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Dramatic Black and white image of Tired, overworked, exhausted health care workers outside the hospital looking at the camera
Doctors, nurses, and researchers in the St. Louis region have been doing cutting-edge work to battle COVID-19 since the start of the pandemic, helping to save lives and prevent suffering both here and around the world. Here are eight ways that St. Louis is playing a prominent role in the fight against COVID-19.
1. We developed a saliva test that simplified detection. A team of researchers at Washington University didn’t just help make COVID-19 testing easier and less invasive; they also developed a Food and Drug Administration–approved saliva test that can detect the virus even before symptoms are present. People using the test were able to collect their own samples, reducing some of the strain placed on front-line workers.
2. We helped develop a vaccine. Dr. Daniel Hoft, director of the Saint Louis University Center for Vaccine Development, is among the hardest-working folks in town. “I’ve been in my office almost every day since last March,” says Hoft, whose department is one of 10 federally funded Vaccine and Treatment Evaluation Units in the United States conducting Phase 3 clinical trials for the Moderna and Johnson & Johnson vaccines. (Washington University’s School of Medicine was also a site for the Phase 3 clinical trial, led by Dr. Rachel Presti.) Hoft’s lab also oversaw trials on remdesivir, the first approved drug for COVID-19. Now, Hoft and his team are developing a vaccine that could prevent a future coronavirus pandemic by targeting the sequences shared by the pathogenic viruses that cause SARS, MERS, and COVID-19. “It’s very possible that next time,” he says, “we’ll already have a T-cell–targeting vaccine that protects against the next pandemic sitting on the shelf.”
3. We’re working on new ways to detect the virus. COVID-19 has been called the invisible enemy. But what if there were tools to reveal airborne SARS-CoV-2 particles before they lead to infection? Wash. U. researchers are developing two devices that might do exactly that: one that could monitor air quality in large public spaces and another that could be used like a Breathalyzer to determine whether a person is infected before they enter a gathering area, such as an office or classroom.
4. We learned that an antidepressant could be a useful treatment. As intensive care units began to fill early in the pandemic, Dr. Angela Reiersen had an idea. A child psychiatrist at Washington University, Reiersen remembered reading about how the drug fluvoxamine, which is commonly prescribed to treat obsessive-compulsive disorder, also helped reduce inflammation in animal models of sepsis. Reiersen and Dr. Eric Lenze started a small clinical trial to test whether the drug could treat COVID-19 patients and lessen the virus’ effects. (60 Minutes featured their work in March.) Results of the pilot study found that none of the patients taking the drug experienced serious deterioration. A larger trial is underway.
5. We provided a lifesaving option for the sickest patients. When a ventilator is no longer enough, there is a final course of action. Extracorporeal membrane oxygenation, or ECMO, involves a heart-lung machine that provides gas exchange and cardiac output while the heart and/or lungs rest and recover. “It’s a last option for taking care of a patient with severe respiratory failure or shock,” says Dr. Muhammad Faraz Masood, director of the ECMO program at Barnes-Jewish Hospital, one of the leading such programs in the nation.
6. We helped people recovering from COVID-19 breathe again. SLUCare’s Airway and Breathing Clinic was in the works long before the pandemic began. But by the time it opened in late 2020, the clinic’s mission had expanded in ways that one of its lead pulmonologists, Dr. Ghassan Kamel, couldn’t have foreseen. “When we opened, we saw two kinds of patients,” Kamel says. “Our regular asthma and COPD patients, and post-COVID patients who still had some residual lung disease or were suffering from shortness of breath.”
7. We coordinated efforts for consistent care across the region. Weeks before the first case of COVID-19 was confirmed in St. Louis, Dr. Hilary Babcock, an infectious disease physician with BJC HealthCare, was already preparing for the worst. In February 2020, Babcock helped establish a virtual incident command center that aligned response plans across the BJC and Washington University medical campuses. Babcock guided efforts to ensure that the health care system’s response was thorough, consistent, and clearly defined at hospitals and medical facilities throughout the region. “We were watching and listening to what was happening on the coasts,” Babcock says. “We needed to develop the policies and procedures that we would need to be able to safely provide care for patients when [cases] started showing up in St. Louis.”
8. We’re learning how to reach more people with vaccines. This spring, Washington University public health professor Matthew Kreuter received $1.9 million in grants that will go toward encouraging African-American residents in the city and county to get vaccinated. The plan calls for monitoring and countering vaccination misinformation, leveraging existing community organizations, and enlisting ambassadors to encourage their social networks to get vaccinated.
FRONT LINE LESSONS
ST. LOUIS–AREA DOCTORS REFLECT ON WHAT THEY LEARNED DURING THE COVID-19 CRISIS
“Facing a global pandemic has been a humbling experience on a professional, spiritual, and familial level. When I reflect back on this year, a few memorable moments come to mind: 1. Patients that we placed on artificial lung support (ECMO) and got another chance at life. It was heartwarming to see them back with their loved ones after long hospitalizations. 2. Moving to a new hospital in the middle of a pandemic and having to move critically ill patients into a different building all in one day. 3. Moving our clinic visits in a short period of time into televisits to continue helping our high-risk patients with pulmonary disorders and prevent them from getting hospitalized.” —DR. GHASSAN KAMEL, PULMONARY MEDICINE, SLUCARE
“As an emergency medicine physician, I would like to think I was prepared for a crisis. What I did not expect was the length of the crisis and that the pandemic would stretch and pull our resources for such a length of time. I’m really proud of my team of health care professionals, both emergency department nurses and physicians alike: 24/7, 365 days, they stood up to the storm like the heroes they are. They placed themselves in front, at significant personal cost, to selflessly treat and diagnosis patients.” —DR. MICHAEL KLEVENS, EMERGENCY MEDICINE, ST. LUKE’S HOSPITAL
“I learned a lot as a pulmonary and critical care physician serving on the front lines during the multiple surges of COVID-19. When given the opportunity, with appropriate support and adequate resources, all of our nursing and support staff rose to the challenge under difficult conditions. They were willing to sacrifice so much of themselves to provide the best care possible to all of our patients no matter the circumstances. I felt truly humbled to be part of an amazing team.” —DR. BOBBY SHAH, PULMONARY MEDICINE, CRITICAL CARE MEDICINE, ST. LUKE’S HOSPITAL
“I would like there to be a national call to improve the health of everyone. Research shows that people have missed attending to their health: care for chronic conditions such as diabetes or screening for colon cancer, [sexually transmitted infections], and cervical cancer. There was a 45 percent drop in testing for STIs in 2020, and at the St. Louis Sexual Health clinic [of which Reno is the medical director], we are seeing only two-thirds of the usual visit levels… I am also concerned that health care workers receive extra support. The stress of a year of caring for patients with COVID cannot be underestimated… Lastly, we need to care for our public health systems. Funding will strengthen the work of public health for our communities, whether that is for STIs, HIV, violence, future pandemics, or work to address disparities.” —DR. HILARY RENO, INFECTIOUS DISEASE, WASHINGTON UNIVERSITY
“For the past 20 years, since the first SARS outbreak, if you asked any infectious disease doctor their worst nightmare, it would be a new respiratory virus for which humans had no immunity. In spite of that prediction, our preparation was terrible. We need to reinvest in public health, develop better diagnostics, and build upon our vaccine capabilities… Science ultimately delivered with effective prevention, but public trust and confidence must be rebuilt so that in the event of the next pandemic, we have less strife and division.” —DR. WILLIAM POWDERLY, INFECTIOUS DISEASE, WASHINGTON UNIVERSITY
“Advances in medicine and public health kept us safe for a century, and now we can approach the problem equipped with things our ancestors didn’t even dream of: advanced medical technology, research tools, manufacturing processes, unprecedented collaboration. We have work to do to ensure less devastation with the next pandemic; we should strengthen public health and surveillance, encourage cooperation between countries, educate people about science, and reckon with the environmental impact of our evolving societies. I remain optimistic.” —DR. JOANN JOSE, INFECTIOUS DISEASE, SLUCARE, SSM HEALTH SLU HOSPITAL
“For the next pandemic, children and teenagers have to be prioritized and more efforts to understand and provide the supports to them are paramount. Additionally, our community must come together to address the behavioral health crisis that has been present prior to the pandemic and exacerbated due to the pandemic.” —DR. JASON NEWLAND, PEDIATRIC INFECTIOUS DISEASE, WASHINGTON UNIVERSITY
