How USC health experts jumped into action to fight COVID-19

As health administrators focused on staff and patient safety, finding a vaccine for COVID-19 became the holy grail for researchers. In late summer 2020, USC began enrolling volunteers in a multicenter clinical trial to test an experimental vaccine developed by the University of Oxford and AstraZeneca, a biopharmaceutical company. To bring the vaccine’s potential benefit to those most at risk of infection and complications, the team especially sought out participants who were “essential workers,” such as people in factories, meat-packing plants and warehouses.

Before Oxford-AstraZeneca completed its clinical trial, two other vaccine makers—Moderna and Pfizer/BioNTech—gained emergency use authorization from the U.S. Food and Drug Administration. Both vaccines started being administered in the United States. But because they needed to be kept at super-cold temperatures, their availability was limited. The Oxford-AstraZeneca vaccine can be stored at warmer temperatures, and the United Kingdom began using it in December.

Jones-López, co-principal investigator of the Oxford-AstraZeneca trial at USC, is concerned that the success of the two front-runner vaccines will dampen interest in others, both in funding and participation. “It’s clear we’re going to need more vaccines and simpler vaccines if we’re going to get out of this pandemic,” he says. “This problem has to be addressed on a global basis.”

One lesson Keck Medicine doctors have learned is that COVID-19 is more complex and can affect people much longer than originally thought. To make sure we have the best array of options to defeat the virus, they continue to push forward with their vaccine and treatment research.

Last fall, USC recruited participants for a nationwide clinical trial of bamlanivimab, an experimental antibody drug for adults and children older than 12 at high risk of going to the hospital with severe COVID-19 symptoms.

Monoclonal antibodies are synthetic versions of natural antibodies—infection-fighting proteins made by the immune system that bind to viruses and prevent them from infecting cells. In early testing, the drug reduced hospitalization by 70%. It’s the first treatment to show promise for these high-risk patients.

Also of growing concern to doctors are “long-haulers”—often people who have mild to moderate cases of COVID-19 but can’t shake the symptoms months after falling ill. Experts are puzzled as to why this virus hits previously healthy adults so hard. Patients might go from running a marathon one day to feeling too exhausted to get out of bed a few weeks later. “One theory is that their immune system went into overdrive to protect them from the virus,” says Rosen, who studies human immunology. “But once it has been eliminated, the immune system remains activated, and this causes problems.”

Mirroring nationwide stats, about 10% of the COVID-19 patients at Keck Medicine are long-haulers, and most are between 20 and 40 years old. To help them, Keck Medicine launched L.A.’s first multidisciplinary recovery clinic in January. It’s open to patients whose symptoms linger past six weeks.

A core team of a primary care physician, pulmonologist and physical therapist assesses each long-hauler and develops an individual plan of care. Because lingering symptoms range from joint pain to brain fog, a navigator arranges appointments with specialists in areas such as cardiology, gastroenterology, infectious diseases, neurology, rheumatology, behavioral health, physical therapy and social work—all to treat the whole patient.

Keck Medicine heads toward a post-pandemic world

Even as Nanda directed hospitalwide safety efforts during USC’s response to COVID-19, she began treating people hospitalized with COVID-19. She remembers one early patient, a man in his 60s who grew sicker and sicker over five days, eventually ending up in the intensive care unit. Though his breathing became weak and ragged, after a week he began to get better. “I watched him leave the hospital to rejoin his family,” she says.

That memory became a beacon of hope for Nanda through the dark days to come. Too many of her patients—on ventilators, separated from loved ones—had no happy ending.

By December, however, it seemed like health care workers finally reached a turning point. Keck Medicine’s first Pfizer vaccine doses arrived. They brought with them optimism and relief for frontline employees, alongside detailed plans to roll out vaccinations for high-risk patients and community members.

Other vaccine candidates are coming. More research will address unanswered questions about COVID-19. And as vaccinations, masks and other public health measures persist, infection rates will go down. Jones-López predicts more innovation throughout this year, fueled by a shared goal. Scientists are collaborative by nature, he says, and the unwavering global teamwork around COVID-19 “has been inspiring to see.”

Fresh challenges will undoubtedly emerge. USC officials plan to continue their COVID-19 response as they always do, Hanners says, “with a unified vision.” But experts warn that COVID-19 won’t be our last pandemic.

“We may not live in a COVID-free world, but we might get to live in a COVID-reduced world,” Nanda says. “This is our opportunity to be better prepared for the next one.”