Children’s Healthcare of Atlanta, the Emory University School of Medicine Department of Pediatrics and the Georgia Institute of Technology are teaming up through the Atlanta Center for Microsystems Engineered Point-of-Care Technologies (ACME POCT) .
The Atlanta center was selected by the National Institutes of Health (NIH) to evaluate COVID-19 detection tests utilizing a portion of a $1.5 billion investment from federal stimulus funding under a newly launched Rapid Acceleration of Diagnostics (RADx) initiative. This initiative will infuse funding into early, innovative technologies to speed development of rapid and widely accessible COVID-19 testing with a mandate that tests be deployed to Americans this fall.
“The National Institute of Biomedical Imaging and Bioengineering (NIBIB) is urging all scientists and inventors with a rapid testing technology to compete in a national COVID-19 testing challenge for a share of up to $500 million over all phases of development that will assist the public’s safe return to normal activities,” said Wilbur Lam, M.D., Ph.D., pediatric hematologist and oncologist at Aflac Cancer and Blood Disorders Center of Children’s and principal investigator of ACME POCT.
As one of only five NIH-funded point-of-care technology centers in the nation within the Point-of-Care Technologies Research Network (POCTRN), ACME POCT will receive a $10 million to $20 million supplement to work closely with relevant technology developers and the medical diagnostics industry across the country to meet the deadline. The technologies will be put through a highly competitive, rapid three-phase selection process to identify the best candidates for at-home or point-of-care tests for COVID-19. The goal is to make millions of accurate and easy-to-use tests per week available to all Americans by the end of summer 2020 and in time for the flu season.
The Center will operate on the frontlines assessing, validating and conducting clinical trials as well as advising in manufacturing and scale-up of relevant COVID-19 tests. They expect hundreds of technology developers and companies to apply for the RADx program and will be involved in clinical validation and shepherding successful projects to meet this national need, making Children’s, Emory and Georgia Tech frontline warriors in this effort.
ACME POCT fosters the development and commercialization of microsystems (microchip-enabled, biosensor-based, microfluidic) diagnostic tests that can be used outside the traditional hospital setting, in places such as the home, community or doctor’s office. Lam and his team will evaluate the tests for the NIBIB as they urgently solicit proposals.
Lam is the principal investigator of ACME POCT and also serves as associate professor of the Emory University School of Medicine Department of Pediatrics and the Wallace H. Coulter Department of Biomedical Engineering at the Georgia Institute of Technology and Emory University. Greg Martin, M.D., is co-principal investigator along with Oliver Brand, Ph.D., executive director of Georgia Tech’s Institute for Electronics and Nanotechnology and a professor in the School of Electrical and Computer Engineering. Together the team makes up the only point-of-care center in the nation dedicated to developing microsystems with sensors, smart phones and wearable technologies. Dr. Martin is also a professor with the Emory University School of Medicine and Chair of Critical Care for Grady Health System.
About Children’s Healthcare of Atlanta: As the only freestanding pediatric healthcare system in Georgia, Children’s Healthcare of Atlanta is the trusted leader in caring for kids. The not-for-profit organization’s mission is to make kids better today and healthier tomorrow through more than 60 pediatric specialties and programs, top healthcare professionals, and leading research and technology. Children’s is one of the largest pediatric clinical care providers in the country, managing more than one million patient visits annually at three hospitals, Marcus Autism Center, the Center for Advanced Pediatrics and 20 neighborhood locations. Consistently ranked among the top children’s hospitals by U.S. News & World Report, Children’s Healthcare of Atlanta has impacted the lives of kids in Georgia, across the United States and around the world for more than 100 years thanks to generous support from the community. Visit www.choa.org for more information.
About Emory University School of Medicine: Emory University School of Medicine is a leading institution with the highest standards in education, biomedical research and patient care, with a commitment to recruiting and developing a diverse group of students and innovative leaders. Emory School of Medicine has more than 2,800 full- and part-time faculty, 556 medical students, 530 allied health students, 1,311 residents and fellows in 106 accredited programs, and 93 MD/PhD students in one of 48 NIH-sponsored Medical Scientist Training Programs. Medical school faculty received $456.3 million in external research funding in fiscal year 2018. The school is best known for its research and treatment in infectious disease, neurosciences, heart disease, cancer, transplantation, orthopaedics, pediatrics, renal disease, ophthalmology and geriatrics.
About the Georgia Institute of Technology: The Georgia Institute of Technology is one of the nation’s leading research universities — a university that embraces change while continually Creating the Next. The next generation of leaders. The next breakthrough startup company. The next lifesaving medical treatment. Georgia Tech provides a focused, technologically based education to more than 36,000 undergraduate and graduate students. The Institute has many nationally recognized programs, all top-ranked by peers and publications alike, and is ranked among the nation’s top five public universities by U.S. News & World Report. It offers degrees through the Colleges of Computing, Design, Engineering, Sciences, the Scheller College of Business, and the Ivan Allen College of Liberal Arts. As a leading technological university, Georgia Tech has more than 100 centers focused on interdisciplinary research that consistently contribute vital research and innovation to American government, industry, and business.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
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]]>That goal received support April 10 with an announcement by Google and Apple that they are collaborating on standards and tools to make it easier for software developers to build apps that can help fight the pandemic.
For the past month, a team of researchers at the Georgia Tech Research Institute (GTRI) has been working with a community-driven open source project on a “privacy first” open-source app that can take advantage of these tools to do something known as “contact tracing.” Contact tracing software, running on smartphones of persons who’ve chosen to participate, records the kind of person-to-person interactions that have the potential for transmitting contagious illnesses. If any of the other participants the user has interacted with becomes ill and chooses to share information about their symptoms, the software then alerts the impacted user anonymously. During this process, all shared information remains completely anonymous – to other users, to the government, to technology companies, and even to the database that makes the exposure matching possible.
Individuals notified of a potential exposure could then receive information and guidance about steps they might take, including suggestions to get tested for COVID-19, to self-quarantine, or to closely monitor for symptoms. The notification would be one part of a larger effort to control virus clusters before they become outbreaks. To be most successful, a software-based contact tracing system will have to be coupled with broad-based testing able to quickly determine who’s infected with the virus.
Similar approaches have proven effective in countries such as Singapore and South Korea, though these systems have weaker privacy guarantees in place. A key feature of this new approach is that it would not exchange or publish any personally identifiable information and does not disclose any information at all unless someone voluntarily chooses to share their symptoms or diagnosis. This approach accomplishes this using Bluetooth signal strength to assess proximity rather than GPS data, which is difficult to anonymize and could be used to identify individual users based on frequently visited locations.
“We really need a better early warning network to guard against the re-emergence of COVID-19 in the general population,” said J. True Merrill, a GTRI senior research scientist who is working on the project. “In the early part of this outbreak, COVID-19 was spreading easily across the United States without an early warning of it. After the current shelter-in-place period is over, we are going to need tools to help people determine when they need to self-quarantine in order to stop outbreaks before they can grow.”
Manual contact tracing to identify who’s been infected has long been part of public health strategies to contain serious communicable diseases, but the speed at which COVID-19 has spread outpaced traditional methods, said Alexa Harter, director of GTRI’s Cybersecurity, Information Protection, and Hardware Evaluation Research Laboratory.
Privacy First, for the Common Good
“Smartphone contact tracing is a way of using technology to automate and augment some of the techniques that public health agencies have used,” she said. “Technology can enable us to do this, but for people in the United States to adopt it, privacy will really have to be locked down. Everything we’re doing in this project aims at providing privacy first. Manual contact tracing is still critically important, but digital contact tracing and alerting can significantly assist these efforts.”
Beyond protecting privacy, large-scale adoption of smartphone contact tracing will need a social component that appeals to supporting the common good.
“To be successful, we’ll need to turn participation in this into a socially good thing, perhaps like the Ice Bucket Challenge,” Merrill said. “We’ll need people to voluntarily opt-in, and to get that, users would need to have full knowledge and control over where their data is stored and with whom they choose to share it.”
An Open-Source Global Effort
GTRI researchers are working with an open source community-driven project known as CoEpi (which stands for Community Epidemiology in Action), which envisions an app of the same name that could be installed on phones running Apple’s iOS or Google’s Android systems. CoEpi focuses on anonymous symptom sharing and alerting to stop the spread of transmissible illnesses like COVID-19.
Other organizations are also working on contact tracing apps, and these organizations have recently joined together to form the TCN Coalition to support privacy-preserving digital contact tracing protocols to flatten the curve and stop the spread of COVID-19 while reopening the economy. TCN, the core component of the effort, stands for “temporary contact number,” which is an anonymous number generated to privately record interactions between mobile devices without allowing the devices themselves (or their users) to be tracked.
The TCN Coalition developed a common, shared protocol so that all of the different apps in the entire digital contact tracing network can cross-communicate, no matter which app is used. The TCN Coalition also developed a "Digital Contact Tracing Bill of Rights" that outlines requirements to minimize data collection, restricts what can be done with the collected data, and establishes security guidelines to protect civil liberties.
The Path Forward, Group Benefits
“A symptom-sharing app such as CoEpi would allow us to relax stay-at-home orders so that we can increasingly return to work and public spaces, while providing a way for individuals to get early alerts about potential exposures to symptoms,” said Dana Lewis, one of the founders of CoEpi. “CoEpi can provide early detection of exposure risks for individuals, and an early warning system for the communities they interact in to detect and slow the transmission of illness like COVID-19, influenza, and even the common cold.”
Convincing a hundred million U.S. citizens to install a new app on their phones could be a significant challenge, but the CoEpi focus on symptom sharing and alerting could yield benefits to smaller groups even before being widely adopted.
“The good thing about this is that it could help protect small groups without needing the buy-in of the whole population,” said Harter. “An example would be a retirement community that is largely self-contained. If someone there got sick, it would be important to alert everybody that person had interacted with so they could self-quarantine and protect other people in the community.”
Other groups might include organizations performing critical services, such as factories, warehouses, or package delivery companies. “If you had a group where people really needed to work together, you could get early alerts to stop outbreaks from happening,” she said. It could also be used among small clusters of high-risk individuals and their family and friends, or at universities and schools as they emerge from self-isolation.
How Contact Tracing Would Work
The contact tracing component of the system would work something like this.
Each user opting into the service would install an app that would generate personal keys – long strings of letters and numbers unique to that specific smartphone, which are in turn used to generate randomized temporary contact numbers. The phones of users opting in would then communicate those temporary numbers with each other when they were nearby, using low-energy Bluetooth, a short-distance protocol widely used on mobile devices. Signal strength could provide a measure of how close the phones are to assess the risk of virus transmission when those people crossed paths.
“The idea is to log close interactions,” said Michael Brown, a GTRI research scientist who is the Georgia Tech technical lead of the project. “We’ll want to eliminate as many false positives as possible. For example, it’s highly unlikely that person-to-person transmission would occur across a large room.” For each interaction, the system could also record the duration of proximity, another factor in assessing potential risk.
Each phone would periodically generate new anonymous unique keys, and use those to generate new temporary contact numbers each time it crossed paths with another phone running similar apps. It would record those keys in a database that would be kept on the phone for a short period of time determined by the incubation period of the virus.
If a CoEpi user developed symptoms, they would share their symptoms in their app. In future versions, the CoEpi developers envision that the sick user would be presented with a series of options such as anonymously notifying public health authorities. For now, the symptoms are sent to the CoEpi system, which would add the anonymous key and symptom report from the sick user’s phone.
Each user’s phone would periodically download the list of keys associated with known symptom reports and check the temporary numbers generated by those keys against those of the phones it had been near. A match between each phone’s database and the numbers generated from the server’s key list would generate a notification of the exposure, and the app would then help the user decide whether the match likely represented a real exposure, and if so, decide what to do: self-quarantine, be tested, and/or notify public health authorities.
“Everyone would be pinged when they get tied to a known case, but only over a time range that really could have created a risk of transmission,” Merrill said. “There would be no identification information exchanged between the phones or the phones and the server.”
Other Potential Epidemiological Uses
Beyond advice on illness and notification of potential contacts, the system could also generate anonymized epidemiological information useful to researchers tracking pandemics. Users of the system would decide if they want to opt into the database and share their anonymized information with public health authorities.
“The CoEpi project will help provide earlier detection and testing of potential cases, and that information would be helpful for our predictive models,” said Pinar Keskinocak, who is William W. George Chair and Professor in Georgia Tech’s H. Milton Stewart School of Industrial and Systems Engineering.
Beyond programming support, GTRI will assist the effort through security analysis and potentially testing in its Atlanta facilities, Brown said. The testing will need to include many different environments and handset types, including multiple variations in operating systems.
The GTRI researchers have been racing to help CoEpi roll out software for beta and on-site testing, which should occur over the next several weeks. “The time line for this is super aggressive,” Harter said. “There is an urgency to this because we know it will be very useful in helping people stop social distancing, return to work and school, and try to get back to a more normal life.”
If you're interested in helping CoEpi as a mobile developer who can help at #WeAreNotWaiting speed (e.g. today or this week), please reach out to CoEpi: https://forms.gle/MLeKz9nerPvX8fwC8
Similarly, individuals who are interested in becoming early testers of CoEpi can sign up via the same form: https://forms.gle/MLeKz9nerPvX8fwC8.
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]]>Research News
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]]>Keskinocak has focused her career on heath and humanitarian systems, including hospital operations management, infectious disease modeling, and evaluating the effectiveness of intervention strategies. Since the initial coronavirus outbreak, she has worked on developing a comprehensive agent-based disease spread model, in collaboration with ISyE Professor Nicoleta Serban and Ph.D. students Buse Eylul Oruc, Arden Baxter, and others. The model estimates the spread of the disease geographically and over time; resource needs such as hospital beds, ICU beds, and ventilators; and enables the team to evaluate the impact of various intervention scenarios to determine the best course of action.
In a recent CNN interview, Keskinocak discusses the impact of social distancing and current shelter in place orders. She cautions that a careful, gradual approach is needed as society plans to go back to work and social life, a balancing act between public health and the economy. She emphasizes the importance of the need to continue social distancing to slow down COVID-19 spread, flatten the curve, and save lives.
To help these employees, volunteers with the “Heroes Helping Heroes” Face Covering Initiative are fabricating cloth face coverings and do-it-yourself (DIY) sewing kits to be donated to any interested on-campus staff member by request. The first batch of face coverings and DIY sewing kits were delivered for distribution on April 14.
“I am continually inspired by the Georgia Tech family’s ability to create and innovate, as well as our deep appreciation for each other,” said JulieAnne Williamson, assistant vice president for Administration and Finance. “A team of leaders, sewers, and experts came together from across the Institute and got this initiative ready in just four days. From those who make the face coverings to those who need them as they work on campus, Georgia Tech’s caring spirit shines through.”
While the cloth face coverings are neither surgical masks nor substitutes for medical-grade personal protective equipment, they can still be helpful in reducing the diffusion of respiratory droplets in situations where social distancing cannot be maintained in the optimal manner. For more information about the effectiveness of cloth face coverings, consult the Centers for Disease Control and Prevention’s cloth face covering guidelines and frequently asked questions.
If you are interested in supporting Heroes Helping Heroes, fill out the Volunteer Survey. Volunteers may donate their finished products at a no-touch drop-off location at Georgia Tech’s Environmental Health and Safety department.
If you’re an on-campus employee and would like a cloth face covering, please visit Heroes Helping Heroes for instructions on how to request one.
For more information about creating, donating, requesting, wearing, or cleaning cloth face coverings, visit Heroes Helping Heroes.
If you have questions about Heroes Helping Heroes, contact JulieAnne Williamson at julieanne@gatech.edu.
Read more about how Georgia Tech is joining the battle against COVID-19 with our expertise, innovation, and indomitable spirit: https://c.gatech.edu/COVID19Help
]]>The organization is interested in working with innovative teams, and the program connects entrepreneurs to mentors, scientists, venture capitalists, and others whose expertise can help accelerate the growth and success of new ventures.
Early-stage ventures interested in participating are invited to complete an application at creativedestructionlab.com/recovery.
CDL’s mission is to transform science projects into massively scalable products and services that benefit humanity. Founded at the University of Toronto’s Rotman School of Management, and now operating across eight universities in four countries, CDL engages leading entrepreneurs, economists, scientists, inventors, business leaders, and investors from around the world to enhance the idea-to-deployment cycle of innovative science and technology via a rigorous, objective-setting process. The program has successfully brought to market new technologies in a diverse set of frontier fields, including quantum computing, space, and artificial intelligence, creating billions of dollars in equity value in its short history.
The new CDL Recovery rapid response program takes these proven methods and applies them to new initiatives built on science that will meet urgent public health needs today and anticipate the needs of a post-COVID-19 world, particularly in efforts to improve preparation and reslience in the face of future crises.
Peter Thompson, a professor in Georgia Tech’s Scheller College of Business and co-site lead of CDL-Atlanta, says it is time to look beyond the immediate crisis to develop support for the recovery.
“So much of our federal, state, and local efforts are quite rightly focused on addressing the immediate needs of the crisis,” he said. “But there is an equally important need to look ahead, to think strategically as well as tactically. We are asking what technologies might help us be more prepared and more resilient a year from now or two years from now, and how we can help make sure those technologies get from the lab to deployment. These are the questions that CDL was built to address.”
CDL-Atlanta is collaborating with several partners in the Atlanta innovation ecosystem. And Lt. Governor Geoff Duncan is leading efforts to bring technology and innovation together.
"It is great to see the technology and innovation sector rallying to the COVID19 crisis,” Duncan said. “I am confident the Creative Destruction Lab's rapid response recovery effort kicking off now will get our best scientists and entrepreneurs together quickly to help with both the medical fight and the economic fight to recover."
ABOUT CREATIVE DESTRUCTION LAB
Creative Destruction Lab (CDL) is a nonprofit organization that delivers an objectives-based program for massively scalable, seed-stage, science- and technology-based companies. Its nine-month program allows founders to learn from experienced entrepreneurs, increasing their likelihood of success. Founded in 2012 by Professor Ajay Agrawal at the Rotman School of Management at the University of Toronto, the program has expanded to eight sites across four countries: Oxford (Saïd Business School, University of Oxford), Paris (HEC Paris), Atlanta (Scheller College of Business, Georgia Institute of Technology), Vancouver (Sauder School of Business, University of British Columbia), Montreal (HEC Montréal), Calgary (Haskayne School of Business, University of Calgary), and Halifax (Rowe School of Business, Dalhousie University).
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“Your mother told you to cover your mouth when you cough, and this is the best way to do it without fail,” said de Heer, a Regents Professor in Georgia Tech’s School of Physics.
De Heer advocates that widespread use of masks can save hundreds of lives in just days, and he is not alone. The Centers for Disease Control and Prevention, the U.S. Surgeon General, and the White House have officially recommended cloth face coverings.
Since people can carry the coronavirus with no COVID-19 symptoms and still spread the virus, everyone is a potential carrier, which means that everyone should wear a DIY mask in public, de Heer said. He compared it to coughing into your sleeve but even better because a DIY mask is always in front of your face, and it can be made out of more effective fabrics than a sleeve.
All of these parties, including de Heer, want people to not buy up masks needed by clinicians. N95 masks are not only not necessary for the general public but are also ineffective for many people, which could be dangerous.
“N95 masks are difficult to wear correctly, and they are hard to breathe through. They are not as effective for everyday use as a more comfortable cloth mask,” de Heer said.
U.S. Surgeon General Jerome Adams has cautioned that wearing masks must not discourage other behaviors to fight contagion like handwashing, avoiding touching your face, and social distancing.
Here is more logic on DIY mask effectiveness followed by links to instructions on how to make them.
As a researcher, de Heer is a leading expert on small clusters, particles the size of the misty droplets that shoot out of mouths when people sneeze or cough. The bigger droplets, the higher the viral loads they likely contain, and face covers catch nearly all larger drops and most smaller ones as well.
Breathing mist from a cough or sneeze or getting it in the eyes, nose, or mouth is likely the primary source of contagion for the coronavirus, according to the CDC. There have also been reports that the mist may hang in the air like exhaled cigarette smoke that people can inhale and become infected.
A hand-sewn mask out of cloth that has a tighter weave can cut down sharply on the mist, de Heer said, but even a bandana is much better than nothing.
“For math’s sake, say a bandana stops 80 percent of dangerous mist. That protection increases when everyone wears them. So, if two people are wearing bandanas – the sender of the spittle and a potential receiver – the math tells us that two bandanas would catch 96 percent of the dangerous mist. This shows that we all need to be wearing something.”
Hordes of Americans wore masks during the last great pandemic to hit the country, the Spanish flu of 1918-1919. Nurses handed out white gauze masks, and people also made them at home.
Georgia Tech researchers have published instructions and guidance for making and using homemade masks. Also, the New York Times has published mask sewing instructions here and the CDC here.
One country, in particular, impressed upon de Heer that the effectiveness of masks – the Czech Republic. A recent movement there led to the very widespread use of homemade cloth masks, and that country also has a very mild curve of new COVID-19 infections.
Countries turn a variety of weapons against contagion with varying success or failure, so it can be hard to determine if a single one stands out. But some countries have clearly reduced the rise in contagion as well as death rates more effectively.
Some are known for world-class healthcare systems with large capacities to serve their populations, but at the same time, they have displayed signature measures in the struggle. In the Czech Republic, this has been widespread cloth mask use.
“If you look at Western countries – and I’m going to include the state of New York in that list – New York has had really high increases in new cases. So have Spain, Italy, and France,” de Heer said. “Then you have outliers. Germany and Austria got out ahead of the game by getting widespread testing going very early on."
The Czech Republic has been another distinct outlier. So have many other places where masks are ubiquitous such as Hong Kong, Japan, or South Korea, de Heer noted, even though they are densely populated, making social distancing more challenging.
Austria also recently mandated the use of face covers when grocery shopping, following the lead of the Czech Republic. De Heer points to the Czech experience and that of successful Asian countries as very conspicuous evidence that masks help and that it is wise to adopt widespread use in the United States as well.
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Also read: Advice on DIY masks
Writer & Media Representative: Ben Brumfield (404-272-2780), email: ben.brumfield@comm.gatech.edu
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]]>The Georgia Tech Police Department and its Office of Emergency Management have assisted in site set up at 352 Peachtree Place and will manage traffic flow to keep individuals being tested isolated to one area. Logistics planning has been done in concert with state and federal health authorities who are leading this effort with CVS Health to provide an area for this testing and its required waiting period in accordance with strict health and safety standards.
Academic instruction is being held online and through distance learning until Fall semester, and campus operations have been modified to only include essential services. Given the currently reduced scope of campus operations, efficient visitor access to the test site with minimal impact on campus services is expected.
For more information about the test and drive-through testing program, visit www.cvs.com/minuteclinic/covid-19-testing.
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