The humanities and health care disciplines are not typically considered compliments, however, an emerging field of inquiry merges both health and humanities together to solve complex problems in health care.
On June 18, Duke in DC co-hosted a virtual congressional briefing with the Duke Franklin Humanities Institute (FHI) Health Humanities Lab about the important role the humanities are playing during COVID-19. The event’s speakers included co-directors of the FHI Health Humanities Lab, Deborah Jenson, professor of romance studies and global health at Duke University and Neil Prose, professor of dermatology, pediatrics and global health at Duke University. The panel also included Megha Gupta, a current student at Duke University Medical School, Marina Tsaplina, an interdisciplinary performing artist and Cuquis Robledo, lab manager at the FHI Health Humanities Lab.
The event’s speakers reflected on the numerous areas that health and the humanities can be linked to help reimagine the current health care system, specifically through narrative medicine. Medical student Megha Gupta explained that narrative medicine helps her “contextualize” disease by listening to a patient’s story rather than a list of symptoms in her textbooks.
As critical as the role doctors and nurses have in our nation’s COVID-19 response, the speakers also noted how vital hospital housekeepers, custodians and additional support staff, who have distanced themselves from their loved ones, are to the health care ecosystem. These housekeepers are often some of a patient’s only in-person emotional support, which is best captured in the FHI film, Keepers of the House.
The National Endowment for the Humanities (NEH) gives federal support to universities, including Duke University, to study the humanities and supports important work at the Franklin Humanities Institute and around campus to promote, preserve and disseminate critical stories about our history and culture.
The panelists were also asked, “What can the federal government do to better encourage the use and study of the humanities in our health care system?” In response they said:
“We’ll need the public institutions to come forward and help recognize that the kind of doctor that’s going to take care of you or your mother or grandmother, is going to depend on our success in bringing humanism into medicine” – Neil Prose
“Title IV funding of foreign area studies, which is key to helping to promote language learning… all of which is crucial to working across the gaps of socioeconomic status, ethnic status, our society is really driven by structural inequalities” – Deborah Jenson
“There’s not a substantive federal funding structure for arts and public health and funding for arts and medical education” – Marina Tsaplina
Duke in DC in partnership with Duke State Relations, the Sanford School of Public Policy and the Duke Center for Child and Family Policy hosted a virtual briefing, “COVID-19’s Lasting Impact on Child and Family Policy in North Carolina,” on June 11. The three panelists, professors Carolyn Barnes, Anna Gassman-Pines and Donald Taylor, all discussed how their ongoing research has been affected by and can help inform a policy response to the COVID-19 pandemic.
Many states, like North Carolina, have implemented temporary changes to federal and state assistance programs to help families who are struggling due to income loss and increased family burdens due to the global pandemic. Professor Carolyn Barnes, who researches childcare policy, family services, and support for young children explained that “the way social policy is carried out in the state requires revenue, which is why you see such variation in each county’s provisions.”
Barnes also noted that during COVID-19, nutrition assistance programs “have made a huge impact for families. While it doesn’t account for job loss and housing costs, families are really experiencing the benefits of these programs.”
Another area of temporary policy change in North Carolina is the state placed a moratorium on evictions in response to COVID-19, which all three panelists supported as important to assist vulnerable families. “What we see is that children whose families face eviction are more financially disadvantaged, more likely to be children of color and more likely to have special education needs, and these challenges all intersect,” said Professor Anna Gassman-Pines.
Mental health is another concern for children and families during the pandemic. Gassman-Pines pointed out that in her ongoing survey work with service industry workers she has found extremely high rates of maternal mental health issues during COVID-19. She stated that mental health is another real challenge that we face right now and our “system is not set up to support the mental and behavioral health issues that we are now seeing in low-income groups.”
In order to fully recover from the pandemic, Professor Don Taylor stated that the U.S. will need to implement asymptomatic testing, especially in nursing home facilities. Skilled nursing homes are wells of infection that put tenants, nurses and other administrative staff at risk of contracting the virus. According to Taylor, “the federal government is the only entity that has the ability to [financially] support this.”
In response to a question about access to sick leave and paid time off, Taylor noted that many workers who we consider essential do not receive paid time off. He stated, “folks working in nursing homes are not to be blamed – they are to be honored and protected.”
The coronavirus crisis has illuminated many of the issues facing U.S. families. All of the event’s speakers shared the opinion that as our nation and the state of North Carolina move forward, we will need to reflect on the fact that the crisis has heightened economic vulnerability for already vulnerable families. In order to address and ameliorate such disparity in overall wellbeing, all levels of government should consider creating more forward-looking family-centered policies.
“This pandemic has helped raise the salience of government for a lot of people,” said Barnes, “many of us have taken for granted the ability of the state to protect families. We need to figure out how to have more conversations about how we can build on our existing program strengths and build new government programs to help families.”
One of the panelists, @DukeSanford Professor Anna Gassman-Pines’ (@agpines) research on working families contains real-time data on how #COVID19 has led to “drastic reductions in work hours, income and family well-being” https://t.co/ApZD3RlUuo
On June 2, 2020, Duke Libraries’ David Hansen testified in front of the Senate Judiciary Subcommittee on Intellectual Property during a hearing on Section 512 of the Digital Millennium Copyright Act (DMCA) on a panel that also featured music legend Don Henley. Hansen opened his testimony stating, “Our mission as a university and research libraries is almost identical to that of the Copyright Act. Ultimately, our goal is to help our nation better understand each other and the world around us.”
He explained that Duke is a service provider that operates a large network, which serves as the technological backbone to education and research materials as well as provides vital health care information. “At Duke, we straddle all sides of Section 512,” Hansen said, in being both a service provider and content producer and stated that, in general, the current framework is balanced.
Hansen went on to note that higher education has been essential to copyright law over the years and expressed hope that research and teaching will not be an afterthought in Congress’ decision related to Section 512 of the DMCA. “We aim to get people to engage with those works, usually with no financial return. Given our interest in widespread dissemination of ideas, our strong preference is a system that keeps content up online unless there is significant evidence that infringement has occurred.”
Especially during the coronavirus pandemic where instruction has moved online, Hansen pointed out that “denying a student access to the network can be debilitating… Given how dependent we all are on internet access, I encourage the committee to consider whether termination of internet access continues to be an accurate remedy.”
“I realize that some stakeholders believe that Section 512 needs significant change, I hope that the subcommittee will understand the unintended consequences that it will have on research and teaching.”
Tomorrow at 2:30pm @DukeLibraries David Hansen will testify in front of the @SenateJudiciary Subcommittee on Intellectual Property
"Our mission as a university and research institution is almost identical to the copyright act. @DukeU's goal is to help our nation better understand the world around us."
On May 10, 1950, President Truman signed the National Science Foundation Act, creating the only federal agency charged with funding fundamental research and education across all fields of science and engineering.
Today, we celebrate the 70th anniversary of the National Science Foundation (NSF) and the outstanding impact it has had on university research and society over that past seven decades. The NSF is currently the third largest federal sponsor of research at Duke, providing over $45 million in total funding in FY 2019. Vice President for Research Larry Carin noted, “The reach and impact of the National Science Foundation at Duke cannot be overstated. It has provided critical support for my research career and has touched a large swath of the Duke community. It has supported graduate students who are at the beginning of their careers, large centers investigating complex issues facing society, and hundreds of projects underway by researchers in biological and social sciences, engineering and physical sciences, and multiple disciplines in between.”
It’s important to not only recognize NSF’s past achievements, but also the great things the agency has in the pipeline for the future and the ways it is impacting our U.S. universities now. This is the first of a series of posts during the remainder of the year that will highlight the impact of NSF at Duke and beyond. The COVID-19 pandemic has upended many aspects of our lives, but also provides a good illustration of the role NSF plays in preparing our country to meet and overcome complex societal challenges.
RAPID Response
NSF provides a mechanism for providing funding for research projects that are urgently exploring outcomes after natural disasters or other unanticipated events. Duke researchers have benefitted from these RAPID awards over the years to learn more about how flash floods develop in the Great Smoky Mountains, the potential of telenursing robots to remotely treat Ebola patients, and the how to improve the design of base-isolated buildings during rebuild following earthquakes, to name a few examples. In March 2020, NSF put out a call for fast-track ideas related to COVID-19 and to date, Duke has received four RAPID awards, two of which are supported through funding made available through the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
Duke biomedical engineers recently received a Rapid Response Research grant from NSF to adapt the fast, simple and low-cost diagnostic tool to detect the COVID-19 virus. The team has been working on adapting a rapid testing platform originally designed to detect Ebola to see whether it could be of use in detecting COVID-19 antigens. Inkjet-printed on a small glass slide, the D4 assay is a self-contained diagnostic test that detects low levels of antigens from a single drop of blood, throat or nose swab sample.
Another key challenge with the SARS-CoV-2 pandemic is developing protective countermeasures that can slow the spread of the disease. With funding from the Macromolecular, Supramolecular and Nanochemistry Program of the Chemistry Division, Professors Stephen L. Craig and Michael Rubinstein of Duke University received an NSF Rapid grant for their research to develop macromolecules for use as inhaled countermeasures to reduce the rate of infection with SARS-CoV-2. The research team is developing an inhaled polymeric countermeasure that will reinforce mucosal layers, enabling individuals to demonstrate a substantially decreased rate of infection from SARS-CoV-2 after exposure or to tolerate a larger dose without developing severe symptoms.
Two other RAPID awards will investigate ways in which we can track and model COVID-19 infection rates. One awards is for Poirot, a privacy-preserving system that uses smartphones to detect contact with potentially infectious individuals and provide recommendations for infection control. Jason Xu, associate professor of statistical science, will use a RAPID award to develop rigorous statistical models to better understand how COVID-19 spreads and which interventions are most successful.
STINGAR
In 2018, the NSF funded a proposal by John Board, associate chief information officer and associate professor of electrical and computer engineering, and Tracy Futhey, Duke’s vice president for information technology and chief information officer, to create a threat detection and intelligence sharing network among universities to fight cyberintrusions. The Shared Threat Intelligent for Network Gatekeeping and Automated Response (STINGAR) is essentially a crowd-sourced threat intelligence system that uses “honeypots”, which are devices deliberately created to be compromised, in order to gather information to identify malicious actors, and block them in near-real time.
Board and Richard Biever, chief information security officer and director of identity management, gave some insights to how STINGAR has brought immense value to Duke. Board noted that now over two dozen schools participate in STINGAR, which is helping universities collectively protect each other from billions of cyber-attacks per day. Board said the “system is easy to operate and low cost, so many colleges and universities including HBCU’s and MSI’s are able to run these tools effectively and economically.”
Under COVID-19 circumstances, STINGAR has proven even more critical to Duke’s cyber security. As offices, labs and classes shut down to prevent the spread of coronavirus, Duke and partner universities did not have to worry about having hands on-site to prevent impending malicious system hackers. Biever explained that because of STINGAR, “our systems at Duke didn’t shut down when people left, our data centers are still running and Duke is still connected to the Internet. Meanwhile, hackers haven’t taken time off. Having this system in place to protect Duke, is a huge deal.”
Biever and Board underlined that STINGAR is helpful to anyone doing any type of research. “STINGAR has definitely contributed to our ability to protect systems involved in research related to COVID-19 from malicious hacks,” Board concluded.
Microscopes for Take Out
The Research Triangle Nanotechnology Network (RTNN) is a partnership between Duke, UNC and NCSU part of the NSF’s National Nanotechnology Coordinated Infrastructure network. As labs closed due to the COVID-19 pandemic, key equipment continued to play a starring role. The cryo-electron microscope (cryo-EM) located in Duke’s Shared Materials Instrumentation Facility (SMIF) is one of a few instruments still running during the shutdown and is proving to be a critical resource for Duke researchers studies the coronavirus protein spike structure, which can aid in the development of an effective vaccine. Holly Leddy is a cryo-EM specialist for SMIF and has been coordinating with Mark Walters, director of SMIF, to keep it operational.
Leddy’s work doesn’t stop there, though, as she also launched an online K-12 educational program called, “Take Out Science.” The program uses a scanning electron microscope that is currently housed in her guest bedroom.
Every Tuesday at noon (ET) the team streams a live 30-minute show focused on a different theme. All shows are designed with K-12 audiences in mind—although adults have found them fascinating too. “We’re aiming for a broad audience and introducing the mechanics slowly over time,” said Leddy’s colleague, RTNN associate director at NC State’s Analytical Instrumentation Facility, Maude Cuchiara.
From left, General Martin Dempsey and Peter Feaver
Recent years have presented unique challenges to civil-military (civ-mil) relations in the United States. And then the global pandemic hit.
On April 23, Duke in DC and Duke’s Program in American Grand Strategy (AGS) co-hosted a virtual congressional briefing with General Martin Dempsey G’84. Peter Feaver, a professor of political science and director of AGS, participated in a Q&A with General Dempsey about the current state of U.S. civil-military relations from his perspective as former Chairman of the Joint Chiefs of Staff.
Feaver first asked Gen. Dempsey how he interpreted the conditions of civ-mil relations prior to the COVID-19 pandemic. General Dempsey named three key priorities in civ-mil relations:
Defining priorities – In civ-mil relations, there is a gulf between our expectations of each other
Defining progress – Measuring readiness and campaign progress comes from so many sources, it can be challenging to truly define progress
Oversight – Each administration and/or congress applies their own level of oversight to military activities
“We are in a crisis now and it will exacerbate certain issues while muting other things,”
Gen. Martin Dempsey
To follow up on his first question, Feaver asked Gen. Dempsey about new developments in civ-mil relations due to COVID-19. “We are in a crisis now,” Dempsey stated, “It will exacerbate certain issues while muting other things.” He also said that he anticipates increased military budget constraints, shifts in defense spending, changes in federal oversight and opinions about America’s role within the global landscape to be challenged.
General Dempsey stated, “We are headed towards significant disagreements from all levels of government on how we want to return to normal. The military is going to be faced with issues related to federal government versus state government compliance, for instance, where soldiers are deployed.”
Feaver stressed that state governors can’t force the military to change their policy. He added that there have always been concerns over the chain of command, but that these issues have been especially prevalent in recent years under the current administration.
“We are headed towards significant disagreements from all levels of government on how we want to return to normal.”
Gen. Martin Dempsey
General Dempsey explained that pandemics are issues of national security and that COVID-19 needs to be prioritized. He said that we should look to the Defense Advanced Research Projects Agency (DARPA) as a leader of technology to counter the pandemic.
Feaver placed the issue in perspective by stating, “Pandemic is priority number one, but it is not our only threat as a country…The rest of the military to-do list remains as important as ever.” He underlined this message by saying congressional staff can help, “make sure those aspects of the force focused on those issues, remain focused on those issues.”
“Pandemic is priority number one, but it is not our only threat as a country…The rest of the military to-do list remains as important as ever.”
The COVID-19 pandemic has caused policymakers around the world to consider how and when surveillance tools and personal data collection should be used in the name of public health and safety. On April 22, three Duke faculty members spoke to congressional staff about these issues in a virtual briefing organized by Duke in DC and the Duke Program in American Grand Strategy.
Sanford professors David Hoffman and David Schanzer were joined by their Law School colleague Shane Stansbury. The conversation was moderated by Inès Jordan-Zoob, T’19, analyst at BMNT and former Baldwin Scholar and vice president of the Cyber Club during her time at Duke.
The briefing addressed the reality that as the U.S. recovers from the initial shockwaves of the pandemic, policymakers will continue to confront the issue of how to properly achieve both privacy and public safety. Questions such as who may safely return to work and how another massive outbreak can be prevented help us determine how to strike that balance.
The briefing covered a myriad of critical questions including:
What kind of personal data should be collected, and under what conditions?
Do methods that have been employed elsewhere around the world violate core democratic values?
Can tools be adapted for use in the United States so that they do not threaten privacy and civil liberties?
David Hoffman began the briefing by laying out the relevant policy issues, presenting some details on how other countries have tried to use technology to enhance contact tracing and quarantine enforcement.
“In a traditional privacy analysis you always look at what the purpose is and then ask what additional data and assumptions you need to be successful.”
David Hoffman
China, for example, has transitioned its existing mass surveillance tools to assist in its COVID-19 suppression, containment, and mitigation efforts. Even Western democracies such as Israel and South Korea have turned to surveillance and personal data collection to track infection patterns and control movement of populations.
Professor Hoffman noted that, “in a traditional privacy analysis you always look at what the purpose is and then ask what additional data and assumptions you need to be successful.”
“Information we want isn’t in our control as a government. It is in the control of private companies.”
Shane Stansbury
Professor Stansbury transitioned to a conversation about lessons learned from the 9/11 era regarding surveillance efforts. He specifically noted two parallel currents between then and our current response to COVID-19.
The first is that “we are facing a crisis of information,” and the second is that the “information we want isn’t in our control as a government. It is in the control of private companies,” noted Professor Stansbury.
David Schanzer closed the opening remarks by presenting a set of potential problems applying possible tech solutions in the U.S. and also laid out recommendations for what Congress should be doing. He framed these surveillance tools ultimately as social control mechanisms and that in the U.S. their use must be paired with strong precautionary measures. When talking about challenges to implementing a national surveillance system, Schanzer observed that compared to some other countries Americans are less compliant and more conditioned to challenge government mandates.
From left, Shane Stansbury, David Schanzer and David Hoffman
Amidst the great challenges presented by COVID-19, Duke University is standing strong to its essential missions of teaching, learning, research, patient care and service to our community. Duke continues to provide significant leadership locally, regionally, nationally, and globally in this time of great uncertainty. The next year will be a difficult one, and Duke is grateful for the support and leadership of policy makers at all levels of government.
Saving Lives
Last month Duke Health began the groundbreaking first trial of a COVID-19 treatment for patients already showing severe symptoms, and Duke is also piloting a study to decontaminate N-95 masks for reuse. Duke physicians and nurses have rapidly scaled up capacity in advance of the anticipated spike in cases by adding beds and moving non-clinical staff to clinical roles to ensure that we are well-prepared to continue serving patients from Durham, the immediate region, and throughout North Carolina. Additionally, Duke Health has developed its own internal models that have been extremely precise in predicting cases, numbers of beds needed, and more.
Discovering Treatments and Cures
Our researchers are hard at work seeking new treatments and a possible vaccine for the virus, and we are leveraging our innovation and commercialization resources to support more rapid vaccine production, repurposing of compounds as potential therapeutics, improved diagnostics platforms, and the development of ventilators that may be used simultaneously with multiple patients.
For instance, the Duke Clinical Research Institute was awarded up to $50 million from the Patient-Centered Outcomes Research Institute for an expedited study to evaluate hydroxychloroquine as a preventive drug for healthcare workers that are at a high risk for COVID-19 infection. The first phase is rapidly identifying and enrolling a large community of healthcare workers at high risk for COVID-19 infection, followed by the second phase of a randomized clinical trial. The Duke DARPA Pandemic Prevent Platform also continues work to rapidly develop countermeasures including diagnostic assays and development of human antibody countermeasures.
Anchoring Our Communities
The impact of this virus is felt far beyond the hospitals, and Duke is working hard to support the economic stability in North Carolina. Duke University and Duke Health employ more than 40,000 North Carolinians, making us the second largest private employer in the state. The university has offered additional medical coverage for telehealth programs for all employees at no additional cost. Duke also created several support funds, including a community fund to support non-profits, small businesses, and community-based organizations
Reinventing Education
Duke University is currently engaged in a great experiment in higher education: virtualizing curriculum at both the undergraduate and graduate levels. While minor disruptions have ensued, this transition has already been a remarkable success, with over 3,000 classes and over 30,000 students participating virtually in the first day alone. Our experience with transitioning DKU online also helped provide necessary infrastructure when Duke needed to move to virtual instruction and provided a model for universities across the nation.
Moving Forward
Duke is grateful for the flexibility Congress has given U.S. institutions in administering student aid programs, providing students and graduates with student loan relief, access to additional resources for research to help gain a better understanding of this virus and develop vaccines and therapies to attack it, and changes to tax provisions that may be helpful in addressing financial challenges in the coming weeks and months.
Given this time of increased economic volatility, Duke has had to make significant changes to its fiscal models, including the imposition of a blanket hiring freeze and significant spending limitations for our staff and faculty and many other great challenges remain. Duke, and many other colleges and universities, will count on additional resources to fight the virus and care for our patients, and provide support to our students, researchers, and all employees
Duke is proud to call North Carolina home, and is committed to helping this great state overcome these unprecedented challenges and emerge even stronger on the other side.
Editor’s Note: Lawrence Carin, Duke’s Vice President for Research, recently authored this blog post about how the coronavirus pandemic has impacted the American university research enterprise. Originally posted here by Duke Research, this blog post highlights the work of several Duke researchers who are working to address and understand the novel COVID-19 virus and the important role of fundamental research, funded by the federal research agencies like the National Institutes of Health, the Department of Defense and others, has played in developing the knowledge base to support this critical work.
The COVID-19 epidemic has impacted the Duke research enterprise in profound ways. Nearly all laboratory-based research has been temporarily halted, except for research directly connected to the fight against COVID-19. It will take much time to return to normal, and that process of renewal will be gradual and will be implemented carefully.
Trying to put this situation into a broader perspective, I thought of the 1939 essay by Abraham Flexner published in Harper’s magazine, entitled “The Usefulness of Useless Knowledge.” Flexner was the founding Director of the Institute for Advanced Study at Princeton, and in that essay, he ruminated on much of the type of knowledge acquired at research universities — knowledge motivated by no objective other than the basic human desire to understand. As Flexner said, the pursuit of this type of knowledge sometimes leads to surprises that transform the way we see that which was previously taken for granted, or for which we had previously given up hope. Such knowledge is sometimes very useful, in highly unintended ways.
The 1918 influenza pandemic led to 500 million confirmed cases, and 50 million deaths. In the Century since, consider how far we have come in our understanding of epidemics, and how that knowledge has impacted our ability to respond. People like Greg Gray, a professor of medicine and member of the Duke Global Health Institute (DGHI), have been quietly studying viruses for many years, including how viruses at domestic animal farms and food markets can leap from animals to humans. Many believe the COVID-19 virus started from a bat and was transferred to a human. Dr. Gray has been a global leader in studying this mechanism of a potential viral pandemic, doing much of his work in Asia, and that experience makes him uniquely positioned to provide understanding of our current predicament.
From the health-policy perspective, Mark McClellan, Director of the Duke Margolis Center for Health Policy, has been a leading voice in understanding viruses and the best policy responses to an epidemic. As a former FDA director, he has experience bringing policy to life, and his voice carries weight in the halls of Washington. Drawing on faculty from across Duke and its extensive applied policy research capacity, the Margolis Center has been at the forefront in guiding policymakers in responding to COVID-19.
Through knowledge accrued by academic leaders like Drs. Gray and McClellan, one notes with awe the difference in how the world has responded to a viral threat today, relative to 100 years ago. While there has been significant turmoil in many people’s lives today, as well as significant hardship, the number of global deaths caused by COVID-19 has been reduced substantially relative to 1918.
One of the seemingly unusual aspects of COVID-19 is that a substantial fraction of the population infected by the virus has no symptoms. However, those asymptomatic individuals shed the virus and infect others. While most people have no or mild symptoms, other people have very adverse effects to COVID-19, some dying quickly.
This heterogeneous response to COVID-19 is a characteristic of viruses studied by Chris Woods, a professor medicine in infectious diseases. Dr. Woods, and his colleagues in the Schools of Medicine and Engineering, have investigated this phenomenon for years, long before the current crisis, focusing their studies on the genomic response of the human host to a virus. This knowledge of viruses has made Dr. Woods and his colleagues leading voices in understanding COVID-19, and guiding the clinical response.
A team led by Greg Sempowski, a professor of pathology in the Human Vaccine Institute is working to isolate protective antibodies from SARS-CoV-2-infected individuals to see if they may be used as drugs to prevent or treat COVID-19. They’re seeking antibodies that can neutralize or kill the virus, which are called neutralizing antibodies.
Many believe that only a vaccine for COVID-19 can truly return life to normal. Human Vaccine Institute Director Barton Haynes, and his colleagues are at the forefront of developing that vaccine to provide human resistance to COVID-19. Dr. Haynes has been focusing on vaccine research for numerous years, and now that work is at the forefront in the fight against COVID-19.
Engineering and materials science have also advanced significantly since 1918. Ken Gall, a professor of mechanical engineering and materials science has led Duke’s novel application of 3D printing to develop methods for creatively designing personal protective equipment (PPE). These PPE are being used in the Duke hospital, and throughout the world to protect healthcare providers in the fight against COVID-19.
Much of the work discussed above, in addition to being motivated by the desire to understand and adapt to viruses, is motivated from the perspective that viruses must be fought to extend human life.
In contrast, several years ago Jennifer Doudna and Emmanuelle Charpentier, academics at Berkeley and the Max Planck Institute, respectively, asked a seemingly useless question. They wanted to understand how bacteria defended themselves against a virus. What may have made this work seem even more useless is that the specific class of viruses (called phage) that infect bacteria do not cause human disease. Useless stuff! The kind of work that can only take place at a university. That basic research led to the discovery of clustered regularly interspaced short palindromic repeats (CRISPR), a bacterial defense system against viruses, as a tool for manipulating genome sequences. Unexpectedly, CRISPR manifested an almost unbelievable ability to edit the genome, with the potential to cure previously incurable genetic diseases.
Charles Gersbach, a professor of Biomedical Engineering, and his colleagues at Duke are at the forefront of CRISPR research for gene and cell therapy. In fact, he is working with Duke surgery professor and gene therapy expert Aravind Asokan to engineer another class of viruses, recently approved by the FDA for other gene therapies, to deliver CRISPR to diseased tissues. Far from a killer, the modified virus is essential to getting CRISPR to the right tissues to perform gene editing in a manner that was previously thought impossible. There is hope that CRISPR technology can lead to cures for sickle cell and other genetic blood disorders. It is also being used to fight cancer and muscular dystrophy, among many other diseases and it is being used at Duke by Dr. Gersbach in the fight against COVID-19.
In another seemingly bizarre use of a virus, a modified form of the polio virus is being used at Duke to fight glioblastoma, a brain tumor. That work is being pursued within the Preston Robert Tisch Brain Tumor Center, for which David Ashley is the Director. The use of modified polio virus excites the innate human immune system to fight glioblastoma, and extends life in ways that were previously unimaginable. But there are still many basic-science questions that must be overcome. The remarkable extension of life with polio-based immunotherapy occurs for only 20% of glioblastoma patients. Why? Recall from the work of Dr. Woods discussed above, and from our own observation of COVID-19, not all people respond to viruses in the same way. Could this explain the mixed effectiveness of immunotherapy for glioblastoma? It is not known at this time, although Dr. Ashley feels it is likely to be a key factor. Much research is required, to better understand the diversity in the host response to viruses, and to further improve immunotherapy.
The COVID-19 pandemic is a challenge that is disrupting all aspects of life. Through fundamental research being done at Duke, our understanding of such a pandemic has advanced markedly, speeding and improving our capacity to respond. By innovative partnerships between Duke engineers and clinicians, novel methods are being developed to protect frontline medical professionals. Further, via innovative technologies like CRISPR and immunotherapy — that could only seem like science fiction in 1918 (and as recently as 2010!) — viruses are being used to save lives for previously intractable diseases.
Viruses can be killers, but they are also scientific marvels. This is the promise of fundamental research; this is the impact of Duke research.
“We shall not cease from exploration And the end of all our exploring Will be to arrive where we started And know the place for the first time.”
T.S. Eliot, Four Quartets
Post by Lawrence Carin, Duke Vice President for Research
On the morning of March 19, the U.S. House of Representatives passed legislation from the Senate that allows veterans on the GI bill to continue receiving full benefits, S.3503, and sent it to President Trump’s desk for his final signature.
Prior to Congress passing the bill, the American Council on Education (ACE), of which Duke is a member, wrote letters on behalf of the higher education community to congressional leadership in the U.S. Senate and House of Representatives requesting that they support the measure.
The GI Bill determines benefits based on whether or not one attends a physical university in person versus an online program, which placed all student veterans at risk of losing their benefits.
In the 2017-2018 academic year, there were more than 34,000 student veterans using their GI Bill benefits in North Carolina. At Duke, there were over 300 student veterans working on degrees in 2019. This legislation secures those benefits for those Duke students, thousands of North Carolinians and even more veterans across the country.
The Duke community is extremely grateful to Senator Thom Tillis (R-NC) for his co-sponsorship of the legislation and his support of student veterans during this period of uncertainty.
“Veterans shouldn’t see the GI Bill benefits they earned unintentionally cut because of the health and safety precautions being taken by our colleges and universities, and this legislation will ensure they will not be affected.” – Senator Thom Tillis
A big thank you to @SenThomTillis for his support of our U.S. student veterans and his work to protect their GI bill benefitshttps://t.co/DfMkznk76S
A presidential election year and post-impeachment partisan gridlock makes for the perfect recipe for legislative inaction.
Below are some of the federal issues that the Office of Government Relations will be monitoring this spring. Beyond federal funding there are several regulatory and agency matters that will affect Duke University.
Budget & Appropriations – Proposal vs. Reality
Having finalized and approved the FY20 budget in December 2019, the White House released its FY21 budget proposal on Feb. 10, roughly a month ahead of last year, which was delayed due to the partial government shutdown.
The White House budget proposal totals $4.8 trillion and includes a boost for defense and security programs offset by cuts to domestic discretionary programs that fall well below the budget caps signed into law last summer. As in previous years, Congress will largely ignore the White House proposal and instead work through their own process in both chambers.
Most of the research agencies of interest to Duke have slightly lower proposed budgets compared to their 2020 final appropriations, and it once again proposes the elimination of ARPA-E and the National Endowment for the Humanities.
However, one potential research area that could present an opportunity for agreement on funding goals between the branches of government is in what the White House deemed “Industries of the Future,” which includes artificial intelligence and quantum information sciences.
Regarding higher education funding priorities, the budget proposes to eliminate international education programs authorized under HEA Title VI. The White House also wants to reduce the federal role in the student loan and repayment process. This proposal would create a single income-drive student loan repayment plan (IDR). The budget also proposes to keep the Maximum Pell award identical to the 2020 final appropriation ($6,345).
Legislative Agenda: What’s on the Congressional Menu
Higher Education Act
Last year the House Education and Labor Committee passed the College Affordability Act, the reauthorization of the Higher Education Act, out of committee, but there has been no momentum to bring it to the floor for a full vote. In the Senate there has been action in recent weeks to work on a reauthorization bill in the Health, Education, Labor & Pensions Committee.
Whether or not the Senate and House are able to reach consensus on a comprehensive reauthorization remains highly questionable, even if they both find ways to pass separate bills.
National Security and Science
We can once again expect significant focus placed on how the U.S. can protect the nation’s research enterprise from foreign influence while also promoting innovation and international collaboration, with the upcoming FY 21 National Defense Authorization Act as a prime vehicle for this discussion on the congressional side.
The federal agencies will continue to refine guidance related to involvement in foreign talent programs and disclosure. The National Science and Technology Council (NSTC) Joint Committee on Research Environments (JCORE) will continue to hold interagency discussions related to national security and the American research community and is expected to begin releasing reports this spring.
Section 117
High profile investigations into the reporting of foreign gifts to universities will keep a spotlight on efforts to revamp the Section 117 reporting requirements. Under Section 117 of the Higher Education Act (HEA) the Department collects information about gifts and contracts to universities that total to $250,000.
The Department of Education withdrew its emergency information collection request (ICR) regarding Section 117, which would have dramatically changed the type and breadth of information collected, in February and plans to resubmit a non-emergency ICR to the Office of Management and Budget (OMB) with a 30-day period for public comment. Various legislative proposals have been introduced to address the murky reporting guidance, but unclear if anything will pass out of Congress.
Immigration
This spring, the U.S. Supreme Court is expected to make a decision on the Deferred Action for Childhood Arrivals (DACA) rescission. In November 2019, the Supreme Court held oral arguments in a set of challenges to the Trump administration’s decision to end DACA. During the hearing, not only did the justices consider whether courts can review DACA and the legality of ending the program, they also considered sending the case back to lower courts for reconsideration.
Given the range of considerations in the case there a number of possibilities for an outcome, making predictions about what will happen next mostly speculative. If the court’s final decision does rule in favor of the Trump administration, it may be up to the White House’s discretion to decide how it ultimately wants to end DACA.
COVID-19
In the first week of March, the U.S. House and Senate passed an $8.3 billion emergency package to respond to COVID-19 and sent it President Trump’s desk to be signed into law. The legislation includes about $826 million for the National Institute of Allergy and Infectious Diseases to develop coronavirus vaccines, treatments and tests. Additionally, the Centers for Disease Control and Prevention, U.S. Department of Education and other federal agencies continue to put out guidance for universities in response to COVID-19. All relevant guidance will be posted on the Duke University Coronavirus Response website.
Aside from emergency aid, coronavirus will directly impact forthcoming legislation this spring. Due to COVID-19’s increasing prevalence, we can expect continued activity in Washington over the next few months to assess the global issue and safeguard Americans from the virus.
