Fallout by UMiami Scientifica Magazine

Issue 17

November 2020

Contents ETHICS

NEWS

Health

Fa l l o u t SILent but deadly

Navigating a Global Pandemic Amidst the Ballooning Climate Crisis

A History of Pandemics and Vulnerable Populations

How History and Racism Affect Medicine

The New Space Race The Next Generation

The Streaming Era Streaming Services in the Age of a Global Pandemic

Were the outcomes of COVID-19 predictable?

Racism Kills

Florida’s Citrus Crisis

THe true Colors behind Covid-19

Outbreak of COVID-19 throughout U.S Detention Centers

Slaying The Yellow Dragon

The Road Towards “Supercoral” Engineering

20 24

On the front lines

The Patriotic Response

Education on the Edge

Secrets of Serotonin

An Interview with Dr. Mehdi Mirsaeidi

Exploring the role that culture has played in the American COVID-19 response

How COVID-19’s latest victim may be education in America

How Bacteria Help our Brain

Cover art by Anam Ahmed

Research

Profiles

Fallout

p. 6

Canes fighting covid Union of Man & Machine Elon Musk and Neuralink

The Progression of the COVID-19 Vaccine

38 40

How far are we from a vaccine, and how far have we come?

Music during a pandemic Pausing a Playlist of Problems

Synthesizing the Future of Public Health

Making Isolation a Little More Social

Neighbors Helping Neighbors

3D Printing Innovations in Protective Gear

The Senior Buddy Program

In this issueâ&#x20AC;&#x2122;s feature section, Fallout (p. 6), Natalia Brown and others examine the far-reaching and longterm consequences of the pandemic, from its capacity to worsen the health effects of climate change to the peril it poses toward vulnerable populations such as people of color and those currently in prisons and ICE detention centers.

How the Buddy System is Targeting Food Insecurity in Miami

The Psychological Effects of COVID-19

UM Researchersâ&#x20AC;&#x2122; Mission to Assess the Risk and Resiliency of Communities Affected by the Pandemic

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l e t t e r f r o m t h e e d i to r “Now is the time, if ever there was one, for us to care selflessly about one another.” - Anthony Fauci

Anuj Shah Microbiology and Immunology Class of 2021 Editor-in-Chief, UMiami Scientifica

The pandemic is a daily presence now, but as we consider the fallout from all that has happened, our attention must also shift to the other ongoing crises it now co-exists with. Comorbid with the deadly virus are issues like climate change and economic struggles that also plague our planet. But with as much dread and despair as we may feel when confronting the future of our public health and climate, I hope this issue instills in you all a sense of pride and unity. In addition to covering the pandemic and more, our goal throughout the making of this issue was to highlight the heroes of our UM community, and the unique and powerful ways in which they’ve been fighting the pandemic. From students providing support for seniors and a physician on the front lines mobilizing Miami against COVID-19 to researchers helping struggling parents and students 3D printing face masks and shields, the work these courageous individuals have partaken in is simply inspiring. If the words above from Dr. Fauci remind us of one thing, it’s that we’re in this together.

letter from the e d i to r i a l A dv i s o r Science has improved every aspect of our civilization. Think of anything, and there is likely a scientific principle or discovery tied to it. We live longer, communicate better, and travel further than ever before. Despite these advances, we are facing a battle over the very field that is responsible for our survival. When we choose to ignore science, whether it relates to the ongoing pandemic, climate change, or anything else, lives are lost. When science loses, we as a civilization lose. As a nation, we’re facing a pivotal decision this year, in choosing to align either with those who are on the side of science or those who are not. In both instances, we must address the fallout of our choices, which affects every one of us regardless of socioeconomic status or creed. We can do our part by assisting our fellow man, from 3D printing masks to working together to protect the most vulnerable members of our society. I encourage everyone to participate in our political processes—it’s one of the few ways we can protect our future. Please enjoy this Roger I. Williams Jr., M.S. Ed. issue, and thank you for your interest. Stay safe. Director, Student Activities Advisor,

Microbiology & Immunology Editorial Advisor, UMiami Scientifica

s c i e n t i f i c a C o r e s ta f f Anuj Shah Shravya Jasti Abigail Adera Aaron Dykxhoorn Megan Buras Sneh Amin Mac Clifton Amirah Rashed Ainsley Hilliard Kimberley Rose Anam Ahmed Austin Berger Sofia Mohammad Victoria Pinilla Roger Williams, M.S. Ed

Editor-in-Chief Magaging Editor Copy Chief Design Director Art Director Director of Photography Webmaster Secretary Distribution Manager Director of Creative Writing Core Associate Director of Public Relations Director of Community Outreach Board of Advisors Liason Editorial Advisor

S c i e n t i f i c a 2 0 2 0 Board of Advisors Barbara Colonna Ph.D. Senior Lecturer Organic Chemistry Department of Chemistry Richard J. Cote, M.D., FRCPath, FCAP Professor & Joseph R. Coutler Jr. Chair Department of Pathology Professor, Dept. of Biochemistry & Molecular Biology Chief of Pathology, Jackson Memorial Hospital Director, Dr. Jonn T. Macdonald Foundation Biochemical Nanotechnology Institute University of Miami Miller School of Medicine Michael S. Gaines, Ph.D. Assistant Provost Undergraduate Research and Community Outreach Professor of Biology Mathias G. Lichtenheld, M.D. Associate Professor of Microbiology & Immunology FBS 3 Coordinator University of Miami Miller School of Medicine Charles Mallery, Ph.D. Associate Professor Biology & Cellular and Molecular Biology Associate Dean April Mann Director of the Writing Center Catherine Newell, Ph.D. Associate Professor of Religion Leticia Oropesa, D.A. Coordinator Department of Mathematics *Eckhard R. Podack, M.D., Ph.D. Professor & Chair Department of Microbiology & Immunology University of Miami Miller School of Medicine Adina Sanchez-Garcia Associate Director of English Composition Senior Lecturer Geoff Sutcliffe, Ph.D. Chair Department of Computer Science Associate Professor of Computer Science Yunqiu (Daniel) Wang, Ph.D. Senior Lecturer Department of Biology * Deceased

s ta f f

SECTION EDITORS ETHICS NEWS RESEARCH HEALTH PROFILES

Amirah Rashed Snigdha Sama Alexandria Hawkins Marissa Maddalon Setareh Gooshvar

COPY EDITORS Nikhil Rajulapati Giovanna Harrell Amrutha Chethikattil Greg Zaroogian Abigail Adera Yashmitha Sadasivuni Aarohi Talati Sneh Amin Avery Boals Kylea Henseler Jeffrey Caldwell Sophia Meibohm Yazmin Quevedo Abdullah Abouradi

DESIGNERS Megan Buras Rachel Murray Megan Piller Varsha Udayakumar Anam Ahmed Cherri Chen Natalia Jimenez Meera Patel Aaron Dykxhoorn

WRITERS Natalia Brown Natalia Perez Baez Ainsley Hilliard Angeline Medvid Aarti Madhu Elan Tran Austin Berger Laila Rayza Nelanda Ellie Martin Sofia Mohammad Bhavana Srikakolapu Diana Mercado Sarthak Chakravarthy Christian Rivera Pavan Gudoor Clara Lavrador Kyle Banker Nikhil Rajulapati Anam Ahmed Sami Tano Lily Schmutter Isabella Lopez

PhotograpHers Dhara Patel Avery Boals Raghuram Reddy Sneh Amin

Artists Natalia Jimenez Cherri Chen Anam Ahmed Megan Buras Varsha Udayakumar Megan Piller Setareh Gooshvar

FALLOUT 6 | Ethics

The pandemic has changed life as we know it. But what are the longterm consequences of our failure to contain the novel coronavirus?

Inside: Silent But Deadly by Natalia Brown

The True Colors Behind COVID-19 by Natalia Perez Baez

A History of Pandemics and Vulnerable Populations by Ainsley Hilliard

Outbreak of COVID-19 Throughout U.S. Detention Centers by Angeline Medvid

Navigating a Global Pandemic Amidst the Ballooning Climate Crisis 8 | Ethics

Silent But

Deadly

by Natalia Brown

Design: Megan Buras

ince this complex crisis took hold of our vulnerabilities, tremendous loss and responsibility have defined our new normal. Over the last nine months, simple day-to-day interactions have become risk-ridden, politically-charged and anxiety-inducing. As we grapple with the immobilization and fracturing of our own vibrant surrounding communities, there is an uncanny sense of hope and connection that comes from witnessing the analogous, distraught responses from our furthest neighbors in the international community. I am referring to the COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). Its rapid spread has been obfuscated and accelerated by the uncoordinated response of community leaders at all levels, in both the private and public sectors. This pandemic has robbed our communities of over 1.1 million parental figures, siblings, caretakers, public servants, first responders, mentors, and friends in a matter of months. Simultaneously, I am referring to the threat-multiplying climate crisis, continuously exacerbated by exploitative and indirectly lethal human activity. It is human nature to focus on immediate threats, so it’s understandable that the risks associated with your highly trafficked grocery store and immunocompromised housemate are more front-of-mind than

the increasingly unpredictable extreme weather events wreaking havoc across the nation. Until, of course, the climate crisis hits your lane. In the United States, we’ve been forced to take on rigorous personal responsibility to keep up with shape-shifting public health guidelines amidst record levels of unemployment, social unrest following a nationwide reckoning with racial injustice, and overlapping extreme weather events. In Northern California, the bigger picture has quite literally been overwhelmed by smoke. A moistureladen heat wave unleashed a surge of extreme weather phenomena: fire-induced tornadoes, a violent wildfire season fueled by frequent lightning storms, and recordshattering triple digit temperatures. The heat and wildfires are degrading the air quality for all residents—directly by releasing smoke and aeresolized ash and indirectly by creating the optimal conditions for smog formation. These pollutants pose the greatest threat to children, older adults, and those with preexisting respiratory ailments—precisely the same groups of people most vulnerable to COVID-19. Historically marginalized populations with less consistent or robust access to healthcare, air-conditioned shelter, fresh food, and broadband internet for local advisories are being disproportionately devastated by the current public health and ecological crises.

“If there is one lesson to be taken from the abounding devastation, may it be the consequences of inaction.” As I reflect on this unsettling overlap, the Western United States is forecast to continue surpassing historical high temperature records, experience a strong downslope wind event with power to alter the footprint of already-massive wildfires, then see a 70-degree downswing in temperatures and an extremely early snow storm in Colorado, New Mexico and Wyoming. Beyond the exacerbation of seemingly apocalyptic living conditions for many in the wake of these events, this “weather whiplash” between hot and cold extremes will have immediate impacts on the agricultural landscape—specifically disrupting food production, threatening biodiversity, and reducing water quality. As stated by Rosemary DiCarlo, Head of Political and Peacebuilding Affairs for the United Nations (2018): “The risks associated with climaterelated disasters do not represent a scenario of some distant future. They are already a reality for millions of people around the globe—and they are not going away.” Quite literally on the flipside, the Gulf Coast is grappling with the aftermath of Hurricane Laura: the strongest hurricane on record to make landfall in Louisiana, as measured by maximum sustained winds. This was one of two storms formed in the Atlantic Basin in August; Laura and Marco exemplify the rarity of two storms progressing simultaneously, projected to impact the same span of the coastline. Before Laura made landfall, emergency management responders were already facing unprecedented demands as they juggled the extreme weather events along the West Coast and national recovery efforts amid the COVID-19 pandemic. Public health

standards heightened challenges for emergency management, from ensuring that sheltering accommodations adhere to social distancing guidelines to coordinating evacuations for those who had the resources to leave while prioritizing services for those bracing at home or in hospital beds. Unsurprisingly, Miami hasn’t been exempt from the record-breaking high temperatures. The first six months of 2020 were the hottest on record for the entire state of Florida, and Miami recorded its hottest week to date in early June. To date, Fort Lauderdale, Miami, and Key West have broken over 170 hot temperature records this year. The rapidly-evolving COVID-19 crisis can inform our response and ability to mitigate the fallout of others, namely the climate crisis. The current pandemic has catalyzed a ripple effect of social, economic, and political discord that has disenfranchised, displaced, and disadvantaged Americans seeking a dignified and healthy life for their families. There is no time to look and listen or wait on the sidelines for a greater call to action: human-caused climate change, uncannily like SARS-CoV-2, has already manifested in unique ways across the nation and world at-large. If there is one lesson to be taken from the abounding devastation, may it be the consequences of inaction. We can and must take informed action to pivot the extractive, exploitative economic and political systems that are contributing to climate collapse. Our generation has a critical responsibility to shape a resilient, livable future with every step we take. The solutions enacted to combat the harm that has been caused need to match the scale of the problem, and there is no limit to the innovation and connectedness that can be channelled in our recovery.

The True True The Colors Behind Behind Colors

by Natalia Perez Baez Design: Natalia Jimenez

ON A NATIONAL LEVEL:

a demographic profile of workers that belong to frontline industries. One of their major findings was that people of color were strikingly overrepresented in “multiple occupations within frontline industries,” he COVID-19 pandemic has taken the United States by storm, such as cleaning, transportation, child-care, and social services, which impacting nearly every facet of society on an unprecedented are generally lower paying occupations. scale. In the span of seven months, nearly seven In addition to being less lucrative, these In the span of million people have been infected and over occupations that the large subsets of minority seven months, nearly seven populations often work in have slim to no capacity 200,000 lives have been lost. The virus has taken an enormous toll on this country, especially for to be work-from-home positions. In fact, the U.S. million people have been minority populations. Black, Hispanic, and Native Bureau of Labor and Statistics recently reported infected and over American people face the highest risk of exposure that African-Americans and Hispanic minorities 200,000 lives have been lost. possess the ability to work from home at a rate to the virus while possessing the least access to immediate healthcare to confront it. Why? On average, minority that is 15% lower than the Caucasian population. With each passing populations have lower incomes and suffer from greater financial day, more minorities have been left unemployed or forced to occupy instability—two factors that make the accommodation of a sudden jobs that pose higher risks to their health in order to cope with the onset of COVID-19 that much more difficult to confront. In a country economic strains that have been placed on them. where systemic racial and economic disparities prevail, two weeks of In July, the CDC was forced to release federal data that missed pay, a doctor’s visit, or other COVID-19 related consequences demonstrated the extent to which minorities across the country are costly realities for many working-class minorities. have fallen ill with the virus. The report reveals that non-Hispanic Since March of 2020, over 40 million people have filed for American Indians, Alaska Natives, and African-Americans are five unemployment, causing the nationwide unemployment rate to spike times more likely to contract COVID-19 compared to non-Hispanic from 4.5% to 14.7% in April. In the midst of this economic upheaval, The report reveals that non-Hispanic American the U.S. Bureau of Labor Statistics released “The Employment Indians, Alaska Natives, and African-Americans are Situation,” which detailed how COVID-19 has dramatically impacted the workforce over the past few months. Although it should not five times more likely to contract COVID-19 compared come as a surprise, it is disturbing to see the extent to which this to non-Hispanic whites. pandemic has disproportionately affected minorities. As of June, the national unemployment rate was 11.1%; however, the rate for whites. Likewise, Hispanics and Latinos have a “rate approximately Caucasians was lower, at about 10.1%. Contrastingly, Asian, Hispanic, four times that of non-Hispanic white persons” for contracting the and African-American people have faced significantly higher rates of virus. It is inexcusable that the various racial disparities that exist in unemployment, at about 13.8%, 14.5%, and 15.4%, respectively. Not America have resulted in higher rates of infection among racial and only are these minorities facing steeper unemployment rates, but ethnic minorities that could potentially result in death or dire health their disproportionate representation within certain occupations have consequences. The way in which minorities have been left nearly put them at an exceedingly higher risk of infection. The Center for defenseless in the wake of a pandemic with little government financial Economic and Policy Research conducted a study which aimed to build aid paints a grim picture for minorities all throughout America.

10 | Ethics

“Health disparities take their ugliest form when they become a matter of life or death.”

LOOKING LOCALLY: SOUTH FLORIDA This conversation extends to Florida, a state which garnered national attention as it quickly became the latest COVID-19 epicenter. Florida quickly began reporting daily cases in the double digits, peaking at about 16,000 new cases in a single day. During this time, the state’s case number surpassed its previous days’ records for the number of positive cases recorded. This trend was accompanied by a worrisome increase in the positivity rate, which reached upwards of 10% statewide. Further reporting showed that the highest concentration of cases belonged to South Florida, including Miami-Dade County, Broward County, and Palm Beach County. Unfortunately, in parallel with the rest of the country, Florida’s minority residents are also disproportionately affected by this pandemic. Despite the overwhelming diversity among South Florida’s population and its abundance of ethnic neighborhoods, such as Little Haiti and Little Havana, the deeply ingrained racial and social disparities have caused those same communities to suffer the most. Several studies have analyzed the data reported by Florida’s Department of Health, and they all seem to come to one conclusion: Floridian residents that are Black or Hispanic contract the virus at a higher rate compared to their White counterparts. One clear example can be seen at one of the largest free health clinics in South Florida: the Caridad Center. This clinic is known to primarily treat at-risk minority populations that lack the financial means for health insurance or traditional hospital care. In the middle of July, Sun Sentinel released an eye-opening article that depicted the bleak reality that many minorities and undocumented residents face in South Florida. Palm Beach County reported a 5.4% positivity rate. That same week, the Caridad Center reported a 12.2% positivity

rate, more than double its own county’s rate. This stark contrast in numbers demonstrates that living in a state home to one of the largest minority populations in the country is not a protective factor. What implication does this increasing positivity rate have for minorities? The answer, unfortunately, is an increase in death rates. In July, 58% of the COVID-19 related deaths in Palm Beach County were Hispanics, 29% of the deaths were African-Americans, and 13% were Caucasians in the under-45 age bracket. Miami-Dade County is no exception; in the same age category, 50% of the COVID-19 related deaths were among Blacks, 39% were Hispanic, and 11% were Caucasian. Its neighboring county, Broward County, saw that a whopping 70% of the COVID-19 related deaths in the same age group were Blacks, compared to 3% for Caucasians and 14% for Hispanics. These statistics constitute a 2400% increase in death rate among Black people compared to Caucasian people. It is undeniable that there is a grave underlying trend within these South Florida counties: Black and Hispanic people are dying at alarmingly higher rates. This trend exists among all age groups but is most prominent in younger to middle-aged groups. Let it be abundantly clear: health disparities take their ugliest form when they become a matter of life or death. This is the situation South Florida faces. Now more than ever, there is a sense of urgency to address the dire realities that surround minorities and their standard of living. Swift action is imperative if we are to end these vicious cycles so that future generations don’t have to pay the price for today’s negligence.

COVID-19-Related Deaths in July in the Under 45 Age Bracket Broward County

Miami-Dade County

Palm Beach County

A History of Pandemics and Vulnerable Populations Were the outcomes of COVID-19 predictable?

by Ainsley Hilliard

Illustration & Design: Anam Ahmed

he past several months have been filled with questions about how to proceed with our daily lives during the COVID-19 pandemic. Could it have been possible to predict some of the outcomes of this pandemic, such as which populations would be most affected and which states were going to be hotspots? Looking at the history of past pandemics, it becomes clear that certain factors of the current pandemicâ&#x20AC;&#x201D;especially which populations get hit hardest and which states would turn into hotspotsâ&#x20AC;&#x201D;are not so unprecedented after all.

1918

H1N1

Influenza A Virus

12 | Ethics

The earliest pandemic in recent history with similarities to SARSCoV-2 was the 1918 H1N1 influenza A virus. It quickly became a global pandemic due to the globalization that accompanied the realities of World War I. No one was safe from this virus; it affected people of all ages. The pandemic caused approximately 675,000 deaths in the United States alone. This pandemic also caused a shortage of healthcare workers, prompted mask suggestions in San Francisco, quarantining of the infected in Salt Lake, and cases of inaccurate testing in San

Mask Suggestions and Healthcare Worker Shortage

1957

Antonio. Sound familiar? The next flu pandemic was the H2N2 flu, also known as the “Asian flu” because it originated in East Asia. The first case appeared in Singapore in February of 1957, followed by Hong Kong in April, and finally U.S. coastal cities by that summer. However, the United States didn’t experience its first spike of cases until October, when children went back to school. Then, another spike occurred in January of 1958 among the elderly, which was more fatal than the first. This pandemic bears similarities to our current pandemic in terms of the virus’s timeline progression, and how and when cases spiked. However, the history of the H2N2 flu does have a silver lining: when a vaccine was introduced in the UK, it was distributed quickly which helped slow the spread. Another recent infectious disease outbreak was the tuberculosis (TB) epidemic of the 2010s. Tuberculosis, like COVID-19, is no stranger to health disparities. Its outbreak in the United States witnessed incarcerated populations suffering from a far higher risk of contracting TB compared to the general population. Across the country, the highest incidences of TB were found in local jails. In 2010, California, Texas, New York, and Florida made up over half of the tuberculosis cases. This isn’t surprising, considering California, Texas, and Florida had the highest number of state and federal prison counts in 2010. All of this begs the question: Why are the effects of COVID-19 so similar to past flu pandemics, when our healthcare has improved so much in the past 100 years? And what does all of this tell us about the U.S.’s ability to respond to public health crises? Let’s look back at the first pandemic, the 1918 flu. At the height of the pandemic, there were 928 deaths per 100,000 people among urban white people. However, the mortality rate among non-whites had been 1123 per 100,000 since 1906. People of color were already dealing with the consequences of health disparities before the 1918 pandemic exacerbated these struggles. During the 1918 pandemic, there were

two waves: a spring wave and an autumn wave. The first wave infected more African Americans than whites, and vice versa for the second. However, when African Americans did get sick in the fall, they were more likely to die than whites because of other complications, such as pneumonia and pre-existing conditions. Miners and factory workers, who were mostly immigrants at the time, also died at higher rates than the general population. Moving the focus to COVID-19, it’s evident that people of color continue to make up the majority of cases. Influenza did this in 1918,

COVID-19 resembles past pandemics because even though medical knowledge has evolved, our society has not. Pandemics are more than just a disease; they highlight

s o c i e ta l d i s pa r i t i e s .

tuberculosis did it in 2010, and now, coronavirus is doing it in 2020. The way the United States addresses pandemics needs to be taken a step further—it’s unacceptable that the same disease hits certain communities harder than others. Past pandemics show us how far our medical knowledge has evolved, but they should also inspire us to improve our social response to better address the current pandemic. If we talk about how to prevent health disparities among vulnerable populations now, we can both prevent the increase of COVID-19 and lessen the impact of infectious diseases to come.

Influenza A H2N2 Subtype

2010s

H2N2

More fatal spike a year later Highest incidences of Tuberculosis in local jails

Outbreak of COVID-19

throughout

U.S. Detention Centers by Angeline Medvid

14 | Ethics

Design: Aaron Dykxhoorn

even months into the COVID-19 pandemic, the United States finds itself incredibly strained. The CDC recommends that all people should avoid close contact with others, as well as utilize hand washing and facial coverings to reduce the spread of the virus. Although these guidelines appear to be straightforward, they only work for the people that possess the capability to follow these suggestions autonomously. Unfortunately, not everyone has the luxury of personal safety in a self-controlled environmentâ&#x20AC;&#x201D;that includes individuals detained in U.S. detention centers representing the more than five thousand detention-related cases of COVID-19 across the United States. The first case of COVID-19 within a U.S. Immigration and Customs Enforcement (ICE) detention center was reported in early March. However, the Pennsylvania detention center chose to not see the case as a warning sign and made no adjustment to normal procedures and protocols. In the months following March, hundreds of detained individuals were transferred between facilities. Many of these transferred individuals had tested positive for COVID-19, and their transfer further spread the virus to centers across the country. The failure to follow and implement safety precautions concerning the virus resulted in the first COVID-19-related death of a detainee in May. Since this time, over twenty-four deaths of individuals in ICE custody have been documented, but this value undercounts the true number of deaths related to ICE detention centers, as ICE only counts deaths directly occurring in their facilities. The agency, according to human rights and migrant aid organizations such as Al Otro Lado, has a pattern of releasing or deporting individuals from facilities rife with positive COVID-19 cases, along with a history of obscuring COVID-19-related data. With overcrowding and a lack of resources, immigrant detention centers serve as a prime breeding ground for the spread of infectious disease. According to the International Rescue Committee, over 20 percent of people detained in ICE facilities are testing positive while being kept in unsanitary conditions, although ICE continues to significantly under-report cases. Of the facilities impacted by COVID-19, none were hit worse than a detention center in Farmville, Virginia. About 90% of detainees at this location tested positive. Reports of inadequate medical care, abusive actions by authority figures, and overall neglect of detainees within this facility has brought greater attention to the morality behind immigrant detention centers as a whole. Fears of falsified data released by the centers complicate the problem and paint a more blurry picture for the fate of detainees. Recently, the U.S. Immigration and Customs Enforcement has tried to take steps to reduce the spread of the virus. It has outlined a set of new COVID-related procedures but many, like social distancing, are physically impossible to adhere to within custody, and many centers are simply neglecting to comply with these new requirements. The failure of U.S. detention centers to follow protocol is nothing new, and COVID-19 has only further highlighted the need for a deeper look into the day-to-day operationalization of U.S. immigrant detention centers and the fate of their detainees. With a public health issue as serious as COVID-19, we canâ&#x20AC;&#x2122;t afford to allow deliberate indifference toward some of the most vulnerable populations in our country.

By the Numbers 12

At least a dozen Latin American and Caribbean countries reported receiving COVID-19 deportees arriving from the U.S.

90%

Over 90% of detainees at a Farmville, Virginia, detention center tested positive for COVID-19, due to a lack of implementation of coronavirus guidelines.

6387

At least 6387 COVID-19 cases have been reported in ICE detention centers since the start of the pandemic, although experts warn that both the infection and death rates have been much higher than reported.

450

As of July 31st, over 450 deportation flights had taken place since the start of the pandemic despite ICEâ&#x20AC;&#x2122;s failure to comprehensively screen detainees for COVID-19.

Racism Kills

How History and Racism Affect Medicine and Healthcare by Aarthi Madhu Design: Rachel Murray

“I

can’t breathe.” An unforgettable, chilling phrase now used as a battling cry for systemic change among U.S. law enforcement. The memories of Eric Garner, George Floyd and the murders of countless other Black men and women have sparked protests across the country and ignited overdue conversations about systemic racism and police brutality. While many have opened their eyes to the overfunding and misuse of police power, the nation’s focus must expand to question not only the actions of those flashing a badge, but also to those boasting white coats. Since enslaved Africans were forcibly brought to Virginia in 1619, a legacy of injustice and racism has haunted this country. Unfortunately, healthcare is not immune to this abuse. Looking back at our country’s 400-year history, a history filled with racism, there is evidence of doctors torturing African Americans under the guise of making “strides in science,” a cover for the propagation of their bigoted ideals. Namely, African American people were exploited to test toxic vaccines, subjected to experimental surgeries while unconscious, and monitored instead of treated to study the progression of deadly diseases. The evil justification was that Black individuals were not human enough to feel pain. Despite decades of scientific advancement, these racial views are still relevant to this day. According to a study published in 2016, 40% of medical students believed that Black people are less sensitive to pain when compared to white people. This inaccurate and worrisome misbelief leads to tremendous disparities in treatment and, in turn, health. One clear example is the routine measurement of kidney function. Physicians use creatine levels to deciphers whether the kidney is working efficiently, the less creatinine, the better the kidney function. However, Black patients often get a “race adjustment” during this test and are documented at levels lower than the true measurement. This adjustment is made because black individuals are

16 | Ethics

supposedly more muscular, which increases creatinine levels in their blood. This is an extremely harmful outlook on the disease, as it is too much of a blanket statement to be accurate in all cases and can often keep black patients from receiving the appropriate treatment and care. Subsequently, Black people have a relatively higher rate of end-stage renal disease than white people. Additionally, studies show that Black patients are placed at an increased risk of mental health struggles, cardiovascular disease, birth defects, complications during pregnancy, and many other fatal outcomes. For minorities, these health disparities are too often a matter of life or death. Doctors vow to treat every patient equally and justly when they receive their white coat. Despite this, implicit bias has proved itself to be a silent killer. Needless to say, biases are passed down throughout generations, from medical school professors to their students. Considering the U.S.’s tough history with racial justice, it would be

“What is necessary to have a society where everyone actually has the opportunity for a fulfilling experience and access to explore, and to grow, and to learn? This is just the basics of rights that we sometimes quote that people have, but in reality, they don’t.”

ignorant to think that today’s youth are free of the biases of their parents and grandparents. Self-awareness and acknowledgement of the U.S.’s shameless history in which these biases are rooted is the first step to ridding the U.S. of racial disparities in medicine and healthcare. Dr. Sannisha Dale, an Assistant Professor in Psychology at the University of Miami, is an expert in the field of psychosocial and structural factors that relate to health disparities. Her research focuses on looking at the resilience, trauma, and health outcomes of Black women living with HIV. When thinking about some of the issues these women face, Dr. Dale could relate them to her own life experiences, “as a Black woman and as someone from multiple marginalized identities, these intersectional issues that determine how oppression plays out and impacts people’s mental and physical health have always been part of my mindset about how I think about and navigate the world.” In Dr. Dale’s study, one of the many things she focuses on are the interactions the women have, including interpersonally with health care workers. Dr. Dale finds that “the people who are supposed to be caring for Black women and advocating for their well-being are not doing it well because of a medical system that has historically been built on the mistreatment of Black individuals.” Rules and customs that were once built in the law and have been changed in hopes to have “equality”, still affect every societal system. These effects take place in a myriad of different ways, including both explicit and unintended racism. The effects of systemic racism can also be seen through microaggressions, every day slights, comments, and behaviors . Macro and micro acts of discrimination can lead to a greatly disproportionate burden of both morbidity and death during medical care towards minority communities. Though these words and actions may be inadvertent, this form of racism is commonplace in medicine and is extremely harmful to non-white patients. Discrimination, no matter the intentionality, has restricted and hurt the lives of racial minorities and immigrants for centuries. Dr. Dale brings up the question, “What is necessary to have a society where everyone actually has the opportunity for a fulfilling experience and access to explore, and to grow, and to learn? This is just the basics of rights that we sometimes quote that people have, but in reality, they don’t.” While hate crimes and police violence pose an obvious threat to the well-being of Black individuals, we must be aware that this issue has roots much deeper than the tragic yet blatant violence we see on the surface. For minorities, this discrimination means unequal access to health, education, wages, housing, and so much more. In the wake of the murders of George Floyd, Amund Aubrey, Breonna Taylor, and many others, attention has been brought to an issue that has plagued our country for decades. This oppression must be combated with big solutions. Dr. Dale suggests, “questioning our national policies around addressing racism, around addressing xenophobia, around addressing anti-LGBTQ+ and anti-immigrant policies, around rethinking the incarceration system and acknowledging it for what it is, which is a derivative of the plantation system that incarcerates the same bodies that were enslaved. It’s a big question that needs work in the macro level, as well as the micro level.” It is the duty of every police officer, every doctor, every nurse, and every citizen to think intently on the predisposed ideas they may have in hopes to dismantle this structural racism from the inside out.

The YELLOW DRAGON Floridaâ&#x20AC;&#x2122;s Citrus Crisis by Elan Tran

18 | News

Illustration & Design: Varsha Udayakumar

mall, unripe oranges lay sprawled across the grove’s floor, while a yellow mottle blankets its sickly canopies. The yellow dragon has threatened the world’s citrus supply since the eighteenth century. Commonly referred to as citrus greening, the disease Citrus Huanglongbing (HLB) has severe implications for the state of Florida, which provides over 70% of the citrus consumed in the United States and is the second largest producer of orange juice worldwide. With considerable help from the state’s sandy soil and subtropical climate, Florida’s citrus industry has reached a nine billion dollar value since its humble beginnings in the mid-1800s. Citrus greening poses a formidable threat to an important contributor of state revenue and jobs. Already, an alarming 90% of Florida’s groves are affected and struggle to manage this devastating disease. So what exactly happens to infected plants? A major consequence of citrus greening is that it prevents fruit from ripening. This often leaves a bitter taste and green appearance, hence the disease’s name. Even if the fruit ripens, it tends to fall before it can be picked. This is a serious issue because Florida law states that fruit which has fallen undisturbed cannot be sold. Besides their ruined fruit, infected trees have a shortened life span and a crippled root system, the latter of which critically hinders the plant’s ability to take in vital nutrients. In order to preserve its limited supply of food, the tree drops its fruit. By the time symptoms are seen in the canopy, over 70% of the root system may be lost. These symptoms include twig dieback and the presence of green, misshapen fruit, and a yellow coloring that creeps along innocent trees’ leaves, shoots and branches. Citrus greening afflicts over 50 countries throughout Africa, Asia, the Americas and the Oceania. Within the United States, the disease prevails in Florida, Georgia, Texas, South Carolina, Louisiana, California, Puerto Rico, and the Virgin Islands. In all of these locations, the spread of the disease can be attributed to two invasive agents. The first is bacteria of the genus Candidatus Liberibacter (CL). Under this distinction, there are three species known to cause illness: CL asiaticus, CL americanus, and CL africanus. Within Florida, citrus greening is caused by CL asiaticus. The second disease-causing agent is an insect called the citrus psyllid, which is capable of transmitting bacteria between plants. During the feeding process, the psyllid sucks in CL asiaticus from an infected leaf and injects the pathogenic bacteria into its next meal. As with the bacterium, there are multiple species of the citrus psyllid that cause infection. In Florida, the disease is spread by the Asian citrus psyllid, Diaphorina citri Kuwayama. Since psyllids prefer warmer temperatures, Florida growers are stuck battling a year-round problem. However, even northern growers who do not currently face psyllid issues may do so soon, as psyllid populations are predicted to move north of Florida due to climate change.

It is important to remember that the term “citrus” extends far beyond oranges. The yellow dragon plagues all citrus crops, including mandarins, lemons, grapefruits, limes, and more. While it poses no risk to humans, it presents a considerable threat to the citrus industry we rely on. In the ten-year period between 2008 and 2018, citrus greening resulted in a 72.2% reduction of U.S. oranges destined for processing. In turn, consumers are forced to meet rising prices. Since citrus greening was first identified in the U.S., the cost of a box of oranges has increased from $2.89 to $9.34. Florida is deeply affected by the disease, having its lowest commercial citrus acreage since 1966, when the USDA began tracking these values. This data supports the prediction made by Adrian Percy, the former head of research for Bayer’s Crop Science division, that “the citrus industry in Florida could be out of business within 10 to 15 years.” An alarming 5,000 Floridian growers have already left the industry.

Beyond the negative impact on the state’s economy, a loss in citrus groves translates to a loss in habitat for wildlife and a loss in natural buffers against industrialized areas. The University of Florida reported that there are over 159 species that are native to grove ecosystems and that one acre of mature citrus trees can produce an incredible 16.7 tons of oxygen per year. These findings highlight just a few of the many ecological benefits jeopardized by citrus greening. The most distressing element of the citrus crisis is the lack of a cure. Farmers currently rely on management strategies to control disease vectors and limit the spread of infection. In practice, this involves removing sick trees, applying pesticides, and employing biological control of the psyllid. If an infected plant is still economically beneficial, foliar sprays, regulation of soil pH, and specialized irrigation may be used. Working to solve this threat are academic institutions and companies alike, including Tropicana, Minute Maid, and Bayer. Researchers at UC Berkeley have identified microbe-associated molecular patterns that could be used to boost citrus plants’ immunity. Additionally, researchers at the University of Florida have shown that benzbromarone and tolfenamic acid are able to reduce infection and increase fruit production. Most promising are advancements made by UC Riverside, whose researchers have uncovered a way to kill the pathogenic bacteria. This discovery was found by studying the properties of greening-tolerant, wild citrus plants. News about this potential treatment reached the media in July, which has touted the treatment’s ability to survive 130° heat, manufacturing ease, and safety for humans. Thankfully, the treatment requires minimal reapplications and is affordable. In a partnership with Invaio Sciences, UC Riverside is starting the necessary processes to get this treatment to the market. Will the yellow dragon finally be slayed? With the continued effort of academics and industry, I would like to think so. As Florida’s citrus production hangs in the balance, there is now a bright yellow glimmer of hope.

THE NEW SPAce RACE =The Next Generation= by Austin Berger

Illustration & Design: Cherri Chen 20 | News

mercury

s the dust settled on WWII, the Allies emerged victorious, with the United States and the Soviet Union becoming the world’s two main superpowers. They represented two beacons of this new age of humanity, but with differing ideologies; the U.S. touted capitalism and the Soviets championed communism. Unfortunately, the relationship between these former partners quickly spiraled into hatred and thus the Cold War began, pitting the superpowered countries against one another in order to determine the world’s dominant political ideology. Part of this was an attempt to capture a new theatre entirely, with both countries looking toward the stars. “Space: the final frontier,” a recurring phrase uttered at the beginning of almost every episode of the original Star Trek series, truly encapsulates the time period in which it was originally aired: the 1960’s. During the Cold War, the United States and Soviet Union were locked in a competition to one-up each other with increasingly difficult feats in the vast arena of space. The Soviets began these efforts earlier and beat the Americans at every stage: sending the first artificial satellite, Sputnik, into orbit, the first human spaceflight, and the first woman in space. However, it was the United States crew that ultimately first set foot on the moon; it still remains the only country that has sent a man to the moon. Following this event in 1969, improving relations between the previous rivals allowed them to begin to cooperate on a more permanent structure in space, culminating into the docking of a United States and Soviet spacecraft in 1975, and subsequently, the International Space Station at the turn of the century. Although missions to space, both manned and robotic, have continued in various countries throughout the world since the Space Race, few are capable of travel to the moon, and none have put a man on it since the Apollo 17 mission in 1972. With more countries’ governments establishing space agencies to launch into the future of science and consumerism, this may change in the coming years. Contrarily, the United States has seen a growing shift away from

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government-sponsored space programs and instead towards private companies. In 2011, the United States Space Shuttle program was ended, with astronaut launches following this date being done from Kazakhstan. This changed with the SpaceX launch on May 30th of this year, which marked the first time that men were launched into orbit from the United States since the end of the Space Shuttle Program, and the first launch of astronauts to Earth’s orbit via a commercial spacecraft. Although SpaceX does work alongside the United States’ National Aeronautics and Space Administration (NASA) through their Commercial Crew Program and payload transport, SpaceX is still a major player in the situation, with its vast stores of technology and expertise being utilized in order to reach its goals of making humanity a multi-planet species. Founded by entrepreneur Elon Musk, SpaceX has made huge strides in privatized space travel. Some mirror the events that took place a half-century ago, including creating the first privately developed liquid fuel rocket to reach Earth’s orbit, and some are completely new, such as developing the first private spacecraft to visit the space station and relaunching the first orbital class rocket. The relatively quick strides that SpaceX has been making in private space travel are astounding. If they are able to continue this ongoing hot streak, the next step would be to send an uncrewed mission to Mars by 2022 and, following this, one with humans by 2024. Eventually, SpaceX wants to create a permanent settlement on Mars. Blue Origin, founded by Jeff Bezos, has a similar goal, albeit in a different place; in the short term, the company wants to establish a permanent base on the moon. In contrast to SpaceX, Blue Origin is taking a slower and more calculated approach to space travel, but while it may currently be lagging behind, it is still a fierce competitor of SpaceX. Adjunct and consequent to the profound scientific endeavor that is spaceflight and permanent settlement is the market for a new type of entertainment: space tourism. The first stage in this new chapter of travel is already upon us. Companies are taking steps in order to reduce the cost of launching people and cargo into space, priming themselves to be able to take people and supplies into Earth’s orbit and beyond. Once permanent colonies are established on their respective cosmic bodies, SpaceX and Blue Origin plan to shuttle people to and from space for them to experience what the solar system has to offer, and to increase the sizes of their colonies. For instance, Bezos envisions billions of people living on sustainable space and lunar colonies. While this is obviously far off in the future, nonetheless, it seems unlikely that humanity will be able to sustain itself purely on the Earth’s resources for eternity, which is another reason why these private companies are entering the New Space Race. The other major billionaire in this market is Richard Branson, founder of the Virgin Group, part of which is Virgin Galactic. Virgin Galactic is more focused on the travel component of space rather than the colonial component; currently, the company wants to send people into orbit, onto the

Mars pathfinder

mars odyssey

Reconnaisance orbiter

22 | News

moon, and beyond. This also puts them in direct competition with Blue Origin, another ambitious provider of space tourism. In brief, this new Space Race pits three billionaires against one another in order to determine who will be the first to popularize the private monetization of the universe beyond Earth. SpaceX is leaning towards colonization and transport, Blue Origin is dipping its toes in colonization, transport, and space tourism, and Virgin Galactic is looking into space travel. Although it is true that these endeavors are rooted in capitalistic gains, the scientific knowledge and glory that are to be gained should not be discounted. One day humans will be able to easily visit Mars and worlds beyond, say “I’d like to live here,” and just move there much like how people visiting their grandparents in Florida do now. To put this whole time period in perspective, the Wright brothers made the first successful powered aircraft in 1903. In approximately 120 years, humanity, once tethered to the ground, was able to not only take to the skies, but is making progress towards inhabiting another planetary body. In another century, who knows what humanity will look like and where it will have gone. As Star Trek puts it, we’ll definitely be going “where no man has gone before.”

spaceship one

viking orbiter

eam Streaming eam

by Laila Rayza Nelanda Photography: Sneh Amin Illustration & Design: Megan Buras

ince society was sent into quarantine in March, many Americans have resorted to streaming services to help them pass the time. Many streaming services including Netflix, Hulu, and Disney Plus have seen a rise in their subscriptions. Surveys show that 80% of U.S. consumers are now subscribed to at least one streaming service, a 13% growth from a pre-COVID-19 survey. One survey from TransUnion found that 56% of US consumers have increased their use of streaming services since March. These survey results are understandable, considering millions have had to quarantine since the onset of the pandemic, making it a massive struggle for Americans to enjoy their usual movie night out. Netflix added nearly 16 million subscribers between January and March of 2020, and further boosted their business with the release of shows such as “Tiger King” and “Love is Blind.” Similarly, Disney Plus also saw a boost in their subscriptions, with the release of many original shows such as “The Mandalorian” and popular movies such as “Onward” attracting millions of viewers. But who exactly constitutes this massive expansion in new subscribers? The TransUnion survey finds that consumers aged 18-29 are the largest age category comprising this new surge. This population consists of Gen Z and Millennials, many of whom opt for streaming services instead of cable, for several compelling reasons. For one, Gen Z and Millennials are very anti-advertisement. Surveys show that 43% of young people are more than willing to shell out the extra cash to pay for Spotify or Hulu’s ad-free services. Gen Z and Millennials are big consumers of original content, and are therefore willing to own multiple subscriptions just to not “miss out” on a show. The COVID-19 pandemic has done more to the entertainment landscape than just impact streaming. Production for many upcoming films was halted due to stay-at-home and social distancing orders. However, Hollywood has since resumed production, after California Governor Gavin Newsom declared that producers can do so as long as film personnel follow specific safety guidelines. Several upcoming movies, including “Avatar 2” and “Jurassic World: Dominion,” have resumed production. Keeping their end of the deal, production teams have been adamant about creating and following rigorous safety protocols to follow during filming. A senior Universal executive confirmed that the filming of Jurassic World will spend over a startling five million dollars on its safety protocols. The funds will be used to cover expenses such as COVID-19 tests, hand sanitizers, COVID-19 safety training for the crew, the cost of doctors and nurses on set, and masks. The same executive at Universal told Deadline news, “We want to make sure that we are going above and beyond the national protocols to create a safe environment. Cost isn’t our main concern now: it’s safety.”

RV re Streaming Services in the Age RV nde a Global Pandemic of a a nde With a halt on production comes a halt on movie releases. Many are being pushed back, while movie premieres, traditionally large social events, are seeing a large adjustment. For example, Disney’s “Mulan,” which was supposed to have its big-screen debut in March, has been postponed over three times. Due to the impossibility of having a Hollywood social or even movie theater debut, Disney premiered Mulan exclusively on its streaming service Disney Plus on September 4 for a premium fee of $29.99 in addition to the per-month subscription cost. As the pandemic persists, we may see other movie studios follow suit with their own releases. Another coronavirus-related victim in the entertainment industry is the movie theater. While large theater companies such as AMC may be able to bear the economic brunt of the pandemic, smaller cinemas haven’t been so lucky. Delays in the release of new blockbusters, paired with social distancing guidelines and a general public anxiety around going out to indoor entertainment, has meant that theaters have faced sharp drops in ticket sales and overall business. “Tenet,” a film from renown director Christopher Nolan, was one of the rare movies to actually be released in theaters in the past few months, and the executives and producers behind its release may be doubting their decision—so far, it hasn’t even hit the 400 million dollar mark at the box office that the production would need to break even. Upon seeing such a big-budget film from one of the world’s most recognizable directors fall short, lesser known directors and producers are undoubtedly asking with trepidation, “if Nolan can’t do it, can we?” The pandemic has created conditions for people to experience movie theater luxuries at home, but will this rise in subscriptions persist post-pandemic? Based on the aforementioned survey by TransUnion, 45% of U.S. consumers will be keeping streaming services as a part of their life even after quarantine ends. However, the pandemic continues to present families with difficult economic burdens, and many predict that streaming services may be a luxury some consumers are willing to let go of. As Jim Nail, a market research analyst at Forrester, puts it, “as this drags on and there are jobs and paychecks lost, I think people will sit down and make tough decisions about where to cut, and one of them might be to cancel streaming services.” Before COVID-19, many consumers subscribed to streaming services for their original content, convenience, and affordability. But as time has passed, the closure of movie theaters, lagging movie releases, and an overall reduction in social activity have catalyzed a unique surge in subscriptions. As uncertainty lingers in the months to come, many are choosing to hang on to their subscriptions with the confidence that one thing is certain: they will never run out of things to watch.

The Road Towards “Supercoral” Engineering

by Ellie Martin Illustration & Design: Anam Ahmed

espite covering less than one percent of the ocean floor, coral reefs are vital to marine ecosystems and humans alike. Case in point: an estimated quarter of all marine species rely on coral reefs for shelter, food chain nutrients, and chemical processes such as carbon and nitrogen fixation. Coral reefs are also considered the most biodiverse marine environments, leading pharmacies to turn to the unique selection of animals and plants for key drug discoveries. The benefits don’t stop there. Reefs prevent life loss, property damage, and erosion by breaking up the force of incoming waves before they reach land. Economically speaking, coral reefs provide jobs ranging from fishing to tourist attractions and deliver an estimated value of at least 30 billion dollars per year to the global economy. Over 500 million people around the world (equatable to the North American population)—particularly in developing countries—are dependent on these beautiful ecosystems in one way or another. And they’re dying, fast. Changes in climate over the last two centuries have drastically affected coral health via three main mechanisms: sea level rise, which increases sedimentation by land erosion and effectively smothers corals; ocean acidification, which results from increased acidic carbon dioxide concentrations and weakens structural integrity and growth rates; and coral bleaching, caused by increasing oceanic temperatures that essentially starve corals. More specifically, coral bleaching involves the release of symbiotic photosynthetic algae, called Symbiodiniaceae, that normally provide the coral host with up to 90% of its energy needs in exchange for shelter and other essential molecules. When waters get uncomfortably warm, photosynthetic machinery can become overworked and break down in the symbiont, rendering it incapable of making that essential food for its coral housing. Because more thermal energy is being absorbed than can be converted, that energy will turn into radicals capable of reacting with—and damaging—the contents of the algal cells. Considering the coral gets nothing out of the relationship in this scenario, it will often

kick out its Symbiodiniaceae in search of better replacements (better tenants, if you will). If the coral is unable to find a functioning set of tenants in time, it will die. Mass bleaching events are becoming increasingly devastating and frequent, as demonstrated by a 2014-2017 global bleaching event that induced bleaching-level heat stress in over 75% of global reefs, with almost 30% receiving mortality-level stress. Australia’s independent climate-communication organization, the Climate Council, has reported that large-scale bleaching events have increased from about one every 27 years to one every six years, with a projection rate of one every two years by 2030 for the Great Barrier Reef (the world’s largest coral reef). According to UNESCO, all reefs could cease to exist by the end of the century under a business-as-usual scenario. A huge amount of effort is being directed towards restoring reefs, with current restoration methods typically replacing decimated reefs with large, fast-growing coral species that can repopulate the area fairly quickly. The problem with these efforts, however, is that they typically fail to prepare corals for the next heatwave and can erase the original biodiversity of the reef. Considering the urgency of the situation and growing interest in maximizing efficiency, researchers are now looking for ways to speed up adaptation to rising temperatures. Dr. Rachel Levin, former PhD at the University of New South Wales, is one such researcher. The idea behind Levin’s work is to genetically engineer preadapted symbionts that could repopulate at-risk and bleaching coral populations before mortality locks in. In order to first identify the types of genes that could help symbionts survive in warmer environments, Levin tested two strains of Symbiodiniaceae in her lab: one thermosensitive, one thermo-tolerant. The thermo-sensitive strain responded as most symbionts would, suffering from a sharp decrease in photosynthetic efficiency and an increase in reactive oxygen species when the temperature approached an atypically high level of 32 °C. The second strain, however, had been collected from the Pacific Island of Palau. Despite the extremely acidic and warm surrounding waters, the island’s reefs are perfectly healthy, suggesting that

CRISPR/Cas9

"Supergenes" in viral vehicle

these corals have found some way to adapt to their changing environment. Unsurprisingly, the Palau strain showed minimal bleaching under the same treatment. But how, exactly? After comparing differential gene expression in the two strains, Levin found that the resilient Symbiodiniaceae significantly scaled up antioxidant and heat shock proteins, enabling them to repair any cellular damage caused by heat stress. After identifying these stand-out “super” genes, Levin’s next goal was to figure out how to insert additional copies into weaker Symbiodiniaceae strains, essentially speeding up the naturally-occuring evolutionary process that had occurred in the Palau symbionts. To call the task daunting would be an understatement. To begin with, these cells are heavily armored. Inserting DNA into Symbiodiniaceae cells would require getting past armored plates, two cell membranes, and a cell wall. Applying enough force could hypothetically break past security, but sheer force with no precision could kill the cell. To get around this problem, Levin’s background in medicine presented a surprisingly suited agent: viruses. While injecting a virus into a symbiont doesn’t seem like the most ideal solution for coral health, viruses have evolved to be highly precise and efficient in transferring target genes into a genome and amplifying them. If viruses could be altered to deliver extra copies of the identified super-genes, they could get the job done with relative precision and the help of cellulase and osmotic agents to remove the cell wall. As a pseudo proof of concept, Levin successfully generated the first Symbiodiniaceae protoplasts, or cells without walls, to indicate that this step can in fact be completed. Assuming viruses could be altered to deliver the target genes, those genes could serve as the repair template for the popular CRISPR/Cas9 gene-editing system. CRISPR/Cas9, which utilizes a naturally-occurring bacterial immune defense system, requires the use of a pre-designed synthetic guide RNA to recruit the Cas9 endonuclease protein and bind at a specific (and

Homologydirected repair

complementary) target site in the genome. The Cas9 protein then interacts with a protospacer associated motif (PAM) to essentially cut the DNA at that site, where it can repair the double-stranded break through one of two methods: non-homologous end joining or homology-directed repair. Non-homologous end joining (NHEJ) creates a random mutation, insertion or deletion that can disable or “knock out” the gene of interest. Homology-directed repair (HDR), on the other hand, utilizes a repair template whose ends line up with the doublestranded break. This repair template can be utilized for gene knockout, introduction of specified mutations/insertions/deletions, or the integration of an entire gene (such as the kind that a virus could deliver). Dr. Levin’s expansive paper on the potential for genetic modification is a great stepping stone for this intimidating task, and her group has even identified ideal target sites on Symbiodiniaceae genomes for gene insertions. Yet no labs have actually ventured as far as to modify any Symbiodiniaceae up to this point. Critics justifiably argue that corals and their symbionts are extremely biodiverse, not very well understood, and difficult to research due to their colossal genomes and unique properties. Attempts to genetically engineer symbionts could result in a host of unexpected and off-target side effects. Additionally, the sheer mass of biodiversity could make it difficult to engineer well-suited symbionts for many different types of environments. But, as Levin has pointed out, the field of medicine faces similar challenges all the time—and moves forward because dire situations often call for radical solutions. Fortunately, the Australian government has recently announced that it will fund laboratories to continue Symbiodiniaceae genetic modification. Considering reefs don’t have much time left, we may have no choice but to investigate these types of cutting-edge solutions. While current restoration techniques are applied in conjunction with steps to slow climate change, it is worth looking into long-lasting solutions in the event that corals can’t make it on their own. Plus, you have to admit that the prospect of genetically engineering the Jason Bourne of corals is pretty ****ing cool.

on the Front Lines An Interview with Dr. Mehdi Mirsaeidi by Sofia Mohammad Photography and Design: Anuj Shah

Physician. Pulmonary & Infectious Disease Specialist. Public Health Scientist. Expert Communicator. Meet Dr. Mehdi Mirsaeidi— the Dr. Fauci of Miami.

t its onset, the COVID-19 pandemic sent seemingly innocuous ripples across the globe—introducing rumors of the emergence of an illusive yet highly infectious disease spreading through China and eventually making its way to other countries of the world. What began as mere ripples has since evolved into a cataclysmic tsunami of infection now threatening the shores of the United States, Miami in particular. Three weeks before the first wave of cases hit the United States, Dr. Mehdi Mirsaeidi, a specialist in pulmonology and infectious disease, was among the first in the University of Miami community to take a proactive stance against the illusive virus, and presented a talk at the University of Miami Miller School of Medicine using evidence-based research based on China’s experiences with COVID-19. His primary aim was simple: introduce and explain as much factual information as possible to educate and equip his colleagues so they could develop a comprehensive action plan for when cases inevitably emerged in Miami-Dade County. As a frontline physician, pulmonologist, infectious disease expert, and public health professional, Dr. Mirsaeidi feels strongly about the notion that we are fighting a pandemic on two fronts with COVID-19: one with respect to preventing and treating COVID-19 cases, and the other with respect to challenging the recent rise in “emotional medicine” by both physicians and patients alike, which is rooted in misinformation about viral transmission and treatment. A pervasive

dedication to both utilizing and contributing to the development of evidence-based medicine encapsulates Dr. Mirsaeidi’s philosophy in serving the Miami community during the COVID-19 pandemic, and he expresses optimism that if we continue translating research into practice in medicinal and social contexts, we can ultimately mitigate the challenges posed by the pandemic. The origins of Dr. Mirsaeidi’s commitment to pursuing greater knowledge and understanding through scientific inquiry can be traced back to his roots as a child in Iran. Growing up, Dr. Mirsaeidi was constantly exposed to a culture of empiricism and intellectual curiosity—two tenets that have cultivated his search for knowledge and ultimately gave rise to his passion for pulmonary medicine. Recounting his first exposure to respiratory conditions, Dr. Mirsaeidi recalls episodes of his father complaining of shortness of breath and thinking, “there should be some way that we can fix that.” This same spirit of scientific inquiry guided him on his path to medicine as he committed to saving enough money, cent by cent, to purchase his first microscope for a miniature lab he developed in his home dedicated to studying different microbes. Fondly recalling his excitement when he visualized new microbes and preserved their slides, Dr. Mirsaeidi cited these experiences as some of his first glimpses into the world of science. In high school, Dr. Mirsaeidi continued to build upon his knowledge as he began formally conducting research in an anatomy lab to delve into the anatomy of the heart and its role in the body.

Ultimately, his experiences culminated in his desire to pursue medical school. Dr. Mirsaeidi began his medical journey in Iran where he dived into studies in internal medicine and infectious disease, later becoming an assistant professor in a lung specialty center where he spent the initial stages of his career treating pulmonary infections. After moving to the United States, Dr. Mirsaeidi became recertified in internal medicine and began new studies in pulmonary critical care—a field that provided him with the opportunity to study beyond his former training in pulmonary infections and to delve into non-pulmonary infections and comorbidities. The new perspective he obtained through treating both pulmonary and non-pulmonary infections provided him with a multidimensional perspective that served him and his patients well during the COVID-19 pandemic, especially when presented with comorbidities of the virus and other sources of infection. Unsurprisingly, COVID-19 is not Dr. Mirsaeidi’s first encounter with respiratory viruses from the coronavirus family. After obtaining his first faculty appointment in 2001, Dr. Mirsaeidi served as a pulmonary and infectious disease specialist during the SARS epidemic. The insights he obtained through treating patients during the initial SARS-CoV epidemic gave Dr. Mirsaeidi unique positionality as he and his colleagues worked to understand COVID-19, better known as SARSCoV-2, especially given that both viruses were very structurally and biochemically similar. “It was a really big thing for me to kind of merge what we already knew about the SARS coronavirus and translate that to the disease that we call SARS-CoV-2,” Dr. Mirsaeidi explained. As the first wave of the pandemic gained traction, Dr. Mirsaeidi stuck to practicing evidence-based medicine, ultimately drawing from already established knowledge regarding pulmonary diseases, Acute Respiratory Distress Syndrome (ARDS), severe viral infections, severe pneumonia, and many other conditions. “Why [should] we be crazy and try many things that aren’t FDA approved and have not been empirically studied?” He continued to explain that centralizing our efforts on initiating clinical trials and learning about what interventions are clinically effective for patients is the most logical course of action in the uncertain circumstances surrounding the pandemic. Reflecting upon whether this strategy was useful or not led to his confrontation of a harsh reality: “It wasn’t as effective in practice because people got crazy. They got emotional. And I think emotional medicine is a major driver for the harm of people.” As a physician, Dr. Mirsaeidi firmly believes that remaining logical, calm, and put together is the best strategy one can adopt when facing as many uncertainties and hysteria as we have both witnessed and experienced during the course of this pandemic. At least 2-3 months into the U.S.’s COVID-19 response, however, he noted that discourse on the coronavirus was dominated by significant and seemingly unending emotional medicine. Dr. Mirsaeidi describes his numerous attempts to push back against the misinformation that was plaguing the masses through Twitter advocacy—an outlet he has found useful in combating unsubstantiated myths about ways to treat and prevent viral infection.

Among the first instances of misinformation perpetuated within the medical community was regarding the use of anti-interleukin-6, which early studies in China cited as a “magic treatment,” to quell the cytokine storm that was triggered during COVID-19 infection. “That was not a fact,” Dr. Mirsaeidi lamented. Studies that were subsequently conducted by Yale University with over 100,000 participants revealed that the treatment was ineffective and resulted in no significant improvements In individuals affected by the virus. Another well known “silver bullet” drug proposed in the early stages of the pandemic was hydroxychloroquine. “Chloroquine plus erythromycin; Chloroquine plus Zinc; Chloroquine plus Vitamin C,” Dr. Mirsaeidi listed as he described the numerous combination therapies that were tested and administered to patients with hopes for improvement, but demonstrated little efficacy. “Don’t do emotional medicine. Do evidence-based medicine. If we don’t do evidence-based medicine, we cause much more harm [than we do] save people,” he described as he recounted the sentiments he shared on Twitter during these critical stages of the pandemic. Dr. Mirsaeidi also uses his platform as a space to discuss social and environmental issues by denouncing racist ideologies following the aftermath of George Floyd’s murder as well as bringing to light the relationship between climate change and the emergence and exacerbation of pulmonary diseases. When asked about progress from that point in time relative to today, Dr. Mirsaeidi describes that in ICUs now at 6 months after the start of the pandemic, there has been an overwhelming reduction in emotional medicine, and an incredible rise in the use of evidence-based medicine, which has also resulted in improved outcomes and reduced strain on the healthcare system. Though COVID-19 is primarily a biologically relevant pulmonary disease that Dr. Mirsaeidi has been treating as a physician, it is also a significant public health crisis, which his Masters in Public Health (MPH) has enabled him to examine more thoroughly. Reflecting on the insights provided by his dual degree, he shared that “whenever you are a physician, your focus is only on one person: your patient. When you are a public health specialist, you understand epidemiology, and the first thing you are thinking about are populations. You are not focused on treating one person and understanding one treatment. Instead, you understand research, and are empowered with the tools to go to the next level and generate population level science.” With a focus on upstream interventions he could take before the pandemic ensued in Miami-Dade, Dr. Mirsaeidi sought to bring awareness to the COVID-19 pandemic in the U.S. based on the dystopian circumstances unfolding in Italy early on. “It was crucial,” he recounts, “given that usually it is hard to change people’s mentalities about something that they are not experiencing firsthand.” He conducted a call with physicians in Milan at the peak of the pandemic in Italy—a dystopia marked by frustration, fear, disillusionment, and a shortage of PPE that was shocking to the 100 University of Miami physicians who were present at the meeting. “It was really an eye opener for all the people from UM, and after that, you could definitely tell that there was a culture change,” he stated.

“Every physician has two lives: one as a doctor and another as a human.

As a human, I was scared to death.”

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Dr. Mirsaeidi spoke frequently about the need to approach medicine, particularly in the most stressful and demanding of times, with a calm and relaxed mindset. “You must keep balanced emotions and you can’t be overcome by fear or doubt,” he said. “You should spend all your head, mind, and soul for your patient.”

His experiences this far shed light on the notion that communication and diplomacy were key to improving the COVID-19 response in Miami. Dr. Mirsaeidi’s constant communication with Dr. Stephanie Liberty from the University of Milan, director of the COVID-19 response in Northern Italy, proved to be invaluable because it truly showed people that the coronavirus was real, that the pandemic was happening, and that they needed a plan for when it came. Connecting with civil society posed unique barriers throughout the first wave of the pandemic, as the initial stages led to 180 hospitalizations at the University of Miami, while the second wave demonstrated a resurgence of cases to over 400, after the severity of the virus was downplayed by numerous politicians and the media. Dr. Mirsaeidi describes that as a whole, this pandemic has been a multifaceted battle where we as a society are fighting against the virus, misinformation, political agendas, and so many more obstacles to reclaim normalcy, and the biggest thing that can make a meaningful difference is if everyone does their part to prevent transmission. One notable aspect of Dr. Mirsaeidi is his infectious optimism regarding the fact that we have made, and will continue to make, significant progress with respect to overcoming the coronavirus pandemic. When asked how he stays so positive, he offered a humble smile and proceeded to explain, “as a physician, you should always focus on just one thing: your patient. You must keep balanced emotions and you can’t be overcome by fear or doubt. You should spend all your head, mind, and soul for your patient. If you always do

that, you’ll always be positive because you will be there to support your patient and do your best to help them feel better.” On a more personal note, Dr. Mirsaeidi also provided insight into the uncertainties and fear the COVID-19 pandemic instilled in him despite his generally positive outlook. “Every physician has two lives: one as a doctor and another as a human. As a human, I was scared to death. I had honest and terrifying conversations with my family about how to proceed should I fall ill, and I took so many precautions to prevent them from getting sick. The pandemic wasn’t a good time for any physician in the world. But again, when you see that you are a person who is supposed to care for others, that is a different story. It is your passion and your career, and I was proud to serve my patients during this time.” Ultimately, Dr. Mirsaeidi’s perspective provides rich insight into the experiences he had as a pulmonologist, infectious disease expert, public health practitioner, and as a person working to make a meaningful change in the world during a time of such uncertainty. As he expressed in his personal accounts of future progress, it is crucial that we as a community contribute to the efforts to combat COVID-19 through following prevention guidelines and ensuring that the most vulnerable groups among us are not further marginalized. As a community, we are thankful for the sacrifices he and other healthcare professionals on the front lines have made as they help us recover from and treat the virus, and we hope that as the next waves emerge, we can do our part and join the effort to mitigate the spread of the virus.

THE PATRIOTIC RESPONSE EXPLORING THE ROLE THAT CULTURE HAS PLAYED IN THE AMERICAN Battle against COVID-19

by Bhavana Srikakolapu

rom its involvement in World Wars I and II to its role as a core member of the United Nations, the United States has always played a substantial part in global politics. With such a responsibility, the United States has assumed the role of a global leader, setting an example to various countries. The COVID-19 pandemic, however, has painted America as an example of what not to do. While the rest of the world begins to open up with a controlled number of cases, the United States seems to have regressed with nearly five states, as of July 2020, experiencing an upwards of a 1000% increase in COVID-19 affected individuals. Many people identify with the idea that the American COVID-19 response has been less than ideal, but that begs the question: what should have been done? International Responses To answer this question, we can look to Time Magazine’s ranking of the top COVID responses around the world. Taiwan, Singapore, and South Korea were respectively placed as first, second, and third. To better

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Illustration & Design: Megan Piller

understand the success of their responses, it’s worth examining three particular components described in the table below: contact tracing, testing, and isolation. The American Response When looking at the big three components—contact tracing, testing, and isolation—the United States arguably gets half a point for each. While some efforts have been made, they were half-hearted at most, with a lot of the efforts being muddled due to lack of coordination between state authorities and local officials. Isolation in the United States was robust in the beginning, with a majority of the public concerned with “flattening the curve.” Most businesses had temporarily shut down, and work from home options were offered to positions where it was feasible. Analyzing COVID-19 cases, we can see that these initial social distancing measures had made some headway, with new cases per day remaining between 20,000 and 30,000 from March to June 23, 2020. Cases were plateauing. Following that period, however, there is an obvious increase in cases from an average of 28,000 between March and June to 55,000 in the time period after. The issue with using such a value, however, lies in the last component: testing. Testing in the United States has been shady, for lack of a better word. Initially, tests were not easy to come by. If a person were to acquire a test they couldn’t present with “just” a cough and sore throat, they had to have more severe symptoms to be considered for a test. Lack of tests forced healthcare workers to ration, which led to a huge delay in detecting cases. The COVID-19 hotlines set up by each state acted as an epitome for the issues the country was facing at a policy and governmental level; reaching the hotline proved to be a challenge for many, and for the few that were able to make it through, they were placed on hold for hours. Eventually, mass testing did become available. Now, however, citizens face a situation where they need to question the accuracy of state-reported numbers of positive cases and the accuracy of the tests. This issue is best exemplified by Florida: in May, public agency worker Rebekah Jones was fired for failing to alter numbers to show a more positive trend in Florida cases. She was fired for reporting accurate numbers. President Trump’s responses to testing were also concerning: “If we don’t test, case numbers will be less.” Tests and testing measures in the United States have been far from perfect, and accurate reporting measures are blocked by misunderstandings and miscommunications between all levels of government. What Should Have Happened? The ideal approach to this pandemic would have included early testing and contact tracing, two components that were severely mishandled. It would

have also included a more strategic model for reopening businesses as well as more early involvement from the Center of Disease Control (CDC). The media has termed February, the earliest month that proper regulation could have begun, as the “lost month.” In addition to the delay in response, there should have been more effective leadership that emphasized the importance of staying home and wearing masks. There are numerous studies that speak to the efficacy of quarantining and staying at home when containing a pandemic. Yet, President Trump and governors not only allowed, but encouraged, premature reopening of states and businesses. Since his motion, the states that have followed through with their reopening plans have experienced exponential growth in cases. The lack of effective leadership to highlight these protocols further exacerbates the situation. President Trump has repeatedly downplayed the dangers of COVID-19, and he himself has rarely been seen wearing a mask since the quarantine orders were given in March. It is no secret that many citizens look to the president and governors as role models, and seeing many of them not follow these guidelines has furthered the false rhetoric that a mask is not needed for individuals who do not have COVID-19. Why Didn’t It Happen? Knowing now what the ideal response could have been, there is an argument to be made that there are cultural and political reasons for why this response could not be handled in the way it should have been. What Taiwan, Singapore, and South Korea did worked for them because they are much smaller in both population and landmass: the United States stands at an area of 3.8 million square miles with around 380 million people, compared to South Korea who has the largest population and land size of the three discussed countries, holds 24 million people in 39,000 square miles. Less people in a smaller area can mean that it is easier to contain these people, and to also provide testing for everyone. As you can imagine, tests for 24 million people would be more than a 10-fold cheaper endeavor than it would be for 380 million people. The biggest argument, however, is the difference of cultures. American culture makes it difficult for effective protocols, namely contact tracing, to be done. America was founded on independence and individualism, which has led to a culture that reflects these values. This is strongly contrasted with the rest of the world, more so in Asian countries, where collectivism is much more prevalent. Why does this matter? Collectivist societies emphasize more altruistic behaviors, like caring for random strangers or people in the community; individualist societies are more particular about caring for individuals that are in immediate circles, like friends and family. Contact tracing requires giving up the human right of privacy, and in collectivist cultures this is more acceptable because giving up one’s individual privacy rights would lead to the wellbeing of society as whole. It is more likely that in individualist societies, this would be seen as a threat

more than a preventive measure that could be effective. The other issue is the politicization of the virus. While governments all over the world have taken advantage of COVID-19 to twist the government in whatever direction they wish to head in, in America the very existence of COVID-19 has become a partisan issue. With a two party system, an upcoming election, and rising social tensions, allegiance to political party has taken precedence over safety, with one party leaning towards a “wearing a mask and social distancing is an infringement of our rights” rhetoric, and the other party holding strongly to the use of masks and social distancing as a way to prevent disease. Based on a Gallup poll done in July, more than 94% of Democrats wore a mask always or very often; this compares to 46% of Republicans and 68% of Independents. This partisanship has furthered the ineffectiveness of proposals, and in conjunction with miscommunication between the federal and state levels, the United States war against COVID-19 is just beginning and the advantage is on the side of the virus. Looking Forward There is much to learn about what a proper COVID-19 response is from other countries like Taiwan, South Korea, and Singapore. While their situations are made slightly easier due to cultural values and population density, it does not give an excuse for the U.S. to have such an abysmal response. The U.S. has one of the highest GDPs in the world, and yet it is not able to offer a stimulus package that is secure enough that individuals feel secure at staying home. While there wasn’t much detail about the shortages in personal protective equipment, like gloves and N-95 masks, these shortages should never have been an issue to begin with. Moving forward, the government needs to pay attention to institutions like the CDC and World Health Organization. A pandemic response should not be politically motivated. It needs to be based on strong scientific principles, and needs all leaders and political parties to come together to reinforce these rules.

Education on the Edge How COVID-19’s latest victim may be education in America by Diana Mercado Photography: Avery Boals Design by Aaron Dykxhoorn

ust like a living system is far from equilibrium, the world also exists in an imbalance. From the difference in charge across a synapse to our economic system, this non-equilibrium allows for a constant flow of energy that sustains life. The imbalance is what, ironically, balances the functionality of each part of the whole and keeps the world in perpetual motion and harmony. However, there is a difference between necessary, functional imbalances, and the unjust ones caused by human nature. The world as of late has not only had its regularly scheduled imbalance, but quite the dose of chaos, fear, and uncertainty as well. A shared experience that virtually all students have undertaken has been the impact of the COVID-19 pandemic on their education. However, although it is a shared experience, not all students have experienced it equally. Education has served to highlight socioeconomic disparity through the transition to and from virtual learning. Students are undoubtedly familiar with various video conferencing platforms such as Zoom, Google Hangouts, Skype for Business, and Microsoft Teams, as well as programs such as Lockdown Browser or Honor Lock that aim protect academic integrity. But how can you use these programs if there is no computer with a camera at home, and you’re not able to afford one, nor a camera for it? How about if your laptop is old and continuously runs into problems, but you can’t afford to fix it or get another one? And what if there is only one computer at home that you share with your family, and suddenly your parents are working from home and your siblings are also doing school online? How can you share this computer since you can’t afford another? Keep in mind, it’s important to sustain what little of a job is left to keep a roof over your head and to attend class because some teachers will fail you if you don’t attend. What if you can’t afford better quality wifi, so you constantly have connectivity issues? To top it off, what if because of COVID unemployment, and you may not be able to continue affording services such as the internet? And yet, students are expected to keep up with their school work in the same manner that they were able to before the pandemic, excluding all the other effects of COVID. These issues afflict a significant number of students across the nation. According to Pew Researchers, 31% of undergraduate students as of the 2015-2016 academic year were in poverty. This means that about 3 in 10 of our peers could be suffering through one or more of these questions. In the broader scope, about 11.9 million children lived in poverty in 2018, which is about 1 in 6 children, making them the poorest age group in America. Moreover, according to childfund. org, “Poverty reduces a child’s readiness for school because it leads to poor physical health and motor skills, diminishes a child’s ability to concentrate and remember information, and reduces attentiveness, curiosity and motivation.” To top it off, “poor children are more likely to have poor academic achievement, drop out of high school and later become unemployed, experience economic hardship and be involved in the criminal justice system.” It’s almost certain that this pandemic further exacerbated all of these inequities, and made education an even more difficult thing to attain for impoverished children.

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These are some of the countless problems that students across the globe have been facing. This leads one to think, “well at this point, it’s better if they go to school in person. That way, none of that will be a problem anymore, and they can keep up with their school work without these worries.” Well, it’s also likely that the school they attend won’t have many resources to ensure their safety as they return. Going to school will put them and their families at risk to contract a potentially deadly disease that they may not have the money to seek medical attention for. How do we know for certain they will be at risk, and how do schools get money? Schools are funded through a mix of local, state, and federal funding. Over half of the local funding comes from our property taxes; the state funds through a foundation grant, guaranteed tax bases, and centralized school finance; and the federal funding and programs account for about 12% of direct funding of primary and secondary schools, ranging from 5% to 16%. Regardless of the variety of sources, the local government is expected to put most of the funding in for schools in the county. Properties in impoverished areas are worth less than those in neighboring, non-impoverished areas. Therefore, the places in which properties are worth less have lower property taxes, which in turn have less money that goes into funding the schools in this area. This means that students in impoverished areas will have less resources to stay safe as they return to school than

those children in other areas. Schools in other states such as Indiana, Louisiana, Oklahoma, Tennessee, and Georgia have had to either temporarily or indefinitely shut down their campuses. They transitioned back to remote learning after reopening in-person this fall, or even after only staff returned to campus before the students. For example, three high schools in the Cherokee Country School District have had to close to in-person learning. This decision was made in light of about 1,921 students and staff being quarantined after coming into contact with a plethora of others on campus who tested positive for COVID-19 between the dates of August 3rd and August 17th. Although families in this district can choose between in-person or online, the overwhelming majority chose in-person learning, and this school district does not require students to wear masks, even though the CDC clearly states that wearing masks are essential in mitigating the spread of the coronavirus. In a similar case occurred at a school in Georgia called North Paulding High School, which reached news after a photo of the crowded hallway filled with mask-less students went viral, and the students that posted it were initially suspended. In light of the photo that spread nationally and the burst in coronavirus cases due to students returning to campus, the Paulding County School District changed its approach to hybrid learning in order to avoid overcrowding. What caused this initial outbreak? Masks were not mandatory, only strongly encouraged, and social distancing was not observed in the classrooms, in the halls, or on buses. So, is there a safe way to reopen schools? Not all schools can afford to place hand sanitizer dispensers everywhere possible, take the temperature of each of their students, pre-packaged boxed lunches, and using acrylic partitions at cafeteria tables like one of Miami-Dade County’s private high schools, Immaculata LaSalle, is doing. Nor can they afford to enforce that all students get tested every two weeks by providing test kits like the University of Miami is doing. A private school can logically afford to make all these purchases, as they have their student’s tuition money to work with. In essence, reopening schools safely is a tedious and costly process, and not all schools have the resources to afford taking all the precautions necessary. The most important aspects of a school’s reopening plan must be enforcing correct usage of face coverings and observing social distancing. This includes covering both one’s nose and mouth, and ensuring a distance of 6 feet between people. These crucial aspects are what was lacking in previous school re-openings, and are vital to Florida’s reopening plans if they want to avoid causing a spike in COVID-19 cases.

Secrets of Serotonin How Bacteria Help Our Brain by Sarthak Chakravarthy Illustration & Design: Megan Buras

ost of you may have heard of serotonin, the “happy chemical.” Even for those who don’t study science, it is common knowledge that any chemicals associated with emotion are found predominantly in the brain. While this is true, current research suggests there is a different system at play: the digestive system. It may be a confusing statement that your intestines play a role in your emotions (besides the immediate satisfaction associated with that first bite out of your favorite food), but studies have shown that natural gut bacteria produce large quantities of serotonin. That is directly related to both the type and quantity of food you consume. Let’s first start with serotonin’s function and production. Serotonin is a neurotransmitter that regulates the signal intensity between neurons, which ultimately leads you to feel excited or happy. Low levels of serotonin essentially mean that your neurons are not firing at a regular pace, which can lead you to feel sad and lethargic. The structure of serotonin is remarkably similar to the amino acid tryptophan, with just an additional -OH group on its side chain. This is why serotonin is often referred to as 5-HT (5 Hydroxy-Tryptophan) in scientific literature. This reaction is a relatively simple two step reaction, which starts by adding this -OH group, then ends with removing the acidic portion of the amino acid tryptophan. Therefore, one way to maintain serotonin levels up would involve ingesting more tryptophan, which can be found naturally in high-protein foods, such as meat, cheese, and nuts. Now let’s discuss serotonin’s connection to the digestive system. Serotonin regulates multiple functions across the entire body, such as causing nausea, blood clotting and maintaining bone health. Studies have shown that gut microbiota play a role in the development of the adult enteric digestive system and communicate with the central nervous system via the vagus nerve. The vagus nerve plays one of the most critical roles in our gut-brain axis, as it regulates heart rate, respiratory rate, blood vessel constriction, as well as reflex actions like coughing, swallowing or vomiting. Unsurprisingly, the vagus nerve also has serotonin receptors, and overproduction of serotonin in the gut can cause the anxiety-like symptoms outlined above, such as heavy breathing and high heart rate combined with the urge to vomit. Thus, there has to be a delicate balance between host diet, microbiome serotonin production, and

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vagus nerve communication to ensure good gut health. In order to properly understand the microbial role in serotonin production and nervous system health, we need to dig into the science a little bit. A study in 2018 claimed that almost 90% of serotonin was produced in the intestines, and that activation of the 5-HT4 receptor in the enteric nervous system played a significant role in the creation, maturation, and protection of neurons in the brain. They tested their claim by comparing germ-free mice, which dont have any bacteria in their gut, to control mice. After a certain time period, they brought bacteria back into these mice to see if they would express behaviors and physiology similar to the control mice after recolonization. The results showed a significant decrease in enteric nervous system innervation, slower digestion, and a smaller glial cell network. After recolonizing bacteria in these mice however, these factors were brought back to the same levels as the control mice. Another experiment showed that brain anatomy in germ free mice was negatively impacted, with structural changes occurring in various areas of the brain such as the hippocampus, amygdala, and prefrontal cortex. These structural changes made the germ free mice have different abilities to react to stress and have depressive and anxiety type symptoms, leading to fewer social behaviors. All this scientific jargon may not seem directly applicable to our daily lives, but we can control a significant portion of our mental and physical health just by controlling our diet. The science shows that short chain fatty acids such as acetate and butyrate can be utilized by both our own cells and bacterial cells for energy or to regulate glucose and fat concentrations. This has big implications for reducing obesity and diabetes in a population that is getting increasingly unhealthier. A diet high in long chain saturated fatty acids along with high levels of protein (a typical western diet) is shown to reduce levels of neurotransmitter producing bacteria in our intestines, creating a chain reaction of negative effects that eventually lead to obesity, diabetes, and anxiety disorders. This can be countered by supplementing with foods rich in soluble and insoluble fibers, along with probiotics, which these bacteria thrive on. Essentially, the key takeaway from the story should be that our diets should not only consist of the burgers and pizzas that we love to eat, but should also be diversified with whole grains, legumes, fruits and vegetables, along with a moderate amount of poultry and seafood, and a decrease in consumption of red meat. Making this adjustment has the potential to increase our physical and mental health, a fact supported both scientifically and anecdotally.

A NEW PERMANENT EXHIBITION Groundbreaking research. Innovative discoveries. Revolutionary solutions. Explore the fascinating and fierce frontiers of science. frostscience.org/powerofscience

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1101 Biscayne Blvd, Miami, FL 33132 | 305-434-9600 -

Study #: 20180908

Effective Date: 10/14/2020

Are you healthy and interested in research? Volunteers needed for clinical research studies WHO: Healthy adults 50 years and older. WHY: To discover biomarkers of amyotrophic lateral sclerosis (ALS) and related diseases that could contribute to the development of effective treatments for these devastating disorders.

INVOLVEMENT: Study procedures will vary depending on your interest and willingness, but may include completion of questionnaires and neurological examination; tests of breathing muscle strength, fine motor function and cognitive function; collection of blood, urine, and spinal fluid (optional); and an MRI scan (optional). The number and types of procedures you complete vary by study.

TIME COMMITMENT: Between 1-5 study visits, depending on the study. Each study visit may last up to 4 hours. COMPENSATION: Available for some studies. WHERE: At the University of Miami/Jackson Medical Campus. Some study visits may be completed remotely. Contact us for more information or to find a study that works for you Phone: (888) 413-9315 Email: ALSresearch@miami.edu

by Christian Rivera, Pavan Gudoor, and Clara Lavrador Illustration: Megan Buras

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“

Elon Musk and Neuralink

UNION OF MAN &MACHINE

Design: Meera Patel

his is going to sound pretty weird,” Elon Musk starts at his launch for his new company, “but [we want] to achieve a sort of symbiosis with artificial intelligence.” Though Musk is right to say it may sound “pretty weird,” it doesn’t mean we are far from achieving it. Just in this generation, we have had an exponential rise in the understanding and making of technology, and soon we will be able to link this technology to our brains. Imagine if Alzheimer’s could be cured with a tiny chip, or if you could telepathically communicate with your friends. If Neuralink is successful, it will completely revolutionize not only technology, but also society and the way we interact with each other. On August 28, 2020, Elon Musk and the 100-member Neuralink team held a product demo conference detailing the most recent updates on their progress. There is a ton of new information to unbox, from neurological implications to machinery design and surgical procedures, but before we even get there, we need to know the history behind brain-machine interfaces (BMIs). The term “brain-machine interface” wasn’t coined until 1973 in a paper written by Belgian researcher Jacques Vidal from UCLA. However, the concept dates back to the 1920s. German scientist Hans Berger demonstrated the human brain’s capacity to produce electric currents, and that such currents can be measured using electrodes placed along the scalp of the subject, known as electroencephalography (EEG). In addition to EEG, researchers during the early part of the 20th century have discovered that electrodes can actually be used to stimulate neurons to create muscular movement. Known as electrical brain stimulation, or EBS, this research expanded on the interplay between brain and machine, which skyrocketed intrigue amongst scientists, especially in the latter half of the century. In 1988, scientists Farwell and Donchin released a paper detailing the “P300-speller,” which is a machine that can spell out words on a computer screen based on brain signals from the user. Whilst initially tested on healthy individ uals, it was found to be fruitful for users with paralysis or motor impairments. During that same decade, the FDA approved cochlear implants, which provided a sense of hearing to individuals exhibiting moderate to severe levels of deafness. Ever since, BMIs have proven to help people with all types of motor dysfunctionalities, including the late theoretical physicist Stephen Hawking who suffered from an early-onset motor

“Imagine if Alzheimer’s could be cured with a tiny chip...”

“...a greater range of conditions can be treated that include but are not limited to paralysis, depression, and blindness...” neurodegenerative condition known as Lou Gehrig’s disease. Hawking used a speech synthesizer that, as implied by the name, enabled him to convey his thoughts into speech, initially by the movement of his hand, but later on (due to his progressing illness), by the twitch of his cheek. And it was through this interface that Hawking was able to write entire books and hold national conventions that propelled the field of theoretical physics. So how do Neuralink and Elon Musk fit into the future of BMIs? Well, the devices that were previously mentioned, such as the cochlear device or the speech generator, use only a relatively small number of electrodes to record brain activity. The technology currently being developed by Neuralink uses over 1000 microelectrodes (each being 1/10 the size of a strand of hair) woven in flexible polymer threads to achieve greater broadband capabilities than BMI precursors. Therefore, by expanding the ability to record brain activity from larger groups of neurons, a greater range of conditions can be treated that include but are not limited to paralysis, depression, and blindness. Much like any other BMI, a device, consisting of multiple electrodes to record brain signals, is implanted into the patient. This implant procedure, however, requires a greater level of precision, which can only be achieved by using a neurosurgical robot to insert the microscopic electrodes and avoid any damage to brain vasculature. After the electrodes are inserted, a pennysized microchip, called the “Link,” is placed inside. This microchip is equipped with sensors that can detect changes in temperature, pressure, and chemical imbalances. The Link is able to process these megabit data packets and convert them into electrical signals that can stimulate nearby target neurons. According to Elon Musk, the surgery should take less than an hour and is minimally invasive, much like a LASIK surgery. The microchip is inductively chargeable (meaning no wires involved) and it has a 24-hour battery life. One of the goals, as stated by Musk, is for the microchip to be a seemingless addition to the goings of daily life, so any given individual can have multiple microchips on at once and others wouldn’t know. And more importantly, whether the microchip is activated or not, the individual will always be capable of living a full and happy life. With Neuralink, we are all living witnesses to what may be marked as the age that man began to keep up with machines. Integrating Neuralink’s BMI with our brain could unlock “secrets” that will revolutionize the way we live, beginning with our mortality.

The technology is being designed to record and hopefully stimulate brain activity, and such data greatly excites neuroscientists. With it, we may gain insight into the neural workings of patients, and create treatments that soar over hurdles in the field. We may experience unprecedented levels of personalization in treatments, maximizing the success rate of recovery. Although this possibility is debated among experts, we may even learn to restore broken connections in the brain. Mere access to the motor cortex means we could restore full movement after spinal injuries and allow bionic limbs to simulate touch. Expand this to the entire brain, and curing blindness becomes the tip of the iceberg. Down the line, what potential does Neuralink hold outside the realm of medicine? The possibilities are bounded by the limits of our imagination. Picture playing in a fully immersed video game or being a character in your favorite movie. Imagine being capable of telepathy and unlocking full consciousness in the dream state. A next generation of art may even be conjuring images in our brain and downloading it to a device. With technologies like Neuralink, we would no longer be defined by the speed of our hands, but rather by the speed of our thought. This likely will not be observed within our lifetimes, but no one can deny that these hypotheticals may become mankind’s new normal. The ethical concerns introduced by Neuralink and the future of BMIs are as vast as the possibilities they point to. At the most fundamental level is the dilemma that our brains are delicate pieces of engineering, and that we can’t undervalue the risks of tampering with it. More complexly, it may sacrifice a lot of the accountability necessary for order in society. It may develop to the point that these chips can influence our thinking. When a person with a neural lace commits a crime, to what degree do we blame man, and what degree do we blame the machine? And most philosophically, do we give up our humanity by using BMIs? What if there came a day in which a chip could replace our entire brain? But regardless of these concerns, as legitimate as they may be, Neuralink is at the frontier of discovery on one of the most perplexing scientific mysteries to this date. Scientists still have yet to decipher a wealth of unknown, untapped information about the brain, but perhaps, the work that is being done by Neuralink could be the bridge that we need to reach the next technological stage of our society. It will be interesting to see how this will play out throughout the first half of the 21st century.

ManXMachine 39

Vaccine Wars

Months keep passing as the public waits for word of an FDA-approved COVID-19 vaccine. It’s undeniable that the science is hard and the process is laborious. All good things are worth the wait—but how long will that be, exactly? by Kyle Banker

Illustration: Setareh Gooshvar

e are in the eighth month of quarantine in the United States, and everyone is aching for a vaccine. When is it going to be finished? What company is frontrunning the vaccine race? Will it be completely effective? While there is a great deal of uncertainty in this dilemma, there are currently three leading companies: Moderna, AstraZeneca, and Pfizer, each competing to deliver a version of the COVID-19 vaccine. With their promising studies, many feel confident about these pharmaceutical companies as they have been working relentlessly through the vaccine production and FDA approval stages. Yet, what does their progression mean in terms of when the vaccine will be released to the general public? Let’s break down the timeline of these three companies’ work to find out. All three frontrunners are in the third phase of FDA Clinical Testing, also known as the “last” set of clinical trials. These trials confirm whether the given vaccine is truly safe and effective enough to be released to the general public. Although these companies have made it to the final phase, it is imperative to note that this phase typically takes 1 to 4 years and involves testing 300 to 3,000 patients to determine the vaccine’s long-term effects. The urgency of COVID-19 will set a faster tempo with a goal to spend as little time testing as many people as they can. That is the ultimate goal, but testing usually doesn’t work that perfectly, so hopefully Moderna, AstraZeneca, and Pfizer can surpass these setbacks that could further extend the timeline for a widely accessible coronavirus vaccine. Moderna Moderna is a biotechnology company founded in 2010 in Cambridge, Massachusetts that focuses on drug discovery and development and vaccine technologies for messenger RNA. As of October 22nd, Moderna has reached their 30,000-person enrollment goal for their clinical trial to assess the effects of their COVID-19

40 | Research

Design: Anuj Shah

vaccine. A volunteer receives progressive injections of the coronavirus vaccine. Upon signing up and receiving their first injection, they must wait 28 days before receiving the second injection. Essentially, this means that the first batch of study subjects will be tested over the next two months, and then more people will be tested two months later, and so on. Even though Moderna has reached their target patient goal, they have yet to give all participants the second vaccine dose. Moderna CEO Stéphane Bance has recently said that they will be filing for an EUA in late-November, and their 25,654th participant received their second dosage of the vaccine as of October 28th. From this, we can see that Moderna has had a strong start to their testing, but they require a similar finish in order to make it through the EUA process. AstraZeneca AstraZeneca is a British-Swedish pharmaceutical company based in Cambridge, England that focuses on therapeutic areas in oncology, cardiovascular, renal, metabolism, respiratory and immunology, and other disease areas. Like Moderna, AstraZeneca is also targeting around 30,000 participants for the third phase of the FDA Clinical Trials. Among participants, they are hoping to test those who are healthy as well as others at a higher risk of being infected by the coronavirus. Each

participant will receive two doses of the vaccine four weeks apart from one another. Overall, this trial is assessing the effectiveness and safety of the vaccine in all participants, no matter their previous or current health conditions. However, AstraZeneca is putting the interest of society first, as clearly stated by CEO Pascal Soriot. Consequently, the company decided on September 8th to delay the phase three clinical trials for their COVID-19 vaccine due to a patient suffering from transverse myelitis: the inflammation of the spinal cord that is triggered by infections. It is thus clear that AstraZeneca wants to be as careful and thorough as possible. Since then, AstraZeneca has restarted their trial as of October, and although this complication affected the timeline of their vaccine release, the company continues to push clinical testing in countries such as Japan, the United Kingdom, and Canada. This cautious approach ensures that their COVID-19 vaccine will be further developed than most, especially with their worldwide testing locations. Pfizer Pfizer is an American pharmaceutical company founded in New York City that focuses on producing products for internal medicine, inflammation and immunology, rare diseases, oncology, and vaccines. Throughout this vaccine race, Pfizer has teamed up with partner BioNTech to help develop the vaccine as soon as possible. As of now, Pfizer has not conducted sufficient testing yet to judge whether their vaccine is trending in the right direction. However, according to their CEO, Albert Bourla, the company is expected to release pivotal coronavirus vaccine data in October or November after sharing early positive

data in late August; this will give the public a better idea of how the company’s vaccine affects its participants. While they are already nearing 42,000 participants enrolled for the study, Pfizer is not quite ready to release information yet. From this, it’s clear that Pfizer remains one of the quieter competitors in terms of releasing clinical trial data, but that is not necessarily a bad thing. In fact, Pfizer CEO Albert Bourla told his employees that they will be moving at “the speed of science” and they will not be impacted by political or social pulls. From this patient approach, we can all hope that it will produce excellent and optimistic results, as their prominent pipeline and published products make Pfizer a trusted source. Will The Vaccine Be 100% Effective? The common misconception about the coronavirus vaccine is that once it is approved and released, it will work for everyone with only one injection. Unfortunately, there has been little evidence of a vaccine perfectly preventing a viral infection. The executive Director of WHO’s Health Emergencies, Dr. Michael Ryan, has even said that “vaccines are never 100% effective.” This is primarily because every human body does not respond the same to a vaccine, so for the shortterm, masks have been the “most important powerful health tool we have” according to CDC director Dr. Robert Redfield. The most common example of this is the influenza vaccine, with an effectiveness at around 40-60%. The annual influenza vaccine that people receive actually targets the viral strain of the year before, yet the inserted antibodies from the shot may still be able to protect certain people from the flu. Now, compare that to coronavirus, which still has many questions yet to be answered. Furthermore, scientists aren’t even sure that antibodies provide “immunity” or protection towards a second coronavirus infection. Overall, while this vaccine isn’t going to be perfect, frontrunning companies are striving to make sure that they will be as effective as possible. When Is The Vaccine Expected To Be Released? Here is the big question that everyone wants the answer to, but no one has the answer. The media has consistently said that they expect a coronavirus vaccine to be available later this year or in early 2021. The optimism behind this claim is that everyone around the globe is focusing on finding and creating this prevention tool, and since there is such an enormous amount of time dedicated to the vaccine, many think it should be completed soon. But, there are so many blockades that come with testing vaccines through the FDA. Even though the vaccine is desperately needed, the FDA will not approve a drug until they are entirely sure that it is safe, efficient, and effective. Many do not expect the FDA to be lenient because of the situation we are in, but since Moderna, AstraZeneca, and Pfizer began the process very early on, it gives us many reasons to hope and dream for a solution to COVID-19.

Regardless of the shifting timeline for a vaccine, many public health experts, including CDC Director Dr. Robert Redfield, continue to cite cloth face coverings as “one of the most powerful weapons we have to slow and stop the spread of the virus.”

The Life of by Setareh Gooshvar

Exploratory Stage Academic and governmental scientists find natural or synthetic antigens that have the potential to prevent or treat a disease.

Pre-Clinical Stage Using culturing systems the candidate vaccine is tested for safety and immunogenicity (ability to provoke an immune response). This stage also gives researchers an idea of possible human cellular responses.

Investigational New Drug Application The application describes manufacturing and testing processes, lab reports, and the proposed study. IRB has to approve the clinical protocol and the FDA has 30 days to approve the application to continue onto the clinical development phase.

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f a Vaccine 4

Clinical Development Phase 1: Goal: assess vaccine safety and determine type and extent of the immune response - Small group of adults receive trial vaccine. Phase 2: Goal: Study vaccineâ&#x20AC;&#x2122;s safety, immunogenicity, proposed doses, schedule of immunizations, and method of delivery - Population expanded; vaccine given to people with the characteristics of the target population. Phase 3: Goal: assess vaccine safety in a large group of people; can discover rare side effects in these studies due to large test population. - Vaccine given to thousands; tested for efficacy and safety. - Vaccine efficacy also examined: Does the vaccine prevent disease? Does it prevent infection with the pathogen? Does it lead to production of antibodies or other types of immune responses related to the pathogen? Phase 4: Formal, ongoing studies even after vaccine approval. Continues to test the vaccine for safety, efficacy, and other potential uses.

Regulatory Review Vaccine developer submits Biologics License Application to the FDA. Additionally, the FDA will inspect the factory and approve vaccine labeling. 43

M US I C d u ring

by Nikhil Rajulapati and Christian Rivera Photography: Raghuram Reddy Illustration & Design: Varsha Udayakumar

here seems to be a historical relationship between times of crisis and surges of creativity. This can be explained on a sociological level: crises such as pandemics are urgent deconstructions of societal norms and expectations. Since preconceived notions are challenged during a crisis, they spur unorthodox ways of thinking that roam outside the boundaries of the previous societal framework. In essence, novel problems call upon novel solutions. What does this have to do with music? Well, it comes as no surprise that times of crisis have coincided with upheavals of musical output. When we look at the data reflecting the COVID-19 pandemic, it is revealed that web searches for instruments such as the ukulele have risen by 99% on Reverb.com. Orders for audio equipment, like microphones and speakers, increased by more than 300% on the same website. Additionally, several unknown artists have “blown up” on social media platforms, namely TikTok and SoundCloud, by posting new music that they have created using their own house equipment. Even famous artists like Taylor Swift and Childish Gambino have released new music out of the blue. Taylor Swift, on the topic of her most recent album Folklore, stated on Twitter that “in isolation [her] imagination has run wild and this album is the result. [She has] told these stories to the best of [her] ability with all the love, wonder, and whimsy they deserve. Now it’s up to you to pass them down.” This pandemic has certainly demonstrated that there is no limit to the eccentricity of the mind. In a joint effort between scientists and musicians, the chemical structure of the coronavirus has been rendered into a near 2-hour long ambient musical piece, featuring floating xylophone hits, soft string plucks, and singing flutes, each representative of the different amino acid components that constitute the virus’s spike proteins. Some researchers have speculated that this sonified version of the virus actually makes it easier for scientists to study it. The melodic sequences that correspond to binding areas within the spike protein can be cross-analyzed with the currently available sound library data that correspond to drugs and tribes before hunting, the caves were used to promote the success and cohesion of communities. While genres and instruments have evolved and morphed over time, their role hasn’t. As we are in the

44 | Research

a pa n d e M i c midst of a worldwide pandemic, music has served the same function. Whether we are watching live streams of our favorite artists perform, or are practicing at home ourselves, music is supporting communities around the world by prioritizing unity. Clearly music’s societal impacts are visible, but on a molecular level, how does music influence our minds? According to Jessica Pouranfar, a music therapist at the Northwestern Medicine Central DuPage Hospital, listening to songs that we enjoy stimulate the release of dopamine and serotonin. Dopamine is used to produce epinephrine and norepinephrine to perpetuate our body’s reward system, whereas serotonin is used to control our sleep cycles and feelings of relaxation. Furthermore, people who sing or play music can produce oxytocin, alleviating stress and anxiety. Studies have also shown that individuals who have been exposed to pleasant music during cardiac surgery experienced reduced tachycardia (rapid heart beating) and hypertensive stress due to elevated oxytocin levels. In regards to the brain, studies have shown that listening to classical music can temporarily increase spatial reasoning skills, a phenomenon known as the “Mozart Effect.” While the effect is not permanent, practicing music can create long lasting changes. People who practice music often exhibit reduced brain aging, improved motor skills, and even create stronger neural connections between the two hemispheres of their brain. Such biological changes have fueled music’s role in society, because not only does it make us feel good, it also changes us for the better. The coronavirus pandemic has put music in the spotlight, providing people an outlet to their own

creativity. Because music has helped us navigate these circumstances, we must ask whether music will ever be the same. In the age of streaming songs and downloading albums, artists struggle to make money solely via releasing music—they must either sell merchandise or go on tours to sustainably profit from their music. Given the current circumstances, this has become difficult. The music concert industry is projected to lose approximately $9 billion this year because artists cannot perform. Large scale concerts such as Coachella and Ultra were cancelled in hopes that the situation would alleviate eventually, however there is currently no end in sight. We are now forced to watch our favorites celebrities perform inside their houses indefinitely. Furthermore, reports have shown that playing brass instruments as well as singing in a choir can further spread COVID-19. More than a hundred members of a choir in Amsterdam all tested positive because projected singing can release particles of the virus into the atmosphere. While the future of music is unknown, we can still look back on all the benefits music holds. Whether looking at the beginning of mankind or this past month, we can see music has shaped our very way of life. From the molecules in our brain to crafting the culture of entire civilizations, music has influenced countless nuances of the life we live today. COVID-19 may continue to have no end in sight, but we’ll always have music to navigate these turbulent times.

Canes fighting Covid Pro f i les o n t h e u n iv e rs ity o f m iam iâ&#x20AC;&#x2122;s students and faculty fighting Covid-19 Photography: Dhara Patel Design: Aaron Dykxhoorn

Arti c les :

Synthesizing the Future of Public Health 3D Printing Innovations in Protective Gear

p. 47

Making Isolation a Little More Social The senior buddy program

p. 48

Neighbors Helping Neighbors How the Buddy System is Targeting Food Insecurity in Miami

p. 50

The Psychological Effects of COVID-19 UM Researchersâ&#x20AC;&#x2122; Mission to Assess the Risk and Resiliency of Communities Affected by the Pandemic

46 | Profiles

p.51

Synthesizing the Future of Public Health 3D Printing Innovations in Protective Gear by Lily Schmutter

longside his two brothers, Marc Levine launched local nonprofit Miami Strong Masks. Its mission is to provide protective face masks to the homeless population near his Brickell apartment. Marc, a recent graduate of the University of Miami and now attending Penn State College of Medicine, saw a striking need amongst those in his community for greater access to masks. With a 3D printer already in their possession for recreational use, Marc and one of his brothers, Lance Levine, commenced research on how to print masks after noticing an abundant homeless population barred from public spaces due to Miami-Dade County’s mask mandate. This project certainly took time and lots of resources to reach a smooth production process. “There are a lot of intricacies with 3D printing, a lot of trial and error,” Marc said. In fact, it took nearly eight hours to print one mask in the early stages of the project. To secure resources, the team turned to GoFundMe to fund necessary materials for production: plastic, vacuum air filters, and rubber trims. These trims allowed for a greater seal on the user as well as a more comfortable positioning from the stretching elastic bands. In terms of the masks’ efficacy, it should be noted that the vacuum filters used on these masks are comparable to N-95. Impressively, Lance has taken

our process was the amount of printers that we had, because it takes so long to print one,” Marc explained. With their sufficient sponsorship, the brothers were able to purchase four additional 3D printers and scale-up production to 80 to 140 masks per week. With their inventory sizing up, the Levines intended on getting their community involved in their efforts as well. “We wanted people to come with us, we wanted to make it a public initiative,” he said. Marc and Lance’s brother, Mitchell, amongst others, spent their weekends distributing masks around Brickell. To date, the initiative has distributed nearly 700 masks to the community. After revisiting the same areas of homelessness to provide updated versions of their masks, the brothers were elated to see that the individuals had still kept their original ones weeks later. In addition to mask distribution, the team takes time to educate the homeless on safe practices during COVID-19 and spread awareness of free health resources in the Miami area. Now that Marc is apart from his brothers during his first year of medical school, he reflects on the bonding experience this project afforded them. “Prior to the pandemic, I’d only see Mitchell once a month, but once COVID-19 hit he would come from Fort Lauderdale every weekend to distribute.” Marc currently has one of the printers in his possession in Pennsylvania and hopes to get a similar project off the ground in collaboration with the resources on his campus. The brothers continue to seek community support and look forward to reuniting in December to distribute their masks all together again.

Marc Levine

B further efforts to test the efficacy of the masks through research at the UM Miller School of Medicine. As the nonprofit continued to receive support, Marc and his brothers decided to expand their target population to the valiant healthcare workers on the frontlines at the University of Miami Gordon Center for Research in Medical Education. Many of these individuals had to re-wear masks for an extended amount of time due to limited resources. Directors of the center were so impressed by the initiative that they graciously donated to the cause and provided them with an award for their service. “We figured the rate-limiting step of

eginning 3D printing at the age of 14, Ronen Pink quickly transformed a hobby into a public service in the wake of COVID-19. A senior from Minneapolis studying Business Management and Business Technology, Pink has always had a passion for community involvement, an important part of his family values. Among other involvements, he is the co-President of Hillel, a member of SAFAC, a Resident Assistant at Stanford Residential College, and the captain of the Ultimate Frisbee team on campus. When the pandemic hit, Pink came across an article highlighting a large-scale initiative amongst 3D printer owners to produce protective face shields, and realized he wanted to be a part of that community. After some research, he developed a design in accordance with the National Institutes of Health’s guidelines and specifications and began printing. At the outset, a single shield took four hours to print. With resources being few and far between, Pink reached out to different outlets in his hometown via Facebook and through his high school to obtain greater access to 3D printers in the area.

Making Isolation a Little More Social The senior buddy program

Ronen Pink Ronen certainly had to tap into his resourceful nature in obtaining all the necessary materials to produce the protective shields, since “there were a lot of people around the country doing the same thing that I was.” Fortunately, he received a donation of industrial elastic string rolls, a needed component to construct the back of his face shields, from a family-friend who owns a large-scale fabric store. He also reached out to his local Office Depot to receive a contribution of binder covers to use as the clear plastic protection for the shield. To obtain the plastic filament needed for the 3D printing mechanism, he connected with his high school to acquire a donation of spools which each produced about 15 face shields. “There was a push to see who I know in these different areas, who had the ability to help me, and I’m very fortunate to get in contact with the right people who saw the importance of what I was doing,” said Pink. His primary location of distribution was a nursing home in his

By Sami Tano

s the words “stay at home” and “isolation” swept across the United States in March of 2020, people started preparing. Students came home from college and adapted to taking classes online, parents began working from home while simultaneously starting to homeschool, and the general public started buying way too much toilet paper. When the chaos settled and quarantine life became the “new normal,” families found ways to keep each other entertained. Whether it was bringing out the dusty board games once shoved to the back of the closet or huddling on the couch to watch a popular Netflix series, many families tried to embrace and cherish this extra time they now

Aileen Cruz-Lezama

community with a desperate need for protective shields. Ronen then expanded his efforts to the healthcare workers at the University of Minnesota, who he valued for their diligent work on the front lines. Through his efforts, Pink distributed upwards of 250 protective face shields across the nursing home and the University of Minnesota communities. Pink believes that “there are always new needs that have to be met. Being constantly aware of these needs and of the fact that they come up is essential… whether or not you’re making an impact on the actual fight against COVID-19, there’s quite a bit that can be done to help those dealing with it.”

48 | Profiles

had with one another. While the message of positivity and comfort made most families feel warm and content while isolating at home, the situation is very different for the elderly population living in senior living facilities. According to the National Center for Assisted Living, about 800,000 Americans currently live in assisted care facilities. On average, more than half of these residents are 85 years and older. Due to their vulnerable status during the COVID-19 pandemic, this population has been faced with an abrupt halting of much of their social interactions and visitation rights. With 8 out of 10 COVID-19 deaths in the United States occurring in the 65 years and older population, these living facilities took necessary and quick precautions to protect their residents. However, as community activities were canceled, communal areas were blocked off, and residents were constrained to eat in their rooms, with many left bored and secluded. While the distance and immediate precautions in these facilities were thought to be effective preventative measures against the transmission of COVID-19, the

emotional toll of this isolation on the senior residents was an aspect entirely overlooked. Before the pandemic, the National Institute on Aging reported that approximately 25% of Americans aged 65 years and older felt lonely. This statistic doubles when considering older citizens living in care facilities. Most individuals rely and thrive on human interactions as well as meaningful connections because these provide people a sense of purpose, self-determination, and a connection to society. Many reports indicate that the lack of these interactions for senior citizens have been linked to many health-related problems including high blood pressure, anxiety, depression, and obesity. While keeping senior residents confined to their room protects against COVID-19 transmission, it also negatively affects other aspects of their health and wellness. A balance must be struck between upholding proper social distancing measures and taking care of residents’ social needs. Hearing about these residents’ needs for social interaction, a non-profit organization called StudentsCare immediately took action. Although

Lauryn Lima founded in 2013 by CEO Erika Sokol Carroll as an organization to pair college students with hospitalized children, the team at StudentsCare Nationals were eager to expand their program to include isolated seniors. College students would be paired with a senior resident and call/video chat with them on a weekly basis. While unable to visit these seniors in person, the leaders at StudentsCare hoped these conversations would not only provide support but a positive escape. Aileen Cruz-Lezama, a senior at the University of Miami majoring in Microbiology and Immunology on the pre-dental track, heard about the work StudentsCare was performing through a friend and immediately decided to join. Having a grandmother living in a nursing home during this time, Aileen immediately felt a connection to the senior residents and understood the importance of this volunteer work. Although she describes being “a little nervous” for her first phone conversation with her buddy, Aileen was pleased that her senior resident was extremely open and eager to talk to her. She describes her buddy as someone who is “very easy to connect to as she is extremely talkative, outgoing, and always willing to both share and listen.” Aileen went on to describe her favorite conversation with her buddy in which they talked for over two hours about various current events. She states how amazing it was to “hear her advice and perspective on everything.” When talking to Aileen her buddy

Lis Liano stated that “even though I may not know you fully, I have enjoyed our conversations because I can tell that you are wise for your age and truly sincere… Many people in this world have bad intentions and pretend to be someone they are not, but through our conversations, I know that you have good intentions and a sincere heart and I’m grateful I’ve been able to learn more about you.” When talking about this program as a whole, Aileen stated “You grow a connection and a bond… it’s amazing to see how much you are able to learn from them and vice versa.” Around the same time Aileen decided to join StudentsCare’s Senior buddy program, Lauryn Lima, a biomedical engineering major on the pre-med track, was also paired with her buddy. Instantly connecting with him, Lauryn was able to teach him how to use Facetime and Zoom so they could see each other’s faces. With a big smile on his face, Lauryn’s buddy says that “there is always something interesting for me that I can tell her or maybe for her too” and that “she’s real, real nice.” He goes on to say that Lauryn “has a way of motivating you and teaching you stuff.” Lauryn notes how strong of a bond they have formed and how eager she is to talk to him each week. Their connection is so strong he even called her out of their scheduled time after hearing a rise in COVID-19 cases at UM. He wanted to make sure she was staying safe. This quick gesture brought tears to Lauryn’s eyes realizing how special and important the bond they formed had become. As a StudentsCare Nationals intern and volunteer at a senior living facility, UM undergraduate Lis Liano understood first-hand the importance and benefits the Senior Buddy Program offered. Paired with a senior buddy who had moved to a senior living facility before the pandemic and had also unfortunately lost her husband, Lis could see that she was left isolated with no distractions as she was trying to heal. From their first phone call to their most recent, Lis has been able to see how her buddy’s overall mood and spirit has changed for the better. Her buddy often tells her that Lis is her first friend since moving and is grateful to have someone to talk and laugh with. While the COVID-19 pandemic has created unimaginable hardships and left people feeling alone and isolated, especially elder populations in assisted care facilities, it is organizations like StudentsCare who are using their platform to connect people and provide compassionate support. Volunteers with StudentsCare have been able to form lasting bonds with their residents that show how a kind and genuine gesture can make a lasting impact.

Neighbors Helping Neighbors How the Buddy System is Targeting Food Insecurity in Miami by Anam Ahmed

ack in March at the outset of Miami Dade’s stay-at-home orders, Kristin Guerin, Jessica Gutierrez, and Eric Trope started a food assistance volunteer program to help the Miami community. In only 6 months, this idea developed into a nonprofit known as Buddy System MIA, which now reaches over 1000 people with the support of over 750 volunteers. Now president of the organization, Kristin speaks of her motivation starting out as a simple thought toward others’ situations: at-risk populations lacked the access to basic resources, especially food, and she wanted to “give the community an opportunity to

Now, the organization is exploring different sustainable solutions to link the hungry with food. Inspired by the pop-up fridges in NYC, they launched a community fridge initiative. At these locations, people are free to take what they need and donate what they do not. Pictured is their second, recently opened, fridge at Ms Williams Groceries in Richmond Heights. They hope to have 20 fridges across the county by the end of the year. This initiative for long-term assistance also follows their central theme of the community helping itself. Kristin reflected that as the organization began to reach more people, they realized there were additional ways to help people; their plan, dubbed “Buddy System 2.0,” focuses on immigration, legal aid, mental health support, and as a liaison to other nonprofit services. Buddy System MIA stays true to its name as its members forge connections within communities for mutual aid. Buddy System is happy and grateful to have more volunteers; find out how you can join on their website https://www.buddysystemmia. com/ and stay updated on their community impact through their Instagram, @buddysystemmia.

The Psychological Effects of COVID-19 UM Researchers’ Mission to Assess the Risk and Resiliency of Communities Affected by the Pandemic

support itself.” This turned into a major component of Buddy System’s mission: “Neighbors helping neighbors.” Although food distributions have drive-thru options, many people don’t have a safe method of transportation to the sites. Buddy System solves this issue by pairing community members in need with volunteers who were readily available to deliver groceries and necessities. The widespread consequences of the pandemic exacerbate existing issues, such as food insecurity. The most recent data from the Household Pulse Survey by the Census Bureau notes that the MiamiFort Lauderdale metropolitan area has the fourth highest percentage of food scarcity in the week of July 16th (13.2%). Prior to the beginning of March, 8.2% of people in the area reported that there was either “sometimes or often not enough” food to eat in the last seven days. Throughout the pandemic, increased food insecurity trends align with weeks that COVID-19 cases increased. Unfortunately, when the pandemic “ends,” its residual effects will continue to worsen underlying socioeconomic issues. Buddy System has branched out far beyond their initial goals.

50 | Profiles

By Isabella Lopez

s we all know, the COVID-19 pandemic has had profound implications within public health sectors, economies, governments, and international relations as the struggle to obtain the vaccine continues on. Yet, one area that is not is not being as heavily addressed nor prioritized may be the mental health effects this pandemic has placed on underserved populations and communities at large. Two psychiatrists at the University of Miami’s Miller School of Medicine Clinical Pediatrics Department are working to learn about this issue and they have been highlighted as one of 20 projects that have been fast-tracked to alleviate the effects of COVID-19. Dr. Ruby Natale, an Assistant Professor of Clinical Pediatrics, and Dr. Bridget Davidson, a former Assistant Professor of Clinical Pediatrics at the Miller School of Medicine recently submitted a research paper for publication titled ‘The Risk and Resilience of Wellbeing in Parents of Young Children in Response to the COVID-19 Pandemic,” where they tackle head-on how the consequences of the

pandemic on the psychosocial wellbeing of diverse family units and neighborhoods across the U.S. Of key importance, they highlight how “the dynamics of pandemic stress, caregiver mental health, and child behavioral functioning” are interrelated and may be influenced by societal factors. For this study, pandemic stress is defined as the state of being overwhelmed and distressed by lockdown and closures of businesses, schools, and other facilities, as well as uncertainty for the future and concerns for safety. The inspiration for this project came from Dr. Natale’s on-going work in Jump Start, a project funded by the Children’s Trust of Miami Dade County to serve childcare centers throughout the county. Their main focus is to support teachers and childcare center directors in improving the behavior management of children by offering mental health consultations to address challenging behaviors from young children. As childcare centers were being closed and becoming less accessible, it became more apparent that there was a major need for there to be a toolkit or resource hub for parents and educators to evaluate behaviors and track mental health concerns. Especially when the pandemic hit, while it became obvious to everyone that there was pressure and stress placed on neighborhoods and families, it became necessary to obtain data on the causes of stress to advocate more for the needs of caregivers and to help them provide better guidance and safe keeping. Although both psychologists had ideas about what community needs were already established, Dr. Davidson points out that it became important to find out which ones were specific priorities for childcare providers of young children, including those with developmental disabilities or disorders. To accomplish this, they together developed an online survey for all members of a family to attain more information about their necessities in order to tailor the development of an online resource platform. This survey was developed in three languages: English, Spanish, and Creole. It was also administered at three different time points, first being mid-April to late-May (beginning of COVID-19 lockdown/shutdown), second at the end of June, and then finally at the end of July to analyze changes occurring. They examined how various factors such as housing, transportation, finances (especially for basic necessities), employment, and food insecurity were influencing mental wellbeing and fitness of

Dr. Bridget Davidson

Dr. Ruby Natale parents and guardians, childcare providers, and youths needing care, as well as how this may influence to what extent their needs are met. Moreover, this was a way of assessing these disruptions to daily life both on general scale and in particular context since the pandemic happened. Coping strategies for families to deal with pandemic stress were another significant aspect of their project. Mainly, they focused on their “self-efficacy,” how confident they felt with managing family needs during times of hardship, and mental health symptoms, such as anxiety, depression, and sleep disorders. The first survey that was sent out was completed by 298 individuals and yielded results that were expected: the higher the pandemic stress, the lower the parental care confidence level and the worse the mental health symptoms documented. Yet, what was surprising about these results were that these negative effects were present in the majority of families surveyed. This survey was also distributed to a wide, varying portion of the South Florida community. This was further confirmed when evaluating the zip codes of the individuals who filled the survey out, showcasing that there was a wide distribution among the zip codes. Of great importance, unlike the surveys that were being posted out nationally, theirs was linguistically diverse, ethnically diverse, and socioeconomically diverse. The research team worked to make this survey precise, methodological, and focused on different aspects. To ensure that the questions were specific to detect complications and address them, they also partnered with several programs of the Mailman Center, such as Early Discovery that works with parents of children with disabilities and HealthySteps that aims to provide comprehensive care for children from birth to age three and family. The last question of the survey they sent out asked the responder what they would need at that moment and provided them a list of options with services directly provided by the Mailman Center to combat their problems, including tool-kit and intensive care services like therapy and support groups. In this triage system, Dr. Natale mentions they were able to individually contact and follow-up with the responders directly and link them to the resources that they would need, including but not limited to food distribution sites and programs for financial support or relief. While there is still a lot of data that is still being analyzed, so far this project is getting closer to achieving its ultimate goal, to build resiliency and buffer the negative outcomes of the COVID-19 pandemic. Both Dr. Natale and Dr. Davidson agree that being able to focus on the positive aspects and strengths of different parts of the South Florida community has been great for helping families to assess their own favorable attributes for combating the challenges that come with the pandemic as well as to deal with the issues that come with barriers and division among individuals of different races, ethnicities, socioeconomic classes, and identities.

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