BIO5 members join forces as team leads on UArizona’s test, trace and treat campus re-entry group

Students, faculty and staff are expected to return to campus this August, but with COVID-19 cases still on the rise in Arizona and the highly social nature of college, the University of Arizona called upon a team of BIO5 Institute members to address inevitable future cases head-on.

Joyce Schroeder, department head and professor of molecular and cellular biology, and Kristen Pogreba-Brown, assistant professor in the College of Public Health, are developing plans for COVID-19 testing, tracing, isolation and medical care that are essential to optimally resuming in-person university operations amid the pandemic. 

“The university quickly realized that if they want to have a successful re-entry plan, they had to be able to stay on top of cases that would inevitably happen on campus,” Pogreba-Brown said. 

As members of the Campus Re-Entry Working Group, the two are using their expertise in human health and disease to co-lead the contact tracing efforts of the three-pronged Test, Trace and Treat team.

“The way that humanity addresses infectious disease is through a well-established scientific method of being able to test for the disease, finding someone with the disease, tracing who they’ve been in contact with, and isolating those groups of people away from the general public,” Schroeder said.

Pogreba-Brown, an expert in using epidemiological data to improve response to disease outbreaks, is leading the manual contract tracing team. As a master’s student in 2005, she created the Student Aid for Field Epidemiology Response (SAFER) team to study food borne illnesses in Maricopa County. In response to the COVID-19 pandemic, Pogreba-Brown quickly pivoted the team’s focus to manual contact tracing for Pima County.  

Manual contact tracing works in two steps: a case investigation into the individual who tested positive for the disease and the notification of potential disease exposure to others who interacted with the infected person. All parties involved are followed up with throughout the entire 14-day window in which they could spread the disease to others. 

Through this method, those involved can be educated with public health guidance on proper isolation and quarantine practices. Team members can also work with students to address any challenges they might have with remaining in quarantine, such as the need to get groceries or take care of a loved one. 

Because manual contact tracing is time and labor intensive, the method is limited by the capacity of the SAFER team. In anticipation of cases rising as students return to campus, Pogreba-Brown has been actively recruiting new student volunteers to share the phone call load.

She is also encouraging employees and students to sign up for Wildcat WellCheck, a text message-based screening system that asks participants to briefly update their daily health status, as well as to self-report their symptoms and positive diagnoses online through Campus Health, which will lessen the number of calls her team has to make. 

Since manual contract tracing relies on the infected individual’s knowledge of the names and contact information of all the people they encountered, it’s impossible to use in a large group setting, such as during a protest, where one is surrounded by hundreds to thousands of strangers.

To address contract tracing on a larger scale, Schroeder is leading an app-based team that is collaborating with COVID Watch to develop an exposure notification cellphone application. Once installed, the app anonymously records signals from other nearby users with Bluetooth, including physical distance and the duration of that interaction. If a user tests positive for COVID-19, they can privately alert others with whom they came into close contact. To prevent false alarms, the COVID Watch app requires a verification code from the lab, doctor or medical center who notified the person of their positive test result.

As part of her role as MCB Department Head, Schroeder served on a teaching and learning team tasked with informing Provost Liesl Folks on the most effective way to transition faculty and students to online learning amid the pandemic. After speaking with another BIO5 member, Joanna Masel, professor of ecology and evolutionary biology, about a way to address reentry from a digital standpoint, the university’s administration asked Schroeder to form and lead an app-based contact tracing team – despite the fact that she knew very little about developing a digital app.

“They pointed out that I didn’t need to know about making an app,” Schroeder said. “What I needed to be able to do was bring a bunch of different types of people together and manage them as a group.” 

To quickly fill this role, Schroeder drew upon her experience leading diverse teams as a principal investigator, department head, and Chief Scientific Officer of the biotech startup Arizona Cancer Therapeutics. Schroeder’s team, composed of experts in public health, privacy and coding, are “working at breakneck speed” to ensure app functionality. Schroeder says one of the biggest obstacles the team is working to address is ensuring the software can differentiate between two phones physically separated by a wall as compared to separate by the fabric of a purse or clothing pocket. 

Another obstacle is getting students, faculty and staff to download and use the app. Schroeder continues to emphasize that installation and utility of the app will be completely up to the individual – no one will force a person to participate, and the technology will not collect any personal data. However, compliance by most students, faculty and staff will better enable a safe return to campus. 

“The more people on our campus that use this technology, the safer we’re all going to be, so we really have to approach this in the perspective that we’re all a part of this big community,” Schroeder said during a recent campus re-entry briefing. “We’re all living together, and the more we can all help each other by keeping track of these sorts of things, the easier it will be for us to get back to normal life…and get back on to the campus we love.”

The smartphone app has yet to be deployed. Schroeder’s team is rigorously testing the app to verify its ability to anonymously integrate users’ distance from one another, the duration of their interaction, and the date and time when the interaction occurred. Finished with the alpha testing phase, Schroeder has placed the app in the hands of Campus Health employees. Beta testing is scheduled to close July 27, with the aim to begin a “pilot rollout” to everyone on campus August 10. 

In addition to using the app, Schroeder and Pogreba-Brown says it will also be essential that students and employees maintain proper social distancing, hand washing and mask wearing to mitigate the spread of disease. However, Pogreba-Brown recognizes that asking students to refrain from social gatherings is quite a tall order.

“We are asking people to do big behavioral changes, and that is always hard. But that is what’s required right now,” she said. “We can pull it off, but it’s just a matter of making sure we get buy-in from the students.”

A recipient of a BIO5 COVID-19 Seed Grant, Pogreba-Brown is also using SAFER to determine symptoms, acute risk factors, and long-term outcomes associated with COVID-19. More than 800 people have already been recruited to their baseline survey. She and her teammates also plan to initiate a long-term study which will collect enough data to generate a database which can be used by all COVID-19 investigators statewide.