June 26, 2020 Vol. LXXII, No. 13

James Gilman, CEO of the Clinical Center. were worried about bringing the virus home.” He introduced her detective story—part of a After thanking a Hospital Epidemiology new lecture series by the Covid-19 scientific Service (HES) staff she called “amazing” GLOVES OFF interest group—on a day (including its former head, when the CC had screened Dr. David Henderson, who As in Hospitals, So in Homes: its 100,000th visitor. semi-retired 5 months ago), Avoiding Coronavirus “That’s an astonishing Palmore embarked on what Infection number,” he said. “But she called the CC’s “quirky we followed the playbook timeline with Covid-19,” BY RICH MCMANUS written by Tara Palmore. beginning on New Year’s The take-home messages—let’s call them The virus has slipped in once Eve, when “vague news of stay-at-home messages—came fast and thick or twice, and we were able undiagnosed pneumonia in during Clinical Center epidemiologist Dr. to do contact-tracing later Wuhan reached us, involv- Tara Palmore’s May 20 lecture on how NIH’s [18 contact studies over 9 ing a few dozen people.” hospital first became aware of a rising threat weeks turned up 4 cases Ten days later, the new from a novel coronavirus, then took steps to of secondary infection of virus’s sequence was posted, keep it not quite out of the CC, but away from staff by patients or other and on Jan. 22, the Clinical staff, some of whom, in Center began screening patients, none of whom, so far, have been Dr. Tara Palmore infected by staff. mid-March, were not yet patients by travel history, “It is impossible to overstate how crucial wearing masks].” Gilman with recent sojourns in Tara Palmore and her staff have been in praised Palmore’s “kindness, understanding China being of particular concern. preventing the spread of Covid-19,” said Dr. and patience, especially with employees who SEE PALMORE, PAGE 4

HISTORY COMES ALIVE Velez’s Lightbulb Moment Students Learn Lessons from Leads to Efficient Employee Previous Pandemic Triage BY DANA TALESNIK Back in early Last fall, when March, an Virginia Tech NIH-wide email professor Dr. E. went out advising Thomas Ewing staff to call the assigned his Occupational history class a Medical Service if research project they had concerns Birx, Kushner visit VRC. See story on p. 2. on the 1918 about exposure to Spanish flu, he Covid-19. ALSO THIS ISSUE never imagined “When I read Safety Officer Serves on Multiple Covid-19 the country would this, I imagined Missions...... 3 be in the middle a phone-based Frank Velez normally rides his bicycle to of another global Royal Society Honors Two NIH’ers...... 5 system would campus, and admits to pandemic by the Dr. E. Thomas Ewing, in be quickly over- missing it: “I still do a New NIEHS Director Named ...... 9 spring semester. front of a pylon listing whelmed, so I virtual bike commute Virginia Tech students each day.” Digest...... 10 Now, their project and alumni killed in contacted [NIH has taken on new World War I, including Milestones...... 11 Deputy Director for Management] Colleen meaning. several who died in the 1918 flu pandemic [McGowan],” said Frank Velez, clinical Two NIH’ers Adapt to New Reality...... 12 SEE SPANISH FLU, PAGE 6 SEE VELEZ, PAGE 8 BRIEFS

NIMH Strategic Plan Paves Way for Advances On May 20, the National Institute of Mental Health released its Strategic Plan for Research. The new plan provides a framework for advancing research priorities that support the institute’s mission: To transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. “Mental illnesses are common in the , affecting tens of millions of people each year,” said NIMH director Dr. Joshua Gordon. “Improving treatment for people with mental illnesses will depend on continued research to define the biological underpinnings of these disorders, as well as ongoing translational and clinical research to turn that knowledge into new or improved treatment options.”

Birx, Kushner, Smith Visit VRC On June 9, NIH hosted a visit by (top, from l) Brad Smith, Dr. and , who toured the Research Center and received an update on NIH response to the global Covid-19 Over the past 5 years, NIMH-supported research pandemic. Birx is White House coronavirus response coordinator. Kushner is senior advisor to the has revealed hundreds of places in the genome President. Smith is director of the Center for Medicare and Medicaid Innovation at the Centers for linked to mental illnesses; fostered the devel- Medicare and Medicaid Services. They were greeted by NIH director Dr. (r) and NIAID opment of new tools and resources that have director Dr. . The briefing included NCI director Dr. Ned Sharpless, who discussed dramatically increased the ability to study the SARS-CoV-2 serology, and NIBIB director Dr. Bruce Tromberg, who outlined the RADx program, along brain; played a role in the development of two with Collins and Dr. Tara Schwetz, NIH associate deputy director. Below, in a VRC lab are (from l) VRC director Dr. John Mascola, Birx, Kushner, Fauci, Smith, Collins, VRC deputy director Dr. Barney Graham novel antidepressants; and proved the utility and vaccine researcher Dr. . of coordinated specialty care for first-episode psychosis—resulting in nationwide implementation PHOTOS: CHIA-CHI CHARLIE CHANG through state-supported mental health clinics. The new plan builds on the successes of previous NIMH strategic plans and provides a framework for scientific research and exploration to address challenges in mental health over the next 5 years and beyond. It will be updated regularly to keep pace with ever-evolving scientific approaches and research priorities that may lead to new discoveries. NIMH developed the plan with input from a variety of stakeholders, including the National Advisory Mental Health Council, federal and private partners, feedback from organizations, advocacy groups and people with lived experiences and their families, and NIMH and NIH leadership and staff. “Over the last decade, we’ve seen incredible scientific advances that have rapidly transformed neuroscience and mental health care,” said Gordon. “While there is still more work to do and challenges ahead, the future is bright.” The plan is available at www.nimh.nih.gov/strate- gic plan.

2 • NIH RECORD • JUNE 26, 2020 Czarnecki’s day job at NIH involves anticipating, NIH Safety Officer evaluating and mitigating occupational hazards, everything from biological and chemical agents to Serves on Multiple physical hazards. Missions “Because NIH is such a diverse place, I get a lot of BY DANA TALESNIK different experiences here that allow me to have a well-rounded approach and for various On a normal day, hundreds of contingencies on a deployment,” he said. officers from the Public Health Service Commissioned Corps go about their Now back at NIH, Czarnecki has returned to Bldg. regular duties at NIH. But these have 13, sharing his frontline experiences with his NIH not been normal days. team. He expressed gratitude to both family and colleagues who assumed the burden of duties in Most of these uniformed health pro- his absence. fessionals—there are more than 6,100 A responder delivers medication to evacuees aboard the “I am forever grateful for the full support of NIH working across government agen- cruise ship. cies—become emergency responders leadership that adjusted workflows as needed when crisis hits. PHOTOS: HHS in my absence, for the full support of my NIH co-workers who backfilled my position, and the full One of these is Lcdr. Brian Czarnecki, “Our team processed about 30 tests per hour, for support of my bride and children that assumed all who normally works as an industrial hygienist at the better part of each day, focusing on health household responsibilities,” said Czarnecki. “These NIH’s Division of Occupational Health and Safety care workers, first responders and the elderly with people are truly unsung heroes.” (DOHS). Starting in early February, he was deployed symptoms,” said Czarnecki. as a safety officer and process engineer assisting on multiple missions in the Covid-19 response. Further working to safeguard Americans, he served on a task force to evaluate the specifications of In early February, Czarnecki headed to Miramar Marine Corps Air Station in San Diego, to receive and quarantine hundreds of Americans traveling home from Wuhan, China. Two weeks later, he traveled to Yokohama, Japan, where he helped dis- embark 360 Americans from the cruise ship and escort them onto U.S.-bound planes for quarantine. He also assisted with swabbing to test all first responders on that mission.

In early March, Czarnecki returned to NIH and, on ON THE COVER: Ebola Virus Particle. This scanning his off-hours, worked on a team that developed a electron micrograph shows a single filamentous covid testing concept-of-operations for occu- Ebola virus particle. Scientists supported by NIH have pants of the Grand Princess cruise ship off the discovered a set of powerful, broadly neutralizing coast of California. People wait in line at the information- antibodies in the blood of Ebola survivors. gathering area at the community-based testing IMAGE: NIAID Later that month, Czarnecki headed to Washington, site in Massachusetts. D.C., to help develop a model for community-based The NIH Record testing sites. He then went north to a private personal protective equipment being procured by partner location in Shrewsbury, Mass., to help the federal government. Throughout his missions, Since 1949, the NIH Record has been published biweekly by the Editorial Operations Branch, launch the pilot, which became the first federal safety was a priority as responders monitored the Office of Communications and Public Liaison, drive-through testing facility. burn rate of PPE, to maximize supplies. National Institutes of Health, Department of Health “Promoting safety as the most import- and Human Services. For editorial policies, email editor or phone (301) 496-2125. ant priority helped ensure the team was protected during their missions Editor: Rich McManus in California, Japan and Boston,” said [email protected] Czarnecki. As a testament to their Associate Editor: Carla Garnett vigilance, despite being near people [email protected] who tested positive for covid, he and Staff Writers: his fellow responders were able to Eric Bock • [email protected] serve safely. Dana Talesnik • [email protected] “Modifying our own behaviors during Subscribe via email: Follow: [email protected] http://nihrecord.nih.gov/

the early stages of the outbreak— Facebook “f” Logo CMYK / .eps Facebook “f” Logo CMYK / .eps avoiding shaking hands and sharing The NIH Record common items, regularly wearing a is recyclable as mask and maintaining a social dis- mixed paper. tance—were perceived as odd before it became a norm in our society,” he said. Now, it seems awkward to shake hands, not wear a mask or encroach on Responders holding swabs stand ready at a testing site. someone’s personal space, he noted.

NIH RECORD • JUNE 26, 2020 • 3 whom were clinical personnel. More than “Living with a husband and three teenage Palmore CONTINUED FROM PAGE 1 1.5 million cases had been reported in the boys, I did not need a scientific study to know U.S., with more than 90,000 deaths. “Both that sneezes can travel that far,” Palmore “Each day seemed like an eternity,” she numbers are probably low,” said Palmore. quipped. said, as employees screened all patients “We’re gonna be in this for months,” she Researchers at NIAID’s Rocky Mountain either in clinic or by phone. said. “We have to be prepared for the current Laboratories showed that SARS-CoV-2 can On Jan. 27, posters went up throughout level of risk for the long haul.” survive for up to 72 hours on stainless steel the CC, warning of signs and symptoms. Palmore paused to point out that and plastic. That day, a call came in that produced alarm. studies of epidemiology curves of Covid-19 “The headlines, too, can be unsettling,” Down in the nuclear medicine department, a infection in Italy and China, as well as data added Palmore, offering as examples: Do 56-year-old cancer patient, who had already from earlier coronavirus outbreaks due to masks work? Is hoarding them wrong? been injected with a radionuclide for her Should people wear them in public? procedure, began coughing. She also had a HES, too, got inquiries: Who is really fever and difficulty breathing. protected by surgical masks? A translator on hand confirmed that Originally made of cotton, surgical masks she was from Wuhan and was suffering were invented more than a century ago, said symptoms not flagged earlier by staff. Palmore. While cotton is still used in some “There had been one or two travel-related parts of the world, most masks nowadays cases” in the United States of a suspected are made of a fluid-resistant polypropylene disease not yet called covid, Palmore said, fabric. Their job was originally to protect but no cases at the Clinical Center. patients from the oral flora of surgeons. “We raced down to nuclear medicine Studies going back to hospital care in 1918 and found the chief technician there, calm showed they could prevent spread of diph- as a cucumber,” she said. They had brought “Living with a husband and three teenage boys, theria, meningitis and pneumonia to health personal protective equipment (PPE) for I did not need a scientific study to know that care personnel. sneezes can travel [17 feet],” Palmore quipped. both the technician and the translator and Today, masks mainly protect others had already “garbed up” themselves. from whatever bug the mask-wearer may be A nasopharyngeal swab from the patient SARS-CoV and MERS-CoV, have reported carrying. They can also protect the wearer was taken to the CC microbiology lab, where occupational infection rates for health care from other peoples’ pathogens, Palmore it tested positive for respiratory syncytial workers of about 20 percent. explained. But when particles can range in virus (RSV). Palmore sought advice from the “So there is significant occupational risk,” size from droplets (5-10 micrometers) to less Maryland health department. The queue she said. “Every day, we are confronted with than 5 micrometers (aerosols), how fine a to reach the CDC by phone was 6 hours new scientific findings…[that] make us not mask is appropriate in which setting? long. The health department advised that, want to leave our house, or our bedroom.” The CDC currently recommends N95 given the positive RSV test, the patient be For example, NIDDK scientists showed masks for health care workers encountering sent home in a mask to self-isolate without that speech itself produces droplets that can Covid-19 patients, and for any medical further testing. procedure likely to generate aerosols. In the “The patient did just fine, and recovered  absence of such masks, surgical masks are from her RSV,” recounted Palmore. “We used, which is the case in many parts of the wiped the sweat off our brows and continued “We’re gonna be in this country lacking adequate PPE. our work, but [the episode] galvanized us for months. We have to be Caregivers at the CC use N95 masks, fitted into action. From that point on, we began prepared for the current level tightly, and sometimes PAPR—powered holding weekly, then daily, then thrice daily air-purifying respirators, which are bat- meetings.” of risk for the long haul.” tery-powered generators of positive air On Mar. 5, the first cases of Covid-19 were ~DR. TARA PALMORE pressure, fitted with HEPA filters, for care of patients with Covid-19. “They’re uncomfort- reported in Maryland. On Mar. 14, the first  known NIH employee was diagnosed. On able, but they work,” noted Palmore. Mar. 24, the first patient was admitted to “Eye protection is also important for any the CC, on an NIAID protocol involving the persist for 8-14 minutes in the air of a closed respiratory viral infection,” she said, though antiviral remdesivir. space, as demonstrated through tracking “face shields are not a substitute” for masks As of May 20, 8 patients had been trans- with a green laser. The very smallest par- in avoiding such infections. ferred to the CC for Covid-19 clinical trials. ticles, called an aerosol, can persist longer. “This is a cruel virus,” she reminded the Some 292 tests on 199 patients had been “That’s unsettling,” said Palmore. audience. “It is unforgiving and it wreaks conducted, 10 of which came back positive. At an MIT lab, researchers showed that havoc in the human body.” The Occupational Medical Service counted the gas cloud produced by sneezing can Fortunately, SARS-CoV-2 is an envel- 171 cases among employees, 14 percent of travel 7-8 meters almost instantly. oped virus and is easily inactivated in the

4 • NIH RECORD • JUNE 26, 2020 bronchoalveolar lavage later revealed Covid-19 infection. Royal Society Honors Two from NIH “That prompted a Two NIH scientists are among the more than massive contact study of 60 scientists from around the world elected more than 75 people,” said as fellows and foreign members of Britain’s Palmore, including staff Royal Society who were selected for their outstanding contributions to scientific who had merely been in understanding. contact with bed linens. Thirty had high-risk Elected fellow was Dr. G. Marius exposures and were imme- Clore, NIH diately home-quarantined. distinguished Thirty-eight had low-risk investigator exposures and continued to and chief of the protein nuclear “We are continually re-evaluating and improving our methods, work with masks on. After based on new science and on feedback,” Palmore said. magnetic reso- 14 days, none turned out nance section, to be infected, “which was Laboratory environment by soap and water, Palmore really a miracle,” said Palmore. “We learned of Chemical said. Viruses such as norovirus, which have a lot of lessons from that incident and we Physics, National no envelope, require stronger measures for made some improvements to our infection Institute of Diabetes and environmental disinfection, such as bleach. control as a result.” Digestive and “A bottle of 409 from under the kitchen The day after Palmore’s talk, the Clinical Kidney Diseases. Dr. G. Marius Clore counter will take care of [SARS-CoV-2], or Center instituted testing of asymptomatic Elected as a new disinfectant wipes,” said Palmore, empha- staff who have patient contact. foreign member sizing that “hand hygiene is critical for all Infection prevention involves a hierar- was NIH director Dr. Francis Collins, who viruses.” chy of controls, she concluded, including was cited “for his contributions to human It may come as a surprise to learn that administrative (symptom screening, social genetics over four decades, including wearing gloves—“often seen around the distancing, rotating care teams and testing), identifying the genetic mutation that causes cystic fibrosis and leading the landmark Clinical Center, and on campus, the Metro engineering (negative-pressure wards, a Human Genome Project.” and in stores—is not a solution to the special operating room for procedures that problem of environmental contamination,” generate aerosols) and PPE. Past fellows and foreign said Palmore. “It makes it worse. All it does is “We are continually re-evaluating and members act as a dirty layer of skin over your own skin. improving our methods, based on new of the Royal It just takes an environmental contaminant science and on feedback,” she said. Society, which and moves it around. It makes everything During a Q&A session, Palmore clarified a began in 1660, dirtier for everyone else.” number of issues. have included Isaac Newton, When barrier protection and • Asked if people should wipe down all Charles hand-washing fail and a person becomes packages that enter their homes, she said, “I Darwin, Albert infected, contact-tracing begins, of anyone don’t do that myself. I wash my hands and Einstein, an infected individual encountered 2-3 try to use common sense. People are worried Dorothy days before noticing symptoms. It is about cardboard, mail, grocery items. I don’t Hodgkin and Stephen thought that peak viral load occurs in believe the virus lasts long enough for special Hawking. the upper respiratory tract at the time of concern on any of these.” Dr. Francis Collins symptom onset. • If you use cloth masks, “the more layers, The society’s motto Nullius This scenario unfolded as Apr. 30 the more useful it’s likely to be…The thicker, in verba is became May 1 in the CC. A woman, 47, in the better, so double up.” taken to mean “take nobody’s word for it.” remission from a blood cancer, who had • If you use hand sanitizer, cover all It is an expression, according to the society, swabbed negative for Covid-19 9 days prior surfaces and let the gel evaporate. “That’s of the determination of fellows to withstand to admission, had fever on admission, a high very important,” said Palmore. “Don’t wipe it the domination of authority and to verify all statements by an appeal to facts determined heart rate, low oxygen (93 percent, when it off on anything.” by experiment. should have been over 95) and looked ill. She • The same goes for disinfectant wipes. coughed incessantly and seemed tired. “Don’t dry surfaces afterward with a paper Second and third swabs were negative. A towel. Allow dwell time. Leave it wet and chest X-ray revealed bilateral pneumonia. A allow it to air dry.” CT scan also was “very bad looking.” The full lecture is available at https:// A bronchoscopy was scheduled and a videocast.nih.gov/watch=37499.

NIH RECORD • JUNE 26, 2020 • 5 Spanish Flu around you dying CONTINUED FROM PAGE 1 from this disease,” noted Ewing. After the Covid-19 outbreak closed their More stories campus in March, Ewing’s 12 undergradu- and lessons would ates became geographically dispersed and unfold as his students thrust into other unexpected situations. set to work mining “What these students have gone historical data and through in some ways is a microcosm of documents. what the whole country is going through,” Reporting on the Flu said Ewing at an Apr. 29 NLM History of One team of Medicine virtual research symposium that students surveyed was part of the ongoing NLM/National U.S. newspapers in 12 Endowment for the Humanities partner- cities, exploring the ship to collaborate on research, education frequency and tone of and career initiatives. flu coverage. In this Oct. 16, 1918, photo taken during the height of the Spanish influenza Despite the challenges, these students— Though it pandemic, office clerks in New York City wear masks at work. six of whom discussed their findings that competed with PHOTO: NATIONAL ARCHIVES afternoon—continued their research with coverage of World renewed vigor, searching for clues from a War I, the Spanish flu dominated the news and how news gets released can affect century ago to inform their understanding and made frequent front-page headlines, public reaction and compliance with health of the current pandemic. particularly during the peak month of guidelines. “I was trying to do something different October 1918. Recording Outcomes in this course,” said Ewing, “which is to “Each city had many examples of flashy ask how we can use and alarming headlines Even a century ago, such guidelines numbers, statistics and that reported tragedies as , mask-wearing and data to cultivate a sense and could create panic in school and business closures were recom- of empathetic under- the public,” said student mended—not necessarily enforced—to curb standing in history.” Louisa Glazunova. But the viral outbreak. For example, he by late fall 1918, more displayed an archival headlines featured • • • photo of women at their preventive measures and desks wearing masks. a calmer tone to allay “I was trying to do something Probing a bit deeper, the public fears. different in this course, photo tells a rich story “[Some] stories and about conditions at that the word choices really which is to ask how we can time. shocked the readers into use numbers, statistics and The young women taking precautions more data to cultivate a sense of were office clerks, seriously during the among the highest peaks of the influenza,” empathetic understanding casualties of the Spanish said student Fiona Tran. in history.” flu by occupation. Later, the tone changed, ~DR. E. THOMAS EWING Published in a New York reassuring the public newspaper, the photo that their cooperation • • • appeared at a time was effective. when more than 10,000 In 1918, the time- Students Jacob Beachley and Yash Joshi Americans were dying Several students referenced Dr. Nancy Bristow’s book, American frame seemed to dictate examined vital statistics, newspapers and daily. And, unusual for Pandemic. Shown above, Bristow, the tone of stories, the other documents to ascertain whether a flu, the mortality rate history department chair at the two students observed, social-distancing measures had an impact. was high among people University of Puget Sound and a virtual seminar discussant, told the whereas during the They focused on Indiana and Missouri, in their 20s and 30s. students: “You discovered flu coverage current covid crisis, two similarly sized states that had similar “If you were in New [which competed with World War I different tones emanate outbreak timelines and flu death rates near York City on Oct. 16, 1918, coverage] was robust in the middle of the pandemic. Not all scholars have from competing news the national average. you were in the midst of a reached that conclusion and that’s an sources. In both cases, Unexpectedly, in both states, they very frightening increase important corrective, I think.” they postulated, when found that counties with the smallest in the number of people

6 • NIH RECORD • JUNE 26, 2020 loved ones; the emotional and physical devas- tation remained. One newspaper in Harrisburg, Pa., reported that the flu left 50,000 children orphaned across the state. “Even after the flu was gone, it couldn’t just be for- gotten and things could not go back to normal,” said Scotto, “because life was completely changed for a lot of people due to the pandemic.” There are These Virginia Tech students signed up for History 2624 last fall with no idea what they were getting into, and they stuck with it echoes of the 1918 through difficult circumstances. Six of them presented their team’s research at the NLM virtual seminar. flu pandemic in the current crisis. populations had the highest death rates. resulted in lower infection rates and death History reminds us that actions and behav- Was this anomaly due to lack of medical tolls in 1918, said Beachley and Joshi, iors have consequences. Today, as then, we care, an overburdened medical system, whereas ending countermeasures too soon watch for a steady decline in cases before or lax social-distancing implementation? could spike death rates and lead to rein- cautiously reopening society. The team plans to further stituted bans and a longer Today, though, noted Kromer, techno- investigate. recovery. logic advances help us track viral spread Also, although the two Reopening and and identify hotspots in real time, providing states both issued statewide Remembering almost instant access to data and other shutdowns early in October urgent information. In November 1918, as 1918, students noted Access to historical source materials Spanish flu cases declined, another curious finding. has also evolved. Not long ago, scholars states cautiously eased “Despite Indiana taking and students would fumble with microfilm restrictions. By late statewide action before reels. Now, many records are digitized. For December, 6 weeks after Missouri, [Indiana] still had these projects, the students relied heavily the last cases appeared, all massively higher cases and on Chronicling America, an online news- restrictions—mask-wear- case rates…than Missouri,” paper repository managed by the Library ing, public gathering bans, said Beachley. What of Congress and National Endowment for forced quarantines, limited happened? Indiana lifted the Humanities. It is available at https:// travel between cities—were restrictions too soon. chroniclingamerica.loc.gov/. Providing historical lifted and businesses, “The fact that Indiana commentary, discussant Dr. Today’s digital media will be tomor- schools and other public opened up social distancing David Morens, NIAID senior row’s historical record for future scholars, scientific adviser, said public places fully reopened. too early led to a resur- observed Dr. Jeffrey Reznick, chief of NLM’s health leaders in 1918 hadn’t Many states experienced a gence in cases,” said Joshi, seen a serious flu outbreak History of Medicine Division, during the second wave in late winter noting that the state had to in 30 years. “A lot of the 1918 symposium. public health actions such as into spring 1919, but the reinstitute its public gath- “A future generation will look back on social distancing and wearing worst was over, reported erings ban. “This extended masks were borrowed from these [and similar] presentations,” said students Katie Kromer and Indiana’s timeline of the activities that were already in Reznick, “as examples of historical research place for tuberculosis,” he said, Alessia Scotto. crisis.” at a historic time, reflecting on the past, noting that self-isolation from Yet, in many ways, the Their research offers a epidemic disease has been through the lens of the present and with an worst wasn’t over, they forewarning in the current intuitive for people around the eye to the future.” world for centuries. said. Countless people lost crisis: Social distancing

NIH RECORD • JUNE 26, 2020 • 7 folks based on their survey responses in order to provide a more efficient follow-up. ONLINE ONLY “With lots of teamwork from NIAID, Matt Breymaier in my office, OMS and the Clinical Center’s health information man- ‘Feds Feed Families’ Gets agement department,” Velez continued, “it Underway for Summer 2020 is turning out to be a fairly successful idea. NIH will again participate in the Feds Feed Once [the pandemic period] passes, I hope Families summer food drive, now through this dataset will also allow us to look at our July 31. Held annually since 2009, the response efforts and the NIH population campaign lets federal agencies and staff fight symptomology in order to be more prepared hunger in their communities. NIH donated almost 50,000 pounds of food in the for the future.” Washington, D.C., metropolitan area and at Velez says his daily work has not really satellite locations across the country during changed all that much, even as his normal the 2019 campaign. routine has shifted rather dramatically. Due to Covid-19, the need for food donations “My work is largely the same as a clinical is urgent. The campaign has adapted to the informatician,” he notes. “I’m more busy social-distancing guidelines and will be run than usual helping our NIDDK clinicians entirely online. NIH’ers have three ways to and a few other [institutes/centers] contribute: prepare new protocols and data collection • Donate Groceries Online: Purchase food NIDDK’s Velez, shown with his new colleagues instruments to capture the progression of via your favorite online grocer and have it at home, says his two sons, ages 5 months delivered directly to a food bank or pantry of and 3 years, “don’t really fit into the usual Covid-19 in their unique populations. There your choosing. office culture, which makes getting work done is also a high level of urgency supporting efficiently difficult. Both my wife and I have OMS in the triage project I volunteered for • Give Money Online: Make a monetary increased workloads and they are very excited donation to a food pantry or food bank of to have us around full time as typically they after realizing our systems could work to your choosing. were in daycare about 50 hours a week. We do augment their efforts. handoffs between virtual meetings and take “The days are long but very fulfilling • Combined Federal Campaign (CFC): Make a some meetings with the boys on our laps when monetary donation to a food pantry or food things conflict.” both personally and professionally,” he bank via CFC special solicitation through concluded. June 30. “I still do a virtual bike commute each Velez Where to donate: CONTINUED FROM PAGE 1 day. That ride, being outside, and eating lunch with my colleagues are what I miss Donate to your choice of food banks or food research informatics analyst in NIDDK’s the most. Overall, I’m thankful my wife and pantries. Information on several organizations, Office of the Clinical Director. “I told her I can both work remotely, that my family including the Children’s Inn at NIH, Safra Family Lodge, Capital Area Food Bank and staff about some tools we had available to is healthy and that I’m able to contribute Manna Food Center, is provided at https:// share that would allow concerned staff to fill to the NIH mission in these extraordinary www.ors.od.nih.gov/FedsFeedFamilies/ out a survey instead of calling. This would times.”—Carla Garnett Pages/default.aspx. then allow us to programmatically triage Record your contribution: For your donation to be counted as part of ‘BEHIND THE MASK’ NIH’s total, you must record it at https://bit. A Call for Real Stories ly/2AuIxvV. During Covid-19 Pandemic Select “U.S. Department of Health and Since January 2020, Covid-19 has Human Services” as your department, and the had an impact on the NIH community “National Institutes of Health” as your agency. in many ways—from researching All donations will be tracked by pounds of and providing information about the food. For monetary donations, the site will disease, to developing therapeutics use a national conversion rate from dollars to and , to caring for patients in pounds. the Clinical Center, to re-configuring the ways we perform our jobs. For more information on the campaign, visit To preserve this important period in NIH history, the Office of NIH History and Stetten Museum has NIH’s FFF website. Questions about the cam- initiated “Behind the Mask: Real Stories from NIH Employees and Contractors during the Covid-19 paign? Email [email protected]. Pandemic.” The project is seeking personal reflections about how those who work at NIH have experi- enced the Covid-19 pandemic and is collecting documents, photos, objects and other types of media that will help narrate the story of Covid-19. To learn more about the project and to participate, visit https://history.nih.gov/display/history/ Behind+the+Mask.

8 • NIH RECORD • JUNE 26, 2020 New NIEHS Director Woychik institute is to deal postdoctoral training in the lab of the late Dr. with individual Philip Leder in Harvard Medical School’s depart- To Lead with Innovation genetic, epigene- ment of genetics. BY CHRISTINE BRUSKE FLOWERS tic and biological variability when In 2010, he moved to NIEHS as deputy director, Dr. Richard “Rick” Woychik has been named new establishing bringing basic science expertise in using genetics NIEHS director. He served as acting director of the research strate- and epigenetics to study the influence of the envi- institute from October 2019 until June 7, the official gies for studying ronment. In nearly a decade of leadership at NIEHS, start of his new role. public health and he built an in-depth awareness of and appreciation for the broad range of scientific activities—such “Innovation has been a hallmark of Rick’s sci- environmental toxicology.” as toxicology, epidemiology and more—that are entific career and it’s at the center of his vision necessary to effectively support the environmental for leading NIEHS,” said NIH director Dr. Francis Woychik earned health sciences community. That experience Collins, announcing the appointment. “He will be his Ph.D. in contributes to the wealth of knowledge he brings to working to support new technologies and scientific molecular biology Dr. Rick Woychik his new role. approaches throughout the field of environmental in 1984 from Case PHOTO: STEVE MCCAW health sciences—applying his proven skills in sci- Western Reserve Prior to his affiliation with NIEHS, Woychik served entific excellence, creativity and rigor to improving University. He nearly 10 years as president and CEO of the public health.” moved into the field of molecular genetics during Jackson Laboratory in Bar Harbor, Maine. As NIEHS director, Woychik takes on additional responsibility as director of the National Toxicology Program (NTP), which reports directly to the Department of Health and Human Services. NTP coordinates toxicology research among NIEHS, the National Center for Toxicological Research at the Food and Drug Administration and the National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention. Woychik is highly respected for a long list of accomplishments in environmental epigenetics and mammalian genetics. His laboratory discovered that mutations in a gene that codes for a certain protein, in a class called protocadherins, interfered with mammalian hearing. The latter gene was ultimately linked to hearing loss in Cushing’s disease patients. Other firsts included identifying a gene associated with polycystic kidney disease, and the first cloning of an obesity-related gene called agouti. Woychik’s passion for epigenetics and environmen- Police Officers Parade in Honor of Caregivers tal health sciences is rooted in his research group’s On May 5, the Montgomery County Police and the NIH Police participated in a motor discovery that the obesity trait associated with an parade to honor agouti mutant mouse line was influenced during embryonic development by the epigenome. health care workers. Several dozen Woychik said he will explore opportunities to vehicles first circled embrace new technologies and implement state- of-the-art and potentially transformative scientific Suburban Hospital approaches for the NIEHS research enterprise. and then entered the NIH campus from “I am particularly interested in better integrating environmental health sciences into the All of Us Old Georgetown Rd., Research Program and precision medicine pro- passing in front of grams at NIH,” he wrote in an email to employees. the Clinical Center He added that achieving insights into the molecular around 7:15 that mechanisms involved in toxicity and other physical morning. responses to environmental exposures will be Salutes to health fundamental to improving risk assessments of care workers have human health impacts. become common in “Individuals, with their unique biological make-up, cities across the U.S. respond to the environment in different ways,” as the profession Woychik explained. “Our current research strat- deals with a global pandemic. egies mostly employ a one-size-fits-all approach that does not factor in this critically important vari- PHOTOS: ORS able. One important element of my vision for the

NIH RECORD • JUNE 26, 2020 • 9 DIGEST

NIH Study Links Cigarette Lung Development May Smoking to Higher Stroke Risk Explain Why Some in African Americans Non-Smokers Get COPD and African Americans who smoke are nearly 2.5 times Some Heavy Smokers Don’t more likely to have a stroke than those who never According to a new study, people with small smoked, while former airways relative to the size of their lungs may have smokers show a simi- a lower breathing capacity and, consequently, an larly lower risk as never increased risk for COPD—even if they don’t smoke smokers, according to or have any other risk factors. The study, funded Researchers found clues to the possible a new study funded in part by NHLBI, appeared June 9 in the Journal cause of recurring, non-contagious fevers by NIH. of the American Medical Association. and sores that affect only children. The findings from the Chronic obstructive pulmonary disease (COPD), NIH Researchers Uncover Genes Jackson Heart Study a debilitating lung condition, often develops as suggests that even a result of smoking, but researchers have long Linked to Common Recurrent after years of smoking, puzzled over why nearly a third of cases occur in Fever in Children African Americans— people who never smoked. Now they may finally who as a group are have an answer—and it may be linked to how Researchers at NHGRI have discovered clues to twice as likely as lungs develop in certain people. the possible cause of recurring, non-contagious whites to have a stroke African Americans fevers and sores that affect only children. Several and die from it—could who smoke are “This work, stemming from the careful analysis genes have been implicated with the syndrome, significantly reduce nearly 2.5 times of lung images of COPD patients, shows that an known as PFAPA syndrome (Periodic Fever, more likely to have their risk if they kicked abnormal lung development may account for Aphthous Stomatitis, Pharyngitis, Adenitis), which the habit. a stroke than those a large proportion of COPD risk among older who never smoked, could lead to new treatments. adults,” said Dr. James Kiley, director of NHLBI’s an NIH-funded The study’s findings, Division of Lung Diseases. “More research is Results were published June 8 in the journal PNAS. funded by NHLBI and study finds. needed to understand what drives this occurrence The findings were made possible by the realization NIMHD, appeared and to devise possible interventions.” online in the Journal of the American Heart of commonalities with other chronic inflammatory Association. COPD, the fourth leading cause of death in the conditions that also involved sores on the body, United States, causes airflow blockage and including the common canker sore. The study Numerous studies have shown the link between breathing-related problems that can severely limit illustrates how long-standing health mysteries smoking and stroke, but few have directly a person’s day-to-day activities. Smoking, asthma may now be solved when researchers discover assessed the relationship solely in African or air pollution new biological connections with the help of Americans. This new study did that and also account for many increasing amounts of genomic data. analyzed traditional risk factors for cardiovascular COPD cases, but diseases and inflammation. In 1987, researchers first described a syndrome up to 30 percent of seen in 12 children, which was marked by recurrent “This study provides further strong evidence of cases occur in people fever, painful canker sores, sore throat and the link between cigarette smoking and stroke who never smoked, inflamed lymph nodes. The condition starts early in African Americans,” said Dr. David Goff of and only a minority in life, between the ages of 1 and 5. The first sign NHLBI’s Division of Cardiovascular Sciences. of heavy smokers is fever, accompanied by sore throat with redness “We know that quitting smoking is one way to develop the disease, and other symptoms. lower the risk for stroke, which is particularly suggesting that there important for the most vulnerable populations are other risk factors “PFAPA syndrome is the most periodic of periodic during this pandemic.” at play. fevers, with many children having an episode every month lasting 3 to 5 days,” said Dr. Kalpana The study included 4,410 black men and women Previous research Study says people Manthiram, clinical fellow at NHGRI and lead without a history of stroke who were enrolled offered a clue about with small airways author of the study. “That is an immense burden relative to the size in the Jackson Heart Study, the largest study of a possible cause, on families since these kids cannot go to school of their lungs may cardiovascular disease in African Americans. finding that about and may be bedridden for days during flares.” half of older adults have lower breathing Researchers classified the participants, who were with COPD appeared capacity and, While PFAPA syndrome has become the most consequently, an 54 on average, into three groups based on their to have low lung common recurring fever syndrome in children increased COPD risk. self-reported smoking history: current smokers, function early in life. from Western countries, diagnosis and treatment past smokers who smoked at least 400 cigarettes methods have remained largely primitive and in their lifetimes, and never smokers. The findings may also help explain why some insufficient. The episodes usually spontaneously lifelong heavy smokers do not develop COPD. stop in pre-adolescence. “The bottom line is the more a person smokes, People with larger airways relative to lung size the greater their chance is of having a stroke,” may be able to withstand lung damage from Because of the nature of the disease, research- said lead study author Dr. Adebamike Oshunbade, smoking and still have enough breathing reserve ers have long thought that answers may lie in a postdoctoral research fellow at the University to prevent them from developing COPD. Still, genomics. After ruling out the possibility that the of Mississippi Medical Center. “It’s important to given the multiple health problems caused by syndrome is caused by mutations in a single gene, communicate this risk to vulnerable populations, tobacco, smokers should do their best to quit, they considered the possibility that multiple genes especially with the growing popularity of new researchers noted. are involved. tobacco products.”

10 • NIH RECORD • JUNE 26, 2020 MILESTONES

George F. Hanks at the University of Utah and using Drosophila to study mitotic drive, and then with Eldon J. Gardner at Utah State University, where he earned his Ph.D. in 1968. Soon after, he became a faculty member at Gonzaga University in Spokane, Wash., where he taught genetics, evolution, histology and history of biology. He was also the first staff geneticist at Sacred Heart Medical Center in Spokane, where he codiscovered the Osebold-Remondini syndrome, a bone dysplasia disease.

Dr. David Remondini in his element, at a grant review meeting in 2004 and in retirement in 2013 Remondini also taught genetics and biology briefly at Michigan B&W PHOTO: MICHAEL LANG Technological University in Houghton before joining CSR Peer Review Legend Remondini gentlemen I’ve ever known—always taking the in 1977 as what was then called an executive time to listen carefully to people’s concerns or secretary, now scientific review officer or SRO. Dies at 88 opinions on proposals or process, and having a wealth of historical knowledge and perspective Through this period, Remondini also maintained Dr. David Remondini, a legendary scientific review a parallel military career as a reservist in the officer at the Center for Scientific Review and the of not just the NIH but also of our fields of study more generally.” California National Guard, the U.S. Army and face of fair peer review for 36 years at NIH, died on the U.S. Coast Guard, from which he retired as a May 7 at age 88 following surgery necessitated by Others at CSR described him as sagacious, kind commander in 1991. He became a private pilot at an automobile accident a few weeks prior. and having a calming effect on whoever met him. age 50. He also volunteered countless hours at St. Dapper, humble and eternally personable, “Whenever the pressure grew for completing Patrick’s Catholic Church in Rockville, Md. Remondini led CSR’s genetics study section from summary statements against deadlines, I would visit his office to talk to him,” said Dr. Syed Amir, Through all his accomplishments and adven- 1977 to his retirement in 2013. After retirement, he tures, Remondini was a consummate family became a volunteer in the Office of NIH History retired CSR scientific review officer. “I came out much less stressed and in an upbeat mood.” man. He is survived by his wife of 67 years, to curate a unique collection of grant reviews Earnestine, his 6 children, 16 grandchildren and 12 gathered from his own tenure great-grandchildren. and that of his predecessor, Dr. • • • Kay Wilson, dating back to the In his memory, his family and Utah State University 1950s and the birth of the field of “Dave’s knowledge and experience have established the David Joseph Remondini molecular genetics. Scholarship Endowment to support scholarships with NIH peer review was legendary, for students studying genetics in the College of Remondini helped to shape CSR’s and he pretty much defined the term Science each year. See https://www.usu.edu/ approach to fair peer review in advancement/drdavidremondini for more informa- his insistence, bordering on the ‘institutional memory.’” tion.—Staff, Office of NIH History ecclesiastical, to deeply analyze data from one’s study sections to ~DR. CHERYL CORSARO ensure every application was dealt with equitably. He wanted reviewers • • • to understand all aspects of the Remondini was born in Deming, N.M., in 1931. field beyond their own subspecialty. At the time of A child of the Great Depression, he described VOLUNTEERS his death, he was writing a paper about what he his early life on a homestead as instrumental in called the “beautiful scientific review process.” preparing for a life in science, from the regimen of “Dave’s knowledge and experience with NIH daily chores to observing his father’s meticulous Adults with SAA Needed for Study peer review was legendary, and he pretty much cattle-breeding records. NHLBI seeks adults with severe aplastic anemia defined the term ‘institutional memory,’” said Dr. After WWII, his family moved to Riverside, Calif., Cheryl Corsaro, a longtime colleague and retired (SAA) for a research study determining viability where a high school teacher encouraged him to and safety of early initiation of oral therapy with CSR scientific review officer. “In addition, he was pursue college. He enrolled in Riverside Community a gracious gentleman, known for his generosity of cyclosporine and eltrombopag in patients with College and graduated from University of SAA. All patients will receive standard treat- spirit and willingness to share his knowledge with California, Santa Barbara, in 1954. colleagues.” ment with cyclosporine, eltrombopag and horse Remondini started his career as a science teacher anti-thymocyte-globulin (h-ATG), unless there “If you chatted with him for even a few minutes, at rural grade schools, doubling as a school bus is complete count recovery with oral therapy. you couldn’t help but love working with him,” said driver. But Sputnik soon launched him in a different Compensation will be provided. Call the Office Dr. Mohamed Noor, former chair of CSR’s genetic direction. With a new surge in funding from the of Patient Recruitment, 800-411-1222 (TTY for variation and evolution study section and now a National Science Foundation in response to the the deaf or hard of hearing 866-411-1010) and professor at Duke University. “He was one of the Soviets’ rocketry advances, Remondini pursued an refer to study 20-H-0033. Read more at https:// sweetest, most generous and most thoughtful advanced degree in genetics, training first under go.usa.gov/xwbDt.

NIH RECORD • JUNE 26, 2020 • 11 NCI Quick-Change Scientist everywhere,” Hesse acknowledges. “Over the past that materially enhance our understanding of this few weeks, I’ve seen the collaborative spirit that is novel pathogen, and I’ve watched as our institu- Hesse Switches Roles, the hallmark of the Intramural Research Program tional leaders help guide the national pandemic Pathogens carry over to new endeavors and non-research- response. I’ve always felt honored to be part of the based contexts. I’ve seen employees across NIH community—and now more than ever.”—Carla Earlier this year, infectious disease fellow Dr. institutes rise to meet incredible demands. I’ve Garnett Shayla Hesse was conducting research full-time read research reports by intramural investigators in the developmental genetics section of NCI’s Laboratory of Molecular Biology in Bldg. 37. She and her colleagues were NIH’er Adjusts to New Reality After Returning from Deployment studying ways to BY ERIC BOCK fight bacteria that were stubbornly “I stepped back into a completely different world.” That’s how Lcdr. Maggie Kemp described her experi- hardy against ence returning to work at NIH after a Public Health Service deployment. antibiotics. Then a novel coronavirus In March, Kemp, acting chief of the ORS Division of Occupational Health and Safety’s (DOHS) Safety struck, Covid-19 Operations and Support Branch, was part of the PHS response to support passengers who had returned emerged and to the United States on the Grand Princess cruise ship. Nearly 3,000 people quarantined for 14 days at Hesse imme- military bases across the country. diately shifted Almost 500 people completed their quarantine at Marine gears. Corps Air Station Miramar, a military base near San Diego, “It’s surreal to where Kemp was deployed. She helped to ensure the safety of think about how patients as well as members of the National Disaster Medical much has changed System and PHS responders. in a short span of Dr. Shayla Hesse “I wasn’t really in touch with staff at NIH while I was gone,” she time,” she says. said. “We were working 15-, 16-hour days. It was crazy. I was “In February, I very isolated from what was happening in the world and in San was focused on Diego outside of the base, because we were working such long a very different type of virus—bacteriophage— hours every day.” with the goal of addressing a very different infectious disease threat—antibiotic-resistant Before she left, the possibility of shutting down research at bacteria. Incubators and centrifuges dominated NIH was mentioned and her office began drafting potential my workspace. A mask was not part of my work guidance for closing labs. While she was away, she heard NIH apparel. Fast-forward to now and I, like many staff employees were teleworking, but she didn’t know the details— members, find myself working in a new capacity she wasn’t involved in the decision-making process. and in a rapidly evolving environment.” When she came back to campus, all eligible employees were Hesse recalls relying on her clinical training to teleworking to the extent possible. The first week back was repurpose herself as a volunteer at a Covid-19 stressful. It took a few days for Kemp to figure out what had drive-through test site that NIH’ers stood up changed and how. Like other parents, she had to balance work, quickly on campus. Within a few short weeks, she child care and home schooling. Slowly, however, telework has had drafted the site’s standard operating proce- become the “new norm.” Lcdr. Maggie Kemp dures. Head and neck anatomy turned out to be a key procedural consideration. For Kemp, teleworking has been a new experience. She has assisted in past natural disaster response for the PHS. During “There I observed hundreds of nasopharyngeal the 2014 Ebola outbreak in West Africa, she stayed at NIH to work in an Ebola lab. swab samplings,” she explains, “and developed a sense of some of the finer aspects of the technique. Her branch consists of a team of safety specialists that support the registered lab spaces on campus to I never thought I’d find myself carrying on a ensure that all laboratories follow safety guidelines. Right now, they are only actively supporting labs that 20-minute conversation about the best strategy are conducting Covid-19 research or those that received exemptions to continue. for navigating a flimsy instrument around the nasal Several PHS members and a National Guard reservist work in DOHS. Other employees have gone on detail turbinates! I have since transitioned to a different to other offices to help with NIH’s Covid-19 response. Many of Kemp’s colleagues have been away much of role as part of a Covid-19-specific team of medical the time. Those remaining have had to juggle more responsibilities and coordinate who’s doing what. providers. Although I’ve amassed only a modest amount of experience on that service so far, I’ve Despite the additional responsibilities, working with the remaining staff “has been really great,” she said. found the highly variable and, in some cases, “They’ve been really flexible and very good about the shifting of duties and taking on different tasks…As rapidly progressive nature of the disease to be both PHS officers, we’re supposed to be there regardless.” humbling as well as harrowing.” During this uncertain time, many employees are concerned about their own health and that of their Several of her new coworkers call Hesse’s contribu- families and friends, in addition to accomplishing their work and meeting personal responsibilities, Kemp tions invaluable. And despite the unusual workload, noted. new work environment and unsettling uncertainty “I appreciate the flexibility we’ve been given by NIH leadership and management,” she concluded. the global pandemic has brought, Hesse says she feels a deep sense of pride being in the thick of the agency’s crisis response. “It is a time in which challenges abound, at NIH and

12 • NIH RECORD • JUNE 26, 2020