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The Infection Prevention Strategy (TIPS)

Jan 18, 2021

The COVID-19 pandemic continues to worsen by most objective measures. We’re breaking records for cases, deaths, and hospitalizations on a regular basis, and many of our hospitals are operating at or near capacity. Further complicating the situation, scientists are tracking the “UK variant” that is more transmissible, and our vaccine distribution has fallen well short of expectations. Emergent problems in a deepening crisis, of course, make us vulnerable to knee-jerk reactions that distract us from the known path to getting the pandemic under control.

On this episode, we’re talking with virologist Dr. Angela Rasmussen about these emergent issues. She helps us to understand what they mean and puts them in context by pointing out the good things that are happening too. First and foremost, the vaccines are more efficacious than expected (i.e., around 95%). Second, the “UK variant”, while worrisome, has not evolved in any way that makes existing, non-pharmaceutical interventions less effective (e.g., masks, social-distancing, avoid crowds, clean high-touch surfaces, etc.).


The UK Strain

Dr. Rasmussen tells us that the B.1.1.7 strain, better known as the “UK variant”, is worrisome. However, travel bans aren't an effective response to the new COVID-19 variant. The new strain was detected first in the UK, but that is likely because the UK is doing more genomic surveillance than most countries. They found it because they were looking, but it could have originated elsewhere. Dr. Rasmussen explains “travel bans are only really effective when you can guarantee that you would not be exporting the virus from one place to another”. And since we don’t know for sure where the variant first-evolved, or where it has spread to, there is simply no way to design an effective travel ban. We also discuss:


  • How viruses mutate and evolve
  • Why the new variant is believed to be more transmissible
  • Potential behavior components that may have impacted the numbers
  • That the known, non-pharmaceutical interventions work against every variant of SARS coronavirus (i.e., the virus hasn’t mutated in a way that makes our masks, social-distancing, etc. less effective). We should double-down on those now.


Communicating Science to the Public

We continue to examine communications lessons that can be learned from the COVID-19 pandemic. Dr Rasmussen tells us that scientists and media tend to make one of two mistakes:


  1. They default to the worst case scenario and communicate in a very reactionary way
  2. They oversimplify things, trying to get the public to understand and comply with certain behaviors


Both approaches create gaps in understanding and acceptance of our message. To mitigate these issues, Dr. Rasmussen tells us to think about three key things whenever we’re communicating science to the public:


  1. Talk openly about what we don't know, and about the nuances, so that people become more comfortable with uncertainty
  2. End every message with actionable advice. Tell them what they can and should do right now to protect themselves.
  3. Repeat the message over and over. In a constantly evolving environment, we may be tempted to jump from topic to topic. Our messaging should always be grounded in the tried and true (e.g., the non-pharmaceutical interventions discussed earlier)


Vaccine Challenges

We’re dealing with a triple threat when it comes to the vaccine. First, we have our current distribution problems. There are vaccines available and they are being administered much more slowly than we’d like. Second, there are known supply challenges that could worsen if/when we alleviate the distribution delays. Third, we’re dealing with vaccine “hesitancy” and the recent discussions around changing dosing regimens, despite the fact that we have no data to support those changes, might cast further doubt for those on the fence. Dr. Rasmussen shares her thoughts on these high-level issues, and gets into the details of each:


  • What is causing our distribution problems, and what are the steps that can be taken right now?
  • What do we know about the potential for widespread supply issues, and how are our current efforts to head them off distracting us from the distribution problem we have right now?
  • What will it take to achieve herd immunity and slow, or stop community transmission?
  • Why the vaccine is a medium-to-long-term solution, and the importance of redoubling our efforts on non-pharmaceutical interventions to slow community spread in the near-term
  • How we can use the tried-and-true epidemiological path, in conjunction with vaccination to slow community transmission and get us on the right path in the foreseeable future


Dr. Angela Rasmussen

Dr. Rasmussen is a virologist studying host responses to infection by combining classical virology with modern systems biology approaches. Her research objectives are to identify host response signatures predictive of infection severity or disease outcome and host pathways to target drug development or repurposing. She is particularly interested in viruses that are highly pathogenic, newly emergent or likely to emerge because of climate change, land development, or ecological disruption. Currently she is focused on SARS-CoV-2, as well as other emerging pathogens with the potential to profoundly impact global health, such as Ebola virus, MERS-CoV, influenza virus, and hemorrhagic fever viruses. She works closely with other faculty and affiliates within the GHSS on the Viral Emergence Research Initiative (the VERENA Consortium), where she leads the core virology team.

Dr. Rasmussen has employed uses in vitro systems, animal models, and clinical specimens to study the relationship between host response and pathogenesis. She previously developed a  model of Ebola virus disease in a genetically diverse panel of mice, the Collaborative Cross (CC), leveraging the diversity of CC mouse disease phenotypes to study genetic and transcriptomic factors underlying disease severity in humans. She has applied this model to developing predictive signatures of disease outcome and infection and identify novel drug targets. She is currently evaluating CC mouse models towards investigation of sex-specific host responses to viral infection, as well as to investigate disease presentation in other viruses that pose a major threat to global public health, including SARS-CoV-2. Ultimately, these host response profiles can be used for translational or biodefense applications, such as diagnosing infection, predicting disease severity, informing vaccine design, and developing or repurposing host-targeted drugs to impair virus replication or reverse pathology. 

Dr. Rasmussen has published numerous original research articles in the peer-reviewed literature and serves on the editorial board of Cell Reports and mSphere. In addition to her scientific work, she believes that engagement of the public is essential to successful public health initiatives and is an active and outspoken science communicator. She has written for Forbes, Foreign Affairs, Slate, the Guardian, and Leapsmag, and appeared many times in media outlets including the New York Times, the Washington Post, National Public Radio, ABC, NBC, CNN, CBC, and BBC. She is also an advocate for equitable and inclusive science, and serves on the NIH Advisory Committee to the Director’s Working Group on Changing the Culture to End Sexual Harassment.



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