The Symbiotic Podcast

Collecting COVID-19 Data for Action

October 20, 2020 The Huck Institutes of the Life Sciences Season 2 Episode 7
The Symbiotic Podcast
Collecting COVID-19 Data for Action
Show Notes Transcript

On October 19, 2020, we teamed up with the hosts of Podward State – a Penn State student-produced podcast, to interview researchers working on a profoundly collaborative project designed to measure multiple impacts of the COVID-19 pandemic on residents and students in Centre County, PA.

Relevant Links:

Guests:

  • Meg Small - Research Associate in the Bennett Pierce Prevention Research Center for the Promotion of Human Development at Penn State and Director of the Health and Human Development Design for Innovation Lab 
  •  Connie Rogers - Associate Professor of Nutritional Sciences at Penn State and Associate Director of the Huck Institutes of the Life Sciences 

Cole Hons: Greetings, fellow Homo sapiens and welcome to The Symbiotic Podcast. For this episode, we teamed up with Penn State students Matthew Ogden and Matt Paolizzi from the podcast Podward State, launched by the popular student blog Onward State. 

Along with Matthew and Matt we hosted two guests: 

Meg Small is a Research Associate in the Bennett Pierce Prevention Research Center for the Promotion of Human Development at Penn State and Director of the Health and Human Development Design for Innovation Lab. 

And Connie Rogers, also from Penn State, is an Associate Professor of Nutritional Sciences and Associate Director of the Huck Institutes of the Life Sciences. 

Meg and Connie are key faculty researchers collaborating on a project called Data 4 Action – an effort to understand the impacts of COVID-19 on the population of Centre County, Pennsylvania – from many perspectives, including physical and mental health, economics, and behavior. 

The Data 4 Action project is a profoundly collaborative effort, involving local government and healthcare facilities, multiple units across the university, and thousands of volunteers from throughout Centre County. 

I hope you’ll enjoy our conversation about this innovative and timely research. 

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Intro (Nina Jablonski): Evolution involves more than the survival of the fittest. It's also about the survival of the most cooperative, and mutually beneficial relationships are critical to the survival of every species. Welcome to The Symbiotic Podcast, where we will explore the collaborative side of life and work to consciously evolve science itself. 

Cole Hons: Hey, thanks, everybody! It's so exciting to be doing this collaborative episode today with Matt and Matt from Podward State podcast, an all-Penn State student-run podcast, and our guests today, Meg small from SSRI, and Connie Rogers from our own Huck Institutes. Thanks, everybody, for being here. 

Meg Leavy Small: Thanks for having us. 

Cole Hons: Great to see you! So, we're here today to talk about the Data 4 Action research project. So, I'm going to let one of our co-hosts from Podward State maybe come in with some early questions for our guests. 

Matthew Paolizzi: Yeah, thanks a lot, Cole. We can go to Meg real quick. Meg, do you just want to give us a definition of what the data of what the Data 4 Action project is for someone who might not know anything about it? 

Meg Leavy Small: Yeah, so, of course. Thank you. And again, thank you for having us and allowing us to share information about this study. It's a complex project it has three components. But at the heart of it is, you know, when the pandemic started, and we realized the depth and the length that this pandemic would take, researchers at Penn State wanted to leverage all the expertise that we have on campus to provide science and evidence to inform the actions that could be taken to help both our community cope and recover from this, as well as our student population and, obviously, the Penn State community more broadly.

The Data 4 Action Project has three components. We started with this really large Centre County-wide survey that involved over 10,000 community members. From there, we recruited a resident cohort that we're collecting both survey data from and also biomarker data from, and we're hoping to begin enrollment with a student cohort. Again, where we'll collect biomarker data and survey data about the social, behavioral, and educational implications of the pandemic. So, it's really combining and leveraging lots of different institutes and research traditions on campus, which it's sort of exciting that we're able to sort of provide this at this time. 

Cole Hons: And Meg, could you talk about some of the data that you're collecting when you're surveying everybody in Centre County? What kinds of information are you pulling from them? 

Meg Leavy Small: Yeah, sure. For the large, that cross-sectional study of community members, we're looking at their experiences with COVID, symptoms they've had, their mitigation behaviors. So, we're asking how often do they were face coverings, wash hands, etc. But we're also looking at the economic impacts: are they employed currently, have they lost their job or been furloughed since the pandemic began? Or did they own a small business, is that business still operational? So those are the kinds of things that we're asking about. 

And then for the cohort study, which is also Centre County community residents, we go much more in-depth about the impacts on family dynamics. For families with young children, how difficult is it to provide educational opportunities when the school is completely shut down? And now some, we have a number of school districts within the county – some are fully open, some are doing a hybrid, a lot of families have chosen to keep kids at home and educate online – so we really want to sort of understand how that's going for them.

And then also just the stress coping and anxiety that goes along with this pandemic. So, a lot of questions about health, well-being, coping strategies, particularly in the student cohort. That's going to be really important to understand the educational implications, but also the stress and anxiety, and as well as the flip side of that, the adaptive coping that students are engaged in. 

Cole Hons: Thank you.

Matt Ogden: How early in the pandemic did this project get started and how, if at all, has it evolved since it first began? 

Meg Leavy Small: Yeah, Connie, you were involved in the beginning. I actually reached out to the entire team, which just grows every week. So, I'll say just a little bit of what I understand it to be, because I came in, you know, not so late, maybe three weeks into the planning, but a lot had already been done. First, I just want to say that the infrastructure that Penn State's invested in allowed us to move really fast and collaborate really effectively.

So, this started in March. I think the genesis was a conversation that Nita Bharti and Matt Ferrari had about mobility and populations moving and then the risk for transmission of infectious diseases, and it was clear that there's this stable population in Centre County, but the students and visitors and tourists and families move in and out of the of the county quite regularly. So, what would the implication of that mobility be? 

They then took it to other folks at Huck pretty quickly. And they said, "We have the tools to provide some information that could really inform risk and resilience in this population, in the sort of really unique population that we're sitting here in." 

And then we immediately reached out to Susan McHale, who's the director of the Social Science Research Institute, and said, "It's not just the bio on this. It's going to be the social, behavioral, educational, coping stress – all of these broader impacts." And that's when the social scientists got involved. And then Connie, you were involved pretty early on because of the significant role that the labs were going to play in assaying, right? 

Connie Rogers: Right. And I kind of walk the lane between doing human subjects research and animal research. My research is very translational, so I was brought in, because I had worked really well with the Clinical Research Center on our own research projects, because this involved getting a group of people who hadn't worked together before to all speak the same language and be very functional. And so, it involves the social and behavioral scientists and designing the right kinds of questionnaires and involves people like me who are involved in clinical studies and also who have a laboratory that can do some of the bio specimen processing and storage. 

Meg Leavy Small: No matter how it's changed over time, I think – I just cannot say enough about two groups of people: the clinical staff, the nurses, and all of the folks that are checking in. A lot of students are volunteering on this project too, checking participants in, really facilitating that bio collection, making everybody comfortable and making sure informed consent is clear, and then all of the students that are working on the back end in the labs, as well. I mean this is just literally a cast of thousands to get these data collected as quickly as we did. 

Connie Rogers: I'd like to just reinforce that. We've been really fortunate to have a number of both graduate students but undergraduates be very interested and become involved in the research process. Because I think many of them have said, "I want to do something. I want to do my part. How do we/how do I do a better job?" or "How do I help the university or help the students move forward?" 

Cole Hons:Matt P., kicking it back to you. 

Matthew Paolizzi: Sure, yeah. You guys were talking about that student involvement. What are some other ways that students can get involved right now with this project? Maybe, whether it's research, not research. 

Connie Rogers: Well, I can answer on the sample, and we have had a lot of students be interested in volunteering to do things like help interview folks when they come in or help get their informed consent to participate in research. We have folks that are simply serving as couriers, you know, they're helping us shuttle all these complicated biological samples from point A to point B. Some of the folks are working in my lab, and they got the appropriate training. And then we're probably going to need students to help with data analysis. So, I think, you know, depending on people's interests, their skills, the time that they have – there's lots of places that they could participate all along the spectrum of the research going on. 

Meg Leavy Small: Yeah. And I'll just add to that, we're again, like I said, we're hoping to start enrolling students into a cohort using same methods that we use with the residents, so we'll need students helping in the clinic to check people in, to do some screening questions, answer questions. It's always really great to have students helping other students go through the process. And then we have pilot testers for our surveys, which are great because a lot of things students catch that researchers don't catch: ways that things are worded, or ways that items could be misunderstood, even additional variables that need to be included. We've had lots of students help us, and we're going to continue this through the spring, so there'll be at least three data collection points. It's always great to get student input and make sure that that that survey has a real student voice to it so that it seems relevant and resonates with students, so we can always use help: people looking over the surveys for us, data collecting, data cleaning on the back end, and doing some of the survey work helps a lot too. 

Connie Rogers: And then even just talking about it amongst yourselves, getting folks familiar with what we're doing and why we're trying to do it. That in and of itself goes a long way to get the word out that this is going on, and we need students to participate. 

Cole Hons: You know, let's talk about that for a second why we're doing this. What is the big picture goal? What are we really trying to accomplish with this study?

Meg Leavy Small: I think what we want to do is provide the very best science we can to help the campus and the community through this pandemic. Whether that's actually giving the numbers on what our risk profile and our exposure profile looks like to the virus or it's helping decision makers, both inside the university but also in the community, target scarce resources. There's a lot of problems that might be flying under the radar right now. Again, I just, you know, sort of thinking about the 18- to 24-year-olds – we know from national survey data that anxiety and depression are on the increase, but we don't know what it looks like on Penn State's campus. So, we really want local data, the highest quality local data we can, to make really informed choices about how we spend our time and our resources so that we get the very highest level of impact we can to reduce our risk and promote our resilience. 

Cole Hons: Thank you. 

Connie Rogers: And I don't have too much to add other than sometimes you think you know what the problem is, but without collecting data that might be unique to a community like Penn State – we're a relatively small town without the students, but we have this symbiotic relationship with the students, the town and the students. And so, I think really getting an understanding of, as Meg said, what are the issues and then how to move forward appropriately based on the, in the best interest of our community and including all of us. 

Cole Hons: Thank you. I understand, because I was involved in some of the marketing that we were reaching out to the local mayor and county commissioners and really involving local officials as well who are looking at this data in partnership with Penn State, which is fantastic. 

Meg Leavy Small: Yeah, we regularly brief council members, mayors, local government, and again, just as an example, and I can share some data here in a minute, but everybody thinks, "Oh, we haven't had a high level of this virus circulating in the community over the summer." But now we have numbers to show that that actually is the case in the resident community. So, we want to continue to monitor that over time. Same with the students: we really don't know what the past exposure to the virus was because so many of our students come from higher prevalence for areas or lower prevalence areas. And we just haven't had the capacity to sort of really assess the antibody levels, the past exposure. I know there's a lot of testing going on right now on campus for live virus for current infections, but you know what's the past infection profile look like? I think it's an interesting question, and we'll be able to answer that. 

Cole Hons: Right. Because if people listening don't realize yet, when you participate in the biological sampling aspect of this study, you're giving blood and you're able to see if you have antibodies in your blood. So, you could have no virus in you whatsoever, and maybe you were exposed in the past, you've got antibodies, and you don't even know it. And that's something that's part of this study, right? Meg, do you want to maybe go ahead and share some slides? We can take a look at some of the research and what you've discovered so far. 

Meg Leavy Small: Sure. So, I'll just quickly talk for a minute about the county survey. This is the cross-sectional, the big survey that we did between June and October. We have a few people that filled this out more recently. But you can see that we ¬– actually we're over 10,000 now, we're just sort of still cleaning the data – but that's the number for all county participants. And then that 1,472 – those are the participants that came through and give us biological samples. As part of that larger survey, we asked community members, "Would you like to be enrolled in the cohort, which we're going to follow at least for three time points over the next year and give us biomarker specimens and then also complete a longer survey?" So that's the 1,472.

Cole Hons: Yeah and so for people just listening who aren't seeing the slides on our audio podcast: we're at over 9,500 – as of October 4: 9,573 – of folks did an online survey about how the pandemic has affected them and then of those, 1,472 folks came in and gave biological samples for part two of the survey. 

Meg Leavy Small: And it's actually up just a bit from that, but that those are right around our final numbers. So, here's some of the early results that I mentioned earlier from the folks that gave us the biomarker data: we are at about 2%. So, a couple of things about the sample. It's not what we call in public health a purposeful sample, so it's a convenience sample in that we tried to get as many participants into that 10-minute survey as possible, but there's still selection bias of the people that did that survey and then the people that chose to give us information and potentially enroll into the cohort study. So, we don't want to misrepresent this as saying, "Okay, this is definitely representative of the entire community." However, the numbers are such, in terms of the number of participants that we have, that we're able to look at the demographics of the county and compare that against our participants, which we will be doing. So, we're going to say a bit more about how our participants look compared to the county overall; however, from not an insignificant number of people who have come through the clinic, we only saw about 2% having been exposed previously to the virus. 

Cole Hons: So, it's 2% of people have antibodies in their blood? 

Meg Leavy Small: Correct, exactly. So again, I think that the Huck folks would say, we're a pretty naive population that we haven't had high levels of exposure of the virus through at least September. We had a few folks come in and give blood in October, but for the most part we were collecting data in August and September. 

Cole Hons: And Meg, just to clarify things, of that group of people that came in, had any of them known that they had had the virus in the past?

Meg Leavy Small: Yeah. So, we asked that on the survey so we can compare that, but I don't have that exact response. You know, it would be anecdotal if they happen to mention it. We will be reporting whether or not they had tested positive or otherwise had a clinical diagnosis of the virus, so we'll also know if they had symptoms. We asked about symptoms independent from a positive test result, so that's how we're combining the survey and the antibody data as well.

If people are interested in learning more, this is where we are, we're going with the somewhere between 1,000 maybe 1,500 students and we're right now under IRB reviews, so we can't say too much about when we're going to launch that, but we're really hoping to do it this month. And again, the same procedures for the students: we'll ask them to enroll, they'll complete the student survey – it's a bit shorter, it's about 20 minutes long. And then they'll come into the clinic and give the same specimens.

Then we're going to start through late November, December with our second wave of community. So, it'll be the same 1,400 and such participants will come back in, and we'll be able to look and see, did we have any increase from time 1 to time 2 in positive antibody results? People can track the study, and we're going to be putting up a dashboard with the results on our website. And if people would like more information about it, if you're a student and want to know if there's opportunities to participate in the research itself, please feel free to email us at the email address there, and we'll get back with you on sort of current openings and opportunities. 

Cole Hons: And for listeners, it's data - the number four - action at P S U dot E D U. data4action@psu.edu. Thanks, Meg. 

Matthew Paolizzi: Meg, thank you so much for sharing that data with us. Has anything surprised you guys so far at least through the research that you both revealed here and in general, some research that you are allowed to reveal at this point? Has anything surprised you or at all, or were you guys pretty blank in terms of expectations coming into this? 

Connie Rogers: I think people had a pretty solid guess that State College had a low prevalence rate of antibodies, and I think just confirming that, I mean, I think that was a hypothesis, but we needed to actually do the experiment to test that. Just at a more global level, I think we are a very large and growing group of people who have never worked together before, and I think there was some anxiety about workflow and how things were going to shape up, and I think all of us have been pleasantly surprised and are working really quite effectively and very productively together. So, it's exciting from a new collaboration standpoint. 

Meg Leavy Small: Yeah, and add to that, I – well, on the data side on the social behavioral data side, I was surprised at how many community residents reported this life disruption. Considering that we started data collection in June, but just a couple of other numbers: that 32% so their lives have been significantly disrupted with another 64% thing moderately disrupted. So, I think that surprised me a bit because we always sort of think about the community as being fairly resilient and pretty stable, but this pandemic has really turned people's lives upside down and to see those numbers was a bit shocking for me.

On the workflow side, I don't know if it's surprise, but I'm really happy to see how many people that have both signed up for the study as participants as well as students who have contacted us and said – Connie, what you alluded to earlier – "I want to do something, I want to do something to positively impact or have some positive impact in the middle of this, sort of terrible crisis." So, a lot of the participants that come in, anecdotally, we heard, "I really want to just provide anything I can, data that will help inform the community and help keep the community safe." And for students, it's the same altruistic motivation, just "Anything I could do to help or be a positive force in the middle of all of this, I want to try to do." So, I'm surprised about that. And then again, I just can't say enough about our nurses, our clinical staff, and the people working in the labs. They're literally working around the clock to get these data collected because it's a small window that we have to really get these numbers. So I'm really happy about that. 

Matt Ogden: Yeah, I do think it's very inspiring and wholesome that during this crisis, all these different factions of this gigantic university have come together and all have a hand in this project, and it seems to be going pretty smoothly. 

Meg Leavy Small: Yeah, we have faculty who are retired, but still had their clearances. they were emeritus status, come in and volunteer in the labs. We had faculty not related necessarily directly to the project come in and volunteer in the clinic to consent and get trained and all of that. So, it's, it's just, like I said, a cast of thousands, but it's been terrific to see how people pulled together to make this happen.

And we should also mention that Provost Nick Jones, that Penn State, has funded this entire effort. It is not an insignificant amount of resources that went into this, again, to make that commitment to keep this community as safe as possible through science. It is not surprising but something that we're very proud of and happy about. 

Cole Hons: Absolutely. And in a minute here, we're going to take a look – for those watching on video, we're going to have a look at what some of this looks like. The Huck team went down and took some photos and video of those nurses you were just talking about, and in Connie's lab, seeing some of the students working with the samples. But before we get into that, and I'm going to ask Connie to let us know what we're looking at there and describe that for people listening, but I just want to unpack a little bit the reasons for studying the students separately from Centre County residents, those two separate cohorts and what's the relationship that you're looking for between those two groups? 

Meg Leavy Small: Yeah, so we're considering this one study that has two cohorts in it. For the most part it's a timing issue of when we bring people through the clinic and trying to get the resident population in first to see, are we truly a naive population? Or is that, you know, we didn't know until we got that 2% that yeah, we didn't have a lot of transmission prior. That was really critical. So, for the most part, we're not really considering them two separate components. It's just a matter of when we stagger the clinic visits and the recruitment process. Now in the resident cohort, we do have some Penn State students. The eligibility criteria to participate as a resident was that you were residing in Centre County from March 2020 through to September 2020, but we will have some students in that cohort. They weren't excluded. 

Cole Hons: And but will you be looking at the relationships in any way? Is there anything built into sort of the way that the student population relates to the Centre County, the town/gown dynamic, and all that stuff?

Meg Leavy Small: Sure, yeah. So of course, we'll be looking at serology and looking at the level of antibodies, etc. But just even on the survey side, we've actually put some of the same items on the students' survey as we did the community survey, and we'll combine those data, particularly when we're looking at vaccine intentions, mitigation behaviors. We want to look at all of the adults that are in our community, not seeing them as separate, realizing that prevention requires everybody to collectively do their part. So, we'll be combining those data, once we have them for both the community residents and the students.

Cole Hons: Got it. And so even though, where we might be a naive population in terms of low serology results, we hope we won't be naive in terms of our we're living our lives. 

Meg Leavy Small: Right, yeah!

Connie Rogers: Right, and the other thing I wanted to add is that we're also collecting health data, other health parameters, because we've learned, unfortunately, there are risk factors that make response to the virus and clearing the virus and illness related to that, and we don't know if those same factors influence a person's ability to make effective antibodies to the virus. So, we're collecting that that data in both the community sample and in the students. I think that's another layer of this, and then we have all of the questionnaire data about psychosocial health, and we're going to be able to look at these complex relationships in a very unique way that we feel pretty excited about, because not a lot of folks have had the wherewithal to put a study like this together, you know, grass roots, and get it launched, so I think we're going to have some really informative information for not only Penn State community but the US at large. 

Cole Hons: That's terrific.

Meg Leavy Small: It can be a model moving forward, not to end, but to become a system where we're monitoring the health and well-being, because this won't be the last health crisis or infectious disease that we see coming our way. So, we'd love to establish this as a model for other university towns, for other towns that have populations that move in/out. So, you can see like beach towns, resort towns, border towns, military towns with military bases. This has a broader set of implications. 

Matt Ogden: Yeah, and Meg, you mentioned earlier about how the students came back in August from all over the country and all over the world basically. Some came from high frequency areas and some came from low frequency areas. What impact do you think that that kind of dynamic is going to have on your results moving forward?

Meg Leavy Small: Yeah, exactly, that's part of what we're trying to study. What is? That's an empirical question. We're stratifying the sample for those who are interested. That means we're sort of grouping students by the prevalence of the counties that they came from before they returned to campus, and then sampling within there so we're getting a mix of that risk strata. So, we really do want to understand, because a lot of them might not know that they were exposed. In the younger population, there is a higher prevalence of asymptomatic spread, as we know, so just understanding that and then understanding how the changes in that student population and the changes in the resident population move together or diverge is something that would be really interesting. And because we've never been in the situation before, we don't have the answer yet. But that's definitely the question that we're asking. 

Cole Hons: Right on. Well, if it's okay, I'm going to share my screen and just take a look at some of this footage, and I'll ask Connie to kind of narrate, if she would, because some of this is from her lab. So, I'm just going to kind of hit play. This is what it looks like when you come in to give your biological samples at the Clinical Research Center on campus. 

Connie Rogers: So, a nurse is, after consenting the person and they agreed to be in research, a nurse would then draw blood and then label the tube with the study participant ID. All the data is de-identified, and then it's properly packaged. Here we're taking in a lock of hair for another research study, and all the biological specimens are being placed in the refrigerator. And here's our clinical team after a long, hard day. The blood then gets sent to my lab, and James McGee, a grad student, is loading the centrifuge, because we're spinning the cells to separate the plasma, or the liquid portion, of the blood from the packed red cells. He's entering data here on the computer. So, we are archiving samples for future research. Another graduate student, Janda Moni, is pipetting off the liquid portion of the blood, or the serum, into vials. And those vials would then be assayed for antibodies, and we have some samples bio-banked in case any other research questions emerge that we want to address. 

Cole Hons: Fantastic. Thanks, Connie. And then those samples are then sent to Mount Nittany, correct? We also have Mount Nittany [Hospital] as a partner in this research. 

Connie Rogers:Yes, yes. We've been fortunate. Mount Nittany has a certified laboratory that is able to evaluate antibodies, and those antibody results are then given back to participants. And so, Mount Nittany has been running all the samples since August 7th for us, so we have established a partnership with our local community hospital as well, which is another part of this team. 

Cole Hons: Yeah, truly it's really an example of a community coming together within Penn State and without Penn State, everybody kind of banding together to do what we can here. Really inspiring stuff. 

Meg Leavy Small: And I don't know if I mentioned this, but individual participants will get their antibody results back. I presented the data that were in aggregate, but that's why the Mount Nittany partnership is so critical because they have the clinical lab that can actually provide results back. It's unusual sometimes in research studies. If you're participating as a resident or a student, you don't get any direct information back. But in this case, you do. 

Cole Hons: That's right, yeah that's key in some ways, because I know a lot of folks are really excited to get those results. My own wife is in the study, and that was one of the things that she really wanted to know, "Have I had this and didn't even know it?" Right.

Matthew Paolizzi: Yeah, I wanted to ask you guys, it seems like there's almost two parts to this research project, which is this social study and the medical study of it. And we talked a lot about the medical studies so far, taking of samples and the detection of antibodies in the samples. But how did those two come together and also, what goes into the social aspect of the research?

Meg Leavy Small: Yeah, so, and Connie, you can take over, because I know this is really your area, but the one thing that I think is really interesting on combining both, directly combining the bio with the social, is around these ideas of inflammation markers, because they have implications both for disease and also for vaccine activation. And we know that students – again, I keep going back to this but highly impacted by stress, anxiety, life course changes, changes in academic plans, impacting everybody from first years all the way up to graduating seniors, of course. So how does that show up in the body, right? We'll have measures of self-report experiences, stress coping etc., support systems. Do they have peers they can go to? Have they been able to talk to advisors and mentors through all of this? But then, and I hand this off to Connie, but then looking at both from the hair, the cortisol that we can get from the hair, as well as the serology. How is that showing up? And what are the implications for health and well-being in the context of inflammation and immunity? 

Connie Rogers: Right. And so, I think what Meg already nicely outlined is each part of this is its own research. You have top notch social science researchers asking these questions just about the effect of the pandemic on social and behavioral outcomes. And then we're looking at the antibody titers and that change, that zero prevalence over time and the mixing of students and residents, and so that's its own biological question, and we're collecting information about health and prior disease risk, risky behavior, stress and anxiety, and ultimately, we hopefully will be able to answer very key questions. Do things like chronic psychological stress that one might experience during a pandemic, is that influencing the conversion, the antibody rate? Are other existing conditions in these populations, whether that's obesity or a high BMI or prior cardiovascular risk or diabetes, how are they impacting the development of antibodies and does play a role in that process? So, I think we're going to be able to ask some very integrated questions at that interface of psychosocial and biological or biomedical outcomes. And again, a very unique opportunity to ask some critically important questions as we move forward. 

Meg Leavy Small: I also wanted to mention that Dr. Rachel Smith and Dr. Jess Myrick, as well as others are looking at health messaging, in particular, and so how do we effectively health message around this? So how do we use our own data to potentially feed into data driven health messages that might resonate with students, with residents, etc. to better manage their overall health, but particularly their COVID-19 behavioral health actions. 

Matthew Paolizzi: Yeah. And, and I feel like you're all taking this really interesting holistic view of health in general, both mental and physical – I know I can speak for myself, if I'm really stressed out for a while, you know, I just feel bad body-wise, you know, physically, and I feel like that could even affect how prone somebody might be to catching the virus potentially – and documenting these effects and noticing patterns. 

Meg Leavy Small: Yeah.

Cole Hons: For sure, the mind body connection. That's a biggie. Well, this has been spectacular. Does anybody have any last questions while we're still on the line together? 

Matt Ogden: Sure, yeah. I just want to ask one final question. Say like, if there is a student out there listening right now who is thinking about participating, whether that be helping out helping to conduct the study or undergoing the study themselves, is there anything else that you guys would like to say to them? 

Meg Leavy Small: Yeah. Well, thank you, first of all, thank you for considering this. Anything that our students again can do to help spread the word about the study, why it's being done and the different aspects, would be really helpful. For the student enrollment, we will be emailing students directly in batches. So please look for an email from Data 4 Action. And if you're invited, consider clicking through at least to learn more. That would be something that we would love for students to understand.

Connie Rogers: And even if you have no history of participating in research, either as a participant or as a volunteer, we have lots of jobs for lots of different kinds of people. So, if you want to make a difference, shoot us an email. Yeah. 

Cole Hons: That's data4action@psu.edu. Well, I just want to thank everybody again for being on the Podward State/Symbiotic Podcast collaborative episode. It's been wonderful talking with you all. I wish you the best of luck with this project and the best of luck to the Podward State hosts with everything they're doing. And yeah, let's just look at this rough situation and realize we can still do positive things to make a difference in the world to make things a little better for everybody. So, we are doing what we can. Thanks a lot. Everybody take care! 

Connie Rogers: Thanks again. 

Matthew Paolizzi: Thank you so much. 

Matt Ogden: Thank you so much. 

Cole Hons: Bye. Cheers!