The Pandemic, Vermont Medicine Magazine, Larner College of Medicine at the University of Vermont

Research: True Stories of our Battle Against COVID-19

Jason Bates, Ph.D.

Bates and Vermont Team Invent Simplified Ventilator

A team of UVM scientists, engineers and doctors have developed a new design—and built a working model— for a simple, inexpensive ventilator, affectionately called the “Vermontilator.” Jason Bates, Ph.D.— a professor in both the Larner College of Medicine and College of Engineering and Mathematical Sciences—has been researching the kind of lung damage that occurs during illnesses like doctors are now seeing in COVID-19 patients for more than fifteen years. He leads the effort to develop the Vermontilator.

Unlike other improvised emergency ventilator designs, the UVM team’s approach uses an alternative mode of helping critically ill patients breathe. It’s called “airway pressure release ventilation” or APRV. This APRV approach may be particularly useful for patients suffering with the new virus. “One of the main complications from COVID-19 is called acute respiratory distress syndrome, a disease where the lungs fill up with an inflammatory fluid,” explains Anne Dixon, M.D., professor of medicine. “Many of these patients end up being dependent on a ventilator for fairly prolonged periods.”

The new ventilator could help these patients by inflating their lungs using long inspirations of air, which are held inflated at a constant and relatively high pressure, Bates explains. Then “at regular intervals, short expirations are allowed during which the lungs expel carbon dioxide,” he says. The APRV approach is the opposite of a normal breathing pattern—and may allow patients with COVID-19 to avoid, or reduce, the lung damage associated with the disease and with extended periods on a ventilator.

Unlike a traditional ventilator—a very complex piece of equipment that can cost more than $25,000—the Vermont-built machine was quickly assembled out of a commercially available motor that drives a rotating disk, conventional medical hoses, and other relatively simple parts, through collaboration with the team at UVM’s IMF Labs. As the COVID-19 pandemic continues to evolve, Bates sees resource-poor areas of the world experiencing severe shortages of healthcare facilities and equipment benefitting from the Vermontilator.

“Seeing the Vermontilator project come together from inception to realization so quickly, thanks to the enthusiasm and commitment of so many people, has certainly been one of the most gratifying experiences of my professional life,” says Bates.

Web Extra

Watch a video about the Vermontilator and the process used to create it.
Read a story about the Vermontilator in the New Yorker, titled "The Engineers Taking On the Ventilator Shortage."

Elias Klemperer, Ph.D.

Study Highlights Impact of COVID-19 on Motivation to Quit Tobacco

A study from researchers at the UVM Vermont Center on Behavior and Health (VCBH) suggests that, for some, knowledge of COVID-19 is associated with a reduction in cigarette and e-cigarette use, as well as an increase in motivation to quit. The study, published in Nicotine & Tobacco Research, is among the first to report changes in tobacco use and motivation to quit using cigarettes and e-cigarettes in response to COVID-19.

In this study, VCBH investigators examined data collected from 345 U.S. adults in an online survey conducted in April 2020. The researchers found that a desire to reduce COVID-19 infection risk prompted nearly a quarter of respondents to reduce their cigarette and e-cigarette use, and more than one-third to increase their motivation to quit. More than 20 percent of respondents reported a quit attempt to reduce risk of harm from COVID-19. These data are consistent with recent Vermont quit line (802Quits) data showing increases in phone and website registrations in March 2020 compared to March 2019.

“These findings demonstrate that some adults who smoke cigarettes and use e-cigarettes are changing in response to the coronavirus pandemic,” said first author Elias Klemperer, Ph.D., a postdoctoral fellow in the VCBH at UVM. “This is important, because quitting cigarettes is often the most important thing you can do to improve your health.”

In addition to Klemperer, co-authors on the study include Julia C. West, B.A., VCBH pre-doctoral fellow, Catherine Peasley-Miklus, Ph.D., VCBH project manager, and Andrea C. Villanti, Ph.D., MPH, associate professor of psychiatry.

Web Extra

Read "Change in Tobacco and Electronic Cigarette Use and Motivation to Quit in Response to COVID-19" in Nicotine and Tobacco Research.

Screenshots from a computer modeling simulation of COVID-19 lung injury

Computer Modeling Helps Researchers Battle COVID-19

Bright blue and white lights pulse across the grid of black squares like fireflies. While reminiscent of a summer night’s sky, the video images are actually a computer model of pulmonary inflammation that UVM Professor of Surgery Gary An, M.D., retooled to depict a COVID-19 cytokine storm. He posted it on Twitter, where scientists worldwide have been sharing ideas to identify potential treatments for the virus.

An has nearly 20 years of experience in creating models of sepsis, which like COVID-19, invokes a hyper-inflammatory response called a cytokine storm. In late March, he and Assistant Professor of Surgery R. Chase Cockrell, Ph.D., joined an international coalition of virologists, pharmacologists, and mathematicians led by Indiana University’s Paul Macklin, Ph.D., to help build a SARS-CoV-2 tissue simulator that models the changing behavior of the virus once it enters the body. An has collaborated with Macklin for several years.

The coalition members modeled the underlying mechanisms of COVID-19, “from viral invasion all the way through manifestation of disease,” An said. “The scientific community pretty rapidly identified the various phases of the viral life cycle and found potential drugs that theoretically targeted those various areas.”

The hurdle, however, was a lack of time to test potential treatments using a traditional approach. Conducting “in silico” trials—using computer models that model the mechanisms of the viral infection—allows scientists to explore how those drugs might work and provide insight about treatments.

The SARS-CoV-2 tissue simulator is an open source project, available to the large community of researchers working on COVID-19 projects worldwide on the project website.

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Web Extra

Visit the project website.
Read a preliminary report titled "Rapid community-driven development of a SARS-CoV-2 tissue simulator."