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ASU, Mayo Clinic and Maricopa County Department of Public Health collaborate on antibody survey

September 2, 2020

The Serosurvey Project will create a more complete picture of COVID-19 infections in Maricopa County

Maricopa County Department of Public Health, Mayo Clinic and Arizona State University are embarking on an ambitious project to better understand the prevalence and spread of COVID-19 cases in the county — and they need the public’s help to do it.

Their Serosurvey Project will send teams across the Valley of the Sun to selected neighborhoods and request blood samples from residents for antibody tests to determine if households had any prior exposure to COVID-19. In the absence of the ability to currently test everyone, such a survey will provide critical insights for the county health department (MCDPH) to better understand and project how many Maricopa County residents may have already been infected with the SARS-CoV-2 virus.

“It will be really eye-opening to get an idea of how much spread we actually have had in Maricopa County,” said Marcy Flanagan, executive director at MCDPH. “Our residents have been great at stepping up to help reduce spread and protect our families, friends, and neighbors, and participating in this serosurvey is a way to contribute to knowledge specific to our community.”

The sample collection and survey of Maricopa County residents will run from Sept. 12 to Sept. 20.

Why Maricopa County health needs your help

The project aims to collect 500 samples from 210 households in selected clusters throughout Maricopa County. The clusters were chosen using a Centers for Disease Control and Prevention technique called Community Assessment for Public Health Emergency Response (CASPER). CASPER is designed to give public health officials a snapshot of a community based on a carefully selected sample representative of the larger population. This can better inform public health strategies, identify information gaps, aid response and recovery, allocate resources and assess new or changing needs in communities. 

The teams will go to people’s homes instead of relying on patients coming to a clinic for testing, because this method ensures a more accurate representation of the community, said Megan Jehn, an associate professor in ASU’s School of Human Evolution and Social Change. Jehn is an infectious disease epidemiologist who leads a student outbreak response team working with MCDPH to support the public health response to COVID-19. 

“We're trying to come out on different days of the week, at different times of the day and to different neighborhoods, because we want everyone to be represented,” Jehn said. “We want to know the true impact of COVID-19 in the community with a sample to reflect our community’s socioeconomic, geographic, age and ethnic diversity.”

What antibodies tell us

Once collected, Mayo Clinic will test the blood samples for antibodies, which are proteins that our bodies produce in a unique response to a particular germ.

“The process of making antibodies starts with exposure to a virus — your body sees that virus, recognizes it as foreign and will generate antibodies against it,” said Erin Kaleta, director of Infectious Disease Serology and co-director of Clinical Chemistry at Mayo Clinic. Kaleta will be leading the sample testing.

A negative test result means that an individual has probably not had the virus, while a positive result means someone was probably infected with COVID-19 at some point in the past. And studies have shown that even people who may be asymptomatic for COVID-19 can produce antibodies to the virus.

Since this antibody data shows who has and hasn’t been infected, it gives public health officials a more accurate idea of the actual number of cases in the county. The serosurvey will allow MCDPH to calculate an estimated total number of undiagnosed cases for Maricopa County. Similar projects in the U.S. found that for every diagnosed case of COVID-19, as many as eight to 10 people had antibodies. This suggests the virus is far more prevalent than diagnostic testing reveals.

“The benefit of this is that we can get a better idea of who's been infected overall, which is a better indicator than using diagnostic testing, as those only see a moment in time,” Kaleta said.

In addition to aiding the county’s public health work, the antibody data could provide useful information to participants volunteering blood samples. 

“You might learn something about how your behavior is associated with your likelihood of contracting COVID-19,” Jehn said. “You may learn something about those risk factors that you have in your life.”

First county household demographic data

Along with blood samples, teams will be conducting a survey with residents to gain a more complete picture of each household’s experience with COVID-19.

The survey questionnaire will provide data on a household’s experience with COVID-19 testing and quarantine, chronic illnesses, employment and access to health care, and finally knowledge, attitudes and household practices related to COVID-19.

Survey questions will be asked at the same time as the blood draw, which will be collected by nursing students from ASU’s Edson College of Nursing and Health Innovation, said Heather Ross, an assistant professor in the Edson College, who aided the survey development.

Ross is also working to staff the serosurvey field teams with ASU students in global health and anthropology programs. In addition, volunteers who support Maricopa County Department of Public Health’s efforts will serve in a variety of roles, both in the field teams and behind-the-scenes.

“The most critical component of this project is field teams asking residents for blood samples,” said Michael Shafer, a professor in the School of Social Work in the Watts College of Public Service and Community Solutions. “That’s a pretty big lift.”

To ease the load, field teams will be partially staffed with students in social work programs, who bring a useful skill set to the Serosurvey Project. 

“Social work students can empathize, build rapport with residents, respond to fluid situations, and will be able to address people’s concerns in a constructive way,” Shafer said. “This is the kind of project that really galvanized me as a young man and taught me about what was important to me.”

Field teams will ask survey questions and collect blood samples in portable tents set up outside with the permission of participating residents, and a mobile clinic will be on hand for support. Team members will wear CDC-recommended personal protective equipment including masks, gloves, gowns and booties when conducting the surveys and drawing blood.

“This is to protect our field teams, but also to provide assurance of protection to a family who is inviting a stranger into their community in the name of public health,” Ross said.

Illustration by Ashley Quay.

Privacy is a priority

Privacy is just as important to the serosurvey team as accuracy. No personal identifying information will be attached to blood samples for testing. Instead, samples will be assigned codes when they are sent to Mayo Clinic. After testing, Mayo Clinic will return the results to MCDPH, who will match the codes with the participants before contacting the participants by phone. Participants can also request a mailed copy of their antibody test results. 

“The thing that's really, really important to know about this is that all of the survey results and all of the blood test results will remain confidential,” Ross said. “They'll be shared with the county public health department. And that's it.”

Armed with that data, MCDPH can more effectively chart a course forward for Maricopa County. This is even more important as schools, businesses, places of worship and other community entities seek guidance on reopening safely.

Top photo: The blood draw will be collected by nursing students from ASU’s Edson College of Nursing and Health Innovation. Photo by Andy DeLisle

Pete Zrioka

Managing editor , Knowledge Enterprise

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ASU's College of Health Solutions appoints 9 new faculty to advance its mission to improve population health


September 2, 2020

The College of Health Solutions at Arizona State University announces the appointment of nine new research and clinical faculty whose wide-ranging expertise and deep research and clinical experience will advance the college’s translational approach to improving health outcomes in Arizona communities and beyond.

“The College of Health Solutions works to address complex global health challenges which requires intense collaboration, not only among researchers from a variety of disciplines, but also with health organizations and professionals in the communities we serve,” College of Health Solutions Dean Deborah Helitzer said. Health North building at the Downtown Phoenix campus The Health North building, part of the College of Health Solutions at ASU's Downtown Phoenix campus. Download Full Image

“Our mission is twofold: To work with our community partners to bring evidence-based solutions to the health challenges our Arizona citizens face, and to prepare the next generation of health leaders to make a difference by improving health outcomes, better managing health challenges and promoting wellness," Helitzer added.

"This year’s new faculty bring impressive expertise to elevate our programs and address this critical mission.”

Population health

Raminta Daniulaityte

Raminta Daniulaityte is an associate professor of population health.

Her research examines social and behavioral factors that affect the health of people who use illicit drugs.

She employs a variety of research methods, including natural history studies with community-recruited participants, qualitative research, forensic toxicology, social media and web-based sources to characterize and evaluate drug use and trends in targeted communities.

She earned Bachelor of Arts and Master of Arts in ethnology from Vytautas Magnus University in Kaunas, Lithuania, and a master’s degree in anthropology and a PhD in social work from the University of Alabama.

Before joining ASU, she was an associate professor and associate director of the Center for Interventions, Treatment and Addictions Research in the Department of Population and Public Health Sciences at the Boonshoft School of Medicine at Wright State University. 

Xing Sherry Zhang

Xing Sherry Zhang, an assistant professor of population health, is a public policy demographer.

Drawing on multiple perspectives and qualitative methods from sociology, public policy, demography and population health, her research focuses on the role of parent-child relationships in shaping young adult health from adolescence to adulthood and how this varies across race, ethnicity, gender and socioeconomic status.

She has a master’s degree in policy and analysis and a Doctor of Philosophy in policy analysis and management with concentrations in racial and ethnic relations and family and social welfare policy from Cornell University.

Movement sciences

Allison Ross

Allison Ross, an assistant professor of exercise and nutritional sciences, joins the College of Health Solutions from ASU’s School of Community Resources and Development where she was a faculty associate and assistant research professor. 

She studies how physical activity in the form of active transportation, play and sport contributes to individual and community health within schools and neighborhoods with a focus on expanding opportunities for youth and promoting a culture of health in schools.

She has a Master of Science in exercise science and sport studies from Springfield College in Massachusetts.

She earned her PhD in community development from ASU’s School of Community Resources and Development in the Watts College of Public Service and Community Solutions.

Nutrition

Shu Wang

Shu Wang is a professor of nutrition with more than 20 years of basic science research experience in the areas of chronic diseases and nutrition. 

She was previously an associate professor in the Department of Nutritional Sciences at Texas Tech University where she created biocompatible and biodegradable nanocarriers that enhance the delivery of nutrients and phytochemicals to the body as a way to prevent and treat chronic diseases, especially cardiovascular disease, obesity and Type 2 diabetes. Patents are pending on two of these nanocarriers.

She earned a Bachelor of Medicine at Norman Bethune University of Medical Sciences in Changchun, China, a Master of Science in biochemistry and molecular biology at Capital Medical University in Beijing, and a PhD in nutritional biochemistry and metabolism at Tufts University.

Health care delivery

Rizwana Biviji

Rizwana Biviji is a lecturer in health care delivery.

Her research focuses on maternal and child health informatics and the use of innovative technologies to overcome health care access barriers among prenatal and postpartum women. 

She earned a PhD in health policy and management and a Master of Science in applied health science from Indiana University. 

She also earned a Bachelor of Science in food science and nutrition from Shreemati Nathibai Damodar Thackersey Women’s University in Mumbai, India. 

Integrated behavioral health

Cady Berkel

Cady Berkel, an associate professor of integrated behavioral health, comes to the College of Health Solutions from ASU’s Department of Psychology where she was an associate research professor. 

In that capacity, Berkel collaborated on several projects with Health Solutions faculty, most notably with Rodger Kessler, Matt Buman and Scott Leischow on an Arizona Biomedical Research Commission-funded dissemination and implementation training grant, and with Associate Professor Meg Bruening on the TRANSCEND program, which works to improve nutrition training in the Southwest.

Her research, which has been funded by the National Institutes of Health, the Centers for Disease Control and the United States Department of Agriculture, addresses health disparities through the dissemination and implementation of family-focused, evidence-based programs in health care settings embedded in systems families regularly use. She also co-leads the college’s Maternal and Child Health Translational Team and Dissemination and Implementation Affinity Network. Her PhD in child and family development and an interdisciplinary graduate certificate in qualitative research are from the University of Georgia. 

Tina Sauber

Tina Sauber is a clinical assistant professor of integrated behavioral health and a licensed occupational therapist.

She was previously an assistant professor in physical medicine and rehabilitation and a senior fellow in the Academy of Educational Excellence and Leadership at Mayo Clinic in Arizona. She developed curriculum and taught doctoral-level occupational therapy students on various conditions that impact human performance at Northern Arizona University’s occupational therapy program.

She holds a Bachelor of Science in occupational therapy and a master’s degree in occupational therapy from the University of North Dakota and a Doctor of Occupational Therapy with emphasis on administration and practice management from Rocky Mountain University of Health Professions in Provo, Utah.

Satya Sarma

Satya Sarma is a physician who joins the College of Health Solutions as a clinical associate professor of integrated behavioral health. 

She comes to the college as a medical director from the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, where she continues to have a part-time appointment. She has also been a health care consultant and an executive in managed care settings in the Phoenix metro area.

Her research interests include population health management, health care workforce development, quality improvement, public policy, health care finance, and health equity and integration.

She earned her medical doctorate from Jefferson Medical College in Philadelphia and did her internal medicine residency at the University of Pittsburgh Medical Center.

Speech and hearing science

Denise Stats-Caldwell

Clinical Associate Professor Denise Stats-Caldwell is rejoining the College of Health Solutions from clinical practice as a speech-language pathologist at Banner Gateway Medical Center where she initiated the voice rehabilitation program at the Banner MD Anderson Cancer Center.

During her tenure there, she remained involved with the college as adjunct faculty and a mentor to graduate students. Her specialty areas include speech, voice and swallowing rehabilitation in adults with an emphasis on oral, head and neck cancer survivorship.

Earlier in her career, she co-founded the first Arizona chapter of Support for People with Oral, Head and Neck Cancer together with a cancer survivor and initiated the first fiberoptic endoscopic examination of swallowing program with Banner Health.

Kelly Krause

Media and communications manager, College of Health Solutions