APRIL 16, 2021 MEDICAL UNIVERSITY OF SOUTH CAROLINA VOL. 37, NO. 10

RemembeRing lives lost duRing pandemic SC coronavirus immunity estimate shocks expert

By Helen AdAms [email protected]

ublic health experts at MUSC estimate statewide Pimmunity to the coronavirus that causes COVID-19 has hit about 65%. “I was a little shocked,” said Michael Sweat, Ph.D., leader of the MUSC COVID-19 Epidemiology Intelligence Project. “But as we went back through the numbers, it was kind of hard to argue.” His team has put not only the statewide estimate but also estimates for every county in South Carolina online, Photo By Sarah Pack updating the website as more Sweat Britt Bates, MUSC Arts and Healing Program, signs the memory wall that was created as part information comes in. It’s part of of the April 14 MUSC Day of Remembrance event held at St. Luke’s Chapel. The event, which a public service MUSC has been offering since the early featured remarks, reflections, music, poetry and prayer, honored the memory of the lives lost days of the pandemic, tracking everything from COVID to the COVID-19 pandemic. case numbers to vaccinations to give the public, health care leaders and politicians solid data for decision making. Pickens, McCormick and Greenville counties have Campus welcomes return of print the highest estimated immunity, all over 70%. Saluda, Jasper and Berkeley counties have the lowest, coming in around 40%. MUSC Catalyst News on April 30 The Charleston Tri–county area, which includes After a year–long hiatus of its hard copy edition, The coronavirus. Berkeley, Charleston and Dorchester counties, has a MUSC Catalyst News will return to print in late April. For this inaugural return to print, we will feature combined estimated 57% immunity. The Office of Public Affairs and Media Relations an in-depth look at MUSC’s Day of Remembrance “I've always been pretty optimistic about the more staff has consulted with MUSC Infectious Disease to commemorate the lives lost and honor all who recent period we're in, because vaccinations are going and Safety and Quality experts and industry studies have sacrificed so much to care for the sick and pretty well,” Sweat said. to confirm that paper products such as newsprint are vulnerable. safe and low–risk in surface–based transmission of the See Immunity on page 11

Patient Gift School–based clinic 4 MICUNew staff HCC honored technology for First–of–its–kindEighty-two days clinic opensat MUSC in 2 BOT Update 5 exceptional care. NorthDouble Charleston. lung transplant 5 Meet Amber Sansbury Detects early stage 8 4 liver cancer. 6 patient heads home. 10 Obit-Dr. Curtis Worthington 2 mUsC CAtAlyst news, April 16, 2021

MUSC Board of Trustees Meeting Update

Recently, MUSC and MUHA Board of include accounting for the extra doses with his wife, Mrs. Ann Edwards, to In addition to simplifying workflows, Trustees met for their regularly scheduled found per vial.” Cawley observed, “This make MUSC second to none in terms Workday will also empower employees to combined committee sessions and week has been particularly challenging of quality care, instruction and research complete human resources and payroll board meeting, April 8 and 9. In light due to last–minute supply issues that are across all colleges. However, as a dentist actions from anywhere using mobile of the ongoing COVID-19 pandemic, out of our control, forcing us to move himself, the College of Dental Medicine devices. many attended the meeting via video and reschedule vaccine appointments. held a special place in Dr. Edwards’ q In other business, the 16–member conference. Those who gathered in Nevertheless, MUSC continues to heart. He and his wife, Ann, who is with MUSC/MUHA board also voted to person in the MUSC boardroom vaccinate as many people as we can as us virtually today, are responsible for approve the following items: observed appropriate safety protocols, fast as possible.” securing the funding for this endowed •Improve access to high–quality breast including wearing masks and social q Despite the enduring challenges chair, which included resources from imaging in the community by locating distancing. In addition to updates on of the pandemic, MUSC continues Conoco–Philips, Waste Management 3D mammography at the MUSC Health its education, research and clinical care to transform and grow. The board and Mr. Peter Lawson-Johnston II.” West Ashley clinic. operations, the board received a primer voted to support filing two certificates He continued, “Ann, on behalf of the •A capital budget request of $2.9 on how the mRNA vaccine works as well of need (CON) with the South MUSC Board of Trustees and senior million for renovations at MUSC Health as information on how MUSC Health Carolina Department of Health and leadership, thank you for your sustained Chester Medical Center. is administering the Pfizer BioNTech Environmental Control (DHEC) for the support and contributions to the •A lease amendment to continue vaccine and how the health system is deployment of a linear accelerator in Medical University of South Carolina providing 46,857 square feet of space to working to reduce vaccine hesitancy. Lancaster County and a surgical robot over the years. Today, we honor Dr. the Department of Veterans Affairs on “During this pandemic, our team focus for MUSC Health Lancaster Medical Edwards and celebrate this achievement the MUSC main campus in Charleston. remains to serve communities across Center. DHEC must issue a CON before in his honor. Thank you both for making •Renewal of an 11,494 square feet lease the state with engagement on multiple certain types of health care acquisitions, the first endowed chair in the College of for office space on Doughty Street in levels, including getting vaccines into expansions and creation of new facilities Dental Medicine possible. The Dr. James Charleston to continue providing space arms, providing virus testing, delivery of are allowed. A linear accelerator is B. Edwards Endowed Chair in Oral and to support the Department of Psychiatry, the newest, most effective therapies to commonly used by a radiation therapist Maxillofacial Surgery will enhance the Clinical Neuroscience Division, drug treat COVID-19 patients and continuing to deliver external beam radiation quality of clinical care and research in abuse research training and the South education about safety and prevention,” treatments to cancer patients. A surgical this area of expertise for years to come.” Carolina Clinical & Translational said David J. Cole, M.D., FACS, MUSC robot serves to extend the physical q The board voted to appoint Martin Research Institute. president. “We are also working at a capabilities of surgeons, adding the most Steed, D.D.S., to the James B. Edwards, •Renewal of a lease for 6,414 square grassroots level to plan and execute advanced and refined technology at the D.M.D., Endowed Chair in Oral feet of clinical space on Hospital Drive vaccine distribution to at–risk and rural fingertips of surgeons to benefit patients. Surgery, effective March 1. Steed is a in Charleston that supports delivery of communities as the limited vaccine q “It is a tremendous honor to professor and chair in the Department therapeutic services, physical therapy supply permits,” he added. announce the establishment of the of Oral and Maxillofacial Surgery and and occupational therapy in the Mount “To date, we have received 83,850 Dr. James B. Edwards Endowed Chair associate dean for Hospital Affairs in the Pleasant area. vaccines and administered 85,407 in Oral and Maxillofacial Surgery in College of Dental Medicine. •Execution of a new lease agreement vaccinations,” said Patrick J. Cawley, the College of Dental Medicine,” said q The board also reviewed and endorsed for 4,500 square feet of clinical space M.D., MUSC Health CEO and vice James Lemon, D.M.D., chairman of the the proposed new enterprise strategy — on Charlotte Highway in Indian Land, president for Health Affairs, University. MUSC/MUHA board. “As President of OneMUSC. The focus of the strategy is which will provide sites for Lancaster “The nearly 102% doses administered MUSC, Dr. Edwards worked tirelessly to empower and propel team members to pediatrics and a multispecialty clinic. achieve greater innovation, impact and •Renewal of a lease for 4,200 square feet influence over the next five–year period. of clinical space on West Meeting Street One such enterprisewide initiative, the in Lancaster to continue providing space MUSC Workday implementation, was for MUSC Health general surgery. shared with the trustees. •A lease renewal for 1,143 parking Editorial Office The MUSC Catalyst News is Workday is a state-of-the-art platform spaces in the Hagood parking lot located MUSC Office of Public Affairs published bi-monthly. Paid that will transform, integrate and at Fishburne Street and Hagood Avenue. & Media Relations, 135 Cannon advertisements,which do not standardize MUSC business processes q The MUSC/MUHA Board of Street, Suite 403C, Charleston, S.C., represent an endorsement by MUSC 29425 or the state of South Carolina, are across finance, human capital and Trustees serves as separate bodies to handled by Island Publications Inc., supply chain across all three major areas govern the university and hospital, 843-792-4107 Moultrie News, 134 Columbus St., of MUSC — the university, MUSC normally holding two days of committee Fax: 843-792-6723 Charleston, S.C., 843-958-7480, 958-7384, Health and MUSC Physicians. It will and board meetings six times a year. For 958-7488 or 937-7489. E-mail: advertising@ Editor: Cindy Abole moultrienews.com. consolidate some 70 different human more information about the MUSC [email protected] resources, finance and payroll systems Board of Trustees, visit https://musc. into a single core cloud–based system. co/3x0hjWw. 3 mUsC CAtAlyst news, April 16, 2021 ‘Wood’ you believe it? High school sophomore shows gratitude to health care workers with gift

By BryCe donovAn Lorenzo said. “They are risking their lives — and some are even dying — to serve [email protected] their communities.” his pandemic has been difficult on Lorenzo's father had kept on him Tpeople of all of ages — none more so about needing to be productive over the than teenagers. summer of 2020, and so, he decided In normal times, high school kids to kill two birds with one stone — and would be hanging out, going to each he started tinkering with wood in the other’s houses, grabbing meals together, family’s workshop. The end result of that playing sports. It’s a formative time in tinkering was a beautiful, hand-carved a young person’s life. But these aren’t wooden half–scale American flag. He Photos by Sarah Pack normal times. And Lorenzo Liberti isn’t knew he wanted to give it to the hospital A group of MUSC Health front-line care team members – ranging from your normal teenager. where his mother worked as a way of security personnel to nurses – gathered to receive a gift from 16-year-old That’s because the 16–year–old saying thanks, but little did he know that Lorenzo Liberti. Bradenton, Florida, native has something that donation would lead to community most high school sophomores often interest well beyond his wildest dreams. lack: perspective. Lorenzo, whose Soon, people all over — not just Florida mother works in health care, got to but nationally — were clamoring for hear firsthand what the front lines were more. And with that increase in demand like in the midst of one of the deadliest came an idea: What if he made one for pandemics in our nation’s history. And a hospital in each state? He would take those tales were frightening. Lorenzo donations for supplies and anything quickly realized there was a new type of extra he raised would go to homeless hero — one who wears scrubs instead of veterans – another type of hero that tights and a cape — that deserved to be Lorenzo feels is often underappreciated. recognized. From that idea Heroic Flags was born. “Their courageous efforts and strength For South Carolina, he chose MUSC. are inspiring everyone across the world,” And on a sunny March day, a small

Each flag takes Lorenzo approximately 20 hours of work to finish. ceremony was held in the Horseshoe now, the money is on Shawn Jenkins where the flag was presented to MUSC Children’s Hospital and Pearl Tourville employees. The finished product is a Women’s Pavilion. brilliant red, white and blue painted flag. “It just makes sense that something On the back is a simple message from so inspiring done by a child would be Lorenzo: “Thank you for your service.” displayed in a place where other children “Just knowing that there are members and their families could appreciate it,” of the community out there who are said Tuk. thinking about front line workers is Since last summer, Lorenzo has made really inspiring,” said Sunday Tuk, more than 60 flags — some for states and principal donor liaison, MUSC Office others for individuals making sizeable of Development. “I can’t overstate how donations to his cause. He said each flag much it means to our health care team takes about 20 hours to make. That's members to know just how much they nearly 1,200 hours of work spent carving are appreciated.” and painting. His goal is to raise $50,000 Hospital leadership is currently making flags. He’s almost halfway there deciding on the perfect place to display already. To learn more or inquire about the gift — which will be accompanied by getting one of your own, visit heroicflags. a commemorative plaque and a photo com. of the day it was received — but right 4 mUsC CAtAlyst news, April 16, 2021 Technology developed at MUSC holds promise for preventing liver cancer

By Kelsey HUdnAll captured glycoproteins are then sprayed with an enzyme that releases the glycans. [email protected] The glycans that are present on each Technology developed by researchers glycoprotein are analyzed for changes that at MUSC Hollings Cancer Center can are associated with liver disease using detect early–stage liver cancer at double MALDI imaging mass spectrometry, a the rate obtained with current standard laser imaging technique used to find diagnostic tools. disease biomarkers. The technology, which is currently The partnership with Bruker only being used for research purposes, is Corporation will link the GlycoTyper designed to classify how sugars known as technology with Bruker’s precision glycans change during the development of MALDI-TOF mass spectrometry cancer. If brought to market, the resulting instrumentation, which will help to product would be a rapid blood test that accelerate a wider adoption of the could detect liver fibrosis (or scarring) approach. in its earliest stages, allowing time for What makes the diagnostic assay unique intervention before the disease progressed is that it can analyze thousands of proteins to permanent liver damage or liver from blood or tissue samples quickly, cancer. The test could also aid providers according to the researchers. Current in determining the current stage of a glycan analyses are only able to analyze a patient’s liver disease. small number of proteins at a time, which Photo by Marquel Coaxum A new seed investment from limits the glycan information that can be Dr. Richard Drake and his team recently received investment funding to Bruker Corporation, a company that collected. further develop and commercialize their patent-pending technology to manufactures scientific instruments The planned laboratory-developed test detect liver disease. and diagnostic solutions, will help the would also be unaffected by co-occurring researchers to further develop, validate conditions, such as obesity, which are The GlycoTyper and commercialize the technology, which problematic for current diagnostic testing technology could is known as GlycoTyper. The researchers protocols for liver fibrosis. be used to identify hope this support will aid them in According to Anand Mehta, Ph.D., chronic conditions bringing the test to market for the benefit Hollings researcher and GlycoPath chief beyond liver of patients within the next few years. financial officer, GlycoTyper’s ability to disease in the GlycoTyper is a patent-pending analyze thousands of samples quickly future. technology developed at MUSC and demonstrates its potential for use in is licensed by GlycoPath Inc. from glycan biomarker studies that extend Photo Provided the MUSC Foundation for Research beyond liver disease and cancer. Development. “In the area of liver disease, including Richard Drake, Ph.D., Hollings liver cancer, GlycoTyper–based analyses researcher and chief executive officer were able to detect early–stage cancer at of GlycoPath Inc., which has licensed double the rate obtained with the current when treatment options are scarce and with diseases besides cancer and liver the technology, said, “We are excited gold standard markers,” said Mehta. less effective. If it’s diagnosed early, disease. Our unique analytical strategy is to partner with Bruker to develop our “The platform is capable of hundreds to simple lifestyle changes involving diet, highly reproducible and robust, offering a clinically important glycan profiling thousands of glycan measurements per exercise and smoking habits can reverse strong foundation for additional clinical technologies and to make GlycoPath day, making it amenable to a wide range liver damage, as the organ can repair and tools targeting disease-associated glycan products available to customers of bioanalytical applications in drug regenerate itself. changes.” worldwide. Our analytical technology development, clinical diagnostics and While GlycoTyper’s abilities could Glycans are produced in the liver, links the immune response to disease with basic and translational research.” be expanded beyond liver disease and making liver disease an easy first target. circulating biomarkers to provide novel cancer to chronic conditions such as According to the researchers, using the diagnostic tools across the spectrum of addRessing a local need heart disease, diabetes and arthritis, the technology to detect liver cancer is simple cancer, infectious disease and aging.” According to the Centers for Disease researchers hope their initial focus on compared to other applications they have Control and Prevention, roughly 4.5 identifying liver fibrosis will help them to planned. How it woRks million U.S. adults (nearly 2% of the meet a pressing health need of the state. In the future, they hope to be able to The proprietary glycan profiling population) have been diagnosed with Hollings researcher and GlycoPath help clinicians to determine whether technology works by first capturing liver disease. While the disease typically chief scientific officer Peggi Angel, Ph.D., any type of cancer is present in the body diagnostic glycoproteins from blood takes years to develop, it often goes said, “GlycoTyper is proving to be an using an antibody array slide. The unnoticed until it reaches a later stage, applicable tool for identifying patients See Liver on page 11 5 mUsC CAtAlyst news, April 16, 2021

Meet AMber

Amber K. Sansbury

College; Years at MUSC College of Health Professions–Occupational Therapy Program; Class of 2023

How are you changing what’s possible at MUSC I have the opportunity to actively innovate occupational therapy within my academic setting while promoting diversity. I have the chance to utilize my knowledge so that I can better serve the community.

What music is in your player now Lofi Hip Hop Radio — beats to relax and study to

Someone in your life who inspires you My mother, Elaine Sansbury-Williams

Latest TV or cable series to binge watch “Ginny and Georgia”

April is OT Month, how will you celebrate By promoting the OT field on all social media

Favorite quote “She is clothed with strength and dignity, and she laughs without fear of the future.” —Proverbs 31:25 6 mUsC CAtAlyst news, April 16, 2021 MUSC Health’s first COVID lung transplant patient heads home

By leslie CAntU Or to be transferred from his home hospital to MUSC Health to undergo a [email protected] double-lung transplant after COVID-19 hen Ryan Nacovitch, of Sumter, ravaged his lungs. WSouth Carolina, celebrated his When he celebrated his 36th birthday, 35th birthday in March 2020, he was a it was in Ashley River Tower (ART) at typical healthy guy, just two months shy MUSC Health. He was in the hospital, of his first wedding anniversary. but he was once again breathing on his Sumter County had recorded two own, thanks to the new set of strong deaths from COVID-19, and Gov. Henry donor lungs in his chest. McMaster had already ordered schools And on April 8, Ryan and Melissa Photos by Sarah Pack across the state to close temporarily, yet walked down the hall from his room to Staff who cared for Ryan Nacovitch during his stay at MUSC Health lines the pandemic had barely begun. a ceremonial bell, where dozens upon the halls to watch his bell-ringing ceremony in honor of his lung donor Sumter had yet to cancel its iconic Iris dozens of people who had cared for him and cheer him on. By coincidence, April is National Donate Life Month. Festival. at some point — doctors, nurses, physical Transplant The Centers for Disease Control and therapists, occupational therapists, patients at MUSC Prevention had yet to recommend even respiratory therapists, perfusionists and Health receive a voluntary mask–wearing. more — waited to cheer for him. pillow shaped like Sumter had yet to pass a mandatory “This is a time for us to gather and their transplanted mask mandate. take a minute to celebrate and reflect on organ. Nacovitch’s His mother, Laura Nacovitch, had yet Ryan’s journey and Melissa’s journey,” is signed by a to contract COVID-19 and die during Heather Geffert, R.N., heart and lung few of the team the summer spike. transplant coordinator, told the group. members who He and Melissa, his wife, had yet “We're going to celebrate that journey cared for him. to contract COVID-19 in the post- and Ryan’s incredible fight. His tenacity. Thanksgiving spike. His drive was relentless in getting us to And Ryan had yet to spend 116 this point today.” days hospitalized; to be at the point where, as one of his doctors said, he national outlook said it seems that fewer than 100 people the person needs supplemental oxygen. was maintaining the “bare minimum It’s unclear, at this point, how many across the country have had lung and/or In some cases, it’s meant that the patient numbers to stay alive” while getting the people who have had COVID-19 have heart transplants following COVID-19. needed an entirely new set of lungs. most medical support possible at a center required transplants. Timothy Whelan, He believes Ryan was the first such But again, doctors are still learning why without a specialized oxygen–delivery M.D., medical director of the Lung patient in the Carolinas, he said. COVID-19 might destroy one person’s machine called ECMO. Transplant Program at MUSC Health, Nor is it clear why people have such lungs while barely affecting another. different experiences with COVID-19. “I don’t know why it happened to “I’ve seen people who are a lot him,” Whelan said. healthier than me die of COVID,” Whelan said. tHe diagnosis With most illnesses that hit the lungs, Ryan was dragging in early December. people either fully recover or go on to He and Melissa were helping one of her develop multisystem problems and die, children to move into an apartment in he explained. But that’s not the case with the Upstate, and he just didn’t have any COVID-19. “We are seeing that there energy. The next day, Melissa started to are people who live through this and, feel poorly, so they went to get COVID instead of having a lung injury that will tests, even though Ryan was pretty sure it slowly get better with time, they seem to was just a cold. just develop dense scarring, or fibrosis.” It was COVID. They didn’t know That scarring is irreversible and means See Transplant on page 7 7 mUsC CAtAlyst news, April 16, 2021

Photos by Sarah Pack Left photo: Ryan and Melissa become emotional as they recount their story from Ryan’s hospital room at MUSC Health. Right photo: Ryan rings the bell in honor of his organ donor. “He’s a trouper,” she said. on ECMO, or extracorporeal membrane trAnsplAnt Continued from Page Six was getting ready for work, and he said, ‘I'm so sorry.’ And I was like, ‘Why?’ He Communication is a common oxygenation, a device that pumps oxygen it, but Sumter — and the rest of South said, ‘I'm having trouble breathing, and frustration for patients on ventilators, directly into the bloodstream to allow the Carolina — was at the start of another they’re going to put me on a ventilator,’” because they cannot speak and can be lungs to rest. Although the process can vicious spike in cases. Melissa said. too weak to write. Because it appeared give patients and doctors the necessary After learning they had COVID on The nurses helped them to FaceTime, Ryan would be on the ventilator for a time to get a situation under control, it Dec. 6, they went home to quarantine and then Ryan was vented. while, Mullins got him a special speaking also comes with risks of complications and recover, but on Dec. 9, with Ryan “Him going on the ventilator was very valve and had a speech therapist teach and must be constantly monitored. feeling worse, they went to Prisma Health frightening for him,” Melissa said. “And him how to use it. At her first session with Ryan, Myers Tuomey Hospital in Sumter where for me.” But, she added, “I told him if I got was able to get him to sit on the edge of they learned he might be developing That was Jan. 12, exactly a month after him the valve, then the first thing he the bed for 15 seconds. pneumonia. At home, they used a pulse he had been admitted. That timeline is had to say was that Dr. Mullins was his That was it. Fifteen seconds. oximeter to monitor their blood oxygen pretty unusual, Whelan said, as most favorite doctor. And he held true. He's “I remember thinking, ‘Oh my levels. Normal blood oxygen levels COVID patients who end up on a a trouper even when I ask him to do goodness, we have our work cut out for should be between 95% and 100%. ventilator do so early in the course of stupid stuff.” us.’ Medically, he couldn’t tolerate doing When Ryan’s hit the 60s on Dec. 12, the disease. With his condition so grave, But most of what she asked wasn’t so more than that. It wasn’t that he didn’t Melissa packed him up and drove him to Melissa was looking to both MUSC light–hearted. Although the possibility want to,” Myers said. the hospital. Health and Duke University Hospital to of a lung transplant had already been But Ryan was determined. And Melissa At the hospital, Ryan’s condition see which center would have space first raised, Ryan wasn’t strong enough for the was by his side, coming to his hospital continued to worsen. He suffered a for Ryan. surgery when he first arrived. He needed room every day and returning at night pneumothorax, or collapsed lung. “MUSC got him first, and we’re nutritional support as well as physical to the garage apartment of a friend of a Already, the doctors there were talking thankful,” Melissa said. “MUSC has therapy to build him back up. friend. The care team universally credits about getting him on a lung transplant saved his life and treated us like family.” The “deconditioning” after being ill Melissa for her role in Ryan’s recovery. waiting list. Whelan said he consulted and bedbound since early December “Half of his resilience is his incredible with the Tuomey team and was able to pRepaRing foR tRansplant had left him incredibly weak. But spouse, who has been through so much clear some insurance hurdles to allow Jessica Mullins, M.D., was the critical unlike other patients whose underlying and has been here in the most amazing Ryan to come to MUSC Health for care doctor on call when Ryan arrived conditions ruled them out as transplant manner,” Myers said. evaluation when Ryan’s condition grew on Jan. 16. He was barely hanging on, candidates, this deconditioning could be Within a week of that first session, even worse, requiring a ventilator. and the doctors figured that if he was reversed, Mullins said. Ryan was standing. Soon he was Ryan and Melissa remember that going to recover on his own, they would “I got a text from Dr. Mullins early in walking. For nearly three weeks before moment. They were both out of COVID have started to see signs of improvement February that said, ‘We have kind of a his surgery, he was walking 300 to 400 quarantine by then, but Tuomey had already. long shot, but this is really his only hope. feet each day. He also rode a recumbent reinstituted visitor restrictions because “We know COVID takes a long time You need to be able to get him to walk,’” bike in his room. In addition to getting the pandemic had spiked again, so they to get better, but he had not gotten any said Alex Myers, physical therapy team strong enough for surgery, he had to communicated via texts. better,” she said. lead at ART. “It was seven o'clock in the morning. I Yet Mullins saw Ryan’s fighting spirit. By that point, Ryan had been placed See Transplant on page 11 8 mUsC CAtAlyst news, April 16, 2021

COVID-19 Vaccines Crowded airplanes, skeptics and other things you need to know

By BryCe donovAn delve into the most relevant topics in the world of vaccine. In light of how [email protected] complex navigating life outside the home So many variables go into a meeting seems to be these days, we thought we’d these days. lead off this week by sharing a really cool Will it be tool put together by the New York Times. outside? Inside? (Just enjoy it; don’t feel obligated to leave Are there going feedback.) Think of it as a choose your to be lots of own adventure book but with yes/no people there? questions relevant to living life outside How many are our own walls. It asks things like, “Will vaccinated? you be there for more than an hour?” Do any of or “Will there be more than 10 people them listen to there?” Each answer leads you to another Nickelback? question until eventually you are given a Two trains are risk rating. Of course, most people will straight driving toward Scheurer one another. up ignore any advice if it isn’t what they The first train leaves Town A at 5 a.m. want to hear, but isn’t it nice to have Photo by Suhyeon Choi for Unsplash traveling at 60 miles per hour. The somebody that isn’t your know–it–all Airplanes are about to get a lot more crowded. second train … cousin doling out a little guidance for a You get the point. It’s complicated. No change? in with Danielle Scheurer, M.D., MUSC hanging in the balance. two situations are seemingly ever similar. With the vaccine landscape changing Health System chief quality officer to ask Each week in this space we try to almost daily, each week we are checking her the most pertinent questions that are See Vaccine Q&A on page 9

For information or to register for the April 30 virtual awards ceremony, visit https://musc. libguides.com/spcpoetrycontest 9 mUsC CAtAlyst news, April 16, 2021

What you need to know about the COVID-19 vaccine – Part 6 Danielle Scheurer, M.D., MUSC Health System’s chief quality officer, weighs in on the most pressing issues related to COVID-19 and vaccination. The following is a condensed compilation from recent articles that can be found in their entirety on the MUSC Catalyst News digital platform at web.musc.edu/ about/news-center.

Q. Coronavirus cases are going up again. In nine states over the past two what pans out. It’s a good question though; it’s just unanswerable right now. weeks, virus cases have risen more than 40%. Michigan led the way with a 133% increase. In light of that, President Biden is calling for reinstating mask Q. How great is the Pfizer trial news about kids 12 to 15? Better results than mandates. How do you feel South Carolina is doing on that front? adults and no virus infections after receiving the vaccine. Why do you think A. On the whole, I think our state has been doing pretty well, so I guess I that is? And do you think this will help sway people who were on the fence was a little surprised by the “back to work” mandate issued recently. I think about vaccinating their kids? businesses have to make individual decisions based on their unique local A. The short answer is immunity becomes more complex the older you get. conditions — you know, things like local epidemiology, open day cares, etc., so It’s basic science: The more things we are exposed to over time, the more a blanket mandate can be really hard to conform to. nuanced our immune system becomes, as opposed to kids who have fewer comorbid conditions. From an immune system standpoint, they are just more Q. Brazil is a very scary place right now. I read that 125 people are dying every predictable. So it shouldn’t really be all that surprising that it’s working so hour from COVID. Do you think we tend to focus more on us as a country well. It’s still great news, though. and not enough as a globe? A. I do. It’s a global economy that we live in today, and people are traveling Q. Italy is now forcing health care workers to get vaccinated. Is this something constantly. So what’s happening in Brazil and India affects us here in the we as a country might be forced to do in the future? United States. As long as there is international travel, we’re always going to A. That is just such a thorny subject. I saw a survey published in the New York continue to have clusters and outbreaks because we have to look at the whole Times last week that focused on vaccine hesitancy. In it they asked health globe. care workers if they were forced to be vaccinated, would they do it or quit their jobs. Sixteen percent of the people surveyed said they would quit. So it’s Q. New York has done the digital passport thing we’ve talked about. How long really all about risk ratios and how organizations make those type of decisions. before South Carolina — or better yet, the U.S. — rolls out its own version? Hospitals have to ask themselves if they are willing to risk a 16% departure to A. I think it’s not too far out on the horizon. They are becoming more and get to that goal. I think the public expects — regardless of their own personal more popular in many states, so I suspect it’s not long before we have one here beliefs — that health care workers should protect themselves so they can as well. protect their patients. That’s certainly my feeling. Patients have to trust us, and in this pandemic era, what better way to gain that trust than by getting Q. It looks like that by June, airlines will go back to putting passengers in every vaccinated? seat. How spooky is that, or will we be in a much better spot by then, making domestic less scary? Q. I’ve asked you this in the past, but what do you think is the best approach A. Air travel should still be approached with some reservations, as there for getting vaccine skeptics to say “yes”? One–on–one talks with a trusted is no way to socially distance. Airlines are also likely going to pursue some person? Money? Days off work? Allowing for greater freedoms (less masking/ combination of vaccine passports and/or negative rapid testing in order for social distancing) for those who get it? passengers to board a flight. Couple that with the fact that most of these A. What the literature points to right now seems to be that the most airplanes have really good air filtration systems, I’d say that if you’re smart it convincing way to get people to get vaccinated is through a trusted colleague should be OK. or community member. Having them — it could be a family member, a pastor, a small–town mayor, that kind of person — get vaccinated and then show Q. How did Pfizer and Moderna get through their trials and to emergency use the skeptic that they are fine. That seems to be the most impactful. When authorization so fast and AstraZeneca didn’t? somebody whose opinion you value says it’s OK, that seems to work best. A. The crazy thing is that all three of them started trials in July. Then AZ had As far as incentives go, I do think some allowance of freedoms might point a small hiccup, followed by another much longer (seven weeks) pause. That people toward getting it. This gets into the concept of passports, allowing almost two–month hiatus really set them back, and I think it was just really those with them to attend larger gatherings, take advantage of air travel difficult to recover enrollment after their trials came back online. without testing, stuff like that. And I think it’s good that the CDC is finally saying to people who have been fully vaccinated that they can actually do Q. I’ve heard that some folks with long COVID have experienced relief from more. their symptoms after they got the vaccine. Have you seen any of this? A. Just anecdotally. There’s nothing in the literature yet. We’ll just have to see 10 mUsC CAtAlyst news, April 16, 2021 Anatomist, medical historian and MUSC leader remembered

By Cindy ABole [email protected]

. Curtis Worthington Jr., M.D., former educator, Wacademic leader and director of the Waring Historical Library, died on March 27, 2021, at the Bishop Gadsden Episcopal Retirement Community in Charleston, South Carolina. He was 95 years old. Originally from Savannah, Georgia, Dr. Worthington grew up in Frogmore, a small community of St. Helena Island, near Beaufort, South Carolina. He attended The Citadel and later completed a B.S./M.D. program with the Medical College of South Carolina (now MUSC) and completed both degrees in 1952. He completed a surgical internship at Boston City Hospital and previously taught at Johns Hopkins Medical School and the University of Illinois, Chicago. He returned in 1957 to MUSC as a faculty member, beginning a career that would span 50–plus years at the institution, and later Photo By Anne Thompson was named chairman of the Department of Anatomy. Dr. Charlie Strange presents the Order of Dr. Worthington also served in academic leadership the Silver Crescent Award to Dr. Curtis positions, most notably as the associate dean of the Worthington given by then-S.C. Gov. Nikki College of Medicine and vice president for Academic Haley in January 2013. Affairs. Dr. Worthington relished his role as a medical archivist and humanist, serving as the second director “He was the kind and of the Waring Historical Library at MUSC, from1982 to 2012. knowledgeable physician who knew In January 2013, Dr. Worthington was honored for the history of MUSC from its his lifetime of service and contributions to MUSC and the South Carolina Lowcountry, receiving the Order early days because he had lived it of the Silver Crescent, the state’s highest civilian award over the more than 50 years of his presented to an individual for his or her significant contributions, leadership and lifelong influence to service to the institution.” a region or community. The award nomination was submitted by former Waring Library Society president Charlie Strange, M.D. Charlie Strange, M.D., professor in the Department of Pulmonary, Critical Care, Allergy and Sleep Medicine. and friend. “Curtis was a person that exemplified from him and will be forever grateful for his knowledge “My remembrances of Curtis are as a friend to anyone great integrity. He had limitless integrity — doing and and wisdom that he shared with me. As I continue who shared his interests in the history of medicine,” believing in what he said. He was a wonderful man.” preserving the institution's historical record, I will ask said Strange. “He was the kind and knowledgeable Brooke Fox, university archivist at the Waring myself, ‘What would Dr. Worthington do?’” physician who knew the history of MUSC from its early Historical Library, worked with Dr. Worthington He was predeceased by his wife, Floride McDermid days because he had lived it over the more than 50 years for several years and admired his dedication and Worthington, and is survived by a son, a daughter, a of his service to the institution. As such, he was a fitting commitment to preserving the rich history of MUSC in son–in–law, daughter–in–law, six grandchildren and recipient of the state of South Carolina’s Order of the the Lowcountry community and throughout the state. four great-grandchildren. Silver Crescent award by former Gov. Nikki Haley in “Dr. Worthington loved this institution and the In lieu of flowers, donations may be made to January 2013.” Waring Historical Library,” said Fox. “His role in the Waring Historical Library at MUSC, Edisto Former professor and MUSC College of Medicine preserving MUSC history and the history of the health Island Open Land Trust, South Carolina Coastal Dean Layton McCurdy, M.D., echoed his deep sciences in South Carolina cannot be overstated. I Conservation League or a charity of choice. admiration for his former teacher, mentor, colleague learned most of what I know about MUSC's history 11 mUsC CAtAlyst news, April 16, 2021 trAnsplAnt Continued from Page Seven category of patients that we're going to be immUnity Continued from Page One offering transplants to,” he said. strengthen his legs in preparation for All told, despite the logistical Vaccinations are one part of the life immediately post-surgery, when challenges of transferring Ryan from complicated formula that helps his he wouldn’t be able to use his arms to ECMO to a cardiopulmonary bypass team estimate immunity. “We take push up from a lying or sitting position. machine for the actual surgery and the into account whether you've had one Pushing up with the arms would exert apprehension of not knowing how the vaccination or two. You just get partial force on the incision through his surgery might unfold, Ryan’s transplant credit for immunity if you've only had sternum, potentially interfering with went remarkably well. one dose. Once you've pretty well,” healing. The team had anticipated keeping Sweat said. Once Ryan was ready for surgery, it was him on ECMO after the surgery to Infections, both documented and a matter of waiting for lungs to become let his heart rest, but Ryan “flew off” estimated, are another key factor. However, Sweat cautions people not to available. the cardiopulmonary bypass machine, Sweat said for every known case of let the good news obscure the fact that “Every day when you’re critically ill, Gibney said. COVID-19, there may be at least five about 35% of South Carolinians may every hour that you have to wait to get “The most remarkable thing, to me, other people who either didn’t get still be vulnerable to the coronavirus the gift can be the difference between has been his positive attitude through sick or didn’t get sick enough to get because they haven’t been vaccinated or getting one and not,” Whelan explained. the entire thing,” Gibney said. “He's tested. infected. People who aren’t eligible to “None of this happens without people been extremely motivated. He has done And the length of time people keep get a vaccine yet, such as children, are making the gift. And unfortunately, everything we've asked him to do, and on their immunity to the coronavirus included in his estimates since they can somebody’s got to have something top of that, our physical therapy staff has after recovering from an infection is get sick and transmit the virus to other bad happen in order for us to do great been really working hard with him.” part of the formula as well. It’s an people. things,” he said. “Thank goodness “This is less a story of COVID and evolving area. As more time passes, “There’s still a lot of virus around. I someone signed their donor card and lungs; this is more a story of motivation scientists know more about it. mean, it doesn’t take much for this to was willing to make the gift.” and teamwork,” Gibney continued. Last week, Sweat’s team extended blow up,” Sweat said. “This virus seems “He wouldn’t have done what he did the length of time it considers people to be whack–a–mole ever since the tHe suRgeRy if he didn’t have the attitude and if the who have had COVID-19 are likely beginning. Michigan, in particular, is COVID-induced lung transplants are physical therapy team wasn’t committed to retain their immunity from three having this massive outbreak. It could still so new that surgeon Barry Gibney, to him recovering.” months to five months, based on high happen again here, too.” D.O., wasn’t sure what he would find quality research published online in He also worries about variants that when he opened Ryan up. Descriptions discHaRge day the respected journal Science. Some help the virus spread more easily. from colleagues across the country were Many of those who had worked with doctors think immunity extends well But those concerns come against the all over the place. Ryan and Melissa gathered last week for beyond that, but that hasn’t been backdrop of more and more people Ryan’s lungs were an odd combination the traditional bell–ringing ceremony in documented yet. getting vaccinated every day - and that of the types of lungs he sees in cystic honor of the organ donor. You can get a lot more detail about encouraging 60% immunity estimate for fibrosis patients and those of people with Many more couldn’t be there: the how the epidemiology team estimates South Carolina. interstitial lung disease, an umbrella term team at Tuomey, who kept him going immunity on its website. “There is a point where you get to, that means scarring caused by disease or until he could be transferred; his and The epidemiology team’s latest traditionally called herd immunity, where an environmental factor. Melissa’s shared workplace family, who update covers a lot of other COVID the virus just can’t propagate anymore. It “It was very easy to see why his lungs held fundraisers and let Melissa remain information as well. COVID in the can’t get through the networks and goes weren't working,” Gibney said. in Charleston at Ryan’s side; and all his Tri–county area rose 7% over the away. I personally don’t think we’ll ever Normal lungs should be soft and friends and family watching his progress past week. It’s easy to get a test and completely do away with this, because spongy. Ryan’s were heavy and dense — from afar via updates from Melissa. hospitals aren’t under any strain from there are reservoirs of the virus in some more like a liver. And the blood vessels Ryan is eager to get back to work the virus. places,” he said. were clumped together and contracted, building firetrucks at Fire Equipment so small that they reminded Gibney of Sales and Service, not to mention lifting iver Continued from Page Four what he might see in a pediatric case. weights and a new woodworking hobby, l of product development at GlycoPath, who received her graduate degree from Gibney thinks Ryan’s is a somewhat though it will be some time before he based on the antibodies that are MUSC, said, “Although the role of unusual case in that few people survive can tackle any of those activities. He’s present. This application could be a glycans and glycoproteins has been for almost two months on ECMO. But also become interested in painting, after useful clinical decision–making tool evaluated in cancer for decades, the lung transplants could become necessary a session with the art therapy team. when clinicians are trying to rule out clinical relevance of these studies has for some people with long COVID, he In the meantime, being “home” with other diseases. been limited due to a lack of clinical said. Melissa, in a temporary apartment near While antibody array technologies assays. GlycoTyper was developed to “I do think that we're going to start MUSC Health so he can complete post- have been around for years, the directly address the need for a more seeing the COVID long–haulers that are surgical rehab, is a welcome first step team believes their novel method for high–throughput method for protein– going to have end–stage lung disease as toward normalcy. glycan analysis can help to fill critical specific glycan analysis from biological it relates to their coronavirus. I would “I'm just glad I got a chance to keep information gaps that still exist in samples.” imagine that it's going to be a new going on,” he said. other analysis methods. Danielle Scott, Ph.D., chief officer 12 mUsC CAtAlyst news, April 16, 2021

“I’ve taken things I used to do traditional teaching methods but completely straightforward in the through the use of video and audio as Online course is on target classroom and turned them into online well. games,” said Kathryn Kinyon, DNP, “What I loved most about the with MUSC educators a professor at the MUSC College of course was it introduced me to new Nursing. Kinyon has made virtual technologies,” said Anthony DeClue, By BryCe donovAn be came up with a way to arm them with escape rooms, online scavenger hunts — Pharm.D., assistant professor in the [email protected] the tools they would need to teach in the anything to keep the students connected. Department of Clinical Pharmacy new world of COVID. “I’m even teaching them to make their and Outcomes Sciences. “Because of year ago, COVID-19 changed the Alex Walters, senior instructional own online learning modules. So, in that, I think I go into teaching more A world forever. And in no place designer and digital accessibility specialist a way, I guess, I’m having them do my confidently. It’s also made me a better was that change more obvious than in at MUSC, along with Melissa Hortman, job,” she said with a laugh. conductor, for lack of a better analogy, in schools. Once buzzing epicenters of Ed.D., associate professor and director of Though MUSC instructors might that I can keep the other players on track learning, these same educational facilities Instructional Technology at MUSC, were vary a great deal when it comes to their because of the skills I came away with.” across the globe became ghost towns. tasked with helping the medical school’s technological IQs, before this pandemic, The course, which went from idea Classrooms that once held dozens of faculty to get up to speed in the new they most certainly all had one thing in to reality in a little over a month, was students were replaced by empty chairs online teaching world — quickly. common: a lack of experience teaching completely developed and implemented and a laptop. Chatter was replaced by “I In a very short amount of time, virtually. by MUSC. think you’re on mute.” And hands-on Walters and Hortman came up with “Our primary goal was to demystify “This is the first time we’ve had learning became decidedly hands off. a course that not only taught faculty online teaching,” said Walters. In something like this on campus,” Though being educationally isolated the basics of teaching online but also doing so, the two aimed to create an Hortman said. “Historically, we’ve was a completely new experience for showed them new and innovative ways online community. “One of the biggest been very traditional when it comes to students, for their professors, it was a to make it more fun. Their brainchild, casualties of remote learning is the loss learning. COVID pushed us into a realm seismic shift. It’s hard enough to discuss the Foundations of Quality Online of community. When you’re physically no one was comfortable with. So we 20th century English literature online. Instruction, is a four–week self–paced spread out and in front of a terminal knew the best way to counter the feeling Now try showing soon–to–be doctors course designed to introduce best instead of a colleague, it’s easy to feel all of distance was to focus on building an how to remove a spleen. practices as well as tools and theories alone,” he said. online community of learners.” Lucky for professors at the Medical related to online instruction. Those who took the course learned More than 130 MUSC professors, University of South Carolina, leadership Not too surprisingly, faculty members how to improve interactivity with their spanning 27 departments in all colleges, realized it couldn’t just expect instructors were very receptive and enthusiastic students more fully, as well as support have taken the course. To sign up for the to “figure it out,” and so the powers that about it. active learning, not only through course, visit the faculty resources page.