Oklahoma City is being eyed as a potential model for a nationwide roll-out of testing and guidance by some of the country’s most respected disease experts on how best to reopen the country and reduce risks of a second wave of COVID-19 infection.
The coalition, consisting of local corporate executives and researchers as well as experts from top institutions including Harvard and Duke, is focused on creating a surplus of tests and samples to delve into how many asymptomatic cases have spread and the search for an antidote to the virus.
Coordinators locally include Dr. Jason Sanders, Provost of the OU Health Sciences Center; Dr. Stephen Prescott, president of the Oklahoma Medical Research Foundation; and Christian Kanady, business executive and investor.
Dubbed the “START Coalition” (Smart Testing and Analysis to Return Tomorrow), the growing list of participants is hoping to lessen the virus’ threat until a vaccine is created and to also come up with long-term preventive measures while also leading to a cure.
“We will be the first city that would understand the true reach of the epidemic,” Kanady said. “We would know who has it, we would know how widespread it is with cluster testing. The goal here is to know more data than in any other city and that is due to the elaborate ecosystem we have.”
The COVID-19 virus is continuing to spread throughout the country even as states are reopening restaurants, shops and other public spaces to restart the economy. Confirmed cases in Oklahoma total 4,732 with 119 added on Tuesday while the death count is at 278, an increase of four since yesterday.
The United States virus count is at 1.3 million testing positive and more than 80,000 dead.
The reopenings are happening in several states, including Oklahoma, despite warnings from Dr. Anthony Fauci who told U.S. Senators Tuesday the states that do not follow guidelines and open too quickly are risking a resurgence of suffering.
“If that occurs there is a real risk of triggering an outbreak you will not be able to control,” Fauci said, “which in fact paradoxically will set you back in leading to suffering and death that could have been avoided but can set you back in seeking economic recovery.”
While part of the coalition’s efforts will be increased testing focused on key populations including teachers, construction workers and grocery employees, another task will be to make the current reopening safer.
Dr. Salmann Keshavjee, a professor in the Department of Global Health and Social Medicine at Harvard Medical School, is a part of the coalition seeking to make the openings already underway safer for those using public spaces.
“We’ve seen millions of people going into unemployment,” Keshavjee said. “And there are surveys showing people are living one paycheck away from being homeless.”
Keshavjee suggests starting in Oklahoma City with what he calls “low hanging fruit” — old technology already being used overseas to combat tuberculosis.
UVC germicidal lighting, which he said is a long-established technology, can be used in spaces with high ceilings and has been effective in sanitizing spaces during previous fights against the H1N1 virus, SARS and the flu.
“It’s light,” Keshavjee said. “We could have it in schools, auditoriums, places like Walmart. You have to figure out how much light a space needs and also how much is needed without hurting people’s eyes.”
In Oklahoma City, he said, the experiment could go on to include nursing homes where death rates have been spiraling.
While the waiting for a vaccine is likely to last another year or more, Keshavjee also sees the work in Oklahoma City leading to the use of other treatments, notably the BCG vaccine, as a means to reduce the severity of COVID-19 infections.
“It’s been used to reduce the severity of disease and the mortality rates with children,” Keshavjee said. “We don’t use it that much in the U.S. because we don’t have tuberculosis. We do use it here sometimes to cure bladder cancer.”
Prescott said the testing and sampling part of the mission relies on key partnerships with the Oklahoma Blood Institute, the Indian Health Clinics and partnerships with tribes including the Chickasaws and Choctaws.
“This is unprecedented,” Prescott said. “I don’t know of a model like this. I was surprised when we were contacted and asked if we wanted to participate. It took a while to describe what it is. The breadth of the idea and initiative is striking.”
Contributors from Oklahoma City will include Dr. Judith James, a renowned immunologist at the Oklahoma Medical Research Foundation.
“Her scientific and clinical wok is based on patients who have autoimmune disorders where our immune systems attack us and not the virus,” Prescott said.
Scientists believe an uptick in children suffering Kawasaki disease-style symptoms are actually afflicted with the COVID-19 virus.
“What we’re going to find is the virus is causing antibodies that are attacking the heart and other organs,” Prescott said. “And that’s what we will be studying in people with the virus and those who are healthy.”
Even as antibodies are developed among those hit with the virus, Keshavjee said the coalition will be tracking whether those antibodies protect the patient or start attacking their organs.
Keshavjee said the coalition will be ramping up testing to find hot spots and also address ongoing infection spreads in nursing homes.
“Let’s test sensibly so we know what our hot spots are,” Keshavjee said. “Randomized testing doesn’t work. So our coalition will be doing focused testing to see where the clusters are. One of the elements in Oklahoma City that make it important is you have an elderly population that is at risk. You have a lot of tribal populations and there is a lot of risk due to other factors like diabetes.”
In coming days, the Oklahoma Medical Research Foundation, University of Oklahoma Health Sciences Center and the START Coalition will announce details regarding when and how the program will unfold, with targeted testing to understand hotspots, careful allocation of appropriate tests and ways to support the community.
“In Oklahoma City, we have a history of moving swiftly to combat tragedy,” Prescott said. “Where others see challenges, we see opportunity. The COVID-19 pandemic now gives us the opportunity to work together to pioneer approaches that will save lives and restore our economy.”