Conquering COVID-19
UF Health at the forefront of combatting the pandemic
As more vaccines become available, the tide finally may be turning in the global battle against COVID-19. For more than a year, University of Florida researchers and clinicians have worked tirelessly to unlock the mysteries of the novel coronavirus, to develop therapeutics and to treat patients in the grip of the disease. Here are several highlights of recent research breakthroughs and treatment advancements emerging from UF laboratories and bedsides.
UF student John Hazzard receives a COVID-19 vaccination from Cynthia Guerin, a fourth-year UF College of Medicine student, at Ben Hill Griffin Stadium.
More than 5,000 flock to Ben Hill Griffin Stadium on first day of major COVID-19 vaccination drive
An audacious push to vaccinate 20,000 people in Alachua County a week for six weeks got off to a roaring start on April 5 when more than 5,000 University of Florida students and Alachua County residents received a dose of the Pfizer-BioNTech COVID-19 vaccine at Ben Hill Griffin Stadium.
On the first day anyone over age 16 in Florida became eligible to receive a COVID-19 vaccine, a steady stream of UF students, faculty, staff and other willing participants flowed through the Champion’s Club on the fifth floor of the stadium’s SkyBox Tower, a spacious indoor area that typically houses premium seating for football spectators.
“It’s an iconic location for something that’s truly historic,” said Michael Lauzardo, M.D., MSc., deputy director of the UF Emerging Pathogens Institute and director of the UF Health Screen, Test & Protect program. “It’s a very big deal.”
The event is part of an ongoing collaboration between the Florida Department of Health in Alachua County, which supplied the vaccines, and UF Health, which provided the personnel to administer the shots.
More than 80,000 people in Alachua County have received at least one vaccine shot as of the beginning of April, according to health department officials, but this initiative aims to spread the protection provided by the vaccines to a broader segment of the population in Alachua County.
“When you think about it, all the vaccinating we’ve done up to this point has been for people who are more vulnerable and at-risk. That’s the right thing to do, but you can’t stay there,” Lauzardo said. “Hospitalizations and deaths are down, which is exactly what we want. But now we are excited to turn our attention to the wider community.”
Immunized college students can be “dead ends” for the virus’ spread, he said, enabling them to play a key role in protecting their communities — and helping everyone return to pre-pandemic life.
“Now is the time to be a dead end,” Lauzardo said. “Even though we all don’t necessarily have the same risk of the same consequences, the way out of this is through immunity, and the safest and best way to get immunity is to get a vaccine.”
Experts from UF Health Screen, Test & Protect designed the logistics for people to receive the vaccine in as little as 15 minutes, including those who have already received a dose of Pfizer’s coronavirus vaccine elsewhere. Lauzardo said UF will soon be able to administer 450 doses per hour.
Kendall Siemienas, a second-year student in the UF College of Agricultural and Life Sciences and the UF College of Education who was volunteering at the vaccination site on Monday, agreed that the timing is right for the vaccine drive.
“I think it’s so important right now because even though it’s during finals, a lot of us are going home for the summer. We want to make sure that we get it now when we have these vaccines available to us here,” she said. “Taking advantage of that is so important.”
Vaccinated students will not have to participate in UF’s routine COVID-19 testing or quarantine if they are a close contact of someone who tested positive for the virus, said D’Andra Mull, Ph.D., vice president for student affairs at UF. Students can receive a second dose of the Pfizer vaccine in their hometowns, but they are encouraged to receive at least one dose before leaving Gainesville, she said. — Halle Marchese
Hundreds of UF students to be part of landmark study on COVID-19 spread
The University of Florida will vaccinate more than 1,000 students as part of a landmark national study to determine whether young people who have received a COVID-19 vaccine can still spread the coronavirus.
Two groups of 500 to 700 students each will be given the Moderna COVID-19 vaccine. The first of those groups will be vaccinated immediately, said Kartik Cherabuddi, M.D., an associate professor in the UF College of Medicine’s division of infectious diseases & global medicine and the principal investigator for the UF portion of the study. The second group of students will be offered vaccine as part of the study in August.
“It’s a very important and unanswered question: Can vaccinated college students still spread the COVID-19 virus?” said Michael Lauzardo, M.D., M.Sc., deputy director of the UF Emerging Pathogens Institute and a co-investigator on the UF portion of the study.
Clinical trials to date show that the vaccine prevents symptomatic illness, but whether it protects against infection is unproven; this study is also expected to shed further light on whether the vaccine prevents people from spreading SARS-CoV-2, the virus that causes COVID-19.
The research is groundbreaking and crucial because scientists have yet to fully understand how the vaccines affect virus transmission. They also have had little opportunity to study the vaccine’s effect on transmission among young people because relatively few of them have received a COVID-19 vaccine. Cherabuddi said the findings could have wide-ranging impact by providing important scientific information for government leaders and public health experts about transmissibility of the virus after vaccination.
Participants in the Prevent COVID U study will be randomly assigned to one of the two groups. The first group will receive two doses of vaccine and will be followed for a total of four months. The second group will be offered study vaccine in August and monitored for a few weeks after their second dose of vaccine, which Cherabuddi said will be sufficient time to collect relevant comparative data. In addition to the students, people who are considered “close contacts” of the study participants have the opportunity to be enrolled and monitored in order to track virus spread.
“We expect that vaccinations are decreasing transmission but we don’t quite know how much or what really is happening among certain groups such as younger people,” Cherabuddi said.
Other participating sites include Louisiana State, Texas A&M and Northwestern universities.
— Doug Bennett and Bill Levesque
The study's findings could have wide-ranging impact by providing important scientific information for government leaders and public health experts about the transmissibility of the virus after vaccination.
UF top among six university campuses for indoor mask use, CDC study finds
The University of Florida led the way in indoor mask compliance among six universities participating in a recent Centers for Disease Control and Prevention study of mask use on campuses during the COVID-19 pandemic.
At UF, 98% of those observed wore a mask, and 95% of those wore their mask correctly. The study found mask use was high overall on the campuses, with 94% of people wearing masks indoors and nearly 92% of mask wearers wearing them properly. The findings appeared in the CDC’s Morbidity and Mortality Weekly Report.
“This study shows us that the university’s messaging about the need to wear a mask has been really effective,” said Cindy Prins, Ph.D., M.P.H., UF’s principal investigator for the study and an associate professor of epidemiology and assistant dean for education at the UF College of Public Health and Health Professions. “We also see faculty, staff and students in all areas who are modeling that behavior, and that has helped make it a norm. It’s just expected that you are going to wear your mask on the UF campus.”
The study also helps dispel the notion that most college students aren’t heeding recommendations to limit COVID-19 transmission, Prins said.
“What we have seen in popular media is a very visible, but small, proportion of students who are maybe going out to bars or gathering without masks,” said Prins, the infection preventionist for UF Health Screen, Test & Protect. “But if you look at the overall population on campus, I do think this is reflective that the majority of students are taking precautions. It’s encouraging.”
The CDC campus mask study used trained observers to measure the proportion of people wearing masks, the type of material used in the mask and if the mask was worn correctly by covering the wearer’s nose and mouth and being properly secured.
Data were collected from observations of 17,200 people at six universities with mask mandates. In addition to UF, these included Auburn University, Colorado State University, the University of Georgia, the University of Pikeville in Kentucky and West Virginia University. During the collection period, which ranged from two to eight weeks of the fall semester, observers recorded mask use at various campus and close-to-campus locations, such as grocery stores, on different days and times.
At UF, a team of 14 undergraduate and graduate students from public health and health science disciplines recorded mask use of 438 people at 10 on-campus and nearby off-campus sites over two weeks beginning in early November.
— Jill Pease
An interdisciplinary team of investigators at UF took a unique approach for the cross-sectional association study.
Vitamin D deficiency tied to increased COVID-19 risk, unique UF data study finds
Patients with a vitamin D deficiency were four times more likely to be COVID-19 positive than those with a sufficient amount of the crucial vitamin, a University of Florida research team has found. And African American patients with insufficient vitamin D levels were three times more likely to be infected by the coronavirus.
Insufficient vitamin D has been linked with respiratory infections, and research suggests vitamin D treatment may help lessen symptoms of COVID-19. African Americans are disproportionally affected by COVID-19 and vitamin D deficiency compared to other races for a variety of reasons including skin pigmentation, which reduces vitamin D production.
An interdisciplinary team of investigators took a unique approach for the cross-sectional association study, which was published in the December 2020 edition of the medical journal Nutrition.
Led by Joseph Katz, D.M.D., a UF College of Dentistry oral medicine professor, the team used the university’s powerful patient database and its Informatics for Integrating Biology and Bedside, or i2b2, patient registry platform to review aggregate data of more than 980,000 patients seen at UF Health medical practices during 2015-2020.
“Research can start out ‘on the bench,’ where you move from small details and work to create a big picture and discover conclusions about a condition or ailment,” said Katz. “In our case, however, we approached the challenge like a jigsaw puzzle in reverse. We were hypothesis-driven: We started with the big picture, that oral diseases are linked to COVID-19. But we didn’t know exactly why. We had to break down the puzzle to learn the reasons.”
Vitamin D deficiency is a key factor in oral health challenges, such as periodontal disease, and its effects on the immune system are well-documented. The receptor that acts as a host to the COVID-19 virus, allowing it to enter and infect human cells, is abundant not only in the lungs and other major organs, but also in the mouth and oral tissues.
Now that vitamin D deficiency has been linked to COVID-19 susceptibility, the next step, Katz said, is for nutrition experts and others to continue that line of research, looking at individualized patient details for more specific causes and results. For example, studies could be conducted to validate the hypothesis that vitamin D supplementation can help prevent or treat COVID-19.
Katz collaborated with Wei Xue, Ph.D., a UF research assistant professor of biostatistics in the UF College of Public Health and Health Professions and the UF College of Medicine, and her colleague Sijia Yue, a UF biostatistics data management analyst. They used the patient data registry to define cohorts of interest and to drill down to identify commonalities and significant risk factors.
They sorted the exhaustive patient dataset by diagnoses codes, risk factors and demographic factors, and made statistical adjustments for comorbidities and demographic variables. For Katz, the ability to collaborate with Xue enabled the team to go deep into the data.
“Traditionally, researchers use i2b2 to determine if a study premise is feasible by asking if enough patients exist within certain criteria for an in-depth study,” said UF Health Chief Research Information Officer Chris Harle, Ph.D., who leads the IDR as a joint program of the UF Clinical and Translational Science Institute and UF Health Information Technology.
“This research team went beyond the norm,” Harle said. “They demonstrated how the i2b2 can be used to conduct cross-sectional analyses and to identify hypothesis-generating associations that stimulate future studies. Using i2b2 in this creative way can lead to more rapid research production by eliminating the need for IRB approval and customized data extractions.” — Kim Rose
UF Health pilot program delivers monoclonal antibody therapy to rural areas
A University of Florida Health pilot program is bringing a new COVID-19 monoclonal antibody therapy to rural communities in North Florida.
As part of the White House’s Operation Warp Speed initiative, the U.S. Department of Health and Human Services selected UF Health and the UF Clinical and Translational Science Institute to coordinate the distribution and administration of 1,000 doses of bamlanivimab, a monoclonal antibody therapy, to eligible residents in rural North Florida communities.
Antibodies are proteins that people’s bodies make to fight viruses, such as the virus that causes COVID-19. Antibodies made in a laboratory, called monoclonal antibodies, act like natural antibodies to limit the amount of virus in your body. Bamlanivimab contains man-made antibodies.
A laboratory worker at Eli Lilly prepares a solution used to manufacture bamlanivimab, a new monoclonal antibody therapy for COVID-19. When given within 10 days of a positive COVID-19 test, these man-made antibodies may help lessen the severity of the disease and reduce the need for hospitalization in people most at risk of developing severe COVID-19.
“The goal of the program is to make sure that people living in rural communities have access to the latest COVID-19 therapies and important health information about COVID-19 therapeutics, testing and vaccines,” said Duane Mitchell, M.D., Ph.D., director of the UF CTSI, who is leading the collaborative effort to coordinate UF Health’s distribution and administration of the treatments with community education and awareness.
The U.S. Food and Drug Administration issued an emergency use authorization for bamlanivimab on Nov. 10 after clinical trials showed it may help lessen the severity of the disease and reduce the need for hospitalization in people most at risk of developing severe COVID-19.
Bamlanivimab must be administered intravenously by a trained health care professional.
UF Health is offering the treatment free of charge to adults ages 65 and older within 10 days of a positive COVID-19 test, and to younger adults with obesity, diabetes, heart disease or other chronic health problems that increase their risk of developing severe disease or hospitalization. Patients hospitalized as a result of COVID-19 are not eligible to receive the treatment.
The pilot program, which is being offered in Columbia County and surrounding rural communities first and later expanded to other counties, has gained private support from the Sarasota-based Louis and Gloria Flanzer Philanthropic Trust with a $250,000 contribution. It is the second donation from the trust in the past nine months to help fund UF Health’s coronavirus response efforts. — Diana Tonnessen
