UC San Diego Health Sciences comprises the region’s only
academic health system, one of the nation’s top research-intensive schools of medicine, the Herbert Wertheim School of Public Health and Longevity Science and the Skaggs School of Pharmacy and Pharmaceutical Sciences.
In March 2020, our response to pandemic SARS-CoV-2 and the disease it causes, COVID-19, demanded dramatic changes to teaching and learning.
It quickly became apparent that the community public health efforts necessary to mitigate rapid spread of the virus, hospitalizations and deaths would require students from the schools of pharmacy, public health and medicine to transition to remote teaching and learning for the remainder of the Spring 2020 quarter.
Evolving science and availability of protective tools would improve clinical care, reduce deaths and ease the burden on health care and public health systems. But we would also learn a lot about living with the virus. Under extraordinary circumstances, UC San Diego became a trailblazer in efforts to provide a place of refuge for students facing unforeseen challenges, from food and housing insecurity to physical and emotional abuse. The campus became a refuge and respite, albeit one filled with the promises and perils of being a pioneer.
In May 2020, Return to Learn debuted, a bold initiative to return students to campus and learning during the pandemic. It was designed to be adaptive and responsive to changes in the local epidemiology of COVID-19. It focused on risk mitigation, viral detection and public health intervention. Every sector of the campus was engaged in preparations for mass testing, delivery of student health services, housing, dining, isolation and quarantine resources, symptoms monitoring, wastewater surveillance and reporting our daily status on a public dashboard. These efforts transcended everyone’s routine job assignments. It was service to an educational mission bigger than oneself.
By Fall 2020, students were presented with the option to return to campus or continue to learn remotely. We welcomed back almost 10,000 students, roughly two-thirds of whom lived on campus. Inside and outside of classrooms, our students, staff and academics demonstrated extraordinary resilience, creativity and commitment.
The new Herbert Wertheim School of Public Health and Human Longevity Science (founded in 2019) partnered with the San Diego County Department of Public Health for contact tracing among those ages 18 to 24 years. A great deal of the success for any public health program relies on human behavior that considers the needs of others. Our students’ behaviors were exemplary.
For much of the fall and winter seasons, the highest prevalence of COVID-19 in San Diego (and across the region and country) was in persons 18 to 24 years old, yet there were very few outbreaks on campus — and none traced to our classrooms. Our students adhered to rigorous testing, isolation, quarantine and monitoring protocols, and their dedication showed.
UC San Diego’s educational programs attract students from all over the world. Meeting these diverse needs requires flexibility. During the pandemic, some classes were in-person in rooms modified to maintain physical distance; some were in specially prepared outdoor settings. Some classes used a hybrid format with some students in-person and others joining lectures remotely. Yet others were fully online.
Across the campus, we emphasized proper hygiene, sanitation, face coverings and the use of other, appropriate personal protective equipment. The Teaching+Learning Commons tool assisted instructors with developing strategies for impactful remote instruction. Our faculty and staff swiftly rose to meet the challenges they faced.
Professors and instructors who, prior to the pandemic, could not have envisioned teaching students online or in hybrid formats reinvented their courses and themselves. They designed lessons that were adaptable to a range of student needs and teaching formats. They ensured high quality interactions using virtual whiteboards, chat features and breakout rooms to stimulate conversation and creative engagement.
Our response to the pandemic has perhaps permanently changed the way students will learn and faculty will teach at UC San Diego. In a stressful time without precedent, we became even more adaptive, more considerate of student needs and more conscious of our impact as educators — regardless of setting.
I hope we continue the educational practices learned over the pandemic. They will help us reduce inequities in student access and increase the reach and impact of UC San Diego’s pharmacy, public health and medical school educational programs.
Amid Tears and Fears, determination, hope and unity of purpose
I remember when I got the initial phone call from the County inquiring if UC San Diego Health would take in the first patients flying out of Wuhan, China to San Diego.
At the time, all we knew was that Wuhan was ground zero for a spreading, previously unknown viral infection. People were dying and there was no existing medical literature, nor any test, for the virus that would be called SARS-CoV-2.
Nonetheless, Marine Corps Air Station Miramar would soon receive a military plane containing multiple Wuhan evacuees; some of whom were possibly infected by the mysterious coronavirus.
Knowing our advanced capabilities as an academic medical center, particularly in the relevant areas of infection prevention and control, public health and respiratory disease, it was actually an easy decision. “This is what we are meant to do,” I thought.
We quickly opened our Hospital Command Center (HCC) and mobilized. Typically, an HCC event lasts roughly a week, maybe two. In this case, weeks became months, then months became more than a year. Time blurred. Zoom calls and masking became as routine and commonplace as handwashing. It would be 412 days between our first case of COVID-19 and the first day when we recorded no new infections.
The pandemic has been the most extraordinary event of my career, and likely for many others. Every single employee of UC San Diego Health was impacted, from custodians, nurses and nutritionists to supply chain managers, screeners, administrators and physicians. Everyone played a role in slowing or stopping the virus and saving lives.
We worked the same hours as COVID-19, which was constantly, day and night, weekends too. It was a coordinated effort of monumental proportions that led to formations of new teams and new levels of trust and innovation that propelled us forward, out of fear and into a new normal.
I cannot write about the pandemic without acknowledging those who died from the virus and whose families were devastated by the loss of loved ones. These tragedies happened disproportionately in many of our underserved and under-reached communities, a historical condition and injustice that shall remain a focus of UC San Diego Health, even as COVID-19 hopefully recedes into the background and our memories.
I’m often asked what about our response I am most proud. There is no single answer. We were first in the region to treat patients with COVID-19; first to open vaccine clinical trials; first to offer a mobile ECMO (extracorporeal membrane oxygenation), a type of machine that pumps and oxygenates a patient’s blood outside the body; first to vaccinate our employees and first to open a vaccination superstation to the public.
We led the way on CA Notify, a mobile solution to identify new exposures of COVID-19 in the community and state. Our nurses and specialists travelled to other hospitals in the United States and Mexico to teach new lessons and insights in the art of critical care; they returned to help vaccinate too. What all of these achievements have in common are unbounded compassion, brilliance and determination that characterizes the people of UC San Diego Health.
For every article in this magazine, I know there were hundreds more unwritten that could tell story of bravery, drive and connectedness during the pandemic. I thank all of my team members for their selfless contributions. I am so very proud of you and grateful for your service and kindness.
I would also like to express a deep and sincere gratitude to our donors, who stepped up at the same time to help us meet so many challenges. Their contributions of time and funding helped us rapidly expand and sustain our efforts to build testing capacity, acquire ventilators and surge supplies and launch multidisciplinary research efforts into new diagnostics, therapies and ways to monitor the virus. Their generosity saved lives and will help us in the future.
With lessons learned, I believe we move forward together, unified, a better and stronger organization.
This is a special issue, a focused look at how UC San Diego scientists, doctors, students, staff and others responded to the COVID-19 pandemic, and how they continue to rise to its many challenges.
The magazine you hold is called Discoveries, an apt name that encompasses the overarching missions of the University of California San Diego, from research that reveals and explains the mysteries of our world to the education of new doctors, artists and engineers who serve our communities to the development of therapies, art and technologies that shape our everyday lives.
You might call this issue Recoveries.
The pandemic has been difficult for everyone, at times tragic. More than 792,000 Americans have died from COVID-19 and millions more became sick, some with lingering effect. These numbers echo around the world. From small villages to great cities, no place has been immune. In the 21 months since the World Health Organization officially declared COVID-19 to be pandemic, we are still working to mitigate its consequences.
UC San Diego did not escape the pandemic’s adverse effects. In this issue, we recall not only what happened, but also how we responded (and continue to respond) through lessons learned. There have been many remarkable achievements, unplanned perhaps, but not surprising. Our nationally recognized Return to Learn program made it possible to restore in-person instruction and research on our campus, and our innovative partnerships with regional government, the San Diego Padres and area businesses created California’s first vaccination super station. These are just two of the programs and initiatives that positively impacted public health, served our community and kept our economy moving.
As one of the world’s great research universities and academic medical centers, UC San Diego is flush with talent, expertise and resources. Confronted by a public health crisis that spanned the globe, our people and programs rose to meet the complex challenges of the pandemic head on. And throughout, our world-class health care system — UC San Diego Health — has shined brightly, a nimble and innovative leader within our state and across our nation.
UC San Diego continues to be an exemplar. In a changing world, we are changing too. We continue to learn, evolve and fulfill our goals to not only make the world better, but also better prepared for the future.
Life is change. It’s about adapting to new situations and circumstances that ensure not just survival, but a presumably better, stronger future.
Virusesare especially good at this, mutating constantly and continuously, often at dizzying rates, for billions of years.
The coronavirus known as Severe Acute Respiratory Syndrome Coronavirus 2 of the genus Betacoronavirus, or slightly more colloquially, SARS-CoV-2, isn’t new at this game of life. It likely existed in other forms in other animals before jumping species, but it was new to us.
Now, we are painfully familiar. The unexpected debut of SARS-CoV-2 in late-2019 and the pandemic that followed have provoked all manner of subsequent change in all manner of ways. Like the virus and its variants, life as we knew it will never be the same.
We are changed and changing, often in ways that have made us wiser, stronger and better. Nowhere is that more evident than in the response of faculty, students and staff at UC San Diego, who pivoted their attentions, expertise, talents and resources to confronting and combatting this highly infectious, often deadly virus festooned with trademark spikes of protein on its surface.
The scope of these efforts and contributions are astounding, from helping pin down the virus’ origins in China, Europe and North America to parsing the threat of aerosolization and understanding the critical performance of neutralizing antibodies.
While much of society necessarily shut down, research at UC San Diego continued, affected but unabashed, even expanding in some cases. For example, we built from scratch a new biosafety level 3 lab capable of handling highly infectious pathogens and pop-up labs for measuring viral loads in patients. We created high-throughput systems to process daily thousands of COVID-19 test samples, including wastewater from our buildings, and to sequence and analyze all viral genomes. We developed a cellphone-based technology to alert users when someone close to them had tested positive.
Researchers shifted priorities, moving robots and equipment around to create new programs in a matter of days when the norm is more often measured in years. It was hard, often exasperating, work. A working scientist might get only one scheduled day in the lab each week, part of vital and exacting safety protocols. It might be only enough time to do a bit of “wet work,” then go home to analyze the data. Zoom calls multiplied like, well, viruses. People grumbled, but they carried on and important work was done.
Perhaps nowhere was the depth and breadth of our expertise more obvious than in our participation in three of the four first and biggest clinical trials for a COVID-19 vaccine: Moderna, AstraZeneca and Johnson & Johnson. UC San Diego Health scientists and the thousands of San Diegans who volunteered in these trials were players in the development of these vaccines. With critical help from the Altman Clinical and Translational Research Institute, they moved the needle. We have learned a lot. We have earned a lot: To date more than $30 million in new grants specifically funding COVID-19-related projects, with more in the works. And from these lessons and efforts, we prepare to change even more with an aptly named project called PREPARE, which will bring together people, programs and infrastructure to be ready for pandemics to come.
“When you are finished changing, you are finished”
— Ben Franklin
The pandemic changed everything, but not our research mission to make the world a better, healthier place. That remains unchanged and our work unfinished.
