The goal of the START coalition is to bring together the best minds to share knowledge to address the challenges we face today with COVID-19, and to make communities safe so that people can return to safe working, education, care-giving and community environments. Working in Oklahoma City, we have a broad range of action items in place to make the city healthy and safe for everyone.
Data-backed approaches to identify and screen people at high risk of disease
We will map cases of COVID-19 in Oklahoma City to identify hotspots of the disease and evaluate the assumptions of previous prevalence surveys. We will perform this hotspot mapping in residential locations of OKC, among contacts of people who work in prisons, and among the employees of industrial sites. This hotspot mapping will be paired with screening for COVID-19 in the areas identified to be at risk through the mapping exercise. Screening in these critical communities has two-fold importance: It is essential for finding cases of COVID-19 to prevent further transmission of the disease particularly to vulnerable populations, and it is necessary for determining the accuracy of existing assumptions for the prevalence and distribution of COVID-19 across communities. People who receive a positive screen for COVID-19 will be linked to supportive services and necessary medical care.
Improvements to environmental infection control
We will pilot and assess the efficacy of different infection control strategies in a variety of settings. Notably among these strategies, we will employ germicidal UV (GUV) lights, which have well-documented efficacy for eliminating other viral and bacteriological agents from air and surfaces. We will use GUV lights of different wavelengths (252 and 222 nanometers) across various settings and applications, with the goal to understand important implementation practices, such as room occupants’ tolerability or sensitivity to GUV of these different wavelengths, or lessons for pairing these technologies with air flow mixing. We will conduct air and surface sampling to evaluate the efficacy of GUV light for eliminating SARS-CoV-2, the virus that causes COVID-19, and there evaluating the utility of these strategies for reducing risk of disease transmission. These strategies will be deployed across a variety of settings that typically contain large numbers or throughput of people, including industrial settings and other places of work, schools and university settings, and retail locations. These strategies will be piloted in such diverse areas to generate implementation lessons with broad applicability to similar commercial, industrial, and residential settings.
Trial for understanding the efficacy of BCG vaccination to prevent COVID-19 or lesson its symptoms
The bacille Calmette-Guerin (BCG) vaccine has been in use for decades to prevent tuberculosis (TB) in children. However, the vaccine is often not administered in places like the US with low rates of TB. The BCG vaccine has shown efficacy against viral respiratory infections similar to SARS-CoV-2, but preliminary evidence is inconclusive on the efficacy of the BCG vaccine to prevent infection with SARS-CoV-2 or prevent COVID-19, given that, to date, no statistically-powered, prospective study has been performed to evaluate its protective effects against COVID-19. As a tool with existing manufacturing facilities and supply chains, the BCG vaccine presents a notable opportunity to mitigate the impact of COVID-19, particularly among people at high risk of the disease, until a new vaccine can be developed for the disease.
We will perform a phase III, randomized control trial of the BCG vaccine among residents and staff of Oklahoma City nursing homes to understand the efficacy of the vaccine to prevent or mitigate COVID-19 among a demographic of people who are at elevated risk of both infection and mortality from the disease. The findings from this study, as with the findings from the activity arms described above, will be rapidly disseminated across expert networks to inform uptake and implementation of these novel strategies to combat COVID-19.
