A Good Idea Goes Viral

Peter Reinhart, PhD, was sitting alone in his fifth-floor office on a cold day in March. The $150 million building that houses the UMass Amherst Institute for Applied Life Sciences (IALS) stood virtually empty. Its halls were void of traffic. Its equipment, silent. Just days before word had come from the Chancellor that the campus was closing. Students were leaving, staff were sent home to work, and labs and facilities were on skeleton crew. A life-threatening virus was on the loose and no one knew how to stop it.

“I was sitting in my office just after the campus had shut down and thinking, ‘what a waste.’ Here we are sitting in a beautiful new building with $60 million of new life science equipment, and we have some of the smartest people on the planet thinking about assay building and sample testing, sitting at home. It really irked me,” says Reinhart.

At the same time, news reports highlighting regional and national shortages of personal protective equipment (PPE), such as masks and face shields, were coming in. Testing centers couldn’t get testing materials, such as swabs and the biological medium necessary to transport virus samples safely to labs. “It was such a disconnect to me, thinking we have all these resources on one side and this massive need on the other side. How could I connect these two?” says Reinhart.

He put out a call to the campus, asking if anyone would be interested in participating in some regional efforts to try to help with the shortages and the societal issues that were hitting the life sciences space. He couldn’t believe what happened next.

“I got a few hundred responses within hours,” says Reinhart. “It made me realize that people were very excited about helping this crisis that was hitting us both nationally and very locally. The phrase ‘COVID-19 Response Teams’ really just formed itself. We were dealing with a COVID-19 crisis, and we were trying to address some of the issues related to it—we were actually creating responses.”

That initial call would result in the formation of more than a dozen Response Teams, each actively addressing COVID-19-related problems.

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The Need for Face Shields

As faculty and staff started to tease apart the issues, it became clear that the lack of PPE for frontline workers was huge. “Nobody had enough face shields,” Reinhart says. “All the frontline workers were complaining that they’d be seeing patients all day long and they didn’t have enough PPE. They would have to clean it at the end of the day. They would have to put their name tags on it, reuse it day after day. We started to brainstorm around it, and pretty soon we had a team that was focusing on face shields.”

Reinhart knew that in order to respond with something useful, and quickly, the team would have to reach outside the Institute for help—something he had learned working in industry. Team members began participating in regional conference calls and collaborating with health care professionals and other academics who could address face shield design from a broad perspective. The Response Team worked together with area clinicians to design prototypes, identify technical issues, and suggest improvements to the design of a low-cost shield for rapid production. It was clear through that process that in order to keep costs down, the shield had to be designed so that it could ship flat. With those design requirements in mind, UMass Amherst engineers Frank Sup and Meghan Huber created an origami-like face shield from a flat sheet of plastic material that could accommodate the wearing of PPE underneath, such as an N95 respirator, and was simple enough to be assembled in 15 seconds or less. The design uses laser cutting or industrial die cutting, which can produce tens of thousands of shields per day, per machine with minimal workforce to reduce the spread of worker infection. Partnering with K+K Thermoforming of Southbridge, Massachusetts, the team fabricated and distributed 100,000 face shields throughout the region.

“We weren’t a delivery organization, yet we somehow had to get them out to all the regional hospitals, to frontline workers, to ambulances, to hospices, to the Holyoke Soldiers' Home. They were all asking for help,” says Reinhart. Ellen Smithline ’21PhD, a longtime emergency care nurse and College of Nursing doctoral student, was asked to vet the needs, and a University Health Services doctor was asked to help with requests. Week by week, they came up with a triage list of who on the front lines needed face shields the most. Campus volunteers jumped into their cars and delivered the shields; team members also provided curbside pickup, putting the number of boxes people had ordered on a table outside the IALS building.

“We went from nothing to having made 100,000 face shields and distributed them to about 60 local medical groups, including Cooley Dickinson Hospital and Baystate Medical Center, in a few weeks’ time,” says Reinhart.

The Dark Days of COVID
In the early days of the virus, planes were chartered to get face masks to Massachusetts from overseas. But did these masks work?

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Richard Peltier ’97, professor of environmental health sciences in the School of Public Health and Health Sciences, leads the face mask team. His lab conducts tests on mask re-use. “Not all face masks can be safely sterilized and reused,” says Peltier, though his research has shown that hydrogen peroxide sterilization for N95 respirators does work. Using state-of-the-art pollution instruments to measure whether microscopic particles can pass through the mask after it is sterilized, his results showed no real difference in filtration between a new mask and a sterilized one. “As new sterilization methods continue to be developed, my lab continues to do rigorous scientific testing to evaluate the efficacy of different mask sterilization methods,” says Peltier.

Another Response Team was quickly formed when Baystate Health’s resident physician, Mat Goebel, and respiratory specialist Kyle Walsh contacted the campus for help with ventilators. Regular 10-foot ventilator cables were on extreme backorder, and longer cables, which would provide added safety to staff by increasing distance and reducing the need for PPE, did not exist.

“If you have an intubated patient on a ventilator in a hospital, you don’t want to be very close to them because clearly they are highly infectious,” explains Reinhart. “But there was no way to take the ventilator control signals away from a patient bed to a safe distance where hospital staff could operate it.” Seems straight forward, but it was a pretty tricky project,” says Reinhart. “We had to get immediate sign off from the legal group in Japan that actually owned some of the patents so we could make some of these parts.”

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After getting permission, UMass engineers were able to fabricate a 50-foot cable that was compatible with Baystate’s ventilators. They contacted Amphenol Sine Systems, who agreed to design and fabricate the longer cables. Baystate is now ordering cables directly from the manufacturer.

Testing, Testing, Testing
Another COVID-related product that was in need in the early days was viral transport medium (VTM). As testing ramped up nationwide, this solution, used to keep COVID-19 samples safe during transport, was in short supply. Most of the medium needed for testing came from a company in Northern Italy, which shut down. Inevitably, the U.S. supply of testing materials dried up. Staff from Cooley Dickinson and Baystate Health again contacted Reinhart for help and a new Response Team swung into action, putting a VTM production line together.

“This is probably the largest group of volunteers we have working, around 30-35 people, working just about around the clock, shift by shift, to manually make this viral transport medium, liter by liter. The Broad Institute ran out, the State testing lab ran out. By the end, we had made about 120,000 tests worth of VTM and supplied all the regional hospitals, from Pittsfield out west to the east. We supplied all of these organizations with our UMass-made VTM, which kept testing going in those dark days in April and May when there was none to be had anywhere,” says Reinhart.

Again, the team had to organize distribution. “This is not something you think about as an academic group. Manufacturing, scaling, the appropriate labeling, making sure the tubes stay sealed during transport, the quality control to make sure there are no PCR (polymerase chain reaction) inhibitors in any batch of our solution, storing them in cold rooms. Erin Poulin, lab manager at UMass Amherst Health Services, was instrumental in being the point of distribution for the local hospitals to either arrange pickup or transport,” says Reinhart.

Expressions of Gratitude
At the end of the day, all of this hard work does not go unnoticed by those who have benefited from the UMass Amherst COVID-19 Response Teams. “We had people whose daughters and sons working in testing tents on the front lines writing letters saying, ‘Who knows? You may have saved my daughter’s life.’” Reinhart reads from a letter from the Holyoke Soldiers' Home (which made national news for high numbers of COVID-19 deaths) filled with such gratitude that it brings tears to one’s eyes. “It makes you feel really good when that happens,” he says.

Reinhart acknowledges the selfless generosity of the many volunteers that came together to create these Response Teams. “Whether the teams were large or small, this was an all-volunteer effort with no compensation of any description, other than the feeling that you are contributing to solutions in a time of crisis. We had many times the number of volunteers that offered to help us than we could possibly find jobs for. The real heroes here are all the individual volunteers who got up on a Saturday morning to come into the lab and sit pipetting for seven hours when they could have been outside enjoying the weather or doing other things,” says Reinhart. “They chose to do this instead.”

UMass Amherst was recently designated one of ten 2020 Healthcare Heroes by BusinessWest. Read the article.

 

UMASS STUDENTS GET ACTIVE

Award-Winning Work
Nursing doctoral student and longtime emergency care nurse Ellen Smithline ’21PhD made Johnson & Johnson’s list of “Ten Nurses Pioneering Innovative COVID-19 Solutions.” Smithline not only contributed to the design of a fast-track face shield for health care workers in a multidisciplinary UMass Amherst project, but she has also helped set up and manage
COVID-19 medical care tents in Springfield to screen homeless people and provide shelter to those who may be infected and need to be isolated.

Helping the Holyoke Soldiers' Home
Two UMass Amherst ROTC cadets—psychology major Jake Gramstorff ’21 and kinesiology major Jacob Goulet ’21—were called up to serve as National Guard medics at the Soldiers’ Home in Holyoke, which has been hard hit by COVID-19. For weeks, both students have been providing direct care to veterans living in the home, among other duties. “Hearing the stories from these amazing men and women and their incredible lives of service inspires me every day,” says Gramstorff. Goulet says providing care to veterans in their time of great need “has truly been both humbling and rewarding.”

A Call from the Commonwealth

In the largest and earliest UMass Amherst volunteer initiative, some 215 graduate and undergraduate students in the School of Public Health and Health Sciences signed up to support dozens of local public health departments across the state as part of the Massachusetts Academic Public Health Volunteer Corps. That group, co-led by Aimee Gilbert Loinaz, Public Health and Health Sciences assistant director for internships and employer engagement, includes students from 12 Massachusetts schools and programs of public health.

Within weeks, 66 students had been assigned to carry out rapid-response tasks from their homes, including the first contact tracing and translation of critical COVID-19 materials into 11 languages. “Nearly 100 other students were hoping to be deployed throughout the summer,” Gilbert Loinaz says. “We are a home-rule state, so every local public health department is different in what their needs are.”