The science of safety
Protecting our campus, community and world
Screen, test and protect
Disease investigator Sneha Sathish
conducts a case interview, including
requesting a list of the person’s close
contacts. Sathish is a second-year
Master of Public Health student with
a concentration in epidemiology.
In mid-March, UF converted classes to online and sent students home, all within a week’s time. As the spring went on, the question soon became: how can we bring tens of thousands of employees and students back to campus safely? The answer is a science- and data-driven program known as UF Health Screen, Test & Protect.
As the program’s lead epidemiologist, Jerne Shapiro, M.P.H., a faculty member in the department of epidemiology, is responsible for training and leading a large group of disease investigators who trace COVID-19 cases among employees and students; maintaining a massive database that tracks the status of UF personnel who have contracted or been exposed to the virus; and conducting several surveillance projects.
“The university has put an amazing amount of resources into UF Health Screen, Test & Protect and put it as their top priority,” Shapiro said. “We have been granted brilliant minds and lots of people in so many diverse areas to try to help our campus open up and maintain operations safely.”
A close relationship with the Alachua County Health Department is another strength, and makes UF’s return-to-campus program unique among others in the state, Shapiro said. Team members are hired by the health department, granting them the authority to isolate and quarantine individuals, as well as access to the state’s COVID-19 case data to cross-reference against the UF Health Screen, Test & Protect database, developed by UF informatics CTS-IT team and epidemiology assistant professor Kelly Gurka, Ph.D.
The testing arm of the program, led by PHHP alumna Meghan Nodurft-Froman, M.P.H., has tested thousands of employees and students at sites throughout campus and her team is now able to offer saliva testing at no out-of-pocket cost.
When a UF affiliate is diagnosed with COVID-19, a three-part investigation begins. To identify transmission trends, disease investigators learn what the individual had been doing in the 14 days prior. Investigators provide prevention education, such as explaining what it means to effectively isolate and how to protect loved ones. Next, they get in touch with every close contact of the infected person to place them in quarantine and monitor symptoms through daily text messages.
“That’s really how you break the chain of transmission, by reaching out to these individuals before they become able to infect others, and limit their exposure,” Shapiro said.
Cindy Prins, Ph.D., M.P.H., an epidemiology associate professor and PHHP’s assistant dean for educational affairs, is UF Health Screen, Test & Protect’s infection preventionist. With a background in virology and hospital infection control, Prins helps campus units conduct risk assessments and create plans for activities and events. The work takes her all over campus to consult on a wide variety of activities.
“It’s challenging, but I’ve been so surprised and impressed with the fact that everyone has put so much thought into their plans before I even meet with them,” said Prins, an alumna of the UF M.P.H. program. “By the time they contact me, they’ve got a really good plan in place and sometimes it’s just answering some questions or tweaking their plan a little bit. People are thinking so critically about how to do their activities and prevent infection.”
As the university eyes more in-person instruction in the spring, Prins plans to focus on compliance and education, helping different groups continue safe practices for the long haul, while balancing the campus community’s desire to gather together after months at a distance.
“We need to start thinking about how we can potentially bring more people together in groups and going back to a little bit more of our normal life, while still preventing infections,” she said.
— Jill Pease
Disease investigator Alfeil Felipe
Monitoring outbreaks through wastewater
The wastewater surveillance system uses self-contained sampling devices that fit beneath a manhole cover. The device fills a bottle with a small amount of wastewater at set intervals to create a composite sample for each site that gets labeled, inventoried and tested for the genomic signature of SARS-CoV-2.
At testing sites around the UF, students, staff and faculty get tested to check for potential COVID-19 infections. Beneath their feet, another testing system churns away, searching for the virus in UF’s wastewater.
Joe Bisesi, Tony Maurelli and Tara Sabo-Attwood, faculty in PHHP’s department of environmental and global health and members of the Emerging Pathogens Institute, partnered with medical and facilities personnel to create GatorWATCH, which stands for Wastewater Analysis and Tracking for Community Health. GatorWATCH monitors wastewater from 28 UF residence halls, campus apartment complexes and fraternity/sorority houses that empty into UF’s wastewater treatment infrastructure.
“Wastewater testing is a proven strategy used in the control of other infectious diseases that helps detect unsuspected infections,” said Michael Lauzardo, M.D., director of UF Health Screen, Test & Protect. “If we find evidence of infection, we will then direct our testing efforts at that site and quickly diagnose the unsuspected case.”
While the wastewater surveillance effort was created with COVID-19 in mind, faculty members see potential beyond the current crisis.
From pathogenic E. coli to campylobacter and salmonella, “there are numerous other infectious diseases that could be monitored through this methodology,” said Bisesi, Ph.D., an environmental toxicologist. “There is potential to use this type of monitoring to track effectiveness of vaccine campaigns if one became available and a suitable marker could be found, as has been done with polio vaccine.”
Community health researchers could even use wastewater testing to understand patterns of pharmaceutical and illegal drug use.
“Because ours is a multidisciplinary, intercollege approach, we see things across the spectrum, not just COVID,” said Maurelli, Ph.D., a molecular biologist. “We’re just at the very start of unleashing the potential of wastewater surveillance in public health.”
The UF team is also conducting wastewater sampling for the city of Gainesville and the town of Cedar Key.
“This really shows the impact of environmental science in the context of public health,” said Sabo-Attwood, Ph.D., an aquatic and pulmonary toxicologist and chair of the department. “I’m proud to use our expertise to rapidly and effectively improve the public health of our community.”
— Alisson Clark
Combating misinformation
Dr. Natalie Dean has appeared
in numerous broadcast outlets, including
CNN’s Inside Politics with John King.
Through her active Twitter account, opinion pieces in high profile media outlets and countless media interviews, Natalie Dean, Ph.D., an assistant professor in the department of biostatistics, has emerged as a thought leader on infectious disease epidemiology and in her particular area of expertise, clinical trial design during public health emergencies. Medium recently named her one of “50 Experts to Trust in a Pandemic.”
Early in the pandemic, Dean was interviewed by Washington Post reporter William Wan for an article on how long experts anticipated social distancing would need to continue. Dean used a memorable analogy in her response —“It’s like asking a fireman when you can move back in, but your house is still on fire”— which CNN anchor Jake Tapper later quoted on air.
“That was a moment I realized I was able to contribute to some sort of larger conversation around what was going on,” Dean said. “A lot of what I do with reporters is explain different scientific concepts and then interpret and place new results back in context and add perspective. Those big picture questions are what I’ve always liked about science and being a researcher.”
Dean, a member of UF’s Emerging Pathogens Institute, is frequently sought after by outlets such as the New York Times, The Atlantic, USA Today, BBC World Radio, National Public Radio, the Wall Street Journal and many others.
“Natalie Dean has been incredibly generous with her time, and her expertise has been invaluable in making sense of the pandemic,” said Ed Yong, a science journalist who reports for The Atlantic. “While many pandemic experts will reliably tell you what is happening, Dean belongs to a special group who will also reliably tell you how to think about what is happening. As a reporter, I appreciate both her insight and humility.”
Dean has authored three opinion pieces for the Washington Post and two for the New York Times and she uses her popular Twitter account (@nataliexdean) as another tool to help the public understand new COVID-19 information. Her Twitter followers numbered around 200 pre-pandemic and now total more than 80,000, at press time. Followers get to see Dean’s thought process as she considers possible limitations and hypotheses when new data are released.
“One of my goals with Twitter has been to help people learn more about biostatistics and infectious diseases and how to think like a scientist,” she said.
— Jill Pease
