The ASU Biodesign Clinical Testing Laboratory began in March 2020 after the severe acute respiratory syndrome, coronavirus 2, began spreading throughout the world. ASU worked towards implementing  its own efficient way of testing for the virus, in order to assist the university but also keep the communities around it safe. By developing its own strategy for COVID-19 testing, ASU was on the forefront of research by developing new ways to test for the virus. This process began when research labs at ASU were quickly converted into clinical testing laboratories, which used saliva testing to develop swift COVID-19 diagnostic tests for the Arizona community. The lab developed more accurate and time efficient results, while also converting Nasopharyngeal tests to saliva tests. Not only did this allow for fewer amounts of resources required, but more individuals were able to get tested at faster rates. The ASU Biodesign Clinical Testing Laboratory (ABCTL) was able to accomplish this through the adaptation of previous machines and personnel to fit the testing needs of the community. In the future, the ABCTL will continue to adapt to the ever-changing needs of the community in regards to the unprecedented COVID-19 pandemic. The research collected throughout the past year following the breakout of the COVID-19 pandemic is a reflection of the impressive strategy ASU has created to keep its communities safe, while continuously working towards improving not only the testing sites and functions, but also the ways in which an institution approaches and manages an unfortunate impact on diverse communities.

This thesis project is part of a larger collaboration documenting the history of the ASU Biodesign Clinical Testing Laboratory (ABCTL). There are many different aspects that need to be considered when transforming to a clinical testing laboratory. This includes the different types of tests performed in the laboratory. In addition to the diagnostic polymerase chain reaction (PCR) test that is performed detecting the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), antibody testing is also performed in clinical laboratories. Antibody testing is used to detect a previous infection. Antibodies are produced as part of the immune response against SARS-CoV-2. There are many different forms of antibody tests and their sensitives and specificities have been examined and reviewed in the literature. Antibody testing can be used to determine the seroprevalence of the disease which can inform policy decisions regarding public health strategies. The results from antibody testing can also be used for creating new therapeutics like vaccines. The ABCTL recognizes the shifting need of the community to begin testing for previous infections of SARS-CoV-2 and is developing new forms of antibody testing that can meet them.

In this project, I examined the relationship between lockdowns implemented by COVID-19 and the activity of animals in urban areas. I hypothesized that animals became more active in urban areas during COVID-19 quarantine than they were before and I wanted to see if my hypothesis could be researched through Twitter crowdsourcing. I began by collecting tweets using python code, but upon examining all data output from code-based searches, I concluded that it is quicker and more efficient to use the advanced search on Twitter website. Based on my research, I can neither confirm nor deny if the appearance of wild animals is due to the COVID-19 lockdowns. However, I was able to discover a correlational relationship between these two factors in some research cases. Although my findings are mixed with regard to my original hypothesis, the impact that this phenomenon had on society cannot be denied.

During the COVID-19 pandemic, increased burdens have been placed on the Arizona healthcare system, and its healthcare providers. Using a survey with a sample of N=308 prescribing providers and nurses in the Arizona healthcare system, the impact of COVID-19 on the wellbeing of healthcare providers was assessed. The survey used measures to evaluate for physical and emotional wellbeing, burnout, stressors associated with COVID-19, and work-life experiences, and found an overall negative impact on the wellbeing of healthcare workers during the COVID-19 pandemic with increased levels of reported stress and tiredness, concern for the health of family and loved ones, concern for the hardships of patients, lack of alignment between organizational priorities and personal values, and low levels of support and appreciation from socially and from leadership at work.

Actuaries can analyze healthcare trends to determine if rates are reasonable and if reserves are adequate. In this talk, we will provide a framework of methods to analyze the healthcare trend during the pandemic. COVID-19 may influence future healthcare cost trends in many ways. First, direct COVID-19 costs may increase the amount of total experienced healthcare costs. However, with the implementation of social distancing, the amount of regularly scheduled care may be deferred to a future date. There are also many unknown factors regarding the transmission of the virus. Implementing epidemiology models allows us to predict infections by studying the dynamics of the disease. The correlation between infection amounts and hospitalization occupancies provide a methodology to estimate the amount of deferred and recouped amounts of regularly scheduled healthcare costs. Thus, the combination of the models allows to model the healthcare cost trend impact due to COVID-19.

The COVID-19 pandemic has resulted in preventative measures and has led to extensive changes in lifestyle for the vast majority of the American population. As the pandemic progresses, a growing amount of evidence shows that minority groups, such as the Deaf community, are often disproportionately and uniquely affected. Deaf people are directly affected in their ability to personally socialize and continue with daily routines. More specifically, this can constitute their ability to meet new people, connect with friends/family, and to perform in their work or learning environment. It also may result in further mental health changes and an increased reliance on technology. The impact of COVID-19 on the Deaf community in clinical settings must also be considered. This includes changes in policies for in-person interpreters and a rise in telehealth. Often, these effects can be representative of the pre-existing low health literacy, frequency of miscommunication, poor treatment, and the inconvenience felt by Deaf people when trying to access healthcare. Ultimately, these effects on the Deaf community must be taken into account when attempting to create a full picture of the societal shift caused by COVID-19.

Lyme disease is a common tick-borne illness caused by the Gram-negative bacterium Borrelia burgdorferi. An outer membrane protein of Borrelia burgdorferi, P66, has been suggested as a possible target for Lyme disease treatments. However, a lack of structural information available for P66 has hindered attempts to design medications to target the protein. Therefore, this study attempted to find methods for expressing and purifying P66 in quantities that can be used for structural studies. It was found that by using the PelB signal sequence, His-tagged P66 could be directed to the outer membrane of Escherichia coli, as confirmed by an anti-His Western blot. Further attempts to optimize P66 expression in the outer membrane were made, pending verification via Western blotting. The ability to direct P66 to the outer membrane using the PelB signal sequence is a promising first step in determining the overall structure of P66, but further work is needed before P66 is ready for large-scale purification for structural studies.

This thesis project is the result of close collaboration with the Arizona State University Biodesign Clinical Testing Laboratory (ABCTL) to document the characteristics of saliva as a test sample, preanalytical considerations, and how the ABCTL utilized saliva testing to develop swift COVID-19 diagnostic tests for the Arizona community. As of April 2021, there have been over 130 million recorded cases of COVID-19 globally, with the United States taking the lead with approximately 31.5 million cases. Developing highly accurate and timely diagnostics has been an important need of our country that the ABCTL has had tremendous success in delivering. Near the start of the pandemic, the ABCTL utilized saliva as a testing sample rather than nasopharyngeal (NP) swabs that were limited in supply, required highly trained medical personnel, and were generally uncomfortable for participants. Results from literature across the globe showed how saliva performed just as well as the NP swabs (the golden standard) while being an easier test to collect and analyze. Going forward, the ABCTL will continue to develop high quality diagnostic tools and adapt to the ever-evolving needs our communities face regarding the COVID-19 pandemic.