Ground Truth and Solutions in the COVID-19 Fight

Plug "coronavirus" into a search engine and more than 2.5 billion results come back. From symptom lists to transmission theories to cleaning tips, there’s no shortage of information about COVID-19.

What concerns Lauren Quattrochi, Ph.D., a MITRE biotechnologist, is the lack of context and accuracy accompanying COVID-19 stories and reports. What's real? What's overhyped? What's just plain wrong? And how do you know what’s right?

With a doctorate in neuropharmacology, expertise in pharmaceutical drug development (what the body does to a drug and vice versa), and clinical trial data transparency, Quattrochi uses her unique lens to get to the ground truth.

"When you summarize a scientific study, you can’t always do it justice," she says. "There’s an element of misinterpretation when caveats or disclaimers are omitted. The news or media grabs the flashy part without careful attention to study design or limitations."

An active working group leader in the COVID-19 Healthcare Coalition, Quattrochi points to a recent study about how long SARS-CoV-2 stays infectious in the air: upwards of three hours! The findings made for a provocative news headline, but the article didn't describe a key factor: the study’s design.

"The researchers used a rotating drum to keep the air swirling, which kept the virus particulates in suspension in the air. Under real-world conditions, the virus will be dispersed by a cough or sneeze and speech but eventually falls to the ground. That background could have helped public understanding on the study’s limitations."

Quattrochi and four colleagues recently published Surviving COVID-19: Best Practices and Tips to Protect Yourself and Others to separate fact from fiction about research-backed non-pharmaceutical interventions, or NPIs, for the general public. The paper is just one of MITRE’s many contributions to the fight against the virus Quattrochi calls a “very patient enemy.”

"With so much information, it’s hard to know what’s rooted in science," Quattrochi says. "Many people don’t know that sanitizer must contain a certain percentage of ethanol and stay on the skin for 30 seconds to be effective. There’s a lot of half-truths circulating out there."

Crowdsourcing Expertise

At the request of private industry, MITRE is managing the COVID-19 Healthcare Coalition to help save lives by using data-driven, real-time insights to improve clinical outcomes. More than 800 healthcare organizations and technology companies have joined and are working on three primary areas: data-driven outcomes, supply chain, and social policies. Working groups tackle specific issues.

"MITRE and the coalition freely share the findings of each working group," Quattrochi says. "Our work isn’t proprietary. We’re doing this to get the right information out there and save lives."

Quattrochi and her colleague Kathy Huynh, an analytical chemist, lead the coalition’s N95 respirator and personal protective equipment (PPE) subgroup, as well as the ICU/Ventilator working group.

Shedding Light on the Decontamination Problem

With limited PPE for frontline healthcare professionals, their safe reuse is critical to combatting the virus’ spread. The N95/PPE group researched and collated effective techniques to decontaminate N95 respirators. (The 95 indicates the percentage of particulates a respirator will block.)

Step-by-Step Protocols for Decontamination Techniques for the Reuse of N95 Respirators outlines materials and conditions required to deactivate the virus: vaporized hydrogen peroxide, ultraviolet germicidal irradiation (UVGI)—also called UV-C—and moist and dry heat.

For urgent care centers, smaller hospitals, fire stations, nursing homes, and funeral homes, which typically have limited budgets and space, there is a UVGI decontamination system made by INPRO Technologies the size of a standing printer in a copy room. Far smaller than an industrial-sized, room-wide system, "it operates on a conveyor belt," Quattrochi says. "In under two minutes, the respirators are dosed with UV-C and can be reused."

The INPRO technology is currently under review by the U.S. Food and Drug Administration (FDA). The Coalition acquired one of the units and is helping the innovators navigate the FDA’s emergency use authorization to accelerate its accepted use in clinical settings.

The team also created a 20-minute tutorial so that practitioners can build and operate this smaller scale, affordable, in-house decontamination system. Both the tutorial and report stress the importance of a proper, no-gap fit of the filtering facepiece respirator.

Quattrochi adds, "Most folks don’t realize that the greatest weakness of any facial PPE, whether a respirator or homemade mask, will likely be at the interface where the item meets the skin."

The PPE group also published an innovative and reusable snorkel mask-inspired PPE design, guidance on International Regulatory Standards,  Step-by-Step Protocols for PPE Decontamination, and health guidelines for 3D-printing medical devices and PPE.

Promoting Accurate Information

When wading through the sea of fast-changing COVID-19 information, use caution. “Check first with reputable sources such as the CDC [Centers for Disease Control and Prevention] and the World Health Organization," Huynh says. "Determine the source and the context in which the data was acquired, and don’t assume it can be generalized to other situations.”

To get accurate information to the public, it’s best to meet people where they’re ingesting their information, Quattrochi says.

Regardless of the medium, "our job as scientists is to make sure the information is digestible—and always put into context."

—by Karina Wright