 Hi, I'm Kate Young, and you're listening to This is Purdue, the official podcast for Purdue University. As a Purdue alum and Indiana native, I know firsthand about the family of students and professors who are in it together, persistently pursuing and relentlessly rethinking. Who are the next game changers, difference makers, ceiling breakers, innovators? Who are these boiler makers? Join me as we feature students, faculty and alumni taking small steps toward their giant leaps and inspiring others to do the same. I think the biggest lesson was learning that Purdue student culture is a critical piece to the university's success so far in managing this pandemic. When I compare the other universities and how some are struggling during this pandemic, many times what's missing is that critical piece of the student body culture. And I think Purdue has an amazing group of students that really wanted to be here on campus and they were willing to work hard for it. You've probably heard it all before when it comes to COVID-19. It's an unprecedented time. We have to work together to adjust to the new normal. And of course, the term quarantine, a word I'd never used in 31 years, was suddenly added to everyone's vocabulary. Before you leave the house, you think keys, check, wallet, check, face mask, check. Let's rewind back to summer of 2020. Many universities throughout the country were waiting before announcing anything firm on going back to school in the fall. Purdue University President Mitch Daniels made the decision to become one of the first university presidents to announce a return to campus. And other presidents soon followed. How is a campus of 50,000 students, faculty and staff able to come back to West Lafayette for the fall 2020 semester and operate in person? Well, that's where the Protect Purdue campaign comes in. Joining me today is Dr. Esteban Ramirez. In addition to being the chief medical officer for the Protect Purdue Health Center, Dr. Ramirez is also a clinical assistant professor of medicine at IU School of Medicine in West Lafayette and a primary care provider for Purdue University's Center for Healthy Living. The Protect Purdue Health Center is the 24-7 virtual health center dedicated to all things COVID-19 related for the Purdue community. It's staffed with a dedicated team of physicians, registered nurses, case managers, contact tracers and support staff. Dr. Ramirez explains what went through his mind when it first came to creating a virtual health center from scratch. The word that came to mind was, boy, is this going to be a challenge, right? It's something that is very unique and it's a neat idea to be able to have far-reaching effects for a large community such as Purdue University. The Protect Purdue implementation team, which was led by David Broker, he had the vision to be able to develop a health center that is virtual so that we can provide multiple outreach not only to our faculty, staff and students and with the help of One to One Health, who helps us provide healthcare to our employees, we were able to build such a team. Before tackling this massive project, Dr. Ramirez needed to think about the top priorities. Who would be on this team? How would they look at all the data coming their way? Yeah, so my top priorities were developing a well-trained clinical case managers and contact tracers. We used various modules to try to teach best practices and select a compassionate group of people that were able to provide medical guidance to our faculty, staff and students. Another key element was developing the Protect Purdue Health Center leadership team that would be able to help us to adjust quickly to any data trends and center for disease control changes and the guidance that tends to come rather quickly and updates rather quickly. And lastly, creating a very good working relationship with Purdue University, local hospitals and typically new county health department. And what was it like when you mentioned all of those people and all of those things that went into this? What's it like to lead a 24-7 medical team, but all virtually? Yes, it's a gargantuan task to be able to oversee the care for a university community that's 50,000 strong is a large task. But I found that the key to such a task is to be able to have good team leaders. So Jen Hodges, Jennifer Husk, Alte Peltow, Kelly Murray, Erica Burchett, among others, they've been instrumental to developing a layered approach of leadership, which has been really helpful for us to be able to keep the polls not only on campus, but to be able to be agile and respond quickly. You know, I remain in constant communication with the teams and the Purdue leadership and with community leaders. And this is done on a very regular basis and multiple times a day, I review the testing data and work with our eye data team and work with the data analysts to see if there's any particular trends in the data and reach out to those team leads to find out what are our next steps using that information. Dr. Ramirez describes how long it took to create this center, which was especially tough with the way things were changing daily, sometimes even hourly when the pandemic first swept the world. So it took approximately about one to two months to be able to develop such a team. The vision was out there already. It was just more getting the hiring process in place, getting the training done, and then identifying just as you mentioned, who are the right individuals to develop this robust team. So we have a large group, we have 160 team members, over 160 team members in Protect Purdue Health Center. And this is composed of 50 case managers, 50 contact tracers, and then of course we have our test sampling team and call center staff. And they undergo that extensive training by our team leaders so that all team members are on the same page. What we find is our case managers are primarily composed of our nursing staff. So there are RNs primarily, and we also have a few physicians who are helping out as well as a nurse practitioner that serves as clinical case managers and provides that medical guidance that is needed to all our students and staff. Our contact tracers as well, they have varied backgrounds, but they are really good at communicating with people. And they also are very adept at providing timely documentation and their charts which is extremely helpful for us to keep on top of who we need to follow up on and when. And then of course our test samplers are composed of nurses and medical assistants who are used to performing tests on patients. So this is a natural transition for them to do that for our community as well. And then lastly of course our call center staff is critical because they help us to maintain that 24 seven ability that we wouldn't have otherwise without them. After President Daniels announced with certainty that Purdue University would be returning in person for the fall 2020 semester, the race was on. How would the Protect Purdue campaign assist in getting 50,000 people to return to campus safely? And why was being in person so important to the Purdue community? Let's go back to August 2020. The students are coming back to campus in West Lafayette during a normal year. The students would be excited for boiler gold rush orientation, meeting new people, starting a fresh school year. What was the biggest challenge when it came to developing a strong plan before that semester started? I would say the biggest tasks we took on in the most difficult challenge was trying to develop a method of testing everyone before they arrived on campus. And developing an aggressive surveillance and testing protocol. So at the time we only had the PCR test or the polymerase chain reaction test that took a day or two to be able to get results back. And it's a really good test. It's a gold standard test but it's not very quick. And so that was part of the concerns we had but it was the only available option at the time. We had our suspicions as to who might be the most exposed populations. But of course without having the actual data to review because of course this was how we were starting the year. We needed to kind of do a test all to find out what the prevalence was of this infection starting the semester. So that's why we did that test all approach. And then using that information we were able to get together with some statisticians to come up with what would be the best surveillance protocol using that prevalence data. So when we talk about the students going into the fall 2020 semester, more than 99% who had been tested negative, which is amazing. And I'm sure that's no coincidence with all you and your team's hard work. How did the Protect Purdue Health Center play a role in this? Absolutely. Again, this is one of those team approaches. Purdue's communications team led by Ethan Braden was instrumental to really getting that information out to the students on current best practices and guidance from the Center for Disease Control on how to avoid becoming infected with this virus before coming to campus. And also once you get here, how do you remain infection free as much as possible? It also helped, of course, that the prevalence of the infection in our faculty, staff and students was only 0.6% at that time, which again, it was just kind of starting. So it was very helpful that the positivity rate was so low and it helped us to be able to get over 99% of individuals test negative. Jenna Rickes, Vice Provost for Teaching and Learning at Purdue University, explains the research that went into this huge decision. And why being in class, especially for college-age students, was so incredibly important. We talked to a lot of students, we did a lot of surveys, and we also looked at our data. And our students who attend class, who are part of the in-person experience, we really found that it really benefited their learning. It benefited their sense of belonging. Really that connection, particularly for the college-age student, is very critical to their overall development and well-being. And we found that being in class was a really positive factor in student well-being and academic success. We've done a lot of deep dives into the data in our classrooms. And we have not found any evidence of transmission in our classrooms. We set out to have Purdue classrooms be one of the safest places you could be in the world. And I think that turns out to be pretty true. A Purdue classroom is probably one of the safest places you could be in our community. And Dr. Ramirez agrees. I think it's the quality of the interactions that you have, not only with fellow students, but also with your professors. And when you take into account labs and a lot of work groups that take place when you're in person, I think it's just more of a rich environment to be able to learn and to learn from one another. So I think that's why a lot of students have chosen to really prefer to come back to campus. And Purdue does a great job of really providing a really strong and comfortable environment here at Purdue. And the students, I think, have acknowledged that and really worked hard to stay here on campus. It's now been more than a year into the pandemic. Since then, Purdue has welcomed a record-breaking number of students, along with a record-breaking class of students. Dr. Ramirez reflects on the past year. I'm curious, what has been the biggest lesson that you've learned throughout all of this? I think the biggest lesson was learning that Purdue's student culture is a critical piece to the university's success so far in managing this pandemic. When I compare the other universities and how some are struggling during this pandemic, many times what's missing is that critical piece of the student body culture. And I think Purdue has an amazing group of students that really wanted to be here on campus. And they were willing to work hard for it. And that meant being willing to wear a mask, social distance, and do great pan hygiene. Has anything surprised you? What probably surprises me was the fact that how much students wanted to enjoy the university environment and the campus life here that they were willing to comply with these current restrictions. I mean, we're asking a lot of students. It's not an easy thing to be able to do all these things, especially when just a few months back, you were not doing any of these things. And now we're asking everyone to do this. As we discussed, students really like the environment on campus. And I think they saw the value in being able to comply with these restrictions at this time so that they can still have that rich environment. I think some of the craziest things for me personally is like you said, you weren't used to doing all these things. And now come April, 2021, you might be watching a show or watching a movie. And you're like, oh my gosh, they're hugging. Where are their masks? That's right. I'm like, that's obviously not in the middle of COVID because they don't have masks in there, not socially distanced. And yeah, it's just amazing how things change like that. I agree with you. Yes. So you've sacrificed so much. You and your team have worked crazy hours while you're still having your day job, right? I'm curious. I know our listeners are too. What does a day in the life of a chief medical officer look like during a global pandemic? Meetings, meetings, and more meetings is a big part of it. But multiple times a day, we get together and we review data. And that's a really critical piece for this particular role because this helps us to quickly identify, where do we need to test? Where do we maybe need to evaluate the buildings or the location and try to do a little bit more digging and to find out if there's areas that we need to focus on or apply more attention to. So it's really helpful for us to be able to have this get together. So we communicate frequently with our medical teams, with the team leaders that I discussed previously to address not only questions that they have, but provide also the updated guidance from the Center for Disease Control guidance that seems to update virtually almost every day, every other day. Lastly, as a physician, I see employees in the Center for Healthy Living. So there's a need for some of our employees that need evaluation even after they completed their isolation and quarantine. And then I participate in helping evaluate them and see if there's anything that we can do to help them through that last part of the healing process. But overall, this position is very rewarding. I feel blessed to be able to help and be a part of keeping Purdue University open during this pandemic. That is super special. And you essentially have answered my next question, but what keeps you motivated and determined throughout all of this, even on the really bad days? You know, I think it's humans helping humans out. It might sound kind of cheesy, but you know, it's really about helping each other out. Do unto others as you want done unto you. If I was in a position where I needed help, I'd like to know that somebody be willing to help me out. I happened to be in a position where I could help out in overseeing this whole process. And I think it's worked out very well. Have your perceptions about Purdue and this community overall changed throughout this year? It's gotten even stronger and I'm more impressed with the Purdue community even more than I was before. I received my MBA from Purdue, my business degree from Purdue. And so I had a couple of years that I've spent there before I started teaching there. And what's amazing is the faculty get along well, the students and the relationships that the students have with their faculty. I don't think I had appreciated how much the students care about their faculty and are willing to do things like masking, social distancing, to try to protect also the faculty and staff and to protect the fellow students. And I just have a renewed awe of the relationship, the relationships that develop there at Purdue and it's just really neat to be a part of that. As of March 31st, anyone over the age of 16 in Indiana is eligible to receive a vaccine, which as Dr. Ramirez says is an absolute game changer. It's good that we have reached the eligibility of the general population. You know, the faster that we can get this vaccine to our community, the better it's gonna be for everyone. And how do you see this impacting Purdue now and for the fall 2021 semester? Well, you know, I think this is probably a major game changer. Just looking at the guidance that's coming out from the Center for Disease Control, they're now saying that those who are fully vaccinated, which I'll provide the definition of fully vaccination or fully vaccinated individual, is someone who has two weeks from their last injection, if it's the J and J vaccine, that would be two weeks from the one vaccine. If it was the Moderna or the Pfizer vaccine, it would be two weeks after the second dose. But those who are fully vaccinated do not need to quarantine after they've been exposed to someone infected. That's as long as they remain without symptoms. And that's huge. Because if you consider who are the folks who are stuck in quarantine, it's those who are around individuals who are positive. But because you have immunity at that point, we know that we won't have to quarantine those individuals, and that's huge. We're reviewing the literature and we're speaking with medical consultants on, can we maybe exclude these individuals who are fully vaccinated also from surveillance testing? Which as you're aware, we have a very aggressive surveillance system. And that's been really, I think, a key part of our success. But if we have individuals that are fully vaccinated and immune, they may be able to be removed from surveillance testing. But that's something that we're still working on right now. And then lastly, being fully vaccinated will help qualify the student to participate in programs such as Study Abroad. Again, for a year, we really haven't had any of those opportunities, but now that we have individuals that are becoming fully vaccinated, that's gonna be an option again. So there's many advantages to getting fully vaccinated outside of just the medical benefits. So what can people expect when it comes to receiving a vaccine? And how does Protect Purdue play a role in all of this in the West Lafayette community? So the vaccine, again, it depends on which one you receive, but Pfizer and Moderna are two doses and the Pfizer vaccine needs to be separated by 21 days and the Moderna doses need to be separated by 28 days. But all of them have been shown to be efficacious in keeping people out of the hospital and also in minimizing severity. So folks who might have ended up in the hospital with shortness of breath or with a pneumonia now are just developing things like congestion and maybe a slight cough, a mild fever, which is really what we're looking for if they're gonna get infected at all. They have very mild symptoms and that's really huge. That's what we're looking to do is can we minimize those folks who are having severe infections and deaths? Between the time that we're talking now and when the listeners will hear this podcast, Purdue University will have opened a vaccine clinic on campus for students. Tell us about your role and the Protect Purdue Health Center's role in this. Purdue is allowing the Protect Purdue Health Center and the one-to-one health team to set up a vaccination clinic at the corec. Per state requirements, we are focusing our vaccinations solely on students at this time and the hope of this is to minimize taking any infections home to their families when they leave after the semester. So we wanna get very aggressive with our vaccinating program. We'll be vaccinating seven days a week for as long as we have the vaccine and our goal is to try to shoot for 3,500 students per day that we can get the vaccine in. Dr. Ramirez tells us what he's looking forward to most within the next year and how this all may impact the university come fall 2021. Assuming no new surge of variants that are resistant to our vaccines, I'm looking forward to a sense of more normalcy, lower positivity rates that leads to less illness in our community. I'm looking forward to less restrictions on our campus and a stepwise redensification of the campus, including returning to more of a sporting and entertainment-like events, which I think everyone misses those sort of get-togethers. And I think we're slowly getting to that point now. And I think as we get vaccinated and get more and more folks vaccinated, that becomes more and more of a reality. We have to see how the summer plays out and we have to see what this virus does. We do have those new variants that are coming up and we need to see how those variants are gonna play into this. Because if there's gonna be a surge that might change things, versus if there is no surge, I would anticipate we could move forward towards maybe less social distancing. I would expect masking will likely still be in place at this time. But again, everything is in ebb and flow. And if this pandemic has taught me anything, is that things can change quickly, including positive things, like updated guidances from the CDC. What can you do to help prevent the spread of COVID? Dr. Ramirez says researching the vaccine and familiarizing yourself with the facts is important. And of course, if you have any questions, Protect Purdue is here to help. I would say the most pointed thing right now is go get vaccinated. Take time to look over the Pfizer vaccine, which is the vaccine that we'll be getting and get familiar with it. If you have questions, ask us. We're more than happy to address them, but the faster we can get our faculty, staff and students vaccinated, the faster we can get back to some level of normalcy that we're all looking forward to. The purpose of a vaccine is to make antibodies and the way our body makes antibodies has those side effects of muscle aches and a little bit of a mild fever and feeling tired. And so those are expected side effects from our vaccines, but they're mild. When you compare that, you'd have these side effects that are one, two, three days long that usually gets better with a little Tylenol or Motrin, Ibuprofen and Acetaminophen. And then it's gone. You won't feel any issues after that. So it's a very small amount of time to feel some potential side effects of the vaccine, but when you consider that some folks are dying from this particular virus or ending up in the hospital for weeks on end, this is a market difference and little discomfort for a couple of days versus weeks of hospitalization, I think it's a fair trade-off. As with anything, we wanna look at the risk-benefit ratio, and I think there's markedly more benefits than risk in this situation for vaccines for most individuals. I know I was very pleasantly surprised as well that I didn't expect to be able to get a vaccine until I don't know May or June, so I'm very happy. Absolutely, well, sign up, we'll get you taken care of. Thank you so much for your time and everything that you and the PPHC team has done to keep produce students and faculty on campus. Like I said, I'm sure it's been a crazy ride for you and all of the students on campus, but everyone really appreciates it. Thank you for having me, I really appreciate that. I think President Daniels says it best. When Boilermakers see a problem, they go to work solving it. When they encounter adversity, they try to face it maybe a little better than most people. On April 6th, Purdue intends to open a COVID-19 vaccine distribution site on campus to help vaccinate as many students as possible before the end of the spring semester. The clinic will operate seven days a week and is located on the northwest side of the co-rec near the current COVID-19 testing center. The campus vaccine clinic will prioritize Purdue West Lafayette students per Indiana Department of Health Guidance. All students ages 16 and older that includes undergraduate, graduate, and professional, regardless of their residency, can use the campus site at no cost. For more information about getting your vaccine or the Protect Purdue Health Center, please visit protect.purdue.edu. Thanks for listening to This is Purdue. For more information on this episode, visit our website at purdue.edu slash podcast. There you can head over to your favorite podcast app to subscribe and leave us a review. And as always, Boiler Up!