during a time when their own lives are being impacted by COVID-19.
“Every day, I am hearing about really exciting and incredibly creative and innovative things that our faculty, our staff, our students are doing to try to solve problems in different arenas for people who are impacted by the COVID-19 epidemic,” said Duane Mitchell, M.D., Ph.D., director of the UF Clinical and Translational Science Institute. “Seeing how remarkably the university community is responding is not a surprise.”
Several of the devices created are in the area of personal protective equipment, or PPE, and are intended to supplement the current stockpiles of such vital gear at UF Health and elsewhere, if such a need were to arise.
Here are just a few of the innovations that have emerged around UF Health during this health crisis.
Respiratory masks
UF College of Dentistry faculty and staff volunteers are sewing gowns and creating other PPE items.
The UF College of Medicine’s department of anesthesiology has developed masks using Halyard H600 two-ply spun polypropylene material that is usually used to wrap surgical instrument trays before they are passed through gas sterilization or an autoclave. The material is thought to be superior to the common surgical mask in its ability to block aerosols and droplets, including water, bacteria and other particles.
The masks are not certified as an N95 mask and are not intended to replace them, nor are they approved by the Food and Drug Administration. But they could fill a need for certain health care workers if a critical shortage of masks were to develop. So far, that has not happened.
“My goal is to promote them throughout the country,” said Bruce Spiess, M.D., a professor of anesthesiology and the person who came up with the idea. “Every hospital uses the same material.”
Elsewhere around UF Health, workers volunteered to sew masks and gowns for front-line workers.
Face shields
The UF College of Medicine’s department of anesthesiology teamed up with UF’s wind engineering laboratory to produce simple face shields, to be worn over a mask or respirator to give health care workers added protection for their eyes, face and skin. A team of anesthetists, administrative personnel and physicians assembled the shields using a self-adherent wrap material already available in the hospital for the straps and a piece of foam between the forehead and the shield to hold it off the face.
The UF College of Pharmacy, students and staff assembled over 500 reusable face shields to be used at COVID-19 testing sites, various UF Health Physicians clinics and the UF Health emergency rooms. The shields are made out of protective plastic covering from an industrial supplier, the elastic straps from local retailers and weather stripping from local hardware stores.
“The pharmacy students have stepped up, and they really understand the need,” said Scott Martin Vouri, Pharm.D., Ph.D., an assistant professor in the UF College of Pharmacy and assistant director of pharmacy services at UF Health Physicians. “I think they’ll certainly look back at this time and know that they made a contribution.”
A new lab rises
In mid-March, a group of researchers, students and lab technicians across campus came together to build a high throughput testing lab in the UF Emerging Pathogens Institute in just 10 days. Under normal circumstances, it would take four to six weeks to create this type of specialized laboratory, which is capable of processing large test volumes.
The effort began when a research project on community surveillance of COVID-19 widened in scope to include testing at The Villages®, Florida’s largest retirement community. What began as a small research effort to offer tests to concerned students and area medical professionals soon blossomed as the opportunity arose to enroll thousands of Floridians in EPI’s community surveillance research project.
But officials soon realized they faced a challenge. A research lab typically runs about 12 to 20 tests a day. Suddenly, they were looking to process up to 400 tests a day. One solution: acquiring an Eppendorf epMotion robot, an automated pipetting machine for handling large numbers of liquid samples, in this case up to 96 samples in a single batch.
The robot was delivered on March 20. The next day, the newly assembled team trained. Two days later they began receiving up to 300 tests per day from participants enrolled in their study from The Villages®. Participants’ results were ready within 48 hours, and this was soon shortened to 24 hours as the team became more efficient.
COVID 19 Testing in the Emerging Pathogens Institute
DIY ventilator
When the novel coronavirus hit, Samsun “Sem” Lampotang, Ph.D., the director of the UF Center for Safety, Simulation and Advanced Learning Technologies, knew ventilators would be essential in combating the effects of the deadly disease. While UF Health had a sufficient number of these machines, Lampotang knew these devices were scarce in other areas. He and his team had an idea: Let’s design and build an inexpensive but reliable prototype ventilator out of readily available materials.
David Lizdas, Ph.D., the lead engineer in Lampotang’s lab, went to Home Depot to gather a few items not usually seen in their work space, including lawn-sprinkler valves and PVC pipes. Gordon Gibby, M.D., a recently retired associate professor of anesthesiology at UF, joined the team, bringing with him his network of ham radio operators and providing critical assistance. Patrick Tighe, M.D., an associate professor of anesthesiology in the UF College of Medicine, prodded Lampotang to act on his idea.
Along with engineering and medical colleagues at UF and — through a burgeoning open-source network — places as far-flung as Canada, India, Ireland, Vietnam and Brazil, Lampotang’s team raced to “MacGyver” these items and other pieces into an open-source ventilator that was made public within days.
“The way I looked at it is, we’re not even trying to reproduce the sophisticated ventilators out there,” said Lampotang, the Joachim S.
Gravenstein Professor of Anesthesiology in the UF College of Medicine and a fellow of the American Institute for Medical and Biological Engineering. “If we run out, you have to decide who gets one and who doesn’t. How do you decide that? The power of our approach is that every well-intentioned volunteer who has access to Home Depot, Ace or Lowe’s or their equivalent worldwide can build one.”
The device will not be patented, and the plans and software are freely available online. His team is adding safety features to meet regulatory guidelines and are running engineering tests for safety, accuracy and the endurance of the machine, which can be built for $250 or less and includes a ham radio DC power supply and microcontroller board.
With the support of a worldwide network of coders, engineers, ham radio operators and physicians, Lampotang’s team is moving toward securing Emergency Use Authorization by the U.S. Food and Drug Administration for a fixed-design prototype based on UF’s open-source design, for use in hospitals when other ventilator options have been exhausted.
The hope, of course, is that no one will ever need the ventilator during the pandemic. But even then, the team’s efforts won’t be for naught.
“When all this comes to pass and the world settles down,” Lampotang said, “we hope it will be repurposed for use in underdeveloped countries, so they can build a safe and inexpensive ventilator for themselves.”
Sanitizer brew
Hand sanitizer is simple chemistry, really. So, where better to quickly develop a large volume of sanitizer than in UF’s chemistry labs?
The idea originated with teaching lab specialist Candace Biggerstaff. She downloaded a World Health Organization formulation for hand sanitizer and realized the UF College of Liberal Arts and Sciences department of chemistry had all the ingredients sitting unused in its teaching labs. Students, after all, were at home.
“She made a batch, and the idea just took off from there,” said Lisa McElwee-White, the Colonel Allen R. and Margaret G. Crow Professor of Chemistry and department chair. “Everyone is doing what they can during this crisis.”
Interactive simulation
With COVID-19, a checklist of protective steps is used when a patient in severe respiratory distress needs to be put on a ventilator. At UF Health Shands, experts in medical simulation are conducting realistic drills in the adult and pediatric emergency rooms and intensive care units where workers train on lifelike simulators and newly created devices such as clear protective barriers and a transparent plastic drape to minimize viral spread. The simulations are designed to realistically rehearse a whole new checklist of critical, protective steps necessary to stop the spread of the infection.
“We’re working in the environments where health care workers will be caring for patients, with the resources and equipment they usually have,” said Mary Patterson, M.D., M.Ed., associate dean of experimental learning in the UF College of Medicine.
Adherence to new Centers for Disease Control and Prevention guidelines created specifically for confirmed or suspected cases of COVID-19 had required a swift change in mindset.
“We all have it ingrained that we must run into the room,” said UF Health pediatric ICU physician Jennifer Muñoz Pareja, M.D. “You have to practice and practice — it’s your heart and your mind that want to go into the room to help out. It’s a change in culture, a change in muscle memory. Now, the mental model that all health care workers have is protect yourself first and then go into the room.”
Coronavirus test strip
Piyush Jain, Ph.D., a chemical engineer in UF’s Herbert Wertheim College of Engineering, and Long Nguyen, a doctoral student in Jain’s lab, developed a test using a strip comparable to a pregnancy test to give a quick visual indicator of the presence of the coronavirus in the body.
Although it has not yet been tested in humans or approved for commercial use, the goal is a test that can be administered at home in less than 30 minutes, eliminating the need for a trip to a health care facility. And because it identifies the virus itself, the test can aid in early detection for patients with an active infection, which would help people know to self-isolate.
This article is based on reporting by DeLene Breeland, Leah Buletti, Alisson Clark, Michelle Koidin Jaffee and Doug Bennett.
