Milken Institute School of Public Health Launches COVID-19 Study to Protect Essential Healthcare Workers

WASHINGTON, DC (May 5, 2020)—Today the George Washington University Milken Institute School of Public Health (GW Milken Institute SPH) announced the launch of a new study that will begin surveillance testing for signs of infection and immunity to the virus that causes COVID-19. Researchers at Milken Institute SPH, in collaboration with the GW Hospital and the GW School of Medicine and Health Sciences (SMHS), aim to test GW healthcare workers to see if they have been infected or have developed antibodies to the deadly virus.

The study will answer some critical questions about the virus, SARS-CoV-2, which causes COVID-19. “First and foremost, we are addressing an extremely important issue in terms of how to keep essential healthcare workers and their family members’ safe,” said Lynn R. Goldman, MD, MS, MPH, the Michael and Lori Milken Dean of Milken Institute SPH. “The many illnesses and deaths of healthcare workers worldwide have been tragic.”

In the study, Cindy Liu, MD, PhD, an associate professor of occupational and environmental health at Milken Institute SPH, and her colleagues are recruiting GW healthcare staff and faculty members to test them for SARS-CoV-2 and the extent to which they are making antibodies to the virus.

This study will evaluate two important questions: First, Liu and her colleagues will assess viral infections among frontline healthcare workers who are not showing overt symptoms of COVID-19. The team will use a rapid, polymerase chain reaction (PCR) test to look for and confirm active infections.

“One of the big mysteries of this virus is how it can cause devastating illness in some people, while others can be infected with no noticeable symptoms. Unfortunately, people who are infected without symptoms may unwittingly spread the disease,” said Liu. “This study will help us identify healthcare workers who are asymptomatically infected, so they can better protect their patients and colleagues as well as their family members, when they take off their protective equipment and go home.”
  
“All healthcare workers at the GW Hospital wear masks and other personal protective equipment so that identification of asymptomatic infected healthcare workers does not mean that patients are unknowingly being placed at risk for infection,” said Gary L. Simon, MD, PhD, chief of infectious diseases at the GW Hospital and SMHS.   

Second, this study would identify if, when and the extent to which those who are infected but only have mild or no symptoms develop antibodies to the virus. Liu and her lab have built upon an existing antibody test to develop an in-house approach that can measure COVID-19 antibodies. 

“Scientists still don’t know when people start making antibodies during the infection process and whether antibodies will reliably protect against a second infection, and if so how long the protection will last,” said Lance B. Price, PhD, director of the Antibiotic Resistance Action Center at Milken Institute SPH and a member of the research team.
 
“We may find that most participants with mild infections begin making antibodies to the virus within a few weeks. We also expect that some participants may have already developed antibodies from infections that they did not know they had. In the best-case scenario, we may see that these antibodies prevent subsequent infections,” Liu said. “If so, they might offer protection against a second bout with COVID-19.”

According to Simon, antibody testing may reveal that a large number of health care workers have had asymptomatic infections. However, at this point, experts cannot say that the presence of antibodies means that an individual is protected from reinfection.

Because of well-known supply chain problems, the research will not compete with health care providers for scarce supplies. Liu contracted with a 3D printing company to manufacture swabs and her lab has produced lab reagents that are not readily available commercially.

“In the field of public health, we are concerned about the faulty antibody tests that are on the market,” Goldman said. “To address that issue, Liu’s lab has validated in-house testing that can both screen for and confirm the amount of antibodies in blood. In future research we hope to develop completely new antibody tests for COVID-19.” 

Even under the most optimistic of predictions, a vaccine may take a year or longer to develop, Goldman points out. To reopen schools and businesses without a vaccine will require widespread, rapid testing to identify people with active infections and contact tracing to prevent the formation of new clusters. 

“These studies will help us determine who has already been infected and who has developed a protective immunity, even in the short run,” Goldman said. “Such information will add to the body of knowledge on COVID-19 and ultimately save lives, especially the lives of our essential frontline healthcare workers.”