Putting UF experts to the test
Vigorous testing efforts help researchers understand how the coronavirus spreads through vulnerable communities
F Health virologist John Lednicky was in seventh grade, living in the Philippines where his father worked, when he enjoyed a meal of a delicious bat stew. Fruit bat was a local delicacy.
Lednicky developed a severe viral respiratory infection, one that he never forgot. Was there a link between his illness and that bat?
“Maybe my illness was purely coincidental,” said Lednicky, PhD, a professor in the department of environmental and global health at the UF College of Public Health and Health Professions. “Was it a coronavirus? I have no idea. But that’s how I got interested in bats.”
That boyhood surprise blossomed into a career as a leading virologist whose interest in bats, in a sense, set him on a road to make an outsized impact during the current coronavirus crisis. Lednicky developed the coronavirus test that is used as part of a UF-led epidemiological public health study in a number of North Central Florida communities to better understand how the virus moves through populations.
That test, which was developed four years ago and has not yet received U.S. Food and Drug Administration approval, combined with UF Health in-house testing capabilities, allowed UF Health researchers, physicians and volunteers to team up with Florida Gov. Ron DeSantis and local and state health officials to offer COVID-19 testing in a variety of communities for residents at risk of severe illness.
The initiative, which tapped the resources of UF Health Pathology Laboratories and the UF Health Medical Lab, the UF Emerging Pathogens Institute, or EPI, and UF epidemiologists, began in late March with large-scale COVID-19 testing for residents of The Villages®, the nation’s largest retirement community, where 80% of residents are over age 65.
“We had seven days to design a program to screen 130,000 residents in The Villages®,” said Michael Lauzardo, MD ’91, deputy director of the EPI and an expert in infectious disease and global health.
He explained the screening was part clinical evaluation, part research study, performed at a polo field. Residents, most driving up in golf cars, were assessed for symptoms, travel and exposure history and tested if they met the clinical criteria. Others could take part in the UF research study to help determine the degree of asymptomatic viral shedding at the onset of a COVID-19 outbreak.
Michael Lauzardo, MD ’91, explains the testing process to UF staff and volunteers assisting with screening seniors in The Villages® for COVID-19 in March.
Photo by Louis Brems
“It was a matter of combining innovation with our experience in public health,” said Lauzardo, who has translated his expertise in the epidemiology of tuberculosis to COVID-19. “The concepts are the same. We created a process to provide medical services in untraditional conditions that were safe and medically valid.”
By mid-May, UF Health and partners from The Villages Health and state health and emergency management officials completed nearly 4,230 tests at The Villages® in what is considered one of the largest testing efforts of its kind in the nation. Overall just 1% of those people tested, or 48 cases, were positive for the coronavirus.
UF Health and the EPI organized a number of testing sites using similar protocols for a variety of vulnerable populations, including in downtown Jacksonville for people who are medically underserved and others who are over 65; at GRACE Marketplace, a homeless resource center serving Gainesville and Alachua County; and at several assisted living centers in Alachua County and surrounding counties. The group also set up testing for first responders and emergency department employees from throughout North Central Florida. And, in an effort to gain a better understanding of the role children play in community transmission of COVID-19, UF Health researchers teamed up with the UF College of Education to enroll more than 500 K-12 students from the P.K. Yonge Developmental Research School affiliated with UF.
Lauzardo hosts a training session for student volunteers at The Villages® community in March.
Photo by Louis Brems
UF Health, The Villages Health lead innovative coronavirus testing project in The Villages
As medical director for the majority of the testing initiatives, Lauzardo said he was most impressed with the students from the health profession colleges who volunteered to assist in the screenings that took place in March, April and May.
“We trained hundreds of mostly medical and PA students in various aspects of public health, including how to swab effectively and how to perform questionnaires and Institutional Review Board consents,” Lauzardo said. “Some are now learning contact tracing. There is nothing more encouraging than talking to medical students who have a genuine interest and enthusiasm for learning about public health and improving care for communities.
“This has been the most challenging experience of my career, and some of the most fulfilling days,” Lauzardo continued. “I have never been so energized by what I’m doing, and a lot of that is because of the medical students.”
By mid-May, the UF EPI test that Lednicky developed and tweaked based on the genetic code of the new coronavirus had been used to collect 5,735 samples from patients and study participants.
“I was happy when my test proved to be a good fit for the virus,” Lednicky said. “I’m a scientist. We’re always wanting to figure out if our work is helpful for things other than what it was designed for.”
Screen, Test & Protect
UF Health began a rigorous “Screen, Test & Protect” program in May to support the phased reopening of UF, an expansive data-driven effort that is allowing students, faculty and staff to return to campus as safely as possible while minimizing the risk of infection from the novel coronavirus.
“We are following public health principles that have long proved to be effective in mitigating the spread of infectious disease,” said David R. Nelson, MD, senior vice president for health affairs at UF and president of UF Health. “We are not helpless in the face of the coronavirus. We can begin to return to our classrooms and our offices and our laboratories. But we need to do so smartly and with an eye toward protecting the most vulnerable among us.”
UF Health infectious disease specialists point out that scientific evidence and modeling show new infections can be controlled and reduced to manageable levels by expanded testing and then quick isolation of those who are infected by the coronavirus.
“It is important to recognize that there isn’t a fire-breathing dragon in our front yard ready to devour us,” said Lauzardo, medical director of UF Health Screen, Test & Protect.
“Data are clearly showing, from a public health perspective, that we need not stay in total lockdown. Screen, Test & Protect will put the brakes on the inevitable spread of the virus.”
