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— Education

Wisdom is Transmissible

Most of us learned and lived through an unprecedented crisis. What will we remember?

In grueling and revealing ways, the COVID-19 pandemic took our measure, both as individuals and as a society. It tested our empathy and compassion, our ability to regulate emotions, to self-reflect, to accept divergent perspectives, to advocate for the common good and to act with decisiveness.

These are all components of wisdom, empirically determined and the subject of ongoing scientific research. They are based in biology, correlating with distinct regions of the brain, which means they can be measured and modified. Each of these wisdom components, in combination with others like curiosity, sense of humor and spirituality, provide insight into how wise we are, where we excel and where we fall short. You don’t need maximum scores for every component to be wise. That’s nearly impossible. All humans are mixed bags.

And so too were our results in terms of how wisely we handled the pandemic. In the beginning, we all were scared, uncertain of what to expect or what to do. We received contradictory and changing advice from experts who were themselves unsure of what was happening. But then, slowly, the reality became clearer. We knew the danger but also developed an idea about what the eventual solution would be — vaccines.

For some of us, the pandemic prompted personal growth. We tapped or expanded reservoirs of compassion. We deepened relationships with our families and friends. We listened to others and acted reasonably and responsibly. We discovered new strengths. We became wiser.

For others though, things got worse, especially in the first months of the crisis. Rates of alcohol and drug use rose, as did overdose deaths and suicides, though the last two phenomena predate the pandemic and are consequences of very complicated social trends. Divisions and disputes abounded; the components of wisdom, like personal protective equipment at times, seemed in short supply.

But I cannot fault those who fell short, at least not too severely. The COVID-19 pandemic was a crisis unlike any other for most of us. It affected more people around the world, directly and indirectly, than any previous public health crisis in recent memory. In the early days, before widespread vaccination began to turn the tide, uncertainty, despondency and fear felt universal. Racial and socioeconomic disparities exposed and exacerbated harms.

Traditional customs and values were set aside. Social distancing became a necessary norm, but it initially brought with it a sense of rejection and rebuff. Why is that person crossing to the other side of the road? I remember attending meetings before we all retreated into the digital world of Zoom and extending naturally, automatically, my hand in introduction, only to quickly withdraw it. Fist and elbow bumps don’t quite convey the same personal connection.

“As individuals, some people rose magnificently to the occasion and challenges. Some hunkered down. Some individuals behaved in ways ranging from inappropriate to appalling.”

However, as a society, I think we responded well overall, even in the context of divided and divisive leadership in different arenas. Arguments and public displays over mask wearing were common. Opposition to this simple and extraordinarily effective way to reduce viral transmission and protect the health of others was notoriously vocal at times and in some places, but the fact is that most Americans wore masks when and where required — and they began doing so from the beginning.

Similarly, we got better at washing our hands and keeping our distance. We didn’t panic. There were crazy and unexpected shortages — remember grocery store shelves devoid of pasta and toilet paper? But these didn’t lead to riots. People, businesses and institutions found workarounds and solutions. We learned how to live differently.

A decade or two from now, historians and others will look hardest at case rates and deaths. In some ways, these massively tragic numbers reflect the successes and failures of our individual and communal behaviors, but mostly they are the product of a previously unknown virus with extraordinary transmissibility and a penchant to kill those with underlying risk factors, such as old age or pre-existing diseases.

To our credit and to all of the scientists and health care professionals at all levels, as well as others who raced to understand the novel coronavirus and how best to treat COVID-19, humanity has come out on the winning side. Not entirely and not without deep wounds and scars, but we’re here. Having largely controlled the virus in the U.S., we have started working on helping the less fortunate people in other parts of the world.

The question now is whether the pandemic has made us better and wiser, as individuals and as a society. No one predicted the precise scope and scale of the COVID-19 pandemic, but it is an absolute certainty that other pandemics will follow. The French novelist Marcel Proust (1871–1922) once wrote: “We don’t receive wisdom; we must discover it for ourselves after a journey that no one can take for us or spare us.”

Are we wiser now than we were before SARS-CoV-2 became a well-recognized and much-dreaded collection of letters and numbers? I think so. I hope so. Time will tell.

— Education

CAMPUS LIFE COVERED THE SPECTRUM

The pandemic came in shades of gray; resilience, compassion and social justice arrived in a rainbow of colors

The first time I stepped foot on campus, all I could see was gray. Granted, my freshman orientation was in the middle of June, and San Diego has long been known for its June gloom. “It gets better, I promise,” my orientation leader told my skeptical group.

“The gray never lasts. You start with May gray. You survive the June gloom. And then finally, the sun comes, and it lasts for months and months. Then you’ll see. It’s called sunny San Diego for a reason.”

The first time I saw UC San Diego with my own eyes as an 18-year-old high school graduate, I hated it. It wasn’t just the sky that was gray. It was the buildings, the dorms, the hallways. As we ambled through Ridge Walk for our brief campus tour, I wondered how a campus that was almost 2,000 acres in size could be constructed entirely of concrete and sharp edges.

My orientation leader was right. The sun started peeking through the sharp edges when I moved in during the month of September 2017. Library Walk, which had been almost deserted when I last saw it, was pulsing with life. The voices were vibrant, inviting, intoxicating. Everyone wanted me to be involved. Everyone was excited. That made me excited.

With time, I began to find little cracks of color seeping through the gray. There were reds and greens in my professors’ slides during lectures. There were pinks and neutrals in the tones of my club members during our weekly meetings. There was a spot of blue if you tilted your head to look at the little house perched on top of the engineering building. And just across the way, the neon lights of the Stuart Arts art piece on the Center for Memory and Recording Research shot through the darkness of the night.

But the biggest reason I grew to love the campus was because of the people I would see every day. Hustling to class to make it for clicker points in the nick of time, stopping by a coffee shop for a quick caffeine buzz, walking with friends to one place or another. Not people I always knew, but students just like me. Trying to make the most of the time they had on the campus they called their home.
When the COVID-19 pandemic hit, the colors I had grown accustomed to seeing slowly drained away. I used to love standing on the third floor of Geisel Library during passing period and peering over the edge to look at the flow of life underneath. You couldn’t see a single cobblestone on Library Walk, just a mass of students ebbing and flowing, the arteries pouring life into the campus gray. At the end of March 2020, right as everything was closing down, I stood on the third floor for the last time before I graduated. I could see the cobblestones again, and I knew nothing would be the same.

The pinks and neutrals of weekly club meetings became the familiar, colorless drone of Zoom gatherings that finished in half the usual time because the lively chatter was gone. Instead of seeing friends’ faces on the walk to class, I saw them through a camera screen. During the pandemic, we were isolated. We felt alone. The gray was back.

The past year has been a whirlwind blur for me — and I’m sure for many other students as well. We didn’t have much time to react. We were just forced to adapt. We didn’t have our annual events to look forward to. No Sun God, no Bear Garden, no Senior Send-off, no commencement.

I didn’t see any spark to reignite our student body until the civil unrest that rocked our country in the Summer of 2020 rose up to grip students of our own community. I saw these students stand, speak out, walk on the streets. I saw other students join in solidarity, offering to help. I saw students demand for justice. I was there. I wrote about it for the campus newspaper, and I saw the spark spread.

During the COVID-19 pandemic, students began to realize that maybe good grades weren’t everything that constituted a solid higher education. In our own quarantine bubbles, we wrestled with other demons. Depression and anxiety settling in during isolation. Family members and friends affected by the coronavirus. The loss of an entire year of their college education. As we navigated a roller coaster of emotions, we remained steadfast. We realized that our college experience was not just measured by the events we went to or the number of A’s on our transcript. It was measured by the memories we carried of the people who most mattered to us. So we kept finding ways to learn, to adapt, to grow. We kept looking for the color in the gray.

We set up our own Zoom movie and game nights. We watched livestreamed concerts with our friends. We sent letters through snail mail. We picked up new hobbies, found new shows to watch. We still graduated and held remote celebrations. We persevered.

Four years after I first set foot on campus, my in-person commencement ceremony was limiting and bittersweet. My family and friends could not be there, due to COVID-19 protocols. I missed them. But I knew they were watching on their screens somewhere, still celebrating with me. Even in the remote pandemic landscape, we students still figured out a way to be there for one another in spirit.

In my four years at UC San Diego, I voted in my first election, witnessed protests firsthand, made friends to last a lifetime and experienced a global pandemic. My college experience can be summed up in a rainbow of colors. And the greatest lesson I will always take away is the ability to find color in any shade of gray, regardless of where I find myself.

— Education

Despite the Pandemic, They Rebounded

For the UC San Diego women’s basketball team, it was a season to be remembered

After countless Zoom meetings, daily screenings, masked practices and some hopeful thinking, we got the green light to play in our first Division I women’s basketball competition against Cal Baptist University on December 21, 2020 at RIMAC Arena.

It had been nine months since we had last played a game together in the gym, and for a brief period, it felt like things were falling back into place. Because we were newcomers to the Big West Conference, we were considered underdogs and not expected to perform at the same level as everybody else.

That game, however, proved that we were not only capable but determined to show up and show out. We were up at halftime by three points and were eager to finish with a win. Of course, it was impossible to shut out the growing COVID-19 pandemic, and reality quickly set back in (I did say it was for a brief period of time).

As some might know, our game was cut short due to a potential positive test from the other team. While we were disappointed that we did not finish the game, we all came out of RIMAC Arena with the same electric energy, knowing that we could still compete and successfully comply with all the COVID-19 protocols and demands.

It quickly became obvious that we would all need to adapt a lot and often to continue with our season. This applied to all of our travel games, bus rides, locker room set-ups and meal distributions. Throughout the year, our team emphasized the importance of flexibility. We were told we would have to wear masks for the first eight weeks of practice. Fine. We would have to be tested three to four times a week to play. Great. All of our classes would be online for the foreseeable future. Awesome.

At one point, I would have to run to the end of the gym, whip out my computer or borrow someone else’s, take a 10-minute quiz, and then race back to the court to practice out-of-bound plays. We knew, though, that these were required steps if we wanted to play. We learned how to get creative with our conditioning and lifting workouts and developed new ways to cheer for each other on the sidelines. Our athletic training staff was determined to make sure that all tests and screenings were completed before entering the gym, not afraid to call out those who were behind. Our coaches made sure we kept our distance during drills and wore our masks when required. We established trust and accountability for one another.

“There was a mutual respect for everybody who had helped us get in the gym and play the sport we love.”

We made it a consistent goal to always remember how lucky we were; lucky that we were one of the few teams to have anything remotely close to a season; lucky that we were all healthy enough to run up and down the court; lucky that we had our friends and families to cheer us on through laptop and TV screens.

Many student-athletes over the past year or so weren’t as lucky. Many saw their college careers concluded without a proper send-off. We saw the pain in the eyes and faces of our seniors, who were with us in Hawaii for the NCAA first-round playoffs when we learned about the severity of COVID-19 and its ramifications for our season. Every game we played and every opportunity we had during practices and lifts, we did our best to remember that at any minute we could easily be in their shoes.

We were also reminded that, if we learned anything, it is that most things are bigger than athletics. As I write this, it is important to note that I can’t possibly speak for every person on our team because we all experienced our own individual struggles and hardships during the most insane year of our lives.

Between the ongoing social injustices in our country — highlighted by the Black Lives Matter movement — and the impact this pandemic continues to have on the collective and individual mental health of so many, it seemed impossible to think that college basketball would be a sufficient Band-Aid.

It wasn’t and isn’t.

But coming together to educate and support one another, as well as understand each person’s limits and comfort with the challenges each day offered, was a starting point. We made it a goal on our team to check in with each other and make the space between us as comfortable as possible. This was important to establish and maintain for both our physical and mental well-being. And for many student-athletes across the globe, the choice to come back and play was extremely personal. I have respect for anybody who had to make that decision, whatever it turned out to be.

Because we were so meticulous about staying safe and following all of the guidelines, playing basketball, especially at the Division I level, did not seem as daunting or massive as we originally thought. There were struggles throughout the season, but we competed every game, and at the end of the day, it was basketball, something simple and second nature to us all. As we played in the middle of a pandemic, the Big West didn’t seem so big.

— Research

My So-Called Pandemic Life

How the COVID-19 pandemic turned out to be a major training experience for one graduate student-researcher

The thought of another day looking at a blank screen made me want to rip my hair out. We were one month into the COVID-19 lockdown, and after cleaning out my incubator of cells and brain organoids, and cleaning my mouse cages, I was tasked with writing a grant proposal. I had two months until the deadline. But there I was, one month in, and I had nothing.

It was difficult to stay motivated. Before our labs closed down, I had finally gotten the hang of culturing brain organoids, and I was getting promising data for my thesis project. I was in the third year of my PhD program — the year where you’re told you will be the most productive and get the majority of your data before the infamous fourth-year slump. I didn’t expect to spend this productive year at home baking sourdough bread and brewing kombucha while procrastinating writing a grant.

Staring at the blank screen wasn’t working, and I knew I needed help. I reached out to my classmate, Margaret, and she came up with a plan to stay focused.

The next morning, I hopped on a Zoom call with Margaret, and she said, “Got your coffee? Ok, let’s write.”

I minimized the Zoom window so she was in a small box in the corner of my screen while we wrote together, following a productivity hack known as the Pomodoro Technique. It was quiet for 25 minutes. When the bell rang for our break, we chatted while we sipped our coffee until the next bell signaled us to get back to work.

After several morning coffee Zoom calls with Margaret, I finished writing the grant with a couple of days to spare. It was the first time I had felt accomplished since the lockdown started. Although I later found out that the grant didn’t get funded, it was a major training experience for me. My experience writing it during the beginning of the COVID-19 pandemic changed how I tackle obstacles in my PhD journey. Now, I’m better at managing my time, and I’m not afraid to ask for help when I need it.

Looking back, the third year of my PhD was a very productive year both at and away from the bench.

— Research

A ROOM OF ONE’S OWN

A physician-scientist recalls how his team quickly got a specialized facility up and running so researchers could work with live coronavirus, speeding the search for new treatments and preventions

My goal as a physician-scientist is to ask clinically important questions, conduct experiments in the laboratory to answer those questions, and translate those research concepts back to the bedside to help patients.

But when COVID-19 exploded, there was nothing but questions. How does this virus hurt people? How can we treat it? How can we prevent it?

I wanted to help answer these questions and so did the UC San Diego research community. Many of these questions couldn’t be answered without performing experiments using infectious SARS-CoV-2 in a biosafety level 3 (BSL-3) facility.
Combining specialized engineering with fastidious work practices, a BSL-3 allows research on important, highly pathogenic organisms to be done in a manner that is safe for both the researchers and for the community.

The UC San Diego BSL-3 became operational in April 2020, and we immediately developed a research program focused on SARS-CoV-2 and other emerging viruses. Together, with a small group of dedicated investigators that includes Davey Smith, MD; Ben Croker, PhD; Sandra Leibel, PhD, and Alex Clark, PhD, we worked tirelessly over two months to develop and optimize the protocols that allow us to conduct leading-edge research on SARS-CoV-2 pathogenesis, diagnosis, treatment and immunity.

Our COVID-19 BSL-3 lab now performs experiments with infectious SARS-CoV-2 for labs across the campus and the San Diego research community. This gives groups without experience working with pathogenic viruses the ability to perform critical proof-of-concept testing of their new COVID-19 rapid diagnostics, vaccines and treatments, in addition to experiments that increase our understanding of the virus and its pathogenesis. Some of these discoveries, like our identification of heparan sulfate as an attachment factor for SARS-CoV-2, have led to novel therapeutic approaches to treating this disease, while others may become the diagnostic, treatment and vaccination approaches of the future.

Sometimes the worst events bring out the best in us. I am thankful for the generosity of many within the UC San Diego community that have contributed to the BSL-3 and for the dedication of our biosafety staff. I am amazed at the cross-disciplinary collaborations that have developed during this pandemic at UC San Diego and their potential to make ground-breaking discoveries.

“When I go to work, my five-year-old daughter asks me, “Are you going to the BSL-3 today to fight COVID-19?” I tell her proudly that I am. But, more importantly, I hope that someday soon children won’t have to think about pandemics or viruses.”

— Research

AIR APPARENT

How aerosols have contributed to the silent spread of COVID-19 around the globe

Over the course of the COVID-19 pandemic, it became clear that the predominant way people were becoming infected was through air transmission — and this was not being acknowledged. As an atmospheric chemist who has spent my entire career studying aerosols, I know first-hand how far aerosols can float through the air. I became deeply concerned and thus have spent much of the past year focusing on communicating the latest scientific evidence about the major role of aerosol transmission in silently spreading SARS-CoV-2 around the globe.

During a “normal” year, my research at UC San Diego focuses on understanding how aerosols — microscopic airborne particles — affect our atmosphere, climate and human health. I am particularly interested in bioaerosols and pathogens that get ejected from the ocean in coastal regions. Sorting out the impacts of aerosols in field studies is challenging, so my colleagues and I have transferred the full complexity of the ocean and atmosphere into the lab at Scripps Institution of Oceanography using a large wave channel. This unique approach to isolating the ocean/atmosphere system allows us to study how physical, chemical and biological processes in the ocean affect the composition of marine aerosols and their ability to seed marine clouds over 71 percent of the Earth, which strongly impacts our climate.

Throughout the pandemic, I have been deeply concerned that public health agencies, including the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), were too narrowly focusing their guidance on protecting against large respiratory droplets. This resulted in an emphasis on advising people to clean surfaces, something now labeled as “hygiene theater.”

Changing this “droplet dogma” has required an intense international grassroots effort imploring the medical community to update their longstanding picture of the transmission modes of respiratory viruses, and at the very least to apply the precautionary principle to better protect health care workers and those at high-risk.
Decades of scientific research have shown that large droplets fall within six feet. Aerosols float. In fact, they can travel thousands of miles around the globe. The only way to explain the thousands of documented superspreader events is by including aerosol transmission. The vast majority of outbreaks have occurred indoors — in places like churches, cruise ships, gyms, nursing facilities and bars.

These outbreaks all have one thing in common: all of those who were infected shared the same indoor air. Similar to the way cigarette smoke builds up and spreads across a room, it only takes one person infected with COVID-19 to expose everyone in poorly ventilated indoor spaces.

Over the past year, I have co-authored several high-profile publications on aerosol transmission along with other aerosol and medical experts, including UC San Diego’s Robert “Chip” Schooley, MD. In The Lancet, for example, we outlined 10 lines of evidence supporting the airborne transmission of SARS-CoV-2 as the predominant pathway. I have done more than 1,000 media interviews on this topic. In addition, I’ve spent significant time advising government officials at local and federal levels on how to safely re-open, encouraging them to focus on cleaning the air. I have also worked closely with a group of UC San Diego experts to help the San Diego Unified School District safely reopen schools.

“And I’ve had conversations with numerous high-ranking officials, including Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, to alert them to the importance of acknowledging the role of aerosol transmission.”

And I’ve had conversations with numerous high-ranking officials, including Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, to alert them to the importance of acknowledging the role of aerosol transmission.

Our work to fully understand the role of aerosol transmission is just getting started. It is highly likely that SARS-CoV-2 is not the only respiratory virus that is spread through aerosols. A retrospective analysis of the transmission pathways for other respiratory viruses is already underway.

I am encouraged that we are starting to see our communication efforts pay off. WHO and CDC have updated their guidance. I am proud of the impact this international group of determined scientists has had in turning our understanding of COVID transmission around.

Once the role of aerosol transmission is clearly acknowledged globally, then we know what steps to take to help end this pandemic. Efforts need to focus on enhancing ventilation and filtration to improve air quality indoors where most infections occur. The long-term benefits of having cleaner indoor air in homes, schools and businesses are enormous. They extend well beyond this pandemic and can improve public health for generations to come.

— Research

History Repeats

Future pandemics are inevitable. We must prepare now.

As 2019 turned into 2020, my husband and I took my parents on their dream vacation: a cruise around New Zealand and Australia. At the same time, a new virus, eventually designated SARS-CoV-2, was breaking out in China, causing a new disease that would be called COVID-19.

By the second week of the cruise, I was eager to get home. Despite reports that it was “contained,” the virus in China still clearly raged. In the modern era of travel, a respiratory virus cannot be contained. Indeed, cases of SARS-CoV-2 had already been reported in Italy and Seattle and in other cruise ships sailing the Pacific. It was on its way everywhere.

Thankfully, my family and I remained healthy. At the time, there were no known, effective treatments specific to COVID-19 and, of course, no vaccines. I had already lived through one pandemic. I knew there were challenges ahead. I knew we would need science to save us. In 1996, when I started my internship and residency at UC San Diego Health, hospitals were filled with patients dying of AIDS, the end-stage of HIV infection.

“Every shift began at the nurses’ station where I would ask if any of my patients had died overnight.”

But before my residency ended in 2000, many of my patients were leaving their hospital beds and going home because scientists, including several at UC San Diego, had developed antiviral medications that prevented HIV from ravaging their immune systems. Today, people with HIV who have access to these medications and are able to take them regularly can lead long, happy lives.

Two decades later in July 2020, the SARS-CoV-2 virus was in full swing in San Diego. Hospitals were filled with patients suffering from COVID-19, and I was back on the hospital wards that were once filled with HIV patients, an infectious disease physician caring for them.

I was putting in long hours, often for days on end, to keep my patients alive. And I was again thinking we needed science to save us. And, we needed to be better prepared for the next pandemic, which would inevitably come.

SCIENCE
SAVES LIVES

Action was needed. We set up international trials to study new vaccines and treatments for COVID-19, such as the ACTIV-2 study, which opened in August 2020. We found effective therapies, vaccines and testing methods and implemented them for our community by setting up large-scale testing, vaccine and treatment centers. We also worked with other regional health care providers. These efforts undoubtedly saved thousands of lives, yet they were all aimed at ending the current crisis. If we want to avoid history repeating itself, perhaps in even more devastating terms, preparations must be made now for the next pandemic, whatever its cause.

PLANNING
FOR PREVENTION

In October 2020, we began outlining the structure of a new institute at UC San Diego. The Pandemic Response to Emerging Pathogens, Antimicrobial Resistance and Equity (PREPARE) Institute is now poised to become a global leader in preparing for, responding to and thwarting pandemics. By connecting interdisciplinary scientists from UC San Diego and other local scientific partners, including the J. Craig Venter Institute, the La Jolla Institute of Immunology, the Sanford Burnham Prebys and Scripps Research, the PREPARE Institute will provide much-needed infrastructure and personnel to respond rapidly to future pathogens.

Effective collaboration across departments, divisions and institutions will equip the PREPARE Institute to rapidly translate lab discoveries to the clinical/patient interface where they can help stem epidemics before they consume our lives.

Together, we can leverage collective knowledge and innovation to reduce the impact of pandemics. Our members are experts in surveillance, proactive therapeutics and vaccine research, health behaviors and public policy. We are gearing up to defend against any infectious disease vector — bacteria, viruses, parasites, fungi or yet-to-be-discovered pathogens.

This is a massive undertaking; public and private support are critical. Whether you are a scientist, CEO, community member or philanthropist, you can help the PREPARE Institute redefine how pandemics are managed. Your knowledge, your innovation and your voice may save countless lives. For information about membership, services or gifts, please email prepare@ucsd.edu.