• Podcast
  • Apr 07 2020

'Behind the Blue': Rebecca Dutch on UK’s Efforts to Treat, Understand and Eradicate COVID-19

Rebecca Dutch has been at the University of Kentucky for nearly 20 years. She is considered a leader in the field of virology — the study of viruses — and now serves as chair of UK’s Department of Molecular and Cellular Biochemistry.

But her newest field of exploration is unlike anything she has done in her storied career.

She is helping lead researchers and faculty from multiple disciplines across the University of Kentucky as part of the global effort to treat, understand and eradicate COVID-19. The COVID-19 Unified Research Experts (CURE) Alliance team, a new workgroup within UK’s College of Medicine, is bringing together UK experts from across the campus to focus on advising COVID-19 patient care and clinical trials based on emerging research and potential treatment options.

College of Medicine Dean Robert DiPaola recently announced the creation of CURE, which the college is funding with additional support from UK’s Vice President for Research Lisa Cassis.

“Over the next weeks, we will assess emerging studies to guide the College of Medicine’s clinical enterprise to provide the best COVID-19 patient care available,” said Dutch, who is CURE leader. “Our goal, in the long term, is to identify the best options for patient participation in ongoing clinical trials, as well as clinical trials we can develop right here at UK.”

Dutch says the team, which is now meeting multiple times a week via Zoom, is also identifying potential COVID-19 research collaborations among UK experts. Several CURE team members have expertise directly related to COVID-19.

In this special edition of "Behind the Blue," Dutch discusses her efforts and those of others across the campus to find treatments for COVID-19 as well as why the virus has spread the way it has and how we can all better protect ourselves and others.

Read more about CURE here: http://uknow.uky.edu/research/university-kentucky-researchers-unite-fight-covid-19.

"Behind the Blue" is available on iTunes, Google Play, Stitcher and Spotify. Become a subscriber to receive new episodes of “Behind the Blue” each week. UK’s latest medical breakthroughs, research, artists and writers will be featured, along with the most important news impacting the university.

For questions or comments about this or any other episode of "Behind the Blue," email BehindTheBlue@uky.edu or tweet your question with #BehindTheBlue. Transcripts for this or other episodes of "Behind the Blue" can be downloaded from the show’s blog page. You can watch a video version of this podcast here.

To discover what’s wildly possible at the University of Kentucky, click here.

UKY Video Production | 2020-04-03 BTB COVID-19 Update 002 (Dr. Rebecca Dutch)




KODY KISER:         Thank you for joining us on another special episode of the Behind the Blue podcast. I'm Kody Kiser with UK Public Relations and Strategic Communications. I'm joined this week by UK Chief Communications Officer, Jay Blanton. And our guest on this episode is Dr. Rebecca Dutch. Dr. Dutch is a professor and chair in the Department of Molecular and Cellular Biochemistry here at UK. She received a BS in biochemistry, a BS in microbiology from Michigan State University in 1986, and then completed a MPhil degree in biochemistry from Cambridge University, focusing on plant biochemistry.

She received her PhD in biochemistry from Stanford University in 1994, and then did her post- doctoral training at Northwestern University HHMI, and then joined the faculty here at UK in 2000. That is a lengthy-- that is very qualified right there. But thank you so much for being with us on the podcast.

DR. REBECCA DUTCH: Oh, you're very, very welcome.

KODY KISER:         I guess, one of the first things I want to jump in and ask about is one of the biggest and easiest misconceptions to tackle, perhaps, first is this idea that people have had that COVID-19 is basically the flu. And it's not the flu, but why are people making that assumption?

DR. REBECCA DUTCH: I think people think of it as flu because some of the symptoms are flu-like. So like the flu, this is a respiratory virus. Your major symptom is going to-- in most cases, or many cases, is going to be a cough. So the cough is different, the fever that you often associate with flu. And in fact, there will be patients who have the flu who think they have this, or people who think they have this who actually have the flu, which is why testing becomes important.

But the viruses themselves are quite different. Influenza virus that causes the flu is one we understand and expect to see every year. We get different strains of seasonal influenza that come through. This is a new virus that hasn't entered the human population before. It first came in on what we think is November of 2019. And what that means is that none of us-- none of our bodies are prepared to face it. It's a member of the coronavirus family, which has some similarities to what the flu virus is that are in the orthomyxo family. But they're not the same.

Their genes are different, their proteins are different, they are very different viruses.

KODY KISER: It's also-- speaking to that, people compare data to-- as far as like transmission, things like that-- to H1N1 or SARS or MERS. But this is different. And what do people need to keep in mind when they're looking at that type of data, trying to make any kind of assumption?

DR. REBECCA DUTCH: So when you look at transmission data, you're trying to figure out how quickly and how easily this virus spreads from one person to other people. And that's really important for understanding just how dangerous this might be. So transmission data and-- we tend to look at two things, transmission data and mortality data, the percentage of people that die from this infection.

And so if you look at seasonal influenza, generally, transmission is pretty good. The numbers I see generally run around 2. And what that means is for every time, if I were to get this virus, on average, I'd give it to the two of you. And the two of you would each give it to two people.

And then you can see that will increase the spread pretty quickly. But it's not a really, really high number. So that's the transmission rate.

If you look at the transmission rate for this one, the numbers-- we're still trying to figure it out. There's a lot of data we don't have. But they think that maybe that transmission rate is more in the 3, 3 and 1/2 range is now the numbers I'm hearing. So it's a little bit higher than a normal seasonal flu.

If you look at something like SARS or MERS-- so there's other coronaviruses. SARS came out in 2002, MERS in 2012. Both of those had lower transmission rates but much higher mortality rates. So the mortality rate from SARS was closer to 10%, which is quite scary, because that would mean out of every 100 patients, 10 people die.

The mortality rate for MERS is even higher. It's close to 50%. But thankfully, it doesn't spread very well so there's not that many cases. Mortality rates for seasonal flu tend to be more on 0.1%, but that can depend on the year. And so for this, we're still trying to figure out a mortality rate. There was actually a newer paper that just came out yesterday that, again, kind of brings that number down. They used to say-- I think the World Health Organization said about 4 something, maybe two or three weeks ago. But the problem is mortality rate is based on the number of people who died divided by the number of people who got infected. And that bottom number is something we really don't understand very well. We don't really know how many people are infected with this virus right now.

So that number may be much more. The study from today suggested it might be more like 0.6 or 0.7, which is still higher by a ways than the seasonal flu, but with a much greater variation depending on age. So older people, still very much at risk. People in their 20's, they may be-- it may be very similar to seasonal flu for them in terms of risk.

JAY BLANTON:      What do people need to-- speaking to that, what do people need to know about how this started and how it is spreading now? Because it seems like there's a lot of talk out there, a lot of media coverage, but a lot of misperception and miscommunication about it as well. What can you tell us about how this started, why it started, how it's spreading?

DR. REBECCA DUTCH: Well, the most important thing for people to understand about how it started is this was a natural thing. There is no evidence whatsoever to support the idea this was some kind of experiment gone wrong or scientists who created this.

So virologists have known for a long time that there are species of coronaviruses that exist in other species of animals, in particular, bats. So bats tend to carry a lot of emerging diseases. Why bats are such good carriers of disease is still something we're working out, but they do seem to be. There are bats that seemed to be involved in the SARS epidemic because it tended to go-- it seemed to go from bats, to civet cats, into the human population.

Bats are likely involved in MERS, it going from bats to camels. Bats are probably involved in Hendra and Nipah virus-- are another set of emerging diseases-- and potentially an Ebola. So there's a lot of connections to bats. So there have been researchers who have been sequencing the viruses in bats. And they've found, actually, viruses that were quite related to this virus we're now seeing in the bats in the area around Wuhan.

So in fact, as long as five years ago, there was a paper from several, really, top coronavirus researchers here in the US-- Ralph Baric at UNC, and Mark Denison down at Vanderbilt, and some others-- where they looked at the sequence of these bat coronaviruses and actually predicted that several of them were pretty close to what would be a human virus. And these had the potential to be pandemic viruses.

So it appears what happened is sometime-- the first case seemed to be in November-- in November, we had-- it looks like a single transmission based on the fact that we see everything tracks to one sequence of virus. Somehow, a person got infected from a bat or from a bat to another species to a carrier. So we don't know for sure which of those is the case yet. And then once it got in the human population, it seemed to be a virus that spreads reasonably easily. And therefore, we're now spreading it slowly across the world.

But there's nothing that-- it's something that, as a virologist, we could have-- we would have said this might happen. And in fact, in my virology class at UK, one of things we talk about is emerging disease and potential for pandemics because there are a lot of different viruses out there.

JAY BLANTON:      What is it about this virus, though, that made it become what, to us, would seem so quickly becoming a pandemic?

DR. REBECCA DUTCH: Well, several things. One is its transmission rate. So if it really is 3 and 1/2, that's pretty high. It's not the highest. The highest I know of is measles, whose transmission rate is 18. So for all of you who don't vaccinate-- maybe this is a touchy subject-- but that's why virologists are so cautious of measles, because a transmission rate of 18 means I infect 18. And all 18 of them infect 18. And pretty soon, we've got a lot of measles.

This one's not that bad, but it's high. I mean, if it's really 3 and 1/2 to 4, that's a lot higher. Because each time you have another person infected, they infect more people. So that's the first thing. The second thing is-- and the thing that I think was a surprise to a number of us-- there seemed to be a good number of people who have this virus who don't know they're sick.

But the speculation-- not speculation, hypothesis now, is that they're actually active and involved in spreading this. Depending on the study you look at-- there is one out of China that suggested as many as 80% of your cases could result from interactions with people who are asymptomatic. They don't have any illness that they perceive, so they go about their daily lives. And therefore, they infect other people.

And there was a study out of South Korea that really supported that, and at least in that study, suggested that the younger people-- the younger you were, the more likely you were to be asymptomatic. So people in their 20's are much less likely to get really ill. Some of them, at least in that study-- and it seems to be more now in other places-- they don't even know they've had it, but they could be spreading it to someone else. And that becomes a significant issue. And that's unusual. Most viruses people are asymptomatic aren't having an active infection. But that seems to be an issue for this one.

KODY KISER:         Let's talk about that, as far as asymptomatic and being able to spread it, and the severity of it.

You mentioned that with younger people, it may not be very severe at all, or may not even manifest. We heard-- I think I heard early on, the number was thrown out that in 80% of these cases, the symptoms of this are mild. But even then, my understanding was that people need to understand that mild doesn't just mean a case of the sniffles. Where is the truth in that as far as--

DR. REBECCA DUTCH: Well, because this is such a rapidly evolving situation, I will say this is the truth as we know it today because we keep getting new data. So for those who are diagnosed, when we say 80% are mild, many of those are mild, meaning they're not hospitalized. They're not that sick. But some of them can be very sick. I know my oldest son knows a few people who've had it, healthy people in their 30's. And they said it was worse than anything they've ever had. For at least 10 days, they could barely get out of bed.

One of the symptoms for many people seems to be just incredible fatigue and some difficulty breathing, which is contributing to your fatigue. And those are in healthy people. But there seem to be other people who don't ever even go in and get diagnosed because they simply don't have enough symptoms to realize they have had a real disease. Why the difference?

Why some people can get this and, if anything, they had a mild cold and then they just go on, we don't know yet.

Likely, there are differences in genetics. There could be differences in how they got the virus, how much they got at one time. Could be differences in their current immune state, whether they recently had other respiratory viruses. There's a whole set of things. But at this point, the only strong predictor we know is age. The older you are, the more likely you are that your consequences will be relatively serious.

KODY KISER:         Is there anything to compare that to as far as a viral infection that has such a wide swing of symptoms from person to person?

DR. REBECCA DUTCH: Well, it's certainly true that age affects viral infection for a lot of diseases. So as we age, our immune responses don't-- they tend to wane some. And we don't have it, and we also tend to have a lot more underlying health defects. And all of those things can contribute to how well we fight back the infection.

So that idea, that it gets harder as we age is certainly true. And certainly, with SARS, children didn't have any trouble with the virus, or really no significant problem. So I think that part we're used to seeing. The idea that there's people who are asymptomatic, we don't have a lot of great data on that, the problem being when people are asymptomatic, they don't go in and see a doctor. So we don't know if they've had a disease.

So one of the things long-term-- or hopefully, short-term-- we need to start doing is doing a lot wider studies to understand who is already immune. They're developing assays now. They've got some slowly coming online. Well, we could go through the population and start looking at who actually has antibodies to this virus. That would indicate someone who'd been infected already. But if they-- I would predict what you're going to see from the studies that are out there is somewhere between 20% and 35% of the people who come up with antibodies never even knew they had it.

That's unusual from our understanding of viruses. But as I said, most of the time, we don't check. How many people might get a different corona-- other coronaviruses cause common colds. Maybe there's lots of times we get those and we don't ever have symptoms because we happen to beat it back in a different way. But we've never looked.

JAY BLANTON:      So would more testing, more widespread testing provide you with that sort of data?

DR. REBECCA DUTCH: Absolutely. I think one of the biggest challenges we have right now, and one of the places that around the world, frankly, we failed, is to ramp up testing fast enough to be able to really follow what's going on. And I will say, as this has gone on over the last few weeks, on a daily basis, the availability of testing, the availability to address this is just growing by leaps and bounds.

You need two types of tests really in place. One is a really good test to test for active infection. When you hear of people going in to be tested for this, that's what they're looking for. They're doing a test that looks for the viral RNA. And those, we've gone from-- for instance, here at UK, a little over a week ago, they started being able to run those tests in a lab. They're scaling up the amount of that that they could do at any time.

But even so, we're still at a point when we're generally testing people with active symptoms as opposed to testing anybody. So long term, you'd want that test to be really rapidly available and very easy to get and cheap, so that you could do widespread testing of people. And as soon as they knew they were positive, they would know to make sure they were quarantining. 

The other, the serological test is coming up online. There was a really nice paper from Mt. Sinai about a week and a half ago, that one of the reagents that they had gotten their test to work with, they've released those. We're already working with those here, people working around the country. And then companies are working around the country and around the world to get these things online.

JAY BLANTON:      Yeah, that kind of leads me to you and others at the University are now taking a pretty focused look at this. What's happening at UK, and where are your colleagues focused?

DR. REBECCA DUTCH: So a lot of it happening at UK because, obviously, we're a large research university. One of the first things that happened is a formation about a week and a half ago, I guess it was, of an alliance grant sponsored through the College of Medicine, but including people long, far beyond the college, with the goal of really bringing together experts from different areas to look at-- we meet twice a week, but everybody is looking at a daily basis of any and new information that's coming out, the new papers that are coming out, of which, I'll be honest.

There's so many, that one researcher cannot keep up.

My lab group, they're all keeping up on this stuff and sending me things, as are researchers from around the campus. I get suggestions, ideas all over the place. So the goal of that alliance is multi-part. One is really to best inform what we should be doing for patients here. The second is really to be looking at what the trials are that are already going nationally and internationally our patients could participate on. And what is not there is what should UK be considering doing clinical trials on, particularly related to repurposed drugs. Because that's the place where we could do something now, as opposed to waiting for something down the pike.

We're also looking at things like how do you coordinate patient samples? How do you deal-- because there's lots of researchers who want to do things, how do we make sure information is getting to clinicians, particularly as they get really busy? As this picks up, clinicians will have less and less time, and it'll be more and more important that they quickly get information.

And then, how do we-- as researchers across campus are looking for, how could I do research on this or that, starting to get all the answers we might need to those questions, if we don't have a resource at UK. For instance, we don't have a biosafety level 3 facility here right now, which is what you would need to do experiments of with the live SARS-CoV-2 virus. Who has it? Who might you be able to collaborate with?

So for instance, University of Louisville has a large regional biocontainment facility with a BSL-

3. They're scaling up to do things there. Another would be if you have something you want to screen against, and I happen to have someone I know who gave me the name of someone in Europe who's doing large screening of compounds against live virus, and hooked up some people from here to talk to them. So that's the kind of-- we're trying to facilitate as possible.

And there is a large number of researchers on campus who are very interested in how they might approach this, everything from our vice president for research, Lisa Cassis, who worked on angiotensin and the systems in the body related to that. Well, the ACE2 receptor, which is the thing the virus docks onto on a cell, is involved in that system. So she's bringing her colleagues in throughout the country to try to understand if that's a way to target it.

My lab group is now starting to look at processing on one of the proteins from the virus. There are other lab groups who are growing, who are making key reagents. There's all sorts of stuff going on related to that. There are people I know, there's people all over the campus doing everything from engineering to other places, asking, how could I bring my expertise to play with this? So the alliance is just-- we're trying to help in other ways we can. I'm sure there's lots of great research I haven't heard about yet, though.

JAY BLANTON:      You know, if we can advent or throw those avenues of interest to you that you think are potentially pretty promising, or that we ought to have been thinking about, looking at?

DR. REBECCA DUTCH: Well, you know, it's challenging right now. Because there's a lot of different reports, some better than others, and not enough time to do the large scale clinical trials you really hope for. So the first thing you want to look for is repurpose drugs. Is there something that's already been approved by the FDA, something we know is safe that could be used?

One of them, I'm sure a lot of people have heard about, is chloroquine or hydroxychloroquine, because this has been brought up in the news a lot. It remains a question. It doesn't mean it won't work, but the data is still slim on that one. So it is certainly one that we're interested in looking at more carefully, particularly that with other things. There was a report out of France with a tiny group of people. It was 36 total patients-- well, six dropped out-- 10 controls and 20 patients. But there was some promise with hydrocychloroquine plus an antibiotic called azithromycin in that study. Problem being, it wasn't what's called a blinded study, so people knew if they had gotten the drug or didn't get the drug, other things like that. So that one's promising.

There's several things in the pipeline that could be promising. There's an antiviral called remdesovir that was originally developed against Ebola virus, but was already known to have some efficacy against SARS. That one is being tried in patients around the world. It has some downsides already. They're saying it has some potential efficacy. What we don't have is any repurposed drug where we have enough data to say, yes. We really think this will work.

And so all around the world, people are trying to coordinate everything they're finding to be able to get an answer of what's the best treatments. One of the problems is getting that coordination and actually doing things in such a way that they're controlled. Because often, patients are getting six, seven, eight different things at one time. And it can be harder to tease out what helped, what didn't, and what might have happened if they didn't have any of it. So we're still unfortunately in kind of early stages with that, though. There's new data that comes out every hour, pretty much.

KODY KISER:         From a perspective-- shifting gears just a little bit and talking about from a perspective of prevention and what we as a community are doing, we talk a whole lot about this idea of flattening the curve, of keeping our infection levels at a lower rate so that we're not overloading our hospital systems and our health care systems.

The numbers that we're seeing here in the state, it seems like projections are bearing out that we're doing a relatively good job of keeping that curve low with our efforts at social distancing. It was one of those phrases that is new to the lexicon that people are talking about. Closing down quote unquote, "nonessential" businesses, things like that. In your opinion, are we, in fact, doing an OK job? Are there things that we could be doing better? Is this-- you know, I don't know that-- I don't think this is an overreaction. But are there things that we could kind of ramp up? Or are we maybe facing--

DR. REBECCA DUTCH: Well, I will say, actually, Kentucky is-- I think Kentucky is in an impressive job. A combination of things-- and I will give great credit to our state leadership because I think they've done a very good job so far of leaning this. It's interesting. There is a new modeling study that came out of the University of Washington sometime yesterday that actually looks per state at what the predictions are. Obviously, it's a model. And models can be wrong. But if you look at that modeling study, they're suggesting we'll hit our peak in early May, and that we will have-- we'll be fine for beds, et cetera, as long as we have maintained-- as long as we're doing the things we're doing-- not so much for some of the states around us.

So I think we are doing a good job of this. I know it's hard for many people to understand why this matters, but you want to keep remembering, every time someone who has this stands in a room of people, they can spread it to other people around them. And if you spread it to one person, they go home and they spread it to someone else. So it's basically keeping your interactive group as small as possible.

For me, that interactive group is my family of five. My three sons are home. That's us. And we try to keep that as it so that you don't add extra interactions. But if each of us went out and interacted with two other people and they all interacted with other people, suddenly your group is huge. So blocking those social interactions or reducing them really helps reduce the amount of spread we see with the virus. And I think Kentucky has done a great job. And I think if you look at some other states who did not enact things as quickly, some of them are really struggling.

JAY BLANTON:      Do you think we're looking at-- depending on what news account you see, the sort of we're going to have it for a while. It may go away for a while, and then it comes back. What are we to make of those sorts of--

DR. REBECCA DUTCH: Ah, yeah. It's a really hard question. And pretty much anyone I know asks, when this is going to be done? So we don't know for sure what will happen. I think it's very likely that this will stay endemic in the human population. We were fortunate in SARS, at the report being around 10,000 cases, we seemed to beat it. It just disappeared. So I think we have too many infected people for the odds that that's going to happen.

So then what we're looking at is reducing the number of vulnerable people who get it and making sure that the hospitals can handle the load of those who do, and then trying to ramp up treatment. So I think we're going to see it go down. I would be surprised if it goes away in the summer. There have been suggestions that it might go away in the warm weather, but there's plenty of places in the world who are in summer right now. South America is shutting down its countries. Australia has got cases. Malaysia has got a lot of cases. So I don't think it's going away. You might see a reduction over the summertime, and that would be great.

And then, I think as it slowly comes back, the thing that helps, though, as we start to get some people who've had it, they essentially can't get it again-- at least in the near term, as far as we understand this virus-- as far as we understand it in most viruses. And so they essentially are a buffer.

The more people who are immune to something, the less people who can get it to spread onto someone else. So I think I would be surprised if we don't see some cases coming back. But the more we can test, the more we can protect. So if, by fall, we have the capacity to really run lots of tests-- not just you can have a test if you need to be hospitalized, but we're going to test most people on a once a week basis who haven't had it before-- as soon as you knew you were positive, you just stay home.

JAY BLANTON:      Which is what South Korea did, right? They were able to test virtually everybody.

DR. REBECCA DUTCH: Yeah. And if we can do that-- I mean, if this were Star Trek and we could just test ourselves each morning, we could make this go away in three weeks because anybody who's got it stays home. And in 14 to 18 days, unless they have to go to the hospital, they're recovering. And they haven't had a chance to spread it to other people. That's the key, is being able to identify who's got the virus infection now.

Right now, the flood of people is too quick and the amount of tests is too small to be able to do that. But if we can do that in the future, then we can address this in a much more targeted way.

JAY BLANTON:      Well, the other side of that coin would be then, I guess, the idea of a vaccine and the length of time it takes to develop that. And can that time frame be shortened?

DR. REBECCA DUTCH: It's long. I know people were extremely excited when they saw a woman in Washington get the first vaccine. What you need to understand is that's the first step in a long process to develop a vaccination. So you want to think about the following. What you need is a vaccine that's safe enough that you can put it into people around the world and that it won't cause significant side effects. Because the last thing you want to do is get a vaccine that hurts 1 in 1,000 people-- or kills 1 in 1,000 people-- to prevent a disease.

So you start first by designing vaccines. There, we have a lot of science behind it, the kinds of things that might work to get you the responses you need in the body. And so we've got many, many candidates around the world for potential vaccinations. But the next and the longest phase is a long set of trials you need to do to see if you get the right immunity to it. Does it protect you from the virus? And is it safe?

And you absolutely can't skip steps because you can't move from a trial with five people to injecting the world without running the risk you're doing something much, much worse. And as an example of that-- and this is why virologists are really cautious of the vaccines-- one of the major respiratory pathogens we still deal with the world is something called respiratory syncytial virus. It is actually the leading cause of hospitalization for kids under 2 in the US. It's really serious in premature babies. And it's dangerous in the very young and the very old. And then the rest of us get it in middle life and we a lot of times, get very sick. But usually, we handle it.

But all the way back in the '60s, they made a measles vaccine by doing something called formalin inactivation. It's a way of treating a virus, part of what makes it so it can't work anymore. But you still give it to the body and it sees it. It's like freezing it and sticking it in. It can't do anything, but we can still learn to recognize it. And that's the key. Vaccines want you to learn to recognize the virus so that your body's ready to respond.

It worked for measles beautifully. That was one of the first measles vaccinations. They tried that with respiratory syncytial virus. They made vaccine the same way. They got to the point of doing trials in babies. And the worst possible thing happened. The kids who got the formalin inactivated RSV were much more likely to die when they got RSV itself.

So this is not a simple, straightforward process. You have to do all the safety checks. You have to make sure you know what you're doing. And that's why when the scientists keep coming back and saying a year to 18 months, that's the time frame, that is true. And obviously, that's assuming and optimistic that we will get an effective vaccination.

Vaccinations are sometimes hard to develop. We don't have one, for instance, to RSV to this day. We don't have one to HIV. But the hope is that we will make progress given the amount of time that-- amount of different approaches people are using.

KODY KISER:         And when we talk about that idea of immunity-- if you've had it, then you may have some immunity-- we currently don't know if that's even a possibility, or at least an amount of time. I mean, it's not an idea of, if you get it, you'll never get it again.

DR. REBECCA DUTCH: So we know that people mount a very rapid immune response to this virus. We know they have a lot of what's called IgG, which is a major antibody class, within three to five days of being infected. And that response looks just like we would expect from other respiratory viruses. So I don't think there's any solid evidence to suggest that people are not immune soon after they've been infected.

I know there have been some reports that someone got it again, but it's also possible those reports, that their first negative test wasn't actually done correctly. Those are usually someone who was told they were negative, and then they seemed to spike up again. It's possible they hadn't completely cleared their infection.

But the question would be how long we stay immune. And so respiratory virus immunity is an interesting thing. Certainly, for the standard coronaviruses, we often-- over a few years-- we wane in our nice antibody response to the ones we've had a year or two ago. But the thing that at least I've been told happens-- and I'm not an immunologist, but-- is that even though that is waned, we still have residual memory to it. So the next time we get it, we tend to not get as sick. And so that would be the hope and that would be the basis, obviously, for vaccination.

Now it's possible that you would need to boost with vaccinations. If people have immune-- if you're waning in terms of your immune response, one way you can handle that is to get a boost. We'd all, for instance, know about that with measles. Kids all have to go when they're 18 now and be boosted again. And that's just to make sure that their immune response is strong enough that they're protected.

KODY KISER:         When we talk about people who are trying to go through those steps that they believe are correct, as far as handwashing and covering the cough, using the hand sanitizer and antibacterial wipes-- now obviously, that only has a limited effect because we're not talking about a bacterial infection, we're talking about a virus. Are there products that will kill this off of surfaces? Do we know how long it lives on surfaces?

DR. REBECCA DUTCH: Oh, yeah. There's tons of products that kill this off of surfaces. So good old soap is great. You know, you don't need anything fancy. Any soap product is going to be good. And the reason is that-- so coronaviruses, on their outside is what's called a membrane. Think of it kind of like a fat layer, like it's coated in like a fatty oil kind of thing. And what you need to do is break that up. And just like if you had some oil in your dishes and you needed to wash it up later-- if you dropped your soap into it, you see it starts to dissolve-- essentially, soap does the same thing to the outside of the virus. It breaks up that membrane.

So handwashing with normal soap, it doesn't have to say antibacterial-- bar soap works. Any kind of soap works. These products like Lysol and other things like that, they all have the soap stuff that you need in there. Alcohols actually also worked too because they also break that up. So those things help a lot. Bleach products can also kill viruses. Obviously, be very careful when you-- bleach is not to be used on your hands. You'd be using that on surfaces and stuff.

But we have a lot of products that kill it, and a lot of evidence. And a lot of people have done those tests to verify that that's true. This is not an indestructible thing. They can break up. And it is a little more stable on surfaces than some other membrane viruses. So it's a reason to be really cautious. I mean, make sure you're aware that when you're touching things outside of your home where you hopefully know you're clean, when you come home, wash your hands right away. Be aware that it's possible you've touched something that could bring it with you.

And that's the same reason they say don't touch your face because it's so easy. You know, you've touched a doorknob or whatever that someone just coughed in their hand and touched. And then if you touch your face, you just moved the virus to where it needs to be. The virus is not coming in through your hands, it's coming in through your respiratory tract. So you want to keep your hands away from that.

KODY KISER:         And to the idea when we go out to the store, we know that we need to keep our distance from others, avoid places that might be busy or crowded. But what about when we return home?

Apart from washing your hands, if you've been out at the grocery store, things like that, do you need to change clothing, take a shower? When I bring my groceries in, do I need to wipe everything down before I put it away?

DR. REBECCA DUTCH: So there's not a-- there's not a strict answer to that because we're still working on this. When I go walk my dogs outside, I certainly am not coming home and changing my clothes. I'm outdoors. The virus particles, they're not free-floating in the air for long periods of time. I'm not particularly worried about it.

I would suggest if you get takeout food and stuff, I tend to bring it home, put it on a plate and throw out the container, and then wash my hands. Because you have to remember, just always think, who might have touched it before? That saves you-- or who might have coughed on it before, right? I do that. When we bring groceries home, I wish I could say I was perfect about this because I know you could wash down every single can. I will be honest, I also know that they don't last on surfaces for more than a few days. So if I know it's something that's going in the back of my pantry for a while, I don't worry about it all that much.

But I certainly rinse all my vegetables and fruits and things that are coming in the house, stuff like that. In terms of your clothes, certainly, I would suggest-- I would think that people who are doing health care type work are coming home and showering and everything before they're interacting with their families, where you might have been in contact with a lot of people, particularly this.

I have a nephew who works at Home Depot. He actually does come-- he helps people all day long, and then he comes home and immediately just kind of changes in the laundry room and takes a shower and stuff, just because he's had-- he's been closer than 6 feet, sometimes, if he's helping a customer over the course of hours.

And I will say one of my children flew home from LA last week. And he did go hang his wool coat up so that it had a chance not to touch stuff for a while and take a shower and stuff when he got home, just because he'd been on planes and with other people and all over the place. So I wouldn't-- we all have to survive. We have to live. And I wouldn't overly panic. But if you've been somewhere for a long time where you think I'm not so sure who I've been around, then I probably would change. If you've been in casual circumstances and you've gone to the grocery store, and as far as you know, you haven't been stuck right next to anybody, then I think you'd be-- I probably wouldn't.

JAY BLANTON:      I just want to be mindful of your time. And as we're wrapping up here, Dr. Dutch, are there things, being a scientist at this moment in time at a university like UK, that-- I know this is a serious issue, but you find it exciting, or are there things that you think our university in particular brings to the table that make this alliance where we're bringing all these disciplines together to work on this? I mean, are there things about this that you can communicate about what this institution brings to the table at this time for this problem?

DR. REBECCA DUTCH: Yeah. I mean, UK really is unique in that having so many different expertise, people with different expertise so close. So it's unusual for your college of medicine, your college of pharmacy to be right next to your main undergraduate campuses. And yet, we have all of that here. And I think that brings something really unique. Because for instance, this alliance includes not just the Dean of the college of medicine, but also the Dean of pharmacy, bringing the questions about from their perspective, what do they see.

I think that unique arrangement is really helpful. And it also allows people who do more basic research to very quickly be able, say, to talk to the head of infectious disease. We're hearing already about, oh, we're seeing this in some patients. We're seeing this in some patients.

That's really rapid interaction between your scientific community and your clinical community. And some of that's much more unique to UK than to other places. And I think that's really powerful.

I also think UK has historically been a really collaborative environment. I mean, one of the reasons I've stayed here coming up on 20 years is because I think how easily people collaborate and how helpful people are with each other is something that is more unique to here. Not that there aren't some other universities that are like that. But in general, people at UK, they just love to do what they love to do. They love their science. They love helping patients. They love thinking through things. And they want to work together. And I think that's another powerful thing what we bring to the table.

KODY KISER:         Is there anything that we haven't asked or made mention of that you feel like is important to get out there? Anything you wanted to add on to anything we've been talking about?

DR. REBECCA DUTCH: I think probably, the biggest thing is this is a really anxiety-producing time for a lot of people, partly because I think we've not, as a society, thought much about possibly this could even happen. I think this has really surprised people. We will get through it. I mean, I think that our governor says that, other people say that, but it is true. I mean, this is a national event. We haven't had a pandemic this big in most people's lifetimes, unless they were alive in 1918. And that was a lot worse than this. But it can happen.

On the other hand, we're so much better off because we have so many more tools to address this. I mean, we knew within weeks what it was. People were starting the vaccine development and the antivirals so soon after this. We have advanced medical care. So don't panic. Listen, take all the right steps to protect yourselves and your family and each other, but don't panic.

Because we will get through it.

KODY KISER:         Well, that is definitely the thing that I feel most comfortable with ending this conversation on.

JAY BLANTON:      We'll go with that, on a hopeful note.

KODY KISER:         We'll go with that. Dr. Rebecca Dutch, thank you so much for being with us. We greatly appreciate your time. And take care of yourself and just thank you for all of the work that you've put in on this and other projects.

DR. REBECCA DUTCH: All right, thank you.

JAY BLANTON:      Thank you so much.