Okay. Hi. Okay. Good afternoon everyone and welcome to this afternoon's event, COVID-19 vaccines and variance. My name is John Bosco and I have the honor of serving as the dean of the College of Arts and Sciences here at the University of Delaware. And I also have the great pleasure of serving as our moderator for today's event. This event hosted by the College of Arts and Sciences is a natural continuation of an event at the provost's office hosted in March of 2020, nearly a year ago. Now, there was a point at which we were all just starting to learn about the COVID-19 pandemic. Since then, we've said all certainly learned a lot more, but there's still much to learn and to understand about the pandemic and its impacts. And that's what today's event is all about. We have a slate of excellent speakers on our panel today will share their knowledge and their perspective and will share their insight. Some very important questions such as how vaccines make a difference in our everyday life? What mixture of vaccinations, masks, social distancing, quarantining, testing, and contact tracing. Do we need to adapt to cope with the pandemic successfully? And what the impacts of variance on the course of the pandemic. Panelists today will each share remarks, won't be taking your questions via the Q&A feature of this webinar. I encourage you to add your questions to the Q and a at anytime. Karen Rosenberg, one of this events organizers and a Professor of Anthropology here at Udi, will be moderating the question answer question answer box throughout will take to Q and a breaks this afternoon and we'll address the questions you submitted at that time. Our first panelists this afternoon is Dr. Carol, Retail, Director of the Delaware Division of Public Health. Dr. retail will give us an overview of Delaware is current response and status in regards to the COVID-19 pandemic. Welcome, Dr. retake. I now invite you to make some remarks. Thank you so much. It's a pleasure to be here with you today. A great pleasure to be with you here today. It's had the honor of being with you all at this time last year for the first two bands. And we have certainly learned and experienced an awful lot since that time. I think much more than we ever would have imagined. So I think this crisis has eclipsed any public health emergency response that we've ever been involved in as far as time magnitude, complexity and the loss of life is devastating. When we look at a regular flu season, we might lose 15 Delaware Aryans are worst flu season ever. We lost 38 Delaware Ian's at this points, 1, 0, 0, 0, and 482 Delaware Arians that we know I've have passed away due to COVID-19 and of course, many others had become ill and hospitalized. We don't know the impact of lung COVID yet. And so clearly this has been very devastating. We've had over 88 thousand cases, positive cases of COVID, report it to public health as of today. And tomorrow marks that one-year anniversary of us announcing our first case. And public health are our division as we've been doing things and our division some that we weren't ready for. Many things that I don't think we thought would ever be our job or that we would ever need to be doing. But we certainly learned and really expanded our capacity and our ability to do many things during this year. So during this whirlwind year, I want to touch base on some of the one of the, some of the highlights of what we have been doing. Contact tracing is a key function of public health. Normally we do it on a fairly small scale like with TB. But in May. And I should go back and just say early on after our first few cases, we almost lost our ability to contact trace early on when we had cases around the UD community, we had quickly about 3000 contacts. And it just as the cases went up quickly, we just didn't have the capacity to contact every case and find out who they're close contexts were who needed to be quarantined and to reach out to them. So in May of 2020, we brought on board a 100 National Guard to help us through while we were building a more permanent system, which is which was stood up at the end of June. The end of June, we in concert with NORC, which is out of University of Chicago. We started with a 100 contact tracers. Are At our highest points, we had 400 contact tracers. So contact tracing is an important piece of what we have been doing. Testing is a huge piece of what we've been doing. Our lab began testing. We were ready to test before our first cases, but we expanded tests testing greatly over time. May 14th was the first community testing an event, the curative event, which I think many of you were aware of. Stark campus thank you. Has been one of our regular testing sites. But with many partners, including our public health lab, which is essentially become a commercial lab. Over the past year. We have maintains one of the highest testing rates in the, in the country of which we're very proud of. And again, we want to thank you for your role in that. We also launched a COVID alert app, which is an exposure notification app which notifies individuals who are 18 years or older and had been in contact, close contact with somebody. As of last week, we had over a 100 thousand Delaware Aryans who had downloaded the COBIT alert DE, app. Again, we think UD big. We know that you've got a lot of students to download this app. So they could be notified if they were in close contact with someone. We have supported partners in many ways. We have delivered over 1.6 million pieces of personal protective equipment like masks and gowns and face shields. And we've had you call we have to call centers right now. We've received more than 91 thousand calls and have responded to over 63 thousand emails. Uh, we we normally inspect food establishments, but we've been inspecting many different types of establishments. We've had over 827 visits to a variety of businesses for COVID compliance and response to complaints. For example, let's say a bar, it wasn't enforced, a mask wearing, which was common. Early on. We also reviewed many different types of plans for gatherings, sporting events, safety plans for schools, including we've also worked very closely with our schools. We have a liaison to every school district in the state. We work with them. Epidemiologists work with them on school-related data and implementation of mitigation strategies. Most exciting is that we have some great vaccines, that we have some great vaccines now in the, in the States. They first arrived in mid-December, December 15th. That's another day. I don't think we'll ever forget. We're rolling out our vaccination and basis. Many of you, I'm sure aware of that. But phase one a was really for healthcare workers who very much needed protection. As our health care system was surging and many were sick. First responders, as well as people in long-term care, facilities, residents and staff. And we're already seeing just a tremendous decrease in cases in those facilities. We were very happy to roll into phase one be January 20th. We have been focusing on seniors 65 plus, with the goal of saving as many lives and preventing as much hospitalization as possible. We recently have announced more fully rolling out the rest of one B. We have been vaccinating K through 12 and childcare providers, poultry workers. We just started last week. Additional first responders, firefighters. But also we've got food manufacturers, a variety of others who are in the manufacturing industry, as well as postal workers. And of course, frontline individuals who are in-person in higher education like the University of Delaware and other colleges and universities. So we have now administered 700,272 thousand doses of the vaccine. As of yesterday, we've received about 360 thousand doses. So in the past couple of weeks, we've seen a significant increase in doses that have made it to the state, which we are extremely excited about. And we're really trying to build this infrastructure and push doses, push these vaccines through a variety of partners. Many of them are just getting started. A lot of different pharmacies, hospitals, health care providers, and, and others. And so we're really, really building the capacity of the system while we're continuing to do large-scale events. So we've done a number of events at DMV sites where we've been able to show in concert with many partners, how we can get many people through quickly. Want to give an enormous shout out to the Medical Reserve Corps, which is housed at the University of Delaware under the leadership of Dr. Bethany Hall, long, with thousands of volunteers. And without the volunteers, There's no way we could make these these activities work. Also, we've worked with the guard, the del dot folks have been critical as has of course Dima, hospitals and others. But we have curative sites just like we have the testing sites, we have some partners, vault and curative, who are helping us do vaccination at three del tech sites right now. And we have now our community health section is doing things like we go into senior high rises and we're working with community partners like churches. And Other community leaders to really help find the individuals who need vaccination. Partner them with a vaccination partner if it's not us and really help us address some of our vaccine equity concerns. You may know that we had a really large scale events that fema helped us with. Towards the end of February, we had over 13 second thousand dose is administered and an almost 3000 childcare providers and teachers, which really helps us make a dent in protecting our childcare provider workforce. So equity is a real issue, both with risk for COVID. So you can see here, the Latino or Hispanic population has the highest COVID rates. I think we know that among our poultry plants, we had a huge outbreak in April and May. That was very serious. We also have higher case rates among our Black and African American population. And as it comes to risk, we know that our older adults and those with chronic underlying conditions, especially diabetes and obesity, COPD, serious cardiovascular diseases and others. Put people at higher risk for the more serious consequences. Vaccine equity really is an important area of focus for us right now. These large vaccination events that we do are really great for getting lots of people vaccinated, but they're not good for equity. We really need to meet people, people from our black and brown communities, in their communities, in the places where they are leadership, for example, their church pastors or their community. The community service places. Our where they're trusted. Champions are getting vaccinated and really encouraging others to get vaccinated. And this is what we've really been focused on, really focused on the many barriers that may be in place for people, especially among our higher risk communities, to get vaccinated. And that includes considering the cultural considerations, making sure that that we have community partners, community leaders who are culturally speaking the same language and really understanding the communities that we're working with and what they want and what they need. Just this past week, we got the Johnson and Johnson vaccine, which we love. We had some events this past weekend. People were really, really excited about this vaccine. We don't have a lot of it in the state right now, but the demand is huge for Johnson and Johnson, and it's going to be a while before we have much in the state. Unfortunately. Just quickly, I just want to say we did adopt new CDC guidance this past week. It was released on Monday and we announced that we were going to adopt it on Tuesday, which is really for those who are fully vaccinated, meaning. You've had your second dose or for Johnson and Johnson, your first dose plus two weeks. You can in very small like residential settings. So not out in public but in small settings, be with others who are fully vaccinated or be with a single household. So like a grandparent could be with their grandchildren as long as there's no one at risk in that setting. Also, those who had been vaccinated no longer need to quarantine or have testing unless they have symptoms. But again, we just want to emphasize in public, especially businesses cell there in the community, many workplaces, long-term care hospitals, mass transportation is still need to wear a mask and social distance as much as possible. We're still strongly advising even for those who are vaccinated to avoid gatherings. So I want to close. I afraid I might have gone too long, but I want to make sure that you that you do keep an eye on our website. It is changing every day with new information, especially around vaccines. If you have vexing questions, you can e-mail them to vaccine, a Delaware.gov. And I thank you very much. Thank you, Karen. Thanks for that update and thanks for sharing your perspective on where we are today. And especially thanks for your leadership throughout this crisis. Our next panelists this afternoon as norm Wagner. Enormous the unit they'll Robert, it'll pick for cheer of Chemical and Biomolecular Engineering. Professor of Physics and Astronomy. Norman, his team have been working on combining aerial observations with artificial intelligence to understand how students are interacting with others on campus and in the surrounding community. Welcome, Norman will turn it over to you. Thank you John. I'm going to share my screen now. We'll play this will work the way I hope and share just a few slides with you, make this full screen. Okay. So thanks to also John and Karen for the opportunity to speak here today, Also, thanks to the previous speaker, Dr. rotates or getting us safe for making a safe. So this is an NSF funded project that is a part of the rapid response NSF and has the main goals of looking at some modelling which I'll show you tell, look in a different way than you're used to probably seg modeling I'm television. And using those bottling parameters to get parameters that can be used in the more traditional epidemiological models that you see. And then, as John mentioned, looking at direct observation for looking at how people are complying with OK, type ideas off on our local environment and developed an educational tool. So briefly the team, this is a collaboration between myself, any barriers in engineering and bricks and Minsky and Greg, Dominic and health sciences includes also a local company spin-off. Recent graduate about Soprano is company, which does AI. And then a very talented PhD students and undergrads and engineering, Alex or Robert and Tom and you'll see their work represented a year. There was a AUD you daily highlight about this just recently. So let me just show you what agent-based modeling is all about. I'm just show you a very sped-up version of the model. I'll skip to some points along the way. Campus map. We've got the classrooms, we've got people in class. We've got people going to the dining halls, we've got people going to the gym, to the library, off-campus activities. We've got a hospital and, and we put in some basic rules of medicine that are coming out of essentially the literature is to transmission rates. How long it takes to become infected, how long you remain infected? You can put quarantines on stay at home orders. And on the right you see the growth of, for example, the red line here, which is the exponential growth of the infection rate until there aren't enough people to infect anymore and it starts to drop off in the gray boxes that everyone's getting sick. And this is a case in which we're not following the rules. But this gives you an idea. We're putting in some basic ideas about human behavior and scheduling and getting information. So I'm just going to show you a few results that I think you might find interesting. We run this model thousands of times and collect statistically meaningful data. And I'll just show you a few of that and then I'll get to some of the surveillance. So for example, the way to read this model, this is a probability on the left 0 to a 100, we're looking at mass compliance. So if we don't wear a mask, basically everybody gets sick. The orange here, the red. The red correspond to people who recovered already, people who are currently infected and people are in the hospital. And as we add mass, more and more mass complies, the blue bars grow and the blue of course, are the people that are healthy. And so you need a bass compliance of about 80, 90 percent on campus if you want at the end of the semester, I should have mentioned that this is for what happens at the end of the simulation. Again, averaged over many simulations. If we have nobody infected at the beginning, nobody vaccinated were not social distancing, but we are wearing masks. And we have about 10 percent infection in the community. And about a third of our students are going off campus on the weekends to work or do other things. We need about like 80, 90 percent mass compliance. Here's what would happen now if we add the vaccine, we've just heard about the vaccine. So the gold bar here is the vaccine and our changing vaccination, we're going to assume that about two-thirds of the people are masking and our social distancing. And that's a number that you'll see from our surveillance is about reasonable, that people are going off campus and doing things that we haven't 10% community infection, which is the current rate. And if you want to get the number of people who were vaccinated are healthy at the end of the semester to be about 90 percent of the campus community, then you really need to get about 75 to 80 percent of the people vaccinated. And that's what's shown here. So again, the modeling can give you a sense that there's a pretty strong tipping point where we need to get a high level vaccination to get the kind of herd immunity that we're talking about. And we need to still have reasonable levels of compliance would protect the flock ideas. Finally, this is about the variant to the, we don't like to call them by the country of origin, that sort of punishing. But you know it as the UK variant paper that came out on the 5th of March recently. And science indicates that the best numbers we have are anywhere between 4390% increase transmissibility. There are other things that the UK variant does, but that's the main issue. So we can run the model with increased transmission factor. Again, if we assume that we had about 10 percent of people infected aren't campus and in the community we asked what happened 62 weeks, I'm sorry, two months into this semester. If we go from the normal variant, which is over here on the left, as we go to the right, we get the UK variant for about halfway out to about where the red arrow, as you see, we really have a problem where we're going to end up with many, many more infections, even if we have a reasonably good compliance with protect the flock. Again, there's no vaccinations in this graph. We can add that in and ask those questions. But you can see the issues with the variant here. Having a higher transmissibility really has a big damaging effect on our ability to keep people safe. Of course, over a two month period. You might find this interesting, this that was modeling, this is real data. This is our pathway, this is the Google Glass. We also use drones all with proper approval and are going around that Rick is taking and as students are taking data, right? With the Google glasses and then we're using AI and, and Humans and AI to analyze the video data. And we can determine what's going on. Are you wearing your mask? Are you wearing it properly or you're not wearing your mask? Are your social distancing. We have all of that information and I'll show you where to get that by the way, on our websites. And this is the fall. And the way to look at this plot is each bar is the non-compliant fraction. So we started out pretty good in the fall. We got 30, 40% of the people non-compliant. And then we started cracking down on wearing masks and social distancing. And compliance got better and blue starts to drop down. Plotted on the right here are from the University of Delaware as Dashboard the number of cases each week. And you see a remarkable agreement. I won't call it, I won't argue for causality here. There's certainly some level of, of connection between at least coincidence, if you will, between our ability to obey the rules and protect the Fock rules and the number of people reporting to be ill. If we look at the spring, we have three weeks worth of data for the spring, things are not going the way we would like at the moment. We're starting to see the spring or the red bars. The blue is the same data you saw before. And you see where now we're starting to see fewer, less compliance with the terms of mask wearing hats, physical distancing not being followed. And we see horrifically large case rate at the university compared to the spring. And it does look like it's going down at the moment. So we need to do our job. We have a dashboard which allows you to look at all of this data and plot it in a zillion different ways and with an interactive map. And that's on our website, that's always listed on the slides. And then you get all sorts of, take a look at interesting things. Men versus women. People that are at high risk, obesity, smokers, things like that are all in the database there. So I'll just reiterate what the previous speaker said. Really pay attention to the rules. They make a huge difference. And I think what you can argue is that the policy matters with that. So John, with that, I will stop sharing and thank you for the opportunity to present our work and people can go to this website down here on the left if you're interested. And get more information about walker, Darren. Thanks. Thank you. Thank you for sharing that work. Our next speaker today is Calvin cure. Calvin is currently the Interim Dean of the College of Agriculture and Natural Resources. Calvin's an expert on if you're in genomics, molecular, molecular immunology, and respiratory viruses, a paltry Birds. Thank you for being here today and welcome. I get APL esco. So the news media is really saturated with references to COVID-19 variance. And I'd like to take just a few minutes to describe what variants actually are at the biological characteristics. So we don't need any reminder that COVID-19 is a coronavirus. We've all seen the pictures of a spherical object studied with spikes. And those spikes give the particle the appearance of a crown, that's the main coronavirus. And these spikes are our proteins called, Fortunately for a spike proteins of the S protein. And inside that sphere is the COVID-19 genome. And it's about 30000 nucleotides long, composed of four nucleotides, cytosine, adenine, guanine in yourself. And think about this genome has two purposes. First, it contains information are the genes that direct the cell it infects to synthesize more viral proteins, which the virus needs to make more virus particles. And one of these genes directs the synthesis of that S or spike protein. And actually that gene is actually composes 13 percent of the genome. It's over 3800 nucleotides long. And the protein that gene encodes is over 1200 amino acids long, 1273 to be exact. And that S protein, that spike protein on the surface is really important. That's the protein that binds to receptors found on the surface of human cells. And that's how the virus actually attaches itself and starts the infectious process. And also these proteins are on the surface of the virus particle. And so that's the protein that's most exposed to the human environment. And that's the protein that are primary protein that our bodies, human immune system responds to. An animal such as us, humans or jelly really good at recognizing things that are foreign, structures that aren't human. One way we respond to COVID-19 this by producing antibodies that recognize the S protein and neutralize the by the virus. So if an antibody sticks to that spike protein on the surface of that virus, then that protein is covered up and then it can't stick to a cell. And remember that's why it takes 10 to 14 days for a body to respond to the virus by making these antibodies. And that's so wide. Technically, if you get a vaccine today, you could still have to be careful because you didn't get sick if you get exposed to COVID-19 immediately after you see that vaccine. The second purpose of that RNA genome is to make more of itself, to make more copies of the RNA genome, to assemble the virus. And our genomes replicate. Sometimes mistakes happen. The human genome, which is composed of DNA, makes very, very few mistakes. But RNA replication results in much higher error rates. Basically the enzyme that copies RNA is more prone to making mistakes. Now some viruses like COVID-19 do have a proofreading enzyme that helps fix those errors. But even so, coronaviruses accumulate one to two mutations or errors a month in their genome. In pay this, the influenza virus that accumulates up the four mutations per month. So as a result at this variability in these areas and replication, if you compare any two COVID-19 genomes, on average, 10 out of there 30000 nucleotides to be different. And as of now there have been hundreds of thousands of COVID-19 genomes that had been sequenced. And over 12 thousand different changes or individual mutations or variants have been identified. And scientists can track the spread and evolution of the virus by tracking these mutations, as we'll learn from later speakers this afternoon. But these base changes or mutations can have different effects on the virus. Some of these mutations may actually slow down the virus and make it less virulent. And that's actually what happened with the previous coronavirus infection, the sars virus. Some mutations have no effect on the virus and other mutations may help the back so the virus spread faster or evade immune response, giving it an advantage. So let's go back to the spike protein. This is why I want to get back to the concept, the variance. So some of these mutations are caused variance of the virus that allow the S protein to bind better to host cells, okay? And some variance may actually make the virus less susceptible to our antibodies. So the virus structure changes so the antibodies aren't as effective at recognizing it. So we can talk about a specific variant as an example and talk about that. The United Kingdom variant B 11, 7. And this variant actually came to the United States in December. And there are now 2600 confirmed cases and 47 states in Puerto Rico. And it's about to become the dominant virus found in the United States. And this bi, variate, the strain actually has 17 different mutations and eight of those, 47 percent of them are in the S gene. We can talk about one of them and you might hear a different nomenclature, B1 17, or you might hear a combination of letters and numbers, in this case with a robot and Bible one. Why? What does that mean? Well, it means that the I, I advise a sequence. We know that an asparagine and amino acid 501, remember this protein is over 1200 amino acids. Well, the amino acid 501 has been changed to a tyrosine, which is a y. Okay? And this particular mutation isn't a pilot put in a binds to the host receptor. It actually increases the ability to bind to that receptor. And why we see that the turkey percent increase infectivity of this virus and there isn't done mutation amino acids synchronized. Similarly, that helps this variant evade the immune response. There are other comment variance is a South African be 151, it's a Brazilian variant P1. And yes, there are other us Variance going to give you a flavor for a specific variant and what it consists of. But we have good news, right? All three of the licensed vaccines are really effective at preventing hospitalizations and deaths from these and other variance. Note, I didn't say that these vaccines prevented infection. The jury is still out. But I think most scientists have come to recognize it's very likely that although the vaccines can significantly reduce, they do not eliminate viral replication and shedding. And so this is why should still wear a mask after being vaccinated. You might feel fine. You might be highly protected, but you could still infect somebody else. Secondly, if needed, it will be relatively easy to auto create vaccines and get them approved for use, is what we do annually for the flu vaccines. And lastly, it's becoming more prey that COVID-19 will most likely become less lethal over time. It actually only a limited number of news that would be useful to the virus to make it more pathogenic. Basically, it has limited options for getting worse. And it went through, is that our common cold started out this way and it is actually caused by a coronavirus. Thank you very much. Thank you for sharing your expertise with us here today. Next up is Esther Biswas, this Chairperson of the Department of Medical molecular sciences in the College of Health Sciences, has to investigate the consequences of genetic variation on structure and function of proteins and their role in human health and disease. Welcome, Esther. Thank you very much and I must say I really have enjoyed the talks that have come by so far today. And Dr. killers talk really sets us up for the next phase of our discussion. And that is the effects of sars CoV-2 variance on diagnostic testing with or without slides, I could see the pictures in my mind of what is meant by variance of Coby too. So when we talk about variance, they really do affect diagnostic testing. And in fact, that is what our area of expertise is here. In the Department of Medical and molecular sciences. Our academic programs train individuals to work in the clinical diagnostic laboratories that perform COVID-19 diagnostic testing. They work in hospitals, public health laboratories and commercial laboratories such as lab core inquest that some of you may already be familiar with. So let's talk about diagnostic testing. How could these variants affect our ability to test? And in fact, when we talk about variance, one of the consequences that has been raised about the variance is will they affect our ability to detect the presence of the virus? Well, in point of fact, is if one thinks about diagnostic lab processes and procedures, the diagnostic tests that scientists develop to two. Detect the presence of these diseases are made with viral evolution in mind. As was said in our previous talk. In RNA viruses, it's expected that the virus will mutate over time. And so when we develop tests, we want them to be sensitive and to be able to still detect these variance. I want them to be specific. And point of fact, the diagnostic tests that have been developed do have the flexibility to allow for variance within the COBIT 19 genome, as well as to be able to distinguish them from other coronaviruses, such as the common cold. Scientists and those that are in the field of laboratory medicine did anticipate that these things would happen and there is ongoing surveillance at many levels. The Center for Disease Control in the United States is actively sequencing variance as they come across. As is the College of American Pathologists. The College of American pathologists in fact, provides sample specimens that other laboratories can use to determine whether or not their tests will pick up these variance. So this is a process. Proficiency testing to detect these variance is a process that is a matter of routine course for diagnostic laboratories. We are constantly working to determine whether or not our chests are still sensitive and specific. And this is why it's important for laboratory testing to be credentialed and certified. In addition, the commercial laboratories that design and develop the diagnostic tests. They too are interested in assuring that their diagnostic tests will be sensitive and specific. And so they are also conducting ongoing surveillance. And that surveillance entails the sequencing of the genome of these various variance as they come across them. Now we know that there are several different types of diagnostic testing. There's the gold standard molecular diagnostics approach that uses the real-time PCR. Now, we mentioned earlier that many of the variants that occur in COVID-19 take place in the gene that codes for the protein. Most importantly, our diagnostic tests that use molecular approaches use what we refer to as a multiplex approach. We don't target only the S protein in our diagnostic tests, we target other genes within the viral genome of COVID-19. So if there is a variation in the S protein, it's unlikely that it will affect the ability of the assay to still remain sensitive. And specific. Other types of assays involve antigens of the virus, detecting the presence of androgens of the virus, or serological tests that detect the presence of antibodies in the patient. And neither of these types of testing are likely to be influenced by the variance that we are seeing in the population. Now this slide is a busy slide and it sort of gives a pictorial representation of the viral genome. So this long bar that you see across here are the different genes that comprise the COVID-19 virus. So on the purple bar is the or F1 gene. The blue bar is the spike protein or the S gene. And then we have some other genes that are to the right of the spike gene. And these small little rectangles here up on top represent all the different new nucleotide substitutions that give rise to these variance. There are different genetic changes that happen within the virus and you can see they occur throughout the genome of the virus. Some were talking about the United Kingdom variant, or we're talking about the South African variant or the Brazilian variant. And you probably won't be able to see this, but there are triangles and squares and circles throughout this diagram. And they correspond to the different changes at the DNA level that are observed in the different variance. But what you can see or can't, or at least I'll explain it to you, is that these different genetic changes, or the multitude of genetic changes that occur characteristic of a particular variant. So there are certain very genetic changes that occurred in the United Kingdom virus. There are certain changes their associated with the Brazilian variant. And then there are certain changes that were associated with the South African variant. But again, because they're not in the tess targets such broads spaces on the viral genome. When we're talking about the molecular diagnostic testing, that it is unlikely that the tests that we have will be affected by this. But we can rest assured that the laboratories that are producing these tests and conducting these tests are continuously checking on that possibility, continuously surveilling and reassessing and validating their assays. And then just to give you a flavor of how many different diagnostic tests that are out there for detecting the virus. At the bottom of this slide and it's not possible for you to read it. But there are just literally nearly a 100 different assays, diagnostic assays that are out there produced by different commercial suppliers that are there to detect on the COVID-19 virus. So a very broad spectrum of diagnostic tests. Some of these have received emergency use authorization and some of them have actually received FDA approval. So we will continue to be able to effectively use diagnostic testing for detecting the presence of the COVID-19 virus and its many variant forms. And we will continue to be able to conduct neurological an antigen base testing to aid in the understanding of how immunity is spreading for public health purposes now and in the future. And that concludes my presentation. Thank you. Excellent. Thank you very much. Yes, sir. Okay. So we still have several more panels to hear from today. But what we're going to do now is we're going to take our first break for question and answer period. I'm going to turn things over to Karen Rosenberg, who's going to have some other panelists address some of the questions that have been raised so far. Okay. Thank you, John. And thank you to all the speakers. We've had a whole bunch of questions coming in. I'm trying to sort of put them together into groups. I'm so first it some questions for Dr. attain. One question questionnaire asks, you may have seen the letter to the editor in the news journal today saying that you should be doing more to get employees vaccinated. And this person asks on what the state's plans are to coordinate an employee vaccination event with you d. And at the same time, someone else is asking the question about whether university faculty are part of educators in the group. And one B. Thank you, Karen, a really great question, and I'm glad that question came up because it's definitely a hot topic right now. So as we look at where we are right now, and one, B, Educators, front-line educators who are in staff. So people in colleges and universities who work either closely with other people, it could be custodial food service. Certainly professors who are teaching face to face with other who are, who are on campus now teaching. Those are at the top of the list of people who are in the 1D category. As far as when we think about colleges and universities. However, we do have kind of a sequence with how we're, we're rolling out access to the vaccine, to the 14 when B workforce one, b is a huge group for us. About 250 to maybe 300 thousand individuals are in this, in this group. So we've had to take an orderly approach. And we we did start with childcare and K through 12 or vaccinating correctional officers, poultry, law enforcement, police officers, firefighters. But also those who are at really high risk. Poultry, food manufacturing, agriculture like migrant farm workers, grocery store workers are at high risk. You think about the checkout clerks, those in mass transit. So as we're rolling this out in order, those who are frontline in-person colleges and universities should be starting vaccination next week, wearing contacts with the colleges and universities in the state. And there is. A plan that has been started and is really getting some more details to it. So you will see some vaccine opportunities. I know at the University of Delaware, there has been a partnership forms with a pharmacy to help assist with vaccination. So that is, that is coming soon. But I do think it's important. Again to emphasize that it's a large group of people who are faculty at the University of Delaware. So you'd, we can't expect everyone to get vaccinated at this time. It's really those who are at the highest risk who are exposed. Okay. Thank you. Just to follow up with one more question for you. One person asked. Tomorrow marks the one-year anniversary since Delaware announced its first case, on which was an AUD faculty member, they say that hindsight is 2020. Full joke there. What, if anything, do you think the state would do differently having gone through the experience that we went through over the last year? Oh, my goodness. That is a really great question. I mean, honestly, if I could rewind it out to a decade ago, there's that's where I wish there were some things I had done differently. We were we're really weak and epidemiology in the Division of Public Health. I wish that's over a decade ago, I would have begged the University of Delaware to start an epidemiology training program, but I'm so grateful that it has started now and your students have been extremely helpful to us. Our data infrastructure, specifically for our lab recording, was really an antiquated system. And that was just about to be modernized by the pandemic really hit us when the system, it really wasn't ready for the quantity of labs that we that we needed to take on. It crashed multiple times. Not in a complete crash way, but it has been, I think one of the most stressful aspects of our of our response. You know, I mean, I just think that there have been a lot of lessons learned along the way, if I wish I had known anything right at the time of the first case, I wish I had known how common asymptomatic spread was going to be because that really was a complete game changer for us. I mean, we didn't think masks were necessary because just look for symptomatic people. It's the symptomatic people, right, that are spreading it, not with this infection. So again, a lot of lessons learned along this journey. I do feel that we're all in a, in a certainly a better place in it. And I can say for our division, we don't ever want to go through this again, but the reality is we probably will and we are in a better place now to be able to handle. This kind of response certainly than we were a year ago. Thanks. I'll just ask you one more question at the moment, which is, are there any plans to vaccinate students before they go back home? Somebody referred to them as super-spreaders. You yeah. So students would be considered one see if they live in group homes or if they live in dormitories, which I'm assuming most of your students, either living group homes or dormitories. And I think they usually go home and early May. So my hope is that we would have adequate vaccine for for, for students. You know, some, some time, maybe in the latter part of April. I know it is hard to know, but that certainly would be great if we're able to do that. Thank you. Thank you very much. A couple of questions for norm. A couple of people were asking about whether certain things were included in your model. One person asked whether the behavior that we see among students, spending time socializing in bars without wearing masks is incorporated into your model. Someone else asked whether asked about hospitalization, saying that your model didn't show much about that. So could you, right, Thanks, thanks for those great questions. And the model that I showed you is sort of what I would call a, sort of a toy model. It at all only a couple of 100 students in it, allowing us to run cases quickly. And it had some idealizations about student behavior, but we did include, for example, contact with the community. And that would be things like going to bars, going out into the environment. And we did include the prevailing sort of number four, the infection rate in that community. In that, we have a much more sophisticated model that requires supercomputing resources that's being developed by Soham as part of his PhD thesis that has actual, what's called social forces in it and everything that includes a lot more detail. And we're also integrating some of that surveillance data on a more real-time basis. That model that I showed you is sort of set it up and let it run and say, Well, what's going to happen over the course of the semester. So we're working on that, but that's, that's orders of magnitude. More effort to get that kind of level of model up and running. But we're working on it and we hope to have that around. And that can allow us to study some more of these nuanced behaviors. Right now, we have hospitalizations fairly low given the age group that we're talking about on campus be largely very young people. But we do account for that as best we can using the best information that's available in the literature as inputs to the model. So these are great questions and we're always open to help. Someone's got ideas or would like to pick it up. All that modelling is on the web. You can download it and play with it. What compliance issues do you think are most critical for AUD rate as this is this is a really excellent question. And what we're finding now from the surveillance, which then is backed up by the modeling, is wear your mask and social distance. And these things really matter. We have not put in the model large gatherings indoors or a theme because we're assuming that people are obeying the rules, right? What the current state guidelines in City of New York guidelines are. Obviously if we had other large events and things, but lots of people indoors that that would create other issues. That would be H FAQ related issues and internal airflow in buildings that we have some of that in a more sophisticated model where we look into some of those aspects. It matters whether you have a classroom with good ventilation or not, write these things batter. Okay. So all of that is higher level type of effort and not in what I showed you, but these irrelevant, but the basic ideas make an enormous difference. It however, we need to get those compliance rates are pretty high. Yeah. Okay. Just one last question. I think someone raised a little concerned about the drone surveillance and asked if he would talk about guidelines of a family. Right. So that's great. And are my colleagues, Rick and Greg, you have an IRB that's been approved by the campus. And we're following all the guidelines, FAA guidelines, et cetera. We went through all the university level approvals including campus safety as well as IRB. So by the way that that team, rick and Greg had been using that surveillance to study health in more general ways. And that's what we were able to leverage, leverage that expertise very rapidly for that and you could find out more information about that on our website, which is the UT COVID model website that you can access. That's great question. Thank you very much, Calvin. So I have one question about variance. So I appreciate what Norm said about referring to the variance by the company name, but I'll do that anyway because that was the question on why are we talking so much about the UK and Brazil variance? What about us variance? That's an interesting question. The, the, the basic reason is that the US is much slower in getting to the sequencing of eye slits that had been collecting United States. So Great Britain has been very aggressive at that. And I think it's up to 10 to 50 percent of their isolates have been sequenced. And we're just starting to get caught up in the US and sequencing. So as you might expect, there are US variance, there's one from B York, is one from California. So maybe we should be careful not named states either. And, but, but the commonality is that many of the same mutations like the one I talked about, the variance, you say the same common events happening in variance as they arrive, as they arise across the world in different states. Thank you. Esther. The World Health Organization says that PCR is not good enough for diagnosis. And someone asked if you could explain why. Well, if it's the World Health Organization, I think that sometimes we don't and don't really think about emerging economies. Molecular diagnostic testing requires a lot of sophisticated instrumentation and laboratory infrastructure that may not be available in countries that do not have the level of facilities that we have here in the United States or Western Europe, for example. So I think it is something that's an emerging and pressing need that should be addressed globally. In how do we provide diagnostic testing to those many places on the globe that don't have access to the sophisticated laboratory testing facilities that we enjoy here in the United States. Thank you. I'm going to turn things back to John to introduce the next speaker. I could care. Thank you, everybody for all your questions. Please continue to add questions to the Q&A. We'll do a second round of Q and a just a little bit later, going to turn now to Eric Womack. Eric is Deputy Dean in the College of Agriculture and Natural Resources. It's a professor in the College. I'm also a Professor of Biological Sciences. Eric recently launched the Center for Environmental and wastewater based epidemiological research. Centers efforts include testing wastewater samples to understand the prevalence of COVID-19 and New Castle County and on the UT campus. Welcome, Eric. Great, John. Thank you so much. And thank you to Karen. And thank you to Karen and John for John, Joan for organizing this. It's a great pleasure to speak with you. I really need to give actually great credit to Kaling Neal, who actually came up with the acronym for sure. And all of this runs out of her laboratory. And so we've worked together jointly on this effort. So in around about July, New Castle County approached approached us and had been contracting with a company out of the Massachusetts Institute of Technology, MIT to actually taste, test wastewater samples from the county from 14 different wastewater treatment plants for the presence of COVID-19. And it, it turns out interestingly that the virus is shed in feces, even though it really isn't, it is a respiratory virus for the most part. However, asymptomatic individuals or pre-symptomatic individuals actually shed virus at fairly high levels. And so it turns out that wastewater is the most leading of leading indicators of infection within a community. And so New Castle County was very interested in knowing where the where the infection was moving throughout the county. And they like I said, they had contact with MIT. Then the price went way up and so they came to us. And so Cali was able to get the the analysis up and running in her lab. And then a PhD student, Brianna Anderson. The term things on a dime and, and managed to get the assay up and working using the bio bought by about protocol that we had been given from MIT. And so I'd like to share the, the steward website. So as I mentioned, we had been we had been sampling New Castle County for some time since July and then around about October, we were able to start sampling actually on campus. And so this picture here, which is the Center for Environmental and wastewater epidemiological research, which was literally founded off to to conduct these analyses and will be an ongoing effort in the College of Agriculture and Natural Resources. And so this picture shows an actual sample of sewage coming out of one of the UD dorm. Down here at the bottom of my pointer can be seen, but there is the, the, uh, device for actually drawing the wastewater out of the sewer. We're working here with Kate, who was from the field and Associates, which is a Civil Environmental Engineering firm that that we've been working with as well. And this is taking notes. And so this website, which I can share in the chat, tell us more about the activities that we've been doing in sampling wastewater and campus. And here you can actually see, I think this is a location it at independence West where we actually have the the peristaltic pump sampling sewage round the clock with 24 hour composited samples. So these samples are actually tested using the exact same diagnostic tests that is used when we test for, for COVID and a person. So it is the quantitative PCR assay that Esther mentioned. We're actually moving to even a new platform called digital PCR. We will be doing that very soon. We, we've been monitoring campus since October, but really the pace of monitoring has is it has grown. And so right now we're monitoring twice weekly at seven locations on campus. And we have actually seen rises and falls in the presence of COVID that actually pre-seed the diagnostic numbers that we're getting out of testing on campus. So I'm, I am an environmental virologist. And so I've always had an interest in viruses in the environment. And so COVID is now a virus in our environment. And I think it's important. Just general procedure generally for everyone to know that viruses do not mutate if they don't replicate, Right? The only time that a virus can actually have its genome change, like, like Dr. Cooler was talking about, is when it's actually making new copies of the genome once the virus. Out of the cell, that's done. There's no more change to the genome. And so they think the critical point is if we can slow down the infection rate, we slow down the replication rate, which slows down the emergence of new variance. So that's why many of these, many of these public health protocols, like we've all been talking about, mask wearing and social distancing, which reduce the infection rate, will reduce the rate at which the virus replicates. And, and so, I think another interesting point is, you can't help but think about Charles Darwin as a, as a biologist, we think about Darwin often. And, and so what Darwin taught us is, is that mutations happen and the environment selects. And so what's happening with these variance is they randomly appear as, as has been talked about before. And sometimes they're actually a little bit better at doing something. And that, that pressure to essentially replicate is, is what we, as biologists call a selective pressure. And so literally, these variants arise all the time, every time the virus replicates. And there's a selective pressure for that virus to become more effective. And his doctor Keeler also mentioned, it's not in the interest of the virus to kill off its host. In fact, viruses do tend to be calm, less virulent, meaning they actually do less damage, but they may become more effective. So that's what at least we're, we're, we're hoping for. Because selection wants the virus to replicate but not kill off its host. So That's all I'll say and, and pass the baton to the next speaker. And and I greatly appreciate the opportunity. Thank you. Thank you, Eric. Fascinating work up. Next is John junk because Professor of Biological Sciences and Mathematical Sciences. And he's one of this events organizers. Jhanas research interests and Mathematical Biology, graph theory, molecular evolution, image analysis, and just interdisciplinary work with artist. He's going to provide an evolutionary perspective on the pandemic. John. Thanks, John. Wouldn't have second here to share my screen. Sorry. Sorry, 1 second. I think it's going to work. Yes. Good job. Thanks. Many of the issues that I wanted to deal with have already come up. And so, in terms of organizing, the essay, bears to actually volunteer to be one of the speakers, but this is related to my own lab and our work as well. And so, you know, Professor Keeler and Professor been lost have already raised many of these things. And Professor Womack anticipated my results, my comments about Darwin. But there's seven questions. Want to briefly talk on what our viral variants that's already been addressed. How did they arise by mutation and when the virus is replicating, but they also can recombine that. Where did they come from? A little bit about evolutionary trees had been raised, but we'll actually look at them. This really affects what we can do in terms of contact tracing. And I design of vaccines. The other three questions and Professor Womack address this, that natural selection and migration to evolutionary forces are going on in terms of the frequency of these mutations and viruses by variance. And that particularly we're looking at the impact of variance in terms of infectivity and lethality. And what's the implications for new vaccines as well. So when we look at doing molecular epidemiology that simply want to introduce that here at the bottom. That those of us who build the evolutionary trees, phylogenetics are part of this community of interdisciplinary work. And so in terms of giving some kind of spectrum, is that obviously there's the clinical and public health things that you've heard about. Doing the clinical pathology is crucially important. Collecting the swabs and some of you've had and then isolating the DNA, RNA and amplifying that sequencing it, et cetera. Professor Wagner talking about modeling in terms of doing it. Other areas dealing with the graph theoretic networks and the databases. And here down in red that I want to focus quickly on phylogenetics. So this is part of that change and the public to be aware that evolution here is a crucial tool in doing this kind of work. And so that we really, the National Center for Science Education has to deal with to it. We're dealing with this era of false facts and so on. Is that evolution is happening all the time and it's not risk responding in terms of the needs, her efforts of individuals, but it's occurring ubiquitously. And with that evolutionary tree, we address three kinds of questions. Both though, who's related to whom? When did things occur? Where did they occur? And briefly show those three. So we start with the sequences and we build trees, and then we test the trees and we tried it in drawing inferences from them. So as already has been indicated with the professor talked about that it's 29,903 nucleotides long. There's four different bases. They can go in it. So raised to that. But roughly 30000 power, it's obviously much greater than the human population. So almost every one of us just kidding around unique variance once infected. And it's the spike protein here that has been a considerable interest in both the building the vaccines and understanding the evolution. So a classic statement by a famous, by biologists, the chance key was nothing in biology makes any sense except in light of evolution. But I, David hilus restated at everything in biology makes more sense in light of phylogeny. So I, at the Max Planck Institute as well as at CDC and elsewhere, collecting all of these sequences. And so these are available in a public database. And it's just, you can think of it as like sentences of a very boring by KVL area of just four letters. And what we do is then align them and then try to figure out how to build a tree. Take the kind of mutations that occur are substitutions, deletions, insertions, and we try to detect as what are the colored bars down below? What are the synapomorphies that what occurred where on a tree. And then we build a phylogenetic tree. And this one's colored by various areas, Africa, Asia, Central America, Europe, North America, etc, kind of thing. And use various software and mathematics to construct these kinds of things. And so one of the earliest things twisted, figure out where did the COVID virus come from? And the general consensus is it came from bats rather than from pangolins. And that we can detect that. And so at the base of the tree, the human viruses were evolutionarily closely related to that fibrosis and here colored by various kinds of regions. And so I'm kind of thing. And one of the questions you ask is how many vaccines do you need that for distinctly different variants and so on. And as these things continue to evolve. And so we test the USA mathematically to see whether there's really differences in them. And we also build what are called phylogenetic networks. Stash how tree ideas, our data editing. And we looked at their level of evolutionary conservation. So this spike protein. And what are they? Again, Professor Womack talked about fitness and so we're trying to look at what's evolutionarily conserved, what's varying, and whether it's really affecting the portion of the spike protein that's interacting with the receptors on human cells. We can also look at where things have come. And so we literally do these kind of network graphs of where various variants are spreading and how rapidly they're spreading and so on, kind of thing around the world. And simply by ending, want to share that. You can go to our website from art by of course curriculum Consortium for the last 35 years where we've done a lot of this project called bedrock bioinformatics education dissemination, reaching out, connecting and knitting together. We have a problem space that to students in my evolutionary genetics recently built this Maggie breaker, never fired in Embry student to hijack code did some preliminary work. But you should also be aware that, that Professor Wu, who's the director variadic Data Science Institute, as for a long time done the protein interact information resource, which is really an incredible resource for doing a lot with this. But we also put educational modules up for COVID, modelling and SIR and so on. So simply to conclude, the importance of using evolution isn't that mathematics is crucial in terms of the public conversation to understand the role of modelling the albums with problem, probability and understanding and how evolution really contributes. So thank you all very much. I appreciate this opportunity. Thank you, John. Next, I want to welcome you, these director of epidemiology, Jennifer 40. Jennifer has certainly been one of the most quoted UD experts during throughout this entire pandemic. Dr. Hardy's research focuses on the impacts of natural disasters on public health, as well as linkages between disaster planning and the actions communities and individuals take to prepare, respond, and recover. Welcome, Jennifer. Thank you. I wrote me a painting that you never hear an academic and you don't have five, but what are you going on that I would pay that. I can flip it the doctor every day presentation and they did. So some of the things that I'm sharing, you're very similar to the information that she shared. I wanted to start out with the focus on vaccination and vaccination coverage. So nationally you can see here the most recent data as of yesterday from the national picture. We've heard about them stunning successes in places like Alaska where you have to take a broad flat and by plane and everything out to get native community, to get those people vaccinated. And then you can always refer to our local data. Healthy community dashboard or Delaware has remained among the top dates in terms of utilizing the back theme that we've received rapidly and not keeping a lot of doses on hand at a time. So why do I know that many people are impatient for their turn to come, for their vaccine. The crowd is getting factor every day. We're getting more depth with all the time. And so I think this is all the trends are in the right direction on that. The other point I wanted to make, which also occurs with Dr. repay said is that and we thought in the data related to COVID cases, hospitalizations and deaths, we began the back Coronation rule out being tremendous inequity among the people who were getting vaccinated for COVID vaccine early on. And I like to follow on regular basis the Kaufmann Family Foundation website, which looks at each state and compare the proportion of their population that is black and Hispanic to the percent of vaccinations as well as the percent in most cases, deaths and in total population. And so that is something that I know the high priority for the Division of Public Health and for the state and for the nation to really be able to reach people who are at higher risk of infection, hospitalization and death from COVID. As well as to reach people who are in the kind of essential workforce that are predominantly minority like in our poultry plants. And so I'm really excited to see if moving towards that faith and in vaccination. And they think it has multiple benefits for a population itself. And the last thing I wanted share a couple of thoughts about what comes next. I hit continue to Thursday recently I'm cautiously optimistic and I, I am we had a new vaccine approved, the Jansen, Johnson and Johnson vaccine, a single dose, 100% effective at preventing hospitalization or death. And so I do think it's important to remember what the end point of the clinical trials were. And enter the endpoint were severe infection, hospitalization or death. They weren't necessarily trying to prevent you testing positive for COVID. They're trying to prevent you from becoming sick and needing to use hospital resources from a COVID infection. And so I think this new vaccine being a single dose that doesn't require the types of extreme refrigeration that the earlier vaccines that really simplifies the logistics piece of that for public health in, gives us a lot of opportunity to address the inequities by being able to have a single dose vaccine. The data that are coming out over the past maybe six weeks or so are trending positive as well. Though we're getting more and more data from the early, from the trial, from the early vaccinations, from people who have them. Infected with COVID and then subsequently been vaccinated with one dose, which provide really strong protection to people who've already had a natural antibody or the child, or children age 12, thousand key are fully enrolled right now and proceeding. I'm Philip, We think it out getting or herd immunity. It's really important that we think about how we can cover younger members of our population. And the last thing is I think that we don't fully understand yet how the vaccine prevent spread. Though again, we don't expect that the back pain provide sterilizing immunity. You make that positive, but hopefully not with an infectious them out. And that's why we're being asked to continue to wear map, wash hands and maintain physical death. And although it is the thing that we did eat eagerly, new guidance on vaccinated people gathering, again in small family group. And so I think that's a critical piece of improving the mental health app that particularly for the elderly, had been though isolated over the path. Now here, the 12-month. So I included my contact information here and I do want to let your members of the UT community and the end in other that i'm I'm always happy to answer your question there. Point e2 reported to the CDC website or BPH. And though I am more than happy for people to reach out to me directly for that. Thank you very much for the opportunity. Thank you, Jennifer. As always, we appreciate you being incredibly willing to share your expertise. Or final panelists this afternoon is Carolyn. He is the director of our nurse managed health care center. Cows, family nurse practitioner with many years of primary care emergency department experience. Preachers theories include chronic care management 2, diabetes, hypertension, hyperlipidemia, women's health, health promotion, and acute care management. Welcome. Tell you everyone, Can you hear me okay? I guess the benefit of being the last speaker is that so much fantastic information has been shared already. I think I'd like to focus really more OMB health-care perspective of this past year and some anecdotal kind of observations from being a a frontline providers since all of this started last March. I really appreciate being included today. The the front line has been a very quickly evolving and rapidly changing environment. From telehealth too. Information from the CDC on everything from how many masks to wear, how far the distance, how long to quarantine, guidance on chronic diseases. And of course, as the year has evolved, we've seen things change even in terms of long-term effects. And of course now the variance, the variance strains are out. That the biggest takeaways hopefully that everyone has learned from, from this really educational opportunity is masks and distancing work. Whether it's within, you know, not having gatherings in your home, everyone's not vaccinated yet. It's still not a good idea. Being very careful where you go out in public. And of course the gatherings are the, are the big contributors to this, to the spread of COVID. These are the things that we've had and we've been on campus since June, since we're in healthcare. We've had on nursing students with awesome with my patients in person. We have not had any exposures or issues within our small subset of area. And of course, we're not full density in the building either. By following the guidelines works steep, get vaccinated when you're eligible, stay educated with all the offerings the state has here our emails. I there's there are so many opportunities within state and now with the Johnson and Johnson vaccine being distributed soon a one and done of the highly effective really going to open the floodgates for availability. So be, be educated on when you're eligible and sign up and get the vaccine. Within my role in the past year. I mentioned witnessing firsthand are so many changes. We're still seeing patients via telehealth, which again last year really wasn't even an option. The payers of the major insurance companies are still covering that. We hope that that's here to stay. And we are seeing patients in person as well. We've had patients with COVID this year, many. We've had a very, very long number that have actually died of COVID. And most patients have been mild with management at home. If you have doubts on guidance on when do I need to be concerned? The CDC is still a wealth of information. In general, basically, confusion, high fevers that you can't bring down with Tylenol or Motrin, pale blues scanner lips, chest pain, those are all red flags that you should probably have a health professional see it you or a family member to make sure you don't have pneumonia, that your oxygen levels are low. For the most part, people are treating at home very conservatively with fluids, rest, Motrin or Tylenol for pains, aches, mild headaches, insignificant body aches and things like that. And when in doubt, of course, always call your health care provider. From the vaccine standpoint, we have definitely gotten some calls based on side effects of the vaccines. Most of them have been extremely mild. These can be also managed at home. And red flags would be things like high fevers of red area that doesn't go away in a few days. But again, Motrin tylenol taken after the vaccine, not before, which is the recommendation of the CDC. Leaving maybe the antihistamine like Claritin or Allegra can be helpful for some local reactions. There have not been any significant reactions from this, but the second dose of Pfizer and Madonna, we definitely again anecdotally seen people not feel so great for a day. Some people have needed to take a day off to stay home and rest a little bit. And they've bounced back very quickly. If I could just kind of go off on a US a slant for a minute from the healthcare perspective, looking at the big picture of a few of the panelists have mentioned accessibility and not all patients have had the same health care availability and disparity. And that is a very true and hoping that this pandemic will bring us out as a health care community, smarter and wiser that we can act on this a little bit better next time. And I know there have been some positive changes. And the mental health aspects of this have been. Incredibly huge, unlocked and largely for people feeling so wisely did not being able to leave their homes. So we, we have seen many, many patients with mental health illness this year that previously had none. So I for one, will be looking forward to a time when people are vaccinated. We can resume a little bit more of what we saw prior to 2020 in our communities. And people can always reach out to our clinic if they have questions for me as well. And we are accepting new patients do we've had a lot of people from the community come to see us this year because they didn't ever primary and we were able to help them and we were really happy to meet that need. That's really all I had. I didn't have any slides to prepare. I just wanted to kind of anecdotally discussed and kind of wrap some of the health care pieces together. Thanks for having me today. Thank you, Carolyn. Thanks for joining us here today. We're going to address a second round of questions now. So I'm going to turn things back over to Karen Rosenberg to moderate the next round of Q and a. Thank you so much. So we have a bunch of questions about what people should do. Should they take the first vaccine that's offered to them? Or is it better to try to go for one of the vaccines rather than another? And kind of related to that. Do you think that we're going to have to have a second round of explanation maybe later in the fall, if what do you think that'll be necessary? So I'm not sure who should answer that question, but would somebody like to speak up? Anybody? Jennifer, I think diaper repay it though I'm hungry. Probably data back. That looks like she is. Hey, I am, I'm sorry. I thought you were looking for that. The current handle it. Yet though, we are excited about all three of the vaccines that are available right now at Dr. Hardy with they all read it back. These are very effective, extremely effective in preventing death and hospitalization, as well as the theory of illness. And we, I mean, they're all great vaccine and our strongest message, when your number comes up for a vaccine, when you get that appointment, take whatever vaccine is available to you. There's no need to shop around for one type over another. They take their birth birth vaccine that that is available to you. Thank you. And I guess a related question to that is, how much do you think this is going to change our behavior in general? Are we going to start wearing masks during flu season? The way people do in some countries is that going to be regular thing or will we be able to stop that sometimes the future. Yet though, I can amplify my perspective, dr. *****, they may have information to add as well, but, you know, I I do think a park and now I mean, it is interesting to the how though many other respiratory infections have been much non-existent. That flat share I me mad map there. Namely effective in preventing the spread of respiratory infection. And so, I mean, that's one thing to keep in mind. I think a lot about are going to feel a lot more comfortable, especially in crowded plate, the mass transit, et cetera. Wearing math, though I do think that that will change at that relate to COVID. And, uh, and I, I appreciate the comment about, you know, add that new hate it possible that they may become a virus. That is why I left consequential have less significant symptoms than an impact over time. And it may almost become like a common cold though. In COVID, it's probably going to be around for awhile. Mac, they're probably going to be around for the rest of this year. My get it. But slowly will be decreasing. They eat that map. I have a feeling that in the coming year, we all will use snack more certainly than we ever have in the path. Thank you. And maybe following up on that question for John jumped on what kind of mutant worries you the most. What do you most concerned about in terms of, um, with the console to some morbidity and mortality. Carriers who don't get the disease but are better spreaders of the virus. What do you do? Professor? Professor Womack? Address the problem? Are you hearing me okay? Yes. So Professor Womack raised the problem that people who are pre-symptomatic or are not going to develop at all, are still able to spread the virus. And if the virus, as he said, is less lethal but is more infectious, and that these people become less aware of their own need because they think it's only sick patients that are really spreading it. And so it becomes a huge danger. And again, part of this is this whole notion of understanding the evolutionary ecology of what's going on. Thank you. One question that just came up is about people's concerns about the vaccines. And so 11 person on the audience asks what our physician saying to the concerns that parents have around the vaccine for young teenagers or young adult children. And how might that affect their future reproductive capacity? This would one of the more clinical people like to answer that. I am happy to ampere about this with a really good question because there, there's a lot on the internet that people are reading and one of the kind of myths or misinformation that it's out there. There's no evidence that the vaccine or any vaccine had any impact whatsoever on reproductive health. And we hope to be able to better tell that myth. But it certainly had gotten some leg on, on the Internet. But again, there's no evidence. Vaccine or any vaccine had any impact on, on reproductive health. And we don't expect to see that in the cyan, a court at all quite effect. I'll potential side effects. They're being monitored very closely. Pretty back dean. But that is not company that we've ever seen in the past or expect to see from the back pain. Okay. Why does the what is the size of vaccines required two doses and the Johnson and Johnson only one mature that's addressed to but anyone who would like to insert? I'm not sure I'm them an expert on the panel to aim for that. But the mRNA by Earth, the I'm sorry, the m RNA vaccine, the Pfizer and Madonna. The way to down that they are immunologically work is that you do need one though to prime them. And if they can do to really stimulate the simpler with bond where the Johnson and Johnson vaccine is developed very differently with a vector and one dough appears to be adequate for both of these vaccines that accompany, that will be monitored. And again, possible that there will be a, a boot or that thing because they are the barium at some point in the future. But again, there may be some, I'm more expert than, than I on the distinction between need vaccines and why one get rid of it? Well, another question about vaccine that maybe if someone wants to take that up, um, they could tack this alone. Is that recent base two results published in Lancet indicate that the traditional sort of deactivated virus vaccine is as effective as the mRNA based vaccines with significantly lower side effects, especially the Sabine teen age group who we were just talking about. Why was the traditional vaccine development not followed in the case of coronavirus? And why was there heavy emphasis on developing the mRNA vaccine? You know, I can I can speak to mRNA vaccine and why? And the reason is Karen, because it's very quick. So actually they started developing the mRNA vaccine. I want to say December of 19, like December or January 20. It was that fast and quick to develop? Yes. And the reason is, is because as soon as the, the genome of the virus was sequenced, then we underst. Good, which wasn't the most likely and best what we call antigenic target. And so when we think of viruses. This little ball, a protein, right? And there's, you know, we know the various proteins on the outside of the cell. And actually that spike protein from studying coronaviruses for many, many decades. There was discovered that in the sixties that, that spike protein is the integral protein for infection. And so we found the spike, or I should say, researchers found that spike protein gene. And then that was immediately, we can synthesize the mRNA in the laboratory. And then that was packaged into this little bowl, what we call a liposome or just a little teeny ball of fat, right? And then that actually merges in with a human cell. And then the human cell actually takes that genetic message. The mRNA manufacturers the spike protein and then antibodies are developed against the spike protein. So it was a much faster way to go than using inactivated virus. And the, the adenovirus vaccine, which is the Johnson and Johnson platform, also took a little more time but was faster was also faster than using inactivated virus. So I believe in well newsletters, but I'm pretty sure it was simply because of the reaction time and the speed with which the vaccine can be developed. Yeah, and I would just add that. That's the thing researcher who had been working the third pandemic in 2003. And then again, when mers emerge on mRNA vaccine, again feed them are viruses. So that's also another point that comes up with some of the vaccine hesitancy that this isn't you factor the two new. And it did not really a brand new technology. There have been people working on the mRNA vaccine in response the other pandemic that they died out before we were able to implement the vaccine than any widespread sort of way. Thank you. I'm going to stop taking questions now. There's lots and lots of questions. What I'm sorry. I didn't get to the one that you asked. I think most of the presenters have been quite willing to answer questions if you would like to e-mail them or or send an e-mail to me and I'll get it to the right person. I'd like now to introduce Robin Morgan. That's going to make some concluding remarks. I'm Robin. Robin Morgan was particularly appropriate person to have is the concluding person presenter on the panel. And we're very happy to have her here with us today. She's the provost of the University of Delaware, which is the highest ranking academic officer. And she's also assigned this with expertise in molecular biology, viruses. Although her own research has focused on viruses that affect chickens, the biology of the same. And we're very pleased to hear for remarks about what she's what's gone on here today. One question that I was saving for her was a question that a couple of people hint to that about what we can do about compliance. I'm campus, I'm compliance with preventative measures for I'm spreading infection if you have some ideas about that. So thank you, Robin. Thank you, Karen, and thank you, everybody. I'll answer that question first and then I'll do what Karen and join actually charged me and doing that's give you a very brief summary of what we've learned and heard today. So compliance on campus, I think Norm Wagner referred to some of our noncompliance that we've dealt with since the start of the spring semester. And I want to I want to I want to just speak for a minute about that. We did bring our students back for the spring semester on the 15th of February. And about a week later, starting the week of February 22nd, we began to see the positivity rate go up from our surveillance testing. By Thursday, we we went to grab and go dining. And we reduce the density of students who could frequent the little bob and the students centers. But we maintain face-to-face classes because we have no reason, no evidence that with proper mask wearing, that COVID spreads in our classrooms. We also really increased surveillance over the weekend in New York and in Rhoda. Several messages, campus-wide letters, but as well as messages through student life about how serious this is and how it is everyone's responsibility to comply. I'm at the worst day we saw was Tuesday, the second of March, which would reflect the surveillance the previous day on Monday that was after that weekend. And I'm very pleased to report. Since then, the students haven't been listening and art are positively rates are going down and you're going down in a very impressive manner. So we're, we're going to be complimenting them. We will maintain grab-and-go dining for a while. But we believe they have listened and they have understood that it really matters that they wear masks and that they not congregate in ways that are unsafe. Now with that, I was asked to provide a sort of summary and I'm going to do it very quickly. I'm reminded that a year ago we gathered in Mitchell Hall and I think John Paul West SCO referred to that. We heard some of the same colleague, Dr. Rita, you were there then. Amen, Thank you for coming back. It's been a busy year. But some of our other speakers for the same plus we've added a different group. I don't think on that day any of us had any idea what the year was going to bring both to our campus, our state, and our country and our world. I feel so fortunate to work on a campus where there's a community and in a community where there are people who can help us better understand this coronavirus. And I'm just going to give you a very, very brief summary. And as I do, I'll be acknowledging our speakers really appreciate their time and their presentations. They were spot. Not too long. Easy to understand. You did a great job. So Dr. Carol retail has one day I went to sit with her and I hope we all will inches here personally wet this year has been, but she's done a fabulous job leading Delaware public health. She started by saying that this is eclipsed any public health response she had dealt with before. I have that highlighted in my notes. I'm going to remember at Carroll, I think it's Eclipse. A lot of what any of us have experienced before. She gave many facts and figures that are interesting and then spent time talking about equity is a problem in getting people vaccinated, in getting people tested. This is a great concern for her and others and I really appreciate that. I think we all do. I'm she also pointed out that down, but everybody is getting vaccinated. The CDC guidance for vaccinated individuals has come out. And this is going to, doesn't completely relax what we need to do. But it will make our lives a bit better and perhaps address some of the mental health issues that have been true for many people, particularly older people. Norm Wagner talked about are fabulous NSF project that he and his colleagues had been working on an agent-based modeling. And looking at our own campus, they've been able to really model what it would take to get us to, in the course of that from beginning to end of a semester, to have a positivity rate that we would feel comfortable with. His group has looked at mass compliance, vaccination, the effect of the variance, and several other factors. I think this is an example of I'm the development of tools that will outlast this pandemic. And that will be useful, very useful in the future as we deal with other emerging diseases and, and know how to manage them. Kelvin Keeler talk about variance and their biological properties, and he focused on the spike protein. I think many of us have heard about spike and we know that that is a major antigen, but he helped to explain why spike matters, that it helps the virus attached to the target cells so that it can actually infect. And he talked about mutations and began to talk about variance and how they arise. Calvin pointed out that many mutations may slow down the virus, make it less virulent. Some are going to be completely silent and some are likely to assist with evasion of the immune responses. He, he pointed out as others also did that COVID-19 will most likely become less lethal over time. It's those newly emerged viruses that jump species in this case, as John jumped, told us, likely from bats to humans, they tend to be very virulent, but over time, they can make peace, so to speak with their host. Esther Biswas talked about the diagnostic test. And she really emphasized that those people doing the test and those people who are developing test understand that a coronavirus will evolve and change. And they designed the test in the case of real-time PCR, to target multiple genes, not just spike. And they design their test to be able to still be effective in the context of mutation. She did point out in a question when, when asked about the World Health Organization saying PCR was not good enough for diagnostics. She pointed out the reason for saying that is that we need to remember what it's like all over the world. Pcr is a very sophisticated technique and there's a compelling and continuous in really important pressing need to develop very sensitive tests that are easy point of care test, accurate and in an easy to do. And they don't require a lot of sophisticated equipment and laboratory expertise. Eric, why am I talked about the work he's doing with Kelly Neil looking at wastewater sampling, and he pointed out that that COVID is spread shed in the feces in pre-symptomatic and asymptomatic individuals pretty robustly. And so wastewater monitoring is a very good way to to track and predict where hotspots might occur. They've been using, uh, by about protocol from MIT and I've actually had the privilege of seeing their data every week. And it's really interesting there now monitoring twice weekly at seven locations across campus, most of them near our residence hall hall's. And again, as with the tool that norm Wagner described, this methodology will have long-term implications for how we can monitor and predict where hotspots will occur. Eric also pointed out, with regard to variation, it requires replication of the genome. Several people talked about that. And if we slow down infection, we slow down replication. We reduce the environmental load and decrease the emergence of variance. He made reference to Darwin cutting some grass that John junk I'm sure intended to cut. But pointed out that selection occurs among all these mutations for fitness, we can help slow the emergence of variance by reducing the environmental load. What I mean by that are the infections with this virus. John, john guy did a great job telling us about phylogenetics. He, he indicated that we can, we can, he can develop network graphs that look at world spreading. And that really provide a lot of molecular information about how related viruses or how they emerged, where they came from. And then understand how we can use all this information, very sophisticated information to understand how the disease is evolving. He also pointed out the educational resources that are being developed. So it's a professor junk is thinking not just about providing a tool for those who were studying the, the basic science or the applied science of COVID, but also that can be used to train another generation to understand the power of phylogenetics. Jin ***** talked a lot about, about epidemiology, just been a real hero around here, sitting in many, many meetings and helping us. But she talked about the process getting more efficient everyday to get vaccination. She made good points about the J and J vaccine. How it's the single dose easy to store product will really simplify logistics of large-scale vaccination, which is again something Esther was referring to with diagnostics, we need to think about the whole world. Didn't did tell us about a website, the Kaufmann Family Foundation website that has a very good one to go to if you want to follow access for higher risk populations. And finally, our last speaker, Carolyn hangs, really talked about from, from her own experience on the front line, what has happened. Talking about the move to telehealth. Telehealth not being something a novel that you didn't really do very much to being what you did a lot of talking about the CDC guidelines and how they changed and one had to be constantly on top of them. Long-term effects, which we may not even know what all of those are and variance. She talked a lot about the need to get vaccinated when and how you can. And that while there are some side effects of vaccines, they're mostly manageable at home. And I really appreciate all of her work to keep the nurse manage primary care clinic open, and to help us all understand what it's like for somebody who really is seeing patients every day. Thank you all for sharing your experiences. It's just been a privilege to hear you and learn from you. And I'd also like to especially now thank the members of the College of Arts and Sciences team who organized this jump. Hello SCO, and he's moderating the event. Caixa Harris, who is their communications manager, and calling pop who's the event manager and made sure that all of this happen. I would Neil, thank the organizers of the event, Karen and John, but I'm going to turn it back over to John polis go but because I know that he really wants to do that. So John, you want to close us out here and thank you, everybody for your presence here for or infer for being on top of this. Stay safe. Wear your mask essentially distance, Washington. Thank you, Robyn. And thanks for that excellent summary. Thanks especially for they can come in Kaizala like them again. They are the true heroes here about myself and on behalf of the College of Arts and Sciences, I want to thank again all of our panelists today. Thank provost Morgan again, and of course everyone here for joining us. I do also want to extend my gratitude to our event organizers, Karen Rosenberg and John junk. You got to meet both of them today. As many of you know, Karen and John worked tirelessly to bring science discussions to our UD community. Darwin days and the Nobel events are just a few examples of their work. And I'm grateful to them for all of their efforts in this space. Thank you again to everybody for joining us today, and I hope you all have a good evening. Goodnight everyone.
Vaccines & Variants
From Andre Smith March 12, 2021
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