Show Me the Science

In this episode, Washington University researchers discuss the Food and Drug Administration's recent full approval of the drug Leqembi (lecanemab) and what it could mean to the future of Alzheimer's disease treatments. The drug is approved for use in people with mild dementia from Alzheimer's disease, but researchers at Washington University's Charles F. and Joanne Knight Alzheimer Disease Research Center (ADRC), believe the drug, along with other medications in clinical trials, one day may help prevent the development of memory loss and problems with thinking in people who have Alzheimer's pathology in the brain but who have not yet developed clinical symptoms of the disease. Barbara Joy Snider, MD, PhD, a professor of neurology and director of clinical trials at the Knight ADRC, says that although Leqembi doesn't cure Alzheimer's disease, it slows the decline in memory and thinking, and it also slows the progression of the disorder by removing some amyloid plaques from the brain. John Morris, MD, director of the Knight ADRC, says with amyloid PET brain scans, blood tests and cerebrospinal fluid tests to detect problems before clinical symptoms of Alzheimer's appear, it soon may be possible to delay or even prevent the development of Alzheimer's dementia in some people at high risk. The podcast, “Show Me the Science,” is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we discuss new research into psychedelic drugs as potential therapies for psychiatric illness. Several studies have suggested that drugs, such as psilocybin, may be useful in treating problems such as post-traumatic stress disorder, addiction and depression. Psychiatry researchers at Washington University School of Medicine in St. Louis have been using a brain-imaging technique called precision functional mapping to learn how psilocybin affects certain networks in the brain. Principal investigator Ginger Nicol, MD, an associate professor of child psychiatry, says scientists have suspected since the 1950s that there may be benefits from some psychedelic drugs, but because the drugs were classified as schedule one substances, researchers weren't allowed to study them. Recently, that has changed and Nicol, with fellow psychiatry researcher Josh Siegel, MD, PhD, gave a lecture sponsored by Washington University's Taylor Family Institute for Innovative Psychiatric Research, outlining some potential benefits of psychedelics in addressing hard-to-treat psychiatric problems. Using high-tech brain scans, they have been able to see what happens in the brain when a person takes psychedelic drugs, and they've found that the drugs cause more rapid changes than other medications used in psychiatry. What they want to learn next is whether the responses they've observed in brain scans translate into similar responses in the clinic, which could lead to improved mental health. They are planning to participate in a phase 3 clinical trial using psilocybin to treat people with treatment-resistant depression. The podcast, “Show Me the Science,” is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we hear from two physician-scientists who have been leaders in the U.S. effort to deal with two medical crises that emerged almost 40 years apart: HIV/AIDS and COVID-19. Anthony S. Fauci, MD, the recently retired director of the National Institute for Allergy and Infectious Diseases at the National Institutes of Health (NIH), spoke to Washington University School of Medicine's 2023 graduating class. His role at NIH made him a leader in the worldwide effort to understand and develop treatments for HIV/AIDS, beginning shortly after the virus first was recognized. Also, in those early days of HIV/AIDS, William G. Powderly, MD, tested emerging therapies at the School of Medicine's AIDS Clinical Trials Unit, which he oversaw. Powderly, now the Larry J. Shapiro Director of the Institute for Public Health, co-director of the Division of Infectious Diseases, and the J. William Campbell Professor of Medicine and director of the Institute of Clinical and Translational Sciences at the School of Medicine, points to key similarities and differences between the nation's response to HIV/AIDS and to COVID-19. In both cases, he says, the key to a successful response involved embracing science and battling against theories that are untrue. In his Commencement speech, Fauci told the 110 newly minted physicians who graduated this spring that they must push back on destructive forces that dispute science. He advised the new doctors to push back with civility, but also with all of the strength they can muster. While he was at Washington University, Fauci also spoke to the St. Louis press corps about the end of the COVID-19 emergency and where we go from here. The podcast, “Show Me the Science,” is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we visit a recent event sponsored by the Becker Medical Library at the School of Medicine. Called “In Our Words: Connection,” the storytelling event brought together 12 faculty members, medical students, residents and fellows who told stories about how their lives have been affected by medicine as caregivers, those receiving care or otherwise. The idea behind the evening was to share stories and assist physicians and trainees in better understanding that they face many of the same challenges that their patients and colleagues face. Knowing that can help prevent burnout among physicians and help them to provide better care for their patients. Emily Podany, MD, is a hematology/oncology fellow who works with cancer patients, many of whom know their time is short. Her story detailed a meeting several years ago with a patient whose only goal was to make it back home one more time to be with her children and her dogs. Podany made it her mission as a provider to help her patient do just that. We also hear from Amy Riek, MD, an associate professor of medicine in the Division of Endocrinology, Metabolism & Lipid Research. Riek was preparing to give birth to her second child when she discovered a lump in her breast. Her story dealt with how cancer can rob patients of the feeling that they have any control over their lives. The podcast, “Show Me the Science,” is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we report on the disturbing spike in maternal mortality rates in recent years. Although rates of maternal death have long been higher in the U.S. than in other wealthy countries, the rate recently reached its highest level since 1965. The number of deaths of mothers has risen from 17.4 deaths per 100,000 births in 2018 to 20.1 deaths in 2019 and 23.8 in 2020 — the first year of the pandemic. Then in 2021, the most recent year for which statistics are available, there were 32.9 deaths per 100,000 births. In all, about 1,200 people died during pregnancy, or within six weeks of giving birth, a 40% increase from the previous year. Ebony B. Carter, MD, an associate professor of obstetrics & gynecology at Washington University School of Medicine in St. Louis, says the groups most likely to be affected by these rising numbers are poor. Many tend to live far away from medical care, and many are members of minority groups. The maternal death rate among Black Americans was 69.9 per 100,000, 2.6 times higher than the rate for pregnant white Americans. Carter says physicians and scientists at Washington University and Barnes-Jewish Hospital are working hard to provide good prenatal care, but she explains that when people get pregnant, they often already have serious health issues that can contribute to maternal death, such as diabetes or hypertension, and put them and their babies at risk. She says the time to try to intervene is before chronic illnesses develop and make an eventual pregnancy risky. That, she says, will require an intentional focus from health-care professionals and systemic changes in how health care and other social services are provided in the United States. The podcast, “Show Me the Science,” is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we report on a major international study involving psychiatry researchers from the School of Medicine who are working to identify causes and effects of the early stages of schizophrenia in young people — an illness characterized by significant changes in thoughts, feelings and behavior that may include a loss of contact with reality. The goal is to improve early diagnosis and treatment to potentially prevent the most devastating effects of the disorder. The study's principal investigator is Daniel Mamah, MD, a professor of psychiatry. He has a clinic in St. Louis, where he works with young people to identify biomarkers in the blood and the brain that may help predict risk of debilitating psychiatric illness. He also studies potential drug targets for treating such conditions. In addition, Mamah and his colleagues have expanded their efforts to East Africa. Working with collaborators in Kenya, the researchers are launching a site in Africa to study young people at risk for schizophrenia in hopes of learning more about what causes the illness, as well as how to potentially prevent it. Mamah previously has collaborated with researchers at the Africa Mental Health Research and Training Foundation, and now the scientists are working to identify and compare risk factors for schizophrenia in patients from North America and from Africa. The podcast, “Show Me the Science,” is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we head to the emergency department. Doctors in most emergency departments around the country are dealing with fewer COVID-19-positive patients than before, but they continue to be faced with a different epidemic of sorts: the 20% to 30% of patients with dementia-related cognitive issues who seek emergency care. As the U.S. population ages, it's more common for emergency physicians to find themselves treating older people who are living with dementia. Further, during the thick of the COVID-19 pandemic, such patients were not allowed to have relatives stay with them to help navigate and better understand what is happening during their visits to the emergency department. While completing his medical training, Christopher Carpenter, MD, a professor of emergency medicine, had a bad emergency department experience involving his grandfather, who was suffering from dementia at the time. For more than two decades since then, Carpenter has looked for ways to make the emergency department experience easier for those who are living with dementia and their family members and caregivers. He is part of a national effort known as the GEAR Network, which stands for Geriatric Emergency Care Applied Research Network. The organization is studying ways to better identify and serve older patients with dementia. Carpenter says it's essential to improve emergency care for people living with dementia because as the U.S. population continues to age, the number of such people seeking treatment in emergency departments will continue to increase. The podcast, “Show Me the Science,” is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we learn more about one of the leading problems associated with long COVID-19. Those who have been infected with the virus are at increased risk for a range of neurological conditions in the first year after an infection. Research conducted at the School of Medicine and the Veterans Affairs St. Louis Health Care System has found that strokes, cognitive and memory problems, depression, anxiety and migraine headaches are more common in people who have had COVID-19 than those who haven't. The most common neurological symptom, called brain fog, makes it more difficult for some people to remember things such as names, daily tasks or where they parked the car. Ziyad Al-Aly, MD, a clinical epidemiologist, says that since the pandemic began, COVID-19 has contributed to more than 40 million new cases of neurological disorders worldwide. Infections even have been associated with movement disorders — from tremors and involuntary muscle movements to epileptic seizures — hearing and vision problems, and issues with balance and coordination. We also speak with Robyn Klein, MD, PhD, director of the Center of Neuroimmunology & Neuroinfectious Diseases at Washington University School of Medicine in St. Louis. Her team studied the brains of hamsters and brain tissue from people who died of COVID-19 infections and found that although the virus doesn't seem to get into neurons directly, it does increase the numbers of immune cells, called microglia, in brain structures important to learning and memory, potentially explaining why some of those structures in the brain may not function as well during and after COVID-19 infections. The podcast, “Show Me the Science,” is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we visit the team at the Washington University Living Well Center. It was launched to improve outcomes for patients with orthopedic issues. For example, if someone needs hip-replacement surgery, that person also can receive help losing weight, stopping smoking and taking other actions to make it more likely the outcome from their surgery will be as good as possible. The center uses dietary counseling, physical therapy, massage, acupuncture and behavioral therapy to prepare some patients for surgery, while helping others improve without surgical intervention. In addition to orthopedic issues, health professionals at the center work with cancer patients, long COVID-19 patients and others. The idea, according to Devyani M. Hunt, MD, a professor of orthopedic surgery and the center's medical director, is to treat the whole patient and to do it all in one place. Specialists at the center work together to apply the “pillars of lifestyle medicine including using food as medicine, encouraging physical activity and exercise, addressing sleep issues, managing stress and addressing anxiety and depression, avoiding risky substances such as tobacco, and encouraging patients to make positive social connections. The center has had more than 200 patients come through its doors the last few years, and the outcomes for those patients suggest the approach is working. The podcast, “Show Me the Science,” is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

As we get deeper into autumn and winter approaches, we discuss COVID-19 vaccines. New boosters have been developed to rev up the immune system not only to fight the original strain of the virus but also to boost the immune system against more recent omicron strains of SARS-CoV-2. In this episode, we discuss the boosters — now approved for use in children as young as 5 — with infectious diseases specialist Rachel M. Presti, MD, PhD, an associate professor of medicine and medical director of Washington University's Infectious Diseases Clinical Research Unit. New vaccines may be on the horizon, too. A nasal vaccine developed by Washington University scientists recently was approved for emergency use in India, and that technology has been licensed to Ocugen, a U.S.-based biotechnology company focused on developing and commercializing novel gene and cell therapies and vaccines. Ocugen plans to seek approval for the nasal vaccine in the U.S., Europe and Japan. The nasal vaccine was developed by Washington University virologist and immunologist Michael S. Diamond, MD, PhD, the Herbert S. Gasser Professor of Medicine and a professor of molecular microbiology, and of pathology & immunology; and David T. Curiel, MD, PhD, the Distinguished Professor of Radiation Oncology. The hope is that the nasal vaccine will stoke the immune response in the nose and throat so that the virus never gets farther into the body. Current vaccines require a person to be infected before antibodies revved up by the vaccine can fight it. As a result, Diamond and Curiel say a nasal spray may be more effective at preventing infections and at keeping vaccinated people from spreading the virus to others. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

If you were coughing, running a fever and felt short of breath, what would you think? Those are common symptoms of COVID-19. But not everyone with such symptoms is infected with the virus. In this episode, we tell the story of a Michael Moffitt, a young man who grew up in St. Louis but was been working in the oil and gas fields of New Mexico. He got sick in November 2020 with a cough, fever and shortness of breath, initially leading his doctor to assume he had COVID-19. Moffitt's tests for the virus came back negative, but for weeks, his health-care providers in New Mexico wondered whether the tests were accurate. He was being treated with antibiotics, but when Moffitt lost 30 pounds in three weeks and needed supplemental oxygen, he knew he needed another opinion. After his wife and mother-in-law drove 14 hours to bring him to St. Louis, Moffitt saw infectious diseases specialist Andrej Spec, MD — an associate professor of medicine and a specialist in fungal infections. Spec put him in the hospital and quickly solved the medical mystery. Moffitt had a fungal infection, likely acquired while exploring caves in New Mexico. Spec started him on strong antifungal medications, and he fully recovered. Spec says the majority of people who have symptoms of COVID-19 actually do have that viral illness. But when treatments don't work, he says, it's important for doctors to think a little differently and consider other factors that may cause illness. Many people have fungal infections in their lungs at some point in their lives, he says. Most of those infections are asymptomatic or feel like bad colds, but in some instances, the infections can become life-threatening without proper treatment. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Infections and hospitalizations are rising again. During this latest wave of COVID-19 infections, many fully vaccinated people are getting sick, as are people who previously were sick with the virus, even those infected in the very recent past. The new strains of omicron — BA.4 and BA.5 — have stricken some well-known, fully vaccinated people, including President Joe Biden and Dr. Anthony Fauci. In this episode, we speak with William G. Powderly, MD, the J. William Campbell Professor and co-director of the Infectious Diseases Division at Washington University. Powderly says the recent increases in cases and hospitalizations are a reminder that, even after two-plus years, the pandemic is not over. Vaccines seem to protect many people from serious disease, but infections among those who are fully vaccinated have become more common as BA.4 and BA.5 have become the virus's dominant strains. Rachel M. Presti, MD, PhD, an infectious diseases specialist and an associate professor of medicine at Washington University, is among those testing new vaccine boosters engineered specifically to target those new strains. Presti, medical director of the university's Infectious Diseases Clinical Research Unit, says it's still too early to be certain but that the updated boosters seem to provide better protection than the currently FDA-approved vaccine. Of course, how long protection provided by the updated booster might last may depend on how quickly the virus continues to evolve. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Brain-computer interfaces connect activity in the brain to an external device by means of a computer. Research has shown it's possible to use such interfaces to move robotic arms and perform other tasks. Almost 30 years ago, Washington University researcher Eric Leuthardt, MD, a professor of neurosurgery, demonstrated that he could hook electrodes to the brains of epilepsy patients who were waiting to have brain surgery, and those patients then could play video games just by thinking about moving things on a screen. Over the years, Leuthardt's team has learned to detect similar brain signals noninvasively. He co-founded the Washington University startup company Neurolutions Inc. to develop a brain-computer interface to help stroke patients recover function in their hands and arms. In this episode, we learn about that device, known as the IpsiHand Upper Extremity Rehabilitation System. The IpsiHand involves a sort of cap that picks up brain signals from a stroke patient and transmits the signals to an exoskeleton fitted over the patient's paralyzed hand. While wearing the system, patients think about moving the affected hand, and the IpsiHand translates that intention into actual hand movement. Over time, the patient's brain slowly learns how to move the hand by itself. In addition to Leuthardt, we'll also speak to a man who helped test an early version of the device years after a stroke left him unable to use his right hand. After working with the IpsiHand, the stroke patient, Mark Forrest, regained enough use of his right hand that he was able to build himself a boat. We'll ride on that boat with him as he catches some fish and discusses his recovery. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

As many as 30% of those who get COVID-19 will continue to have problems in the weeks and months after their infections. Long COVID-19 is defined as a condition in which issues persist for at least three months. But for many, the difficulties last much longer. Extreme fatigue, shortness of breath and what many call brain fog lead the list of long-term complications. Some people also develop heart problems, diabetes, psychiatric issues and trouble with pain in the weeks and months following the initial illness. In this episode, we speak with Maureen Lyons, MD, an assistant professor of medicine and director of the Care & Recovery After COVID-19 Clinic at the School of Medicine. The clinic was designed specifically to work with so-called long-haulers. She says many of her patients are frustrated at their inability to get back to life as they knew it before COVID-19. We also hear from one of Lyons' patients, Michelle Wilson. She's a nurse who became ill with COVID-19 in November 2020 and is still having problems with fatigue, shortness of breath and other difficulties. And we'll hear from epidemiologist Ziyad Al-Aly, MD, an assistant professor of medicine at Washington University who treats patients in the Veterans Affairs St. Louis Health Care System. He has found that vaccination provides some protection against long COVID-19, but just as vaccinated people still can get breakthrough infections, they also can develop long COVID-19. It's not as common in vaccinated people, but there's still a significant risk. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

In this episode, we discuss issues that were problems long before anyone ever heard of COVID-19: alcohol use disorder and opioid overdose. Both seem to have gotten worse during the pandemic. Alcohol sales rose during the early days of lockdown, and they've remained high. Laura J. Bierut, MD, the Alumni Endowed Professor of Psychiatry, says another issue is that with some people losing their jobs while millions more have worked from home, some of the guardrails that have kept people from drinking too much have just gone away. She expects the fallout from the pandemic, in terms of alcohol use, will continue being felt for years to come. And just as the pandemic has fueled alcohol problems, deaths from drug overdoses have continued to climb, with more than 107,000 overdose deaths reported in the U.S. during a recent 12-month period. One issue, according to Kevin Xu, MD, a resident in psychiatry and Evan S. Schwarz, MD, an associate professor of emergency medicine and director of the Division of Medical Toxicology, is that many who use opioids are not prescribed a drug that can reduce cravings and lower risk of future overdose. That drug, buprenorphine, is prescribed for only about half of the patients treated for opioid use disorder, and it's used even less frequently in people who use opioids along with other substances, such as cocaine, alcohol or methamphetamine. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

But for this episode, we're sticking with COVID-19. In 2020, when the pandemic shut down much of the country, our very first guest on “Show Me the Science” was Steven J. Lawrence, MD, a professor of medicine in the Division of Infectious Diseases. He also was our first guest of our second season of podcast episodes last year. And we've brought him back again, for year three. As the pandemic first gripped the St. Louis area, Lawrence was worried whether there would be adequate ventilators, ICU beds and medical staff to care for patients with COVID-19. A year later, in spring 2021, he was touting vaccines as a potential way out of the pandemic. Now, after having to deal with the delta and omicron variants of the virus, and with new worries about an even more infectious version of omicron, Lawrence has thoughts on moving forward as well as what people got right and wrong during the first two years of the pandemic. He also has some ideas regarding where we may be headed. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

The death toll isn't the only staggering statistic from the first two years of the pandemic. What's become increasing clear is that some COVID-19 patients don't get well right away. Since the earliest days of the pandemic, we've heard of survivors who continue to experience shortness of breath, extreme fatigue, lingering difficulty with taste and smell, and brain fog. But researchers at Washington University School of Medicine in St. Louis and the Veterans Administration have found that other problems also affect people long after infection with the virus. In a series of studies, epidemiologist Ziyad Al-Aly, MD, an assistant professor of medicine who treats patients in the VA St. Louis Health Care System, has found that following COVID-19 infection, people are more likely to develop kidney problems, heart issues, diabetes and mental health difficulties such as depression and anxiety. The percentage of patients who go on to have those issues is relatively low, but with so many people having been infected, the absolute number of people with lingering problems is in the millions. Meanwhile, another team of researchers at Washington University School of Medicine found that those who tested positive for the virus are more likely to report problems with peripheral neuropathy, which is characterized by pain and tingling in the hands and feet. Simon Haroutonian, PhD, an associate professor of anesthesiology and chief of clinical research at the Washington University Pain Center, found that nearly 30% of patients who tested positive for COVID-19 also reported neuropathy problems, and in 6% to 7% of those patients, the problems persisted for up to three months. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

With the pandemic death toll approaching 1 million people in the United States, Rochelle P. Walensky, MD, the director of the U.S. Centers for Disease Control and Prevention (CDC), and a Washington University alum, visited Washington University School of Medicine on March 2 and March 3, 2022. As part of the Department of Medicine's weekly Grand Rounds series, she sat down with William G. Powderly, MD, the J. William Campbell Professor of Medicine and co-director of the Division of Infectious Diseases, for a conversation about the challenges and successes of the pandemic. During the conversation with Powderly, Walensky answered questions about COVID-19 and noted that her earlier experiences as a physician working during the HIV/AIDS epidemic influenced her thinking about this newer public health crisis. She says the AIDS epidemic demonstrated that infectious diseases tend to weigh more heavily on some communities than others, and that this unequal burden is rooted in social inequities. She also praised the rapid development and deployment of COVID-19 vaccines, even as she admitted that vaccination rates need to improve in the U.S. and around the world in order to help the planet emerge from the pandemic. And she told trainees that, as difficult as the last two years have been for health-care providers, she wanted them to remember that a pandemic like the one we have been experiencing is exactly what that they trained for. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

More than 900,000 people in the United States have died of COVID-19, and over the last year, almost all of those deaths have been among unvaccinated people. Still, many people remain unvaccinated, and many say they are not sure whether they can trust the things public health officials say about COVID vaccines. Washington University infectious diseases specialist Elvin H. Geng, MD, a professor of medicine, recently recalled similar issues with communication and trust in a Perspective essay he wrote for The New England Journal of Medicine. In the essay, Geng discussed a patient he worked with years ago who was convinced that HIV didn't cause AIDS. That patient saw no need to take anti-retroviral medication when it became available, even as he got progressively sicker. But Geng continued talking to this patient and, eventually, he changed his mind. Geng writes that similar efforts are needed to ease the fears of people who have very real concerns about the safety of COVID vaccines. He writes that “no disembodied message (even if crafted by marketing experts) can compete with someone you know who will pull up a chair.” Although Geng says he understands it's difficult for doctors to make time for heart-to-heart talks with every anxious patient, he also says it's clear from the low rates of vaccination that something has to change; and he believes deeper, more empathetic conversations between doctors and patients could be an important step. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

With U.S. hospitals crowded with COVID-19 patients for almost two years, the pandemic's relentlessness has pushed many doctors, nurses and other health-care professionals to the brink. Many have decided to leave the field or question whether to remain. Researchers at Washington University School of Medicine in St. Louis have launched a research project as part of a new program funded by the Health Resources and Services Administration of the U.S. Department of Health and Human Services. The goal is to reduce burnout and promote mental health and wellness among those in the health-care workforce. Psychiatrist Ginger E. Nicol, MD, is the study's principal investigator. She says the fact that the pandemic has dragged on for so long makes it especially difficult to handle. And co-investigator, psychiatrist Jessica A. Gold, MD, the director of wellness, engagement and outreach for the Department of Psychiatry, says the culture within health care — that although workers are willing to go to great lengths to help others, they don't like to ask for help themselves — presents a major challenge. The School of Medicine is trying to change that culture as it trains the next generation of health-care professionals. Eva Aagaard, MD, the senior associate dean and vice chancellor for medical education, says the school is working hard to identify potential burnout in students and to encourage them to seek help when problems arise. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

The omicron variant of SARS-CoV-2 arrived in the United States around Thanksgiving. Within a few weeks, it was the dominant variant in the country, and hospitals suddenly were crowded with COVID-19 patients again. More patients were hospitalized in the St. Louis region as the omicron wave hit than at any other time during the pandemic. The good news is that although there have been breakthrough infections in vaccinated people — even in those who received booster shots — omicron doesn't make most quite as sick as earlier strains of the virus. Virologist and immunologist Michael S. Diamond, MD, PhD, has found in animal studies that omicron does not attack lung tissue in the way prior strains did. Diamond also found that some of the monoclonal antibodies that worked as treatments for other strains of the coronavirus are not effective against omicron. The FDA recently withdrew its emergency use authorization for two of those antibodies, so they no longer can be used to treat COVID-19 patients. Diamond says that although omicron doesn't make most people as sick as prior strains, it still makes many very sick and is deadly for some. And he says there's no guarantee that future variants won't evolve to be as infectious as omicron and as deadly as earlier strains. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

When SARS-CoV-2 first arrived, it was as if a raging wildfire had been blown by a strong wind through dry, flammable timber. So says Ali Ellebedy, PhD, an immunologist at Washington University School of Medicine in St. Louis. As a population, he says, we were completely vulnerable to the virus because no one's immune system had seen it before. In the two years since the virus first appeared, millions of infections and vaccinations have been able to tamp down some of the flames, and Ellebedy says that process should continue in the coming weeks and months. He's looking forward to new vaccines being tested that are designed specifically to fight the omicron variant. He says if society wants to return to a more normal way of living, it's important to vaccinate as many people as possible, as soon as possible, throughout the country and the world. But it's also important to update vaccines to make them more effective. Ellebedy says that although he has no idea whether omicron will be the last of the major COVID-19 variants, he is confident that if another variant does arise, it will be more similar to omicron than to former variants, so he says omicron-derived vaccines should be beneficial even as the virus continues to evolve. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Although there seems to be evidence that infections with the omicron variant of SARS-CoV-2 are somewhat milder, you wouldn't know that from the number of COVID-19 patients in the hospital. A post-holiday spike in cases has seen the number of inpatients at Barnes-Jewish Hospital and St. Louis Children's Hospital rise to levels higher than any seen since the pandemic began. In this episode, a pair of Washington University physicians report that because of the number of hospitalized COVID-19 patients, people with other ailments — from sports injuries to heart issues — are having to wait longer to be seen in the emergency department and for hospital beds to open up. Hilary M. Babcock, MD, a professor of medicine in the Division of Infectious Diseases and BJC Healthcare vice president and chief quality officer, says it's getting harder for the health-care system to keep up with the rising number of patients. Meanwhile, Jason G. Newland, MD, a professor of pediatrics in the Division of Infectious Diseases, says that even with the current surge, it's important to keep kids in school if at all possible. Both Babcock and Newland say that although breakthrough infections have occurred, vaccinations are keeping most people out of the hospital. They are encouraging all who are not fully vaccinated and boosted to get those vaccinations as soon as possible, to avoid crowds and to wear masks in public to try to slow the spread of the virus. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

The omicron variant of SARS-CoV-2 is here, but it's the delta variant that has been driving a rapid increase in COVID-19 hospitalizations in recent weeks as people get out into the world more, antibody responses from vaccines wane, and families travel and gather in larger groups. As cases surge and hospitalizations increase, health-care workers are facing a second holiday season with emergency rooms and intensive care units (ICUs) crowded with COVID-19 patients. Nguyet Nguyen, MD, an assistant professor of medicine in the Division of Pulmonary & Critical Care Medicine, spent Christmas Day 2020 in the ICU. At the time, she hoped that what were then newly available vaccines would make 2021 markedly better. As she works with COVID-19 patients this year, Nguyen says she is doing her best to convince them and their family members to get vaccinated. Meanwhile, Tiffany M. Osborn, MD, a professor of surgery and of emergency medicine, says that although she and her colleagues are tired, they're still committed to working hard to give patients what they need to get better. She says if more people could see what she sees, she's convinced almost everyone would get vaccinated and wear a mask. For now, both Nguyen and Osborn say that they, unfortunately, expect to remain busy for the foreseeable future. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

A few weeks ago, no one had heard of the omicron variant of SARS-CoV-2. Since its recent discovery by scientists in South Africa, infections with the variant have been found in dozens of U.S. states and countries around the world. Scientists are scrambling to understand whether the new variant, which houses several mutations on the spike protein that infects cells, might be able to evade protection from current vaccines. Virologist and researcher Larissa B. Thackray, PhD, an associate professor of medicine, recently completed experiments in mice in which her team tested the efficacy of vaccines against an earlier SARS-CoV-2 variant, the beta variant. She plans to use the same strategy to test the vaccines against omicron. Meanwhile, Steven J. Lawrence, MD, an associate professor of medicine in the Division of Infectious Diseases, says omicron is likely not the last worrisome variant that will be discovered. But he says old, reliable mitigation techniques — such as wearing a mask, avoiding big crowds and staying home from work when you don't feel well — will remain effective, no matter how infectious omicron turns out to be and no matter how many new viral mutations appear. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Over a million kids ages 5 to 11 have had the first dose of the COVID-19 vaccine, and a growing number of older people are getting booster shots. Although the official recommendation limits the booster to those over age 65, with weakened immune systems or who have jobs that put them at high risk for exposure to the novel coronavirus, that's expected to change soon. Some states and cities already have begun recommending boosters for everyone over age 18. There's little doubt boosters are helping to protect some people, according to Rachel M. Presti, MD, PhD, an infectious diseases specialist and an associate professor of medicine at Washington University. Presti says boosters rev up antibodies and provide protection as the months pass and the pandemic lingers. The medical director of the Infectious Disease Clinical Research Unit and co-director of the Center for Vaccine Research at the university, Presti recommends that anyone eligible for a booster get one. But how much do boosters really help, especially people who have compromised immune systems? That's a key question for Alfred Kim, MD, PhD, a rheumatologist and assistant professor of medicine who treats patients with autoimmune conditions. He has found that when those with compromised immune systems get the vaccine, their responses are only about one-third as strong as in people with stronger immune systems. Kim says it's unclear how much extra shots will help, but he says if some patients skip immune-suppressing medications for a couple of weeks when they get a shot, it might make vaccines more effective, though further study is needed. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

COVID-19 has killed more than 5 million people around the world, with more than 740,000 dead in the United States. Although the virus is far more deadly in older people than in children, more than 650 kids have died of COVID-19 in the United States. Meanwhile, during the surge caused by the delta variant, hospitalizations of children increased fivefold. Some 90% of the 12- to 17-year-olds hospitalized for the illness? were unvaccinated, and none of the hospitalized children under age 12 were vaccinated because they were not eligible. Until now. The Food and Drug Administration and the Centers for Disease Control & Prevention have authorized emergency use of the Pfizer-BioNTech COVID-19 vaccine for children ages 5 to  11. Infectious diseases specialist Jason Newland, MD, a professor of pediatrics, called the authorization a “ginormous” development in the fight against COVID-19. Newland has been involved in the vaccine trials in younger patients, and he says that as more young children are able to be vaccinated, fewer and fewer will require hospitalization. And he says better protection for kids also will provide better protection for the adults with whom they live. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Even as the numbers of COVID-19 cases around the country decline again, with cooler weather and people moving back indoors, we're being warned about the possibility of another swing upward in cases. Such an increase would represent yet another wave of illness during this pandemic. And after all these months, the stress is getting to many people. Groups particularly vulnerable to such stress are older adults — who face the greatest risk from the virus — and young children. But as the pandemic continues, we've been hearing more about resilience in these groups. In this episode, we speak with a pair of experts on resilience. Psychiatrist Eric J. Lenze, MD, director of the Healthy Mind Lab at Washington University, recently was awarded a $9.1 million grant from the National Institute on Aging of the National Institutes of Health (NIH) to study resilience in older adults, as well as the pandemic's potential cognitive and emotional effects on them, such as depression, anxiety and even dementia. His team is looking in particular at the impact? of exercise and mindfulness on resilience in seniors. We also speak with Neha Navsaria Kirtane, PhD, an associate professor of child psychiatry, about resilience in children and adolescents. During the pandemic, they've faced changes in schooling and in how they are allowed to interact with friends. Some kids can't get vaccinated yet, but almost all are back at school, in person. She says adult mentors who can point out to children when they are doing well and provide examples of resilience are important in helping kids remain hopeful as we head toward an uncertain future. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Recently, the federal government decided that vaccine booster shots will be made available for Americans 65 and older, those with compromised immune systems and others in high-risk jobs. In addition, Pfizer has submitted data asserting its vaccine is safe and effective for children ages 5-12. The next step could be an emergency use authorization from the Food & Drug Administration, allowing younger children to be vaccinated. Despite breakthrough infections involving vaccinated people, suggesting the shots don't prevent infection in everyone, health officials say vaccines continue to protect the vast majority of people from severe disease. Meanwhile, in the St. Louis region, sporting events, concerts, restaurants and theatrical productions are drawing crowds again. At some such events, patrons are asked to provide proof of vaccination or a negative COVID-19 test to get in the door. But health officials in the region continue to worry that crowded events combined with high COVID-19 case numbers and the start of the flu season could make for a dangerous fall and winter. In this episode, we speak with two leaders in the field of infectious diseases: Victoria J. Fraser, MD, the Adolphus Busch Professor of Medicine and head of the John T. Milliken Department of Medicine at Washington University, and William G. Powderly, MD, the J. William Campbell Professor of Medicine, the Larry J. Shapiro Director of the Institute for Public Health and co-director of the Infectious Diseases Division. Both say that despite the highly infectious delta variant, we are winning in the fight against COVID-19 at the moment. But they warn that the game isn't over yet. And neither expects we'll be getting rid of our masks anytime soon. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

In March 2020, the first cases of COVID-19 were reported in the St. Louis region, and health officials in St. Louis County and the city of St. Louis issued emergency orders to try to halt the virus' spread. A new study from researchers at Washington University School of Medicine in St. Louis determined that those orders may have saved hundreds of lives and prevented thousands of hospitalizations. An analysis conducted by infectious diseases specialist Elvin H. Geng, MD, a professor of medicine, indicates that had the orders been delayed by as little as two weeks, the number of deaths in the city and county could have increased almost sevenfold. Geng says it's important to be proactive and do whatever possible to stop a virus' spread, especially in the early days of a pandemic. Over time, restrictions may become more reactive to a given scenario, in response to peaks in the spread of infection. Now confronted with the highly infectious delta variant, public health officials again have been considering stricter measures to slow the number of infections, hospitalizations and deaths. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

It's been a busy summer in the laboratory of Ali Ellebedy, PhD, an associate professor of pathology & immunology and of molecular microbiology at Washington University School of Medicine in St. Louis. Studying samples from patients with COVID-19 infections and others who have been vaccinated against the virus, he's found hopeful signs in the immune system — even regarding the vaccine's response to the highly infectious Delta variant. His laboratory has reported that the immune system continues to make protective antibodies for many months after both natural infection and vaccination, but he says that as long as anyone on the planet is infected with COVID-19, the rest of the world can't be fully protected. As his research continues to show that vaccines are effective at preventing severe disease, Ellebedy says it's important to increase access to vaccines and to encourage people to get vaccinated. The current vaccines are effective at protecting the vaccinated from severe disease in the lungs, but to eliminate most  breakthrough infections, Ellebedy says it may be important to develop vaccines that better protect tissues in the nose and throat. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

As patients infected with the delta variant of the COVID-19 virus fill hospitals in parts of Missouri, and the virus spreads new infections around the country, Washington University data scientists and infectious diseases specialists are urging people to mask up again, regardless of vaccination status. The researchers say that although vaccination remains remarkably effective, masking and other public health practices that slowed the spread prior to the availability of vaccines are necessary again. Clay Dunagan, MD, a professor of medicine, senior vice president and chief clinical officer for BJC HealthCare and a member of the Metropolitan St. Louis Pandemic Task Force says that as case numbers rise, public health measures have become more important. Dunagan, and fellow infectious diseases specialist Hilary M. Babcock, MD, a professor of medicine and medical director of infection prevention and occupational infection prevention for BJC HealthCare, say even if more people get vaccinated, it will be weeks before they are protected, and during those weeks, people will need to turn back to the practices that protected them before vaccines became available. Meanwhile, Philip R.O. Payne, PhD, the Janet and Bernard Becker Professor and director of the Institute for Informatics, associate dean for health information and data science and the chief data scientist at the School of Medicine, says computer models his team has created continue to predict a rapid increase in infections in St. Louis and in the surrounding area. And he says those models don't show a peak yet, meaning we could be in the current wave of infections for quite some time. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Pregnant patients who get COVID-19 have much worse outcomes than women who don't get infected. They are three times as likely to end up in intensive care, three times as likely to need a ventilator to help them breathe and twice as likely to die. Ebony Boyce Carter, MD, an assistant professor of obstetrics & gynecology, has delivered babies throughout the pandemic while promoting health equity for high-risk pregnant women and their babies. Carter herself has three young daughters, and she says the pandemic has been challenging, not only in terms of keeping her patients safe and healthy but also because of the steps she must take to avoid exposing her children — who are too young to be vaccinated — to the SARS-CoV-2 virus. While Carter has delivered babies and encouraged new moms to get vaccinated, Heather A. Jones, MD, an assistant professor of dermatology, gave birth to a baby during the pandemic. Her pregnancy was particularly stressful because she has to be physically close to patients while examining them, including times when patients unmask to receive thorough skin exams. Jones became eligible for, and received, the vaccine a couple of weeks after giving birth. Now she says her main concern is for her older child, who, unlike her infant, is not getting COVID-19 antibodies through breast milk and also is too young to get vaccinated. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Whether and how children can return to classrooms has been hotly debated during the past year. Requiring teachers and students to wear masks, spreading out kids in classrooms and preventing students and staff from coming to school when sick has made most schools safe. With many teachers now vaccinated and more children now eligible, it's expected that classrooms will be even safer when school resumes in the fall, according to pediatric infectious disease specialist Jason Newland, MD, a professor of pediatrics. As Newland works to prevent infections in kids, his colleague, pediatric cardiologist William B. Orr, MD, an assistant professor of pediatrics, has been treating children with COVID-19 who have become seriously ill and required hospitalization. Much of Orr's focus has involved children with MIS-C (Multisystem Inflammatory Syndrome in Children), a complication related to COVID-19. Those kids can develop issues related to the heart, the gastrointestinal tract, the nervous system or other organs following COVID-19 infection. Both Newland and Orr said they believe hospitalizations will be much less common for children as more are able to be vaccinated. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

After recently announcing that vaccinated people could safely take off their masks outdoors and gather in small groups with other vaccinated people indoors, the U.S. Centers for Disease Control and Prevention (CDC) next decided that vaccinated people no longer need to wear masks indoors either. The new guidelines caught many by surprise, but William G. Powderly, MD, the Larry J. Shapiro Director of the Institute for Public Health and co-director of the Division of Infectious Diseases at Washington University School of Medicine in St. Louis, says the new guidelines provide evidence that, for many vaccinated individuals, going without a mask indoors is safe. He says vaccines against the virus are very effective and that although they don’t provide 100% protection, they come pretty close. But Powderly, also director of the university’s Institute of Clinical and Translational Sciences, says people need to remain aware that the pandemic is far from over, that the virus may fight back, and that the CDC may need to change its recommendations again at some point. For now, though, most vaccinated people are fairly safe without masks, he says. On the Washington University Medical Campus, masks still will be required in public areas in hospitals and in clinical areas. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Infections with the virus that causes COVID-19 are not the only cause of pandemic-related hospitalizations. Although children tend to be at lower risk of COVID-19, the number of kids with mental health and behavioral problems has exploded during the pandemic, driving an increase in pediatric hospital admissions nationwide. Stressors associated with remote schooling, fear of infection, and concern about older relatives have contributed to a tidal wave of hospital admissions for psychiatric issues, according to John N. Constantino, MD, the Blanche F. Ittelson Professor of Psychiatry and Pediatrics, and director of the William Greenleaf Eliot Division of Child & Adolescent Psychiatry. Constantino, also psychiatrist-in-chief at St. Louis Children’s Hospital and co-director of Washington University’s Intellectual and Developmental Disabilities Research Center (IDDRC), says virtual schooling has contributed significantly to the problem. He says it’s important to get back to normal learning routines, particularly for kids with special needs. In the St. Louis area, the return to in-person schooling for such students has been made possible partly due to a COVID-19 testing program in St. Louis County’s Special School District. That testing effort is being coordinated by the other IDDRC co-director, Christina Gurnett, MD, PhD, who is also director of the Division of Pediatric and Developmental Neurology and neurologist-in-chief at Children’s Hospital. She says that ensuring schools are safe and getting kids back into more normal routines can help reduce the need to hospitalize kids for psychiatric and behavioral issues. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Even before the first case of COVID-19 was reported in the United States, Michael S. Diamond, MD, PhD, the Herbert S. Gasser Professor of Medicine, started setting the stage with Sean Whelan, PhD, the Marvin A. Brennecke Distinguished Professor of Molecular Microbiology, for scientists at the university to study the virus. Whelan had just arrived in St. Louis to begin his new role as head of the Department of Molecular Microbiology and didn’t even have an operational laboratory when the two scientists jumped into the breach and started work to equip and certify a Biosafety Level III laboratory, where researchers could study SARS-CoV-2. Since those early days of improvising to get funding and equipment in place, the researchers not only have studied the novel coronavirus; they’ve also made a less dangerous form of the virus. that has allowed a wider circle of scientists to study it. And after discovering that SARS-CoV-2 does not naturally infect mice, they used a viral vector to temporarily make the mice susceptible to the virus, enabling scientists to learn more about how it behaves in an animal model. Diamond and Whelan also have played a role in efforts to develop new vaccines, including a nasal vaccine that prevents infection in mice. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

When we launched this podcast in March 2020, our first guest was a doctor who had spent years planning responses to epidemics, bioterrorism and other disasters. Last March, Steven J. Lawrence, MD, a professor of medicine in the Division of Infectious Diseases, told us what he thought might happen as the pandemic progressed. He worried about whether there would be enough ventilators, ICU beds and medical staff to care for those who would become infected with the novel coronavirus. He praised some of the restrictions and measures that prevented the pandemic from becoming even worse. But nowhere in our discussion a year ago did he consider that within 12 months, millions of people already would be vaccinated. As we check in with Lawrence again — a year and more than half a million American deaths later — he evaluates how we’ve adjusted to pandemic life and discusses where things appear to be going from here. Looking to the future, Lawrence speaks not of returning to normal but of creating a new normal to better address the medical and societal problems laid bare by the virus, such as more effective communication and better access to healthcare for all people. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

In the year since COVID-19 infections first appeared in the United States, a few things have become clear. One is that many who get sick don’t recover quickly. Even those who don’t have to be hospitalized can experience symptoms that linger. Called long-haulers, these individuals suffer from a variety of issues such as shortness of breath, abnormal heart rhythms, fatigue and loss of the ability to smell. In fact, many people first realize they may be infected with the virus when they notice they’ve lost the ability to taste and smell food. For most, these symptoms disappear quickly, but some people continue to struggle. Doctors and researchers at the School of Medicine are working with long-haulers to help them deal with these lasting effects of the SARS-CoV-2 virus. In this episode, we’ll hear from ear, nose & throat specialist Jay F. Piccirillo, MD, a professor of otolaryngology and the department’s vice chair for research. He is conducting several studies involving long-haulers, trying to help them regain the ability to smell. We’ll also hear from Amanda K. Verma, MD, an assistant professor of medicine and a cardiologist who normally works with very sick patients whose heart disease has made them candidates for implanted heart assist devices or even transplants. Over the last year, she’s seen many long-haul COVID-19 patients who have developed problems similar to those faced by heart transplant patients. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

It’s been a year since the first COVID-19 cases started appearing in the United States, and during this span, many people have been living with the stress of trying to work from home while simultaneously trying to help their kids attend online school. Essential workers haven’t had the safety of home, having to continue working in grocery stores, and child-care, food-production and other such settings. Meanwhile, first responders and physicians have faced the at times overwhelming stress of dealing directly with patients infected with the SARS-CoV-2 virus. Continuous stretches of stress aren’t good for mental health. In this episode, we speak to Jessica Gold, MD, an assistant professor of psychiatry, about maintaining mental health during these trying times. She’s given several lectures to health-care providers about the need to remember that. Though their first instincts as caregivers may be to help others, the pandemic has highlighted the importance of self-care, too. Resident physician Mohit Harsh, MD, attended one of Gold’s lectures not long ago. After hearing her talk, he realized his feelings of hopelessness might be more than fatigue. He’s since received therapy and says he’s better able to take care of his patients now that he’s taking better care of himself. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

For the past year, we’ve heard about the importance of wearing masks, avoiding crowds, maintaining physical distance and regularly washing our hands. All of us have been asked to take simple steps to protect ourselves and those around us. But nothing is simple when you have to do it every day for months, particularly while receiving mixed messages from some friends and leaders. In this episode, we’ll hear about how focused marketing and health communication could help more people do the right thing and make better decisions to keep themselves and their loved ones safe. We speak to Mary C. Politi, PhD, a health psychologist and a professor in the Division of Public Health Sciences in the Department of Surgery at Washington University School of Medicine in St. Louis; and to Robyn LeBoeuf, PhD, a professor of marketing at the university’s Olin Business School. They discuss how our biases, judgments and health behaviors might be shaped, even changed, by targeted, consistent messages from health-care providers and government leaders. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

COVID-19 vaccine development has been rapid and successful. Two vaccines that report more than 90% efficacy against the virus already are in use, with approval of more vaccines expected in the coming weeks. Meanwhile, the development of treatments for those infected with the virus has been slower. Only one drug, the steroid dexamethasone, has been proven to reduce the risk of death in those hospitalized with COVID-19. In this episode, we’ll hear reasons why the development of effective treatments has progressed so slowly. Discussing this with us is William G. Powderly, MD, the Larry J. Shapiro Director of the Institute for Public Health, co-director of the Division of Infectious Diseases at Washington University School of Medicine in St. Louis and director of the university’s Institute of Clinical and Translational Sciences. He says one reason development of therapies has been slow is because there haven’t been enough big, well-controlled studies. We’ll also hear from Eric J. Lenze, MD, the Wallace and Lucille Renard Professor of Psychiatry, and Angela M. Reiersen, MD, an associate professor of psychiatry. They led a preliminary study at the School of Medicine in which a psychiatric drug was used to keep people with COVID-19 from getting sick enough to be hospitalized. Their study was successful. Now they’re expanding the trial to include COVID-19 patients in all of the United States. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Drug companies are reporting eye-popping success rates in clinical trials of their vaccines to prevent COVID-19. It’s possible the first people in the U.S. could begin getting shots before the end of the year. In this episode, we’ll hear about the amazing pace of vaccine development, as well as Washington University’s role in vaccine research, from infectious diseases specialist Rachel Presti, MD, PhD, an associate professor of medicine and medical director of Washington University’s Infectious Diseases Clinical Research Unit. Presti discusses how soon most of us can expect to get a vaccine and how safe those shots are likely to be. In addition, we visit again with Matifadza Hlatshwayo Davis, MD, a clinical instructor of medicine in the Division of Infectious Diseases. She discusses how COVID-19 and the flu might interact as the pandemic continues during flu season. Hlatshwayo Davis believes it’s important for everyone to get a flu shot, and she and Presti both think that if we can double down on use of masks, hand-washing and social distancing, it will limit the spread of COVID-19 while also cutting down on the number of flu cases we will see. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Winter is coming, and the pandemic is intensifying in most of the country, with numbers of COVID-19 cases setting records almost daily, cold weather approaching and people moving activities indoors. In addition, college students who have been away at school for the last few months will return home soon, and extended families are trying to figure out whether it will be safe to gather for holiday meals and other celebrations. Staying safe during the current spike in cases is a major challenge, and infectious disease experts at Washington University School of Medicine say it’s essential that families and friends have some difficult conversations about how they plan to confront the challenges of the next several weeks. In this episode, Andrew B. Janowski, MD, an instructor in pediatrics in the Division of Infectious Diseases, discusses the risks now associated with cold weather, family gatherings and holiday traditions. We also hear from Matifadza Hlatshwayo Davis, MD, a clinical instructor of medicine in the Division of Infectious Diseases. She works with COVID-19 patients, but she also had a baby during the pandemic. That’s meant pandemic-related upheaval in her personal and professional life, as well as some very challenging conversations with grandparents. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Testing, social distancing, wearing masks and regular hand washing are among the tools recommended to limit the spread of the SARS-CoV-2 virus that causes COVID-19. But achieving such practices can be challenging for people who don’t have homes and often must eat and sleep in places with other people. Experts from Washington University School of Medicine, the Brown School, the St. Louis County and city health departments, and several other healthcare organizations have been assessing challenges faced by those without adequate housing. They propose certain practices to limit the spread of infection in such populations. In this episode, Stephen Y. Liang, MD, an associate professor of medicine in the Division of Infectious Diseases, and Nathanial S. Nolan, MD, a fellow in the same division, discuss what they’ve learned about the risks faced by unhoused people in the St. Louis region. They also discuss recommendations and changes being implemented at various shelters and meal centers in the region to try to limit the spread of COVID-19 in this potentially vulnerable population. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Since the start of the COVID-19 pandemic, health officials have talked about the need for better, faster and more frequent testing. Recently, researchers at Washington University School of Medicine in St. Louis developed a saliva test that can detect the SARS-CoV-2 virus without inserting a nasopharyngeal swab into the nose or throat. The saliva test also doesn’t require chemical reagents to extract RNA from the sample. Such reagents have been in short supply, often resulting in delays in reporting test results. The test can be run in a few hours and, ideally, can return results the next day. Further, it can test for more than one virus at a time, making it particularly useful as the COVID-19 outbreak stretches into flu season. The new test was developed by a team from the School of Medicine’s Department of Genetics and the McDonnell Genome Institute, in collaboration with the biotechnology company Fluidigm. The test has attracted the attention of state officials in Missouri, who are planning to use the test to screen populations known to be at risk for the virus. In this episode, scientists Jeffrey Milbrandt, MD, PhD, and Richard Head discuss why they believe the saliva test will be important in detecting the virus’s presence even before people begin having symptoms, including in individuals who remain asymptomatic. Milbrandt is the James S. McDonnell Professor and head of the Department of Genetics and the McDonnell Genome Institute, and Head is a professor of genetics and director of the Genome Technology Access Center at the McDonnell Genome Institute. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

The pandemic is affecting everyone, but the stresses it causes are particularly rough for those with intellectual and developmental disabilities and their families. Providing effective education to such children and getting services to those who need help in their homes is typically complex, but those issues are even more difficult in the face of COVID-19. Child psychiatrist John N. Constantino, MD, is the Blanche F. Ittleson Professor of Psychiatry and Pediatrics, director of the William Greenleaf Eliot Division of Child & Adolescent Psychiatry, and co-director of the Intellectual and Developmental Disabilities Research Center at Washington University School of Medicine in St. Louis. As debates continue over whether children should be in classrooms or involved in online learning from home, Constantino says little has been said about kids with intellectual and developmental disabilities, many of whom have a great deal of trouble trying to learn online. Meanwhile, information available online and over social media may be adding to the stress and anxiety many people are experiencing during the pandemic. Another team of psychiatry researchers is studying that issue. Led by Patricia A. Cavazos-Rehg, PhD, a professor of psychiatry, the team is analyzing the effects of social media on anxiety and depression, and working to use messages delivered over social media to lower stress and anxiety levels. The podcast “Show Me the Science” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

It’s possible some people may have been infected earlier, but the first COVID-19 diagnoses in the U.S. occurred in late January. Since then, testing failures, partisan political debates, conspiracy theories and desperate searches for effective treatments have characterized the pandemic response in the United States. However, through all of the noise, scientists have learned quite a bit, according to William G. Powderly, MD, the Larry J. Shapiro Director of the Institute for Public Health and co-director of the Division of Infectious Diseases at Washington University School of Medicine in St. Louis. Powderly, also the J. William Campbell Professor of Medicine and director of the university’s Institute of Clinical and Translational Sciences, is a veteran of the fight against HIV and AIDS. Many of the lessons learned during that epidemic can be applied to the battle against SARS-CoV-2, he said. But a big problem facing the U.S. in its response to the virus is that so many people seem to want simple answers, and simple answers are highly unlikely, he added. And Powderly said we can expect to live with upheaval from the virus until a vaccine is developed. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

New research from scientists at Washington University School of Medicine in St. Louis suggests that the immune systems of COVID-19 patients can’t do enough to protect them from the virus. A popular theory has it that patients’ immune systems get so revved up fighting the virus that, after several days, a so-called cytokine storm ensues, resulting in potentially fatal organ damage, particularly to the lungs. But new findings from a team of researchers led by Richard S. Hotchkiss, MD, a professor of anesthesiology, and Kenneth E. Remy, MD, an assistant professor of pediatrics, have found that many patients get very sick because their immune systems can’t do enough to protect them from the virus. They’re suggesting that rather than trying to dampen the immune response, a better treatment strategy for COVID-19 would involve boosting immunity. The podcast, “Show Me the Science,” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

The crowdsourced supercomputing project Folding@home harnesses the combined processing power of millions of computers whose owners download software and run simulations to model how proteins move and fold. Now, in response to the COVID-19 pandemic, individuals, universities companies, even the Spanish soccer league La Liga, have joined forces to model how the coronavirus uses its spike protein to bind to human cells. In this episode, we speak with Greg Bowman, PhD, an associate professor of biochemistry and molecular biophysics and the international leader of the Folding@home effort, about using computer processing power to run simulations that would take more than 100 years to complete on a standard computer. Bowman says that with thousands of new participants, the project now has more raw computing power than the world’s largest 500 supercomputers … combined. The podcast “Show Me the Science” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

The virus that causes COVID-19 is thought to have originated in wild bats that live in caves around Wuhan, China. It also may have been passed to a second animal species before it began infecting people. Many devastating epidemics in recent years — including SARS, Ebola and HIV/AIDS — were caused by animal viruses that spilled over into people. Before another pandemic begins, a diverse group of infectious disease experts, ecologists, wildlife biologists and other experts say that a new, decentralized, global system of wildlife surveillance must be established to identify animal viruses in wild animals that have the potential to infect and sicken people. In this episode, Jennifer A. Philips, MD, PhD, an associate professor of medicine and co-director of the Division of Infectious Diseases at Washington University School of Medicine in St. Louis, and Gideon Erkenswick, PhD, a postdoctoral research associate in Philips’ lab and director of Field Projects International, discuss what needs to happen to create an early-detection system for viruses with the potential to trigger the next pandemic. The podcast “Show Me the Science” is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.