A Look Back on Carle Illinois' Response to COVID-19

This series is a reflection of Carle Illinois’ collaborations, contributions, and impact on the COVID-19 response from March 2020 to March 2021.  It is told by Carle Illinois Associate Dean for Research and SHIELD team leader, Martin Burke.

Part 1: The Early Days

As the pandemic was bearing down on the world, experts at the University of Illinois realized combatting it was going to be a very big challenge.

Leadership at UIUC and Carle Illinois College of Medicine had one goal in mind: Figure out how we open and stay open in the Fall. “Even as we were sending the students home, we were already planning, how do we bring them back?” Martin Burke, Carle Illinois associate dean for research explains.

The take-off point was a phone call Burke received from Provost Andreas Cangellaris in early April 2020. “It was clear in the beginning we needed scalable testing with a comprehensive framework.” “The key driver is from a passionate understanding and commitment that our mission as a land grant institution is to serve the public good,” Martin Burke, Carle Illinois associate dean for research explains.

A silver-lining was discovering how prepared Carle Illinois was for the pandemic and the need for innovation that would follow. Carle Illinois had been working for years to prepare for this moment in history – and it was able to fly. “Carle Illinois catalyzed an extraordinary cross-disciplinary that would bring together,” Burke said. The nodes existed, and because of this unmatched ecosystem, Carle Illinois’ faculty was able to respond at this critical moment in the history of health.

Part 2: Challenges

By April 2020, experts at UIUC quickly realized they did not have the tools, methods, and technologies that would be required to solve the problems before them. However, Carle Illinois and experts across the campus saw those challenges as an opportunity for innovation.

So, they made a list. “Here’s all the things we can’t do but if we could do them, we could actually have a really good chance of getting ahead of this and creating a safer space for our student,” Martin Burke, Carle Illinois associate dean for research said.

At the top of the list was a test. The team identified too many roadblocks to the standard nasal swab and insisted there must be a better way. “Paul Hergenrother had the brilliant idea to skip steps and go straight from saliva to the PCR,” Burke recalled, and it worked. “This is where we had an opportunity to innovate in a way that would have a huge impact.”

The UIUC team went on a “full-court all-out blitz” of innovation. “After failing 1,000 times, the team discovered a method that goes directly from salvia to PCR,” Burke said. The method later became SHIELD and has been performed more than a million times across UIUC’s campus- keeping positivity rates low and avoiding deaths and hospitalizations.

Data Science and communication innovations were also critical to UIUC’s success. A team of UIUC data scientists built a strategy for how to deploy fast, scalable testing. The Safer Illinois app was created to take results from the lab to a person’s smartphone, enable an accessibility feature to enter buildings, and relay exposure notifications.

Part 3: Responding to Roadblocks

UIUC experts knew the students returning from around the country and the world would bring COVID-19 into the community. “We ran the numbers and saw many of them were going to bring COVID-19 with them,” Martin Burke, Carle Illinois associate dean for research said.

With all of that, we had a plan. Our plan and modeling predicted that with the fast, frequent, testing we would be able to mitigate the spread of an initial bump that would come with the students arriving.

Leaders at UIUC had modeled very carefully what they thought was going to happen. The goal: be transparent, forthright, and understanding about all the challenges that the students' return to campus represented.

Campus leaders prepared for roadblocks by modeling into the data science predictions that not all students were going to comply with the COVID-19 testing and contact tracing requirements. “We wanted to make sure we knew what we were up against,” Burke said. Burke and his team predicted some students would go to parties, and that they wouldn’t wear masks.

Warning signals came to the team quickly after the students returned. Something wasn’t working. However, because UIUC was conducting fast, frequent COVID-19 testing, leaders were able to go on offense and do something about it.

The team quickly learned what was causing this: a small subset of students made very bad choices, including knowing they were positive for COVID-19 and going to parties, or knowing they were positive for COVID-19 and hosting parties. This reality was not in the team’s data modeling predictions.

UIUC got a COVID-19 spike that threatened the shutdown of campus. However, the team was able to connect the dots and trace back the non-compliance. “Because we had the fast, frequent testing, we knew about it early and could respond fast. We made immediate changes that had a fast effect,” Burke said

Campus quickly moved to “essential activities only” for undergraduates and testing frequency was increased.

Next, Burke’s team launched a new team- SHIELD Team 30 – to speed up results and notifications to help get information to those who test positive faster- ideally within 30 minutes.

With all of those things together, the spike got reversed. “Because we went on offense and made changes in a data-driven way, we brought the spike right back down, and over the course of the next several weeks, we got back down to a low positivity rate and eventually hit 0.05%,” Burke explained.

The team was able to leverage the testing in an extraordinary way, in real-time, to mitigate what otherwise would have been a really difficult situation. That was the biggest challenge.

Part 4: Structures Critical to Success

Partnerships across Champaign-Urbana were critical to the SHIELD team’s success. The team partnered with Champaign-Urbana Public Health District, the mayors of Champaign and Urbana, local businesses, and collaborators campus-wide.

Community leadership, including the mayors of Champaign and Urbana, facilitated partnerships with local businesses and community groups to foster prospective actions to be prepared to address any challenges that arose.

The pandemic also presented a major communications challenge: how do we all communicate when we cannot be together? This is where Martin Burke, Carle Illinois associate dean for research, says virtual meetings through software like Zoom, were a silver lining. Not only did virtual meetings foster collaboration and success, but they also allowed for many more people to come together and collaborate than would have been able to in an in-person setting.

“It was a very useful way to bring people together quickly who would otherwise be able to get into the same room, “Burke said. “We’ve gotten a lot better at video conferencing and it sounds simple, but it’s been extremely powerful to see how quickly we can get all the right stake-holders into the 'same room' virtually and have really engaging meaningful discussions.”

Some days, video conferencing went on from 7:30 a.m. to 9:00 p.m. nearly non-stop. This was one of the ways that got everyone together quickly. “We all knew we were in a crisis and rather than cower under that stress or strain and climb into our caves and hope for the best, we all teamed up and said ‘We’re going to push back. We are going to go on offense and find a way to leverage innovation and collaboration to make a difference,” Burke said.

Part 5: Biggest Achievements

The SHIELD team’s metrics for success were simple: avoid hospitalizations and deaths.

It accomplished that goal. The fast, frequent testing, data modeling, communications, and science the team had access to lead to no hospitalizations and deaths among students.

The team also accomplished the university’s land grant mission to educate the students, engage in research, and engage the community.

A safe space was created, and the university thrived during the COVID-19 global pandemic. “Not only were we able to achieve that here, but we were able to model to the rest of the country and the world that can happen,” Martin Burke, Carle Illinois associate dean for research said. “That has been another key part of our success- that the University of Illinois and Carle Illinois College of Medicine are now rightly viewed as an example of how you can reopen and stay open safely during this very challenging time.”

The innovations and learnings from UIUC and Carle Illinois College of Medicine faculty have inspired many others to aim to do the same in spring 2021.

“We feel really proud that we can help show the world that it is possible to continue to do really important things like continue to be educating the leaders of tomorrow in a way that is safe,” Burke emphasized.

The road to get there was thanks to the remarkable desire and ability to innovate, brilliant minds, and willingness to collaborate across many disciplines in the UIUC campus. Burke calls it the Shield Team’s “special sauce.”

Burke called Paul Hergenrother early in the pandemic and they agreed “failure is not an option.” The two decided to make sure that was true.

They reached out to their colleague Tim Fan, who brought the idea to turn the UIUC Veterinary Medicine laboratory into a COVID-19 human testing facility.

Burke reached out further across campus to Rebecca Smith and Nigel Goldenfeld. They listed all the reasons bringing the students back to campus would be very challenging. These early team members dispersed to get to work and reconvened a short time later. When they came back together, they all agreed: if there is a way to test everybody twice a week, we can do this.

The ping-pong ball came back to the Shield testing team to figure out how to do it. Burke reached out to Bill Sullivan and asked how to turn the testing into disease mitigation. Sullivan’s team came back the next day with a plan to create a new app with a lot of new code, that would help communicate testing results, exposure notifications, offer information, and serve as a screening access tool to campus buildings.

“That’s what makes us special, and the pandemic shined a bright spotlight on the power of innovation and collaboration that makes Illinois such a remarkable place,” Burke said.

Part 6: A Powerful Combination of Healthcare, Engineering, and Data Science

The success of the SHIELD team was derived from the University of Illinois’ historic strengths in data science and engineering, combined with an absolute frontier catalyst for healthcare innovation--Carle Illinois College of Medicine.

Shield harnessed the tremendous data science expertise on UIUC’s campus to determine who to test, when to test, and how often to test for COVID-19 in the wake of the students’ return to campus in fall 2020.

Science and engineering breakthroughs, in partnership with Carle Illinois, took the COVID-19 salvia-based test and created a portable trailer to create the opportunity to share SHIELD with the rest of the world.

Part 7: Shield

SHIELD is now expanding across the state, country, with the potential and interest to expand around the world. The breakthroughs discovered at the University of Illinois Urbana-Champaign became a model to institutions around the world as an example of how to reopen as safely as possible.

During the summer of 2020, President Tim Killeen told the SHIELD T3 team their work was an “Illinois moment in the making” and tasked the SHIELD T3 team with making it as big as possible. The team did.

“We knew this was going to be bigger than our campus,” Martin Burke, Carle Illinois associate dean for research said.

The university system launched two organizations to share the SHIELD ecosystem with the state of Illinois and with the world. Illinois SHIELD was launched to spread UIUC’s approach across the state, including efforts for K-12 schools. SHIELD T3 (Target, Test, Tell) was launched to expand it across the country. SHIELD T3 is university-run and set up with a model to allow its efforts to be resourced appropriately to industrialize the SHIELD platform.

SHIELD T3 has now expanded to more than 20 universities across the country- with the number growing at press time. Bloom Energy has also launched a commercial enterprise from the platform in California. Additionally, New Zealand marks one of the first international partners to begin launching the Shield platform in its country.

“Our charge as a land grant mission is to serve the public good. We take that very seriously. That is what drives us- is to make an impact and we all talk as a team. At the end of the day, we all just want to tell our grandkids about a story where we hopefully made a difference during this really challenging time,” Burke said. “That kind of common commitment to do something that matters, that has been the key driver.”

Part 8: Looking Ahead

The SHIELD team is now preparing for the future of the pandemic and advocating for an increased focus on safe socialization.

As of March 2021, the team says restrictions to remain safe and vigilant are expected to remain in place through 2021 The team also predicts vaccine rollout will take longer than most people would like, to get to the point where enough people are vaccinating to create substantial changes in going back to pre-COVID-19 life.

“We are advocating as a SHIELD team ‘eyes wide open’ and this is going to be a year. It is going to take another year to finally get to a situation where we can feel like things are under control,” Martin Burke, Carle Illinois associate dean for research said. “I hope I am wrong, by the way, but we are planning for a year.”

The team continues to discover ways SHIELD can be stronger and more effective. A phased re-entry of students opened spring semester 2021 at UIUC and partnerships with aligned goals have only expanded.

One of the most profound themes moving forward has become 'pandemic fatigue.'“This is something we need to acknowledge and see it as another opportunity for innovation,” Burke said. The team is now dedicating collaboration to safe socialization. “Socializing safely in a way that is long-term sustainable, is an interesting problem, huge opportunity for social science and innovation, but also technology and how we do it,” Burke explained.

The final piece to the path to success moving forward is a recommitment from everyone to do their part. “Let’s take a deep breath, recommit and let’s get through the next four months, then the summer, then the fall, and then we will be on a track that I think is going to get us there,” Burke said.