PART 1 THE STORM BREAKS
Susan R. Wente first learned of the virus in December 2019ânot in her role as the head of Vanderbilt University, but as a scientist.
Online reports of a ânovel coronavirusâ causing dozens of cases of pneumonia in Wuhan, a city of eleven million in central China, were circulating among cell biologists like Wente, who, after shifting from a distinguished career in science to join the upper ranks of Vanderbiltâs leadership, continued to run an internationally respected research program on campus. Her lab had made important discoveries regarding how RNA molecules travel within cells and how different viruses alter those pathways during infection. The pathogen that had emerged in Wuhan was the kind of RNA virus Wenteâs lab studied, so she read about it with interest.
Assessing the scant data coming out of China as best they could, Wente and most of her peers viewed the virus as something to watch closely but that, with luck, would be contained quickly, like the coronavirus that had caused the global SARS outbreak in the early 2000s.
As a scientist, Wente could observe with curiosity from half a world away as facts about the new virus came to light. But as someone serving double duty as Vanderbiltâs longtime provost and its current interim chancellor, she was compelled to consider taking actionâeven if as just a precaution against what seemed like the remote possibility that the virus could become a danger to Vanderbiltâs people and assets.
âThe issue,â she recalls, â[was] that there just wasnât a lot of information coming out to enable us to determine [the threat], scientifically or institutionally.â
Wente continued to track online discussions of the virus as 2020 arrived and, with it, some thirteen thousand students returning to Vanderbiltâs campus for the spring semester. Before long, what had begun as a handful of reports from a city many Americans had never heard of built slowly into a steady drumbeat of increasingly concerning news. On January 11, Chinese state media reported that a sixty-one-year-old man had died of an illness caused by the novel coronavirusâthe first such death to be reported. Fewer than ten days later, coronavirus cases were reported in Japan, South Korea, and Thailand. The first US case was confirmed near Seattle on January 21.2 And on January 23, the Chinese government locked down the residents of Wuhan in a belated attempt to keep the coronavirus from spreading.3
It was about this time that the team in Vanderbiltâs Office of Emergency Preparedness, which had also been monitoring reports of the virus, decided it was time to brief their boss, Vice Chancellor for Administration Eric Kopstain.
âThey gave me a deck of slides, and we had a very interesting conversation,â Kopstain recalls. âWe concluded with two decisions: One, letâs keep a close eye on this and hope we donât have to talk a lot more about it because it will be contained. But letâs also establish a coronavirus commission with people from across the university.â
The commissionâs nearly forty members would represent virtually the entire university administrationâfrom public safety, finance, and academic affairs to communications, IT, legal, and dining services. The plan was for the panel to convene at the end of the month to begin developing a playbook that university leadership could draw from in the event that the coronavirus came to campus. The team wouldnât be starting from scratchâthe broad, earlier planning for an outbreak of any dangerous contagion gave it a running start.
Across West End Avenue from Kopstainâs office, at the Loews Vanderbilt office plaza, Vanderbilt Director of Strategic Communications Princine Lewis was also tracking news of the virus. With outbreaks now prominent in the headlinesâincluding possible cases at Tennessee Tech and Texas A&Mâparents and others were bound to have questions about Vanderbiltâs strategy for protecting students. Already a local television reporter was asking about the implications for the universityâs study abroad program. The university needed a communications plan, Lewis thought, and fast.
On January 28, the same day Kopstain got his briefing, Lewis went to Associate Vice Chancellor for Strategic Communications Ian Morrison with two recommendations: Vanderbilt should increase its communication about the virus beyond occasional bits of news on the Office of Emergency Preparedness web page. And it should start right away, posting a message to the universityâs official news site. Lewis and Morrison agreed that the matter of the virus was growing serious enough that its daily handling ought to be escalated to the highest level of Vanderbiltâs administrationâthe ten vice chancellors who oversaw all aspects of the universityâs operations. Morrison planned to call their boss, Vice Chancellor for Communications Steve Ertel, that night.
When he reached Ertel, it was a difficult conversationânot only because of the subject matter, but because Ertel was at a noisy roller rink with his sonâs grade-school class and had a hard time hearing. But he heard enough to understand Morrisonâs concerns and agreed to take them to Kopstain right away. Searching for the quietest place in the rink, Ertel wedged himself into a nook housing an ATM. After speaking with Kopstain, he next dialed Lewis, who had to dash out from the salon, her hair still wet, to take the urgent call from the privacy of her car. Ertel then connected both Lewis and Morrison with Kopstain, who listened as they described their concerns and the near-term communications plan Lewis outlined. He agreed to run with their recommendations and to raise the issue among the other vice chancellors.
âThat was the beginning of a more concerted focus among the leadership of the university,â Ertel says.
The next day, the first item about the coronavirus appeared on the Vanderbilt news site beneath the headline âUniversity monitoring coronavirus outbreak.â âAt this time, there are no reports of coronavirus cases on the Vanderbilt campus, and there are no confirmed cases in Tennessee,â the report noted. It went on to say that student requests for travel to China for university-sponsored activities would be subject to additional review and that faculty and staff should reconsider nonessential travel to the country.4
Despite the growing concern behind the scenes, the new semester was getting off to a normal start. During the week of January 26, in addition to the daily hum and shuffle of classes, lab activity, and office work, there was a screening of a documentary called A Free Trip to Egypt. Several PhD candidates defended their dissertations. The Wondâry, Vanderbiltâs Innovation Center, hosted an evening of live music and original poetry. The womenâs swim team traveled to a meet at the University of ArkansasâLittle Rock, menâs tennis faced Indiana, the womenâs basketball team took on Alabama and Tennessee, and the menâs hoops squad traveled to Lexington to square off against the University of Kentucky. The Blair School of Music offered several master classes, and the universityâs InclusAbility organization sponsored a presentation called âDeaf and Awareness Culture 101.â5 Tickets were moving briskly for upcoming talks with former national security advisers Susan Rice and John Bolton and broadcast journalist and Vanderbilt family scion Anderson Cooper, among others.6 For most people, as Assistant Vice Chancellor for Plant Operations Mark Petty remembers, the coronavirus was âthis thing over there. It was not here.â
On January 30, the World Health Organization declared the novel coronavirus to be a global emergency.7 Three days later, the Philippines reported that a man had died of the virusâthe first death reported outside China. The Diamond Princess, a cruise ship, was anchored off the coast of Japan, its 3,700 passengers quarantined after an outbreak onboard. More than 700 eventually tested positive, and 14 of them would later die.8
On February 11, the virus got its official name: severe acute respiratory syndrome coronavirus-2, or SARS-CoV-2 for short. The illness it caused was named too: COVID-19.9 France, on Valentineâs Day, reported Europeâs first COVID-19 death.10
For an early February meeting of the Vanderbilt Board of Trust, Wente invited Dr. William Schaffner, a professor of preventive medicine and infectious disease at the Vanderbilt University School of Medicine, to brief trustees on what was known about the virus. That same month, Dawn Turton, an associate provost in Wenteâs office, called Vanderbilt professor Dr. Mark Denison after Vanderbilt University Medical Center CEO Dr. Jeffrey Balser suggested she invite Denison to speak to the universityâs coronavirus commission. Denison had studied coronaviruses for more than three decades and was one of the worldâs foremost experts on the pathogens. When Turton reached him, he was waiting to catch a flight back to Nashville from Washington, DC, where heâd met with infectious disease experts at the US Centers for Disease Control and Prevention and the National Institutes of Health. The next day, Denison stood in front of the commission and told them what he knew. His assessment was sobering, Turton remembers. Denison dispelled any hopes that the outbreak might be seasonal. More distressingly, he explained that the virus could apparently be spread by people who had no symptoms. A person could have the virus and never know it, appearing perfectly healthy. Others could contract it simply by being near enough to that person.
âHow would you deal with that in a student population?â Turton recalls wondering. âI didnât see the way forward.â Hopes that this virus would go the way of SARS were fading rapidly.
As administrators learned more, Wente stayed in close contact with Bruce Evans, the chair of Vanderbiltâs Board of Trust, to keep him informed about the commissionâs thinking. She also made regular calls to incoming chancellor Daniel Diermeier. In early December, the board had appointed Diermeier, the University of Chicago provost, as the permanent replacement for longtime Vanderbilt chancellor Nicholas Zeppos, who had retired the previous August. Diermeier was not scheduled to assume the chancellorâs role until July 1, but Wente kept him apprised of Vanderbiltâs decision-making.
Meanwhile, the virus spread around the world, with hotspots emerging in Italy and Iran. By February 27, more than 82,000 SARS-CoV-2 infections had been reported in forty-seven countries, with more than 2,800 reported deaths.11 In the US, the CDC warned Americans to begin preparing for the virus to spread.12
As the strict lockdown in Wuhan continued, and as Italian authorities issued stay-at-home orders for several of that countryâs hard-hit provinces, the prospect of similar shutdowns in American cities began to look possible. For the nationâs colleges and universities, such an unprecedented move could have enormous, even existential consequences. How, in a worst-case scenario, could students be locked down or quickly evacuated from campus? How could professors pivot to online learning? How could research laboratories, Americaâs mighty innovation engine, simply idle? How might a shutdown, and the resulting loss of revenue, affect a universityâs finances? These were questions no administrator wanted to think about, but in February 2020, they were questions that demanded answers.
At the Forefront of Research
As university leadership began dealing with the realities of the coronavirus heading toward their campus, faculty researchers and their colleagues at Vanderbilt University Medical Center were contributing to the fight against the pandemic at the local, national, and global levels, joining their colleagues worldwide to lend a hand as soon as news of the virus broke. Researchers from all of the universityâs schools and colleges were involved,13 in fields ranging from microbiology, engineering, and psychology to anthropology, history, public health, and education.
At the center of some of the most important efforts was Denison. His lab had been funded for more than thirty years by the National Institutes of Health to investigate the replication, pathogenesis, and evolution of coronavirusesâincluding SARS, MERS, and now SARS-CoV-2. Since he began studying coronaviruses in 1984, Denisonâs lab had made several seminal discoveries in their biology and in the development of antivirals and vaccines.14
Early on, the Denison Lab was a key player in several vital efforts that the entire world was watching with hope. One was the development of a COVID-19 vaccine. Denison and his team were preparing to lead Phase 1 of human testing of mRNA-1273, a vaccine candidate developed by Cambridge, Massachusetts-based biotech company Moderna. This particular vaccine candidate was built on work going back to the 1990s by Dr. Barney Graham, a Vanderbilt PhD alumnus who had been a professor of microbiology and immunology at the university, and who was now deputy director of the National Institutes of Health Vaccine Research Center. Based on a concept devised by Graham, mRNA-1273 was thought to work by triggering the production of antibodies that attack the âspikeâ protein that enables SARS-CoV-2 to infect cells in the body. By blocking the spike protein, researchers believed, the antibodies âneutralizedâ the virus.15
Vanderbiltâs central role in COVID-19 vaccine development was no accident. Researchers like Graham and Denison had built on a century of foundational work, including pathology professor Dr. Ernest Goodpastureâs propagation of viruses in chicken eggs in the early 1930s. When COVID-19 emerged, Vanderbilt researchers were ready with knowledge and innovations amassed over decades. âPeople say, âHow could they make vaccines for corona so fast?â â says Vanderbilt professor and researcher Dr. James Crowe. âWell, they did it based on more than thirty years of research on RSV, HIV, and MERS.â16
Denison and his colleagues were also involved in investigating the antiviral drug remdesivir, a potential COVID-19 treatment that was in clinical trials in the United States and China. The Denison Lab had researched remdesivir since 2014; Andrea Pruijssers, an assistant professor of pediatrics and the lead antiviral scientist in Denisonâs lab, had been the first to demonstrate that the drug was effective against SARS-CoV-2.17 The pharmaceutical company Gilead Sciences would begin testing remdesivir in Phase 3 clinical trials in March 2020.18
And the previous November, Pruijssers had reported the first evidence that EIDD-1931, an antiviral developed at Emory University, blocked replication of a broad spectrum of coronaviruses in laboratory tests and prevented the viruses from developing resistance against it. Denison and his colleagues also contributed to a study at the University of North CarolinaâChapel Hill, which showed that a form of EIDD-1931 that could be taken orally prevented severe lung injury in infected mice. Human clinical studies on that therapy were scheduled to begin in the spring.19
Meanwhile, at the Vanderbilt Vaccine Center, not far from Denisonâs lab, Crowe and Associate Professor Robert Carnahan had moved sleeping cots into their lab so they could work around the clock with an international team of academic, governmental, and corporate partners to identify and analyze antibodies that could be used against ...