For Trent Towne, Pharm.D., an associate professor of pharmacy practice at Manchester University, everything changed in March. He, like many others, quickly adapted to safe social distancing by teaching and conducting patient care online.
The University faced tough decisions on how to run an academic institution with two campus locations in a new era overshadowed by the most infectious virus to encircle the globe in centuries. As a new reality began to unfold, Towne served to advise on matters of risk and safety for students, faculty and staff.
Towne teaches academic and clinical courses in the Doctor of Pharmacy Program from pharmacotherapy of infectious diseases to precepting fourth-year students on their clinical rotations. He also provides patient care in community health care facilities, accessing patient records through a secure server from home. His responsibilities include reviewing patient medical records for improving antimicrobial use, which means looking at patient antibiotics to find ways to optimize medication use to reduce cost and prevent overuse which may lead to antibiotic resistance.
A board-certified pharmacotherapy specialist with expertise in infectious diseases, Towne understands very well the epidemiological threat of COVID-19.
“Viruses are evaluated for transmissibility by what’s call an R naught (R0) value,” Towne explains. “The influenza virus has an approximate R1 value which means every infection causes one new infection, making it more stable to control.”
Early data showed that the COVID-19 virus is closer to an R3 value. One case causes three more infections, which cause nine, which cause 27, and so on, exponentially. A study from the Centers for Disease Control and Prevention (CDC) examined data from the initial viral spread in China. Models indicated that the virus actually may have reached a median R6 value in China. The study, released online early May, was slated for publication in July.
“We have to remind ourselves constantly that we are dealing with a virus that we have known about for all of four months,” Towne said last spring.
As a pharmacist and clinician who specializes in infectious disease, Towne was well-prepared to lend his knowledge and expertise to Manchester University leadership, Allen County and the local community. He began serving in early March to help inform the University and community decision-makers in real time as the pandemic rapidly began to take root and spread to every state in America.
As a member of the Allen County COVID-19 Pandemic Advisory Board Task Force, Towne joined many other medical professionals, first responders, police and community leaders. At the first meeting, the county health commissioner proposed a purely hypothetical scenario of what school closings might mean. It was a shocking suggestion that task force members thought would never happen, Towne said.
He and his colleagues soon came to understand the reality of a never-before-seen virus with high transmissibility, paired with lack of population immunity – and lack of a vaccine.
“Now, I will be more shocked if we get through the next academic school year without interruption, such as a new round of social distancing,” said Towne. “The virus is too easy to transmit without a vaccine.”
Under the task force, Towne also serves on the Resource Allocations Committee. It is tasked with analyzing how the most difficult decisions might be made if the health system becomes overwhelmed with more patients than beds, an insufficient supply of lifesaving equipment, or other seemingly impossible choices.
Much of the taskforce work was done from mid-March to early April, Towne said. The work focused on establishing policy, protocols and education.
Contributing to educating the broader community, Towne also has participated with a local Public Broadcasting Service, PBS Fort Wayne, in its broadcast series, Coronavirus: A Live Community Forum, which aired weekly in April. He addressed evolving questions and issues related to safety and effectiveness of existing medications, and clinical trials leading to new drug treatments or vaccines.
Towne sees hope that international clinical trials, now underway for an antiviral drug, Remdesivir – originally developed for Ebola – may prove to be an effective patient treatment to lessen the severity of the infection and speed recovery.