Speaker 1:

Hello and welcome to the podcast. In the coming weeks, we'll be learning more about coronavirus, not just about the virus itself, but of the response to the global pandemic that has shut down cities, forced people into their homes, and started a race to find effective treatments and therapeutics.

Speaker 1:

In today's episode, we're talking to Dr. Clay Marsh. He's the vice president and executive dean for health sciences at West Virginia University. He's also currently serving as the West Virginia State COVID-19 Czar, a title given to him by West Virginia governor, Jim Justice. In this episode, we'll talk about his role at the government level, how organizations have worked together, how West Virginia has responded, and how WVU decided to close and its plans for reopening, as well as much more.

Speaker 1:

Dr. Clay Marsh is an optimist. He sees the response to the novel coronavirus as part of "the rise of the state of West Virginia." Marsh is the vice president and executive dean for health sciences at West Virginia University. He says the Mountain State will be stronger than ever before, but not because of any commercial or competitive advantage.

Dr. Clay Marsh:

It's because the fiber and the foundation of who we are is now, at the most important point in all of our lives, shining through.

Speaker 1:

Marsh was appointed by Governor Jim Justice as the state's coronavirus czar. He believes that we as people are called to do things at the right moment.

Dr. Clay Marsh:

I believe this is a moment for this state to be able to shine very brightly. In many ways, some of the things that maybe pre-COVID, we would have said, "They're really challenges for West Virginia. We don't have a big airport, we don't have big cities, we don't have a lot of national businesses, we don't have hubs, we don't have this and that, but they made us resilient, they've made us able to withstand this in a good way."

Speaker 1:

Having a smaller, more rural population has been beneficial, as the coronavirus primarily spreads from person-to-person contact. The virus has a high infectivity reproduction rate, so one person has the potential to infect hundreds of others, but West Virginians, as they so often demonstrate during trying times, have pulled together to take care of their most vulnerable.

Dr. Clay Marsh:

The community that we have and the connection and togetherness and the self-sufficiency and the fact that we're very resourceful, that makes us go beyond resilient and it makes us actually potentially benefit in some strange ways from this kind of a challenge. I think that people all over the country now are starting to look at West Virginia and saying, "Wow, that's a beautiful state. Maybe I'd want to live in a state like that, a state where people really rally together, they help each other. They do the right thing, not because someone's holding a gun to their head, it's because that's their choice, because they love each other and they have community and they have family."

Speaker 1:

From Marsh, that's the point he consistently reflects on. He's humbled and grateful for the opportunity to lead the state through one of the most challenging public health crises in recent memory.

Dr. Clay Marsh:

I feel like that I'm really contributing to past part of myself to a place that I believe is going to be much richer in the future in many, many ways. I think we are becoming, not can become, but are becoming a beacon that other people are looking at.

Speaker 1:

Because of West Virginians taking care of themselves and of others so well, Marsh says West Virginia is in a great position to start reopening businesses and getting folks back to work. The initial projections from the University of Washington had West Virginia tragically losing 500 people through August 4th. The model also projected the state needing additional ventilators in ICU beds. However, after protective measures were established, such as physical distancing and Governor Jim Justice's stay-at-home order, the projections have been drastically reduced. Marsh says it couldn't have happened without West Virginia stepping up to the challenge and staying vigilant by practicing physical distancing, washing their hands regularly, and not touching their mouths, nose, and eyes.

Dr. Clay Marsh:

By flattening the curve, we also are doing that so we protect the health of our first responders and our healthcare workers and our essential workers. At some point, that's a responsibility that's not only you taking care of your own health, but really by doing that, you're taking care of our whole state's health. I think most people really get that

Speaker 1:

As West Virginia businesses are reopening and crowds are beginning to rejoin them, Marsh says the risk of spreading COVID-19 is still present.

Dr. Clay Marsh:

We are now in a much trickier part. The trickier part is when we are reopening to come back out to live with the virus. I think that West Virginia has done spectacularly well. The governor has talked almost daily at the briefings, as have many other people, including me about the incredible commitment of the people of West Virginia to protect themselves, protect each other. But I know people are tired. The weather is nice. There's lots of things going on, including many peaceful protests going on around this country. That's bringing people together again. At the same time, we're opening businesses, we're opening restaurants, we're about to open casinos. As we come together, the risk of the COVID spread goes up.

Dr. Clay Marsh:

I think that the key is, and we've talked about this before, that I think the secret sauce is wearing masks. Remember, wearing a mask is not to protect you from somebody else who's infected, it's to protect them from you who might be infected because masks reduce that generation of droplets and we know that people breathing, speaking normally, speaking loudly, or singing or coughing or sneezing can create droplets that can contain virus. In a laboratory setting, even talking normally can suspend those dropouts up in the air for up to 15 minutes and we know that a choir concert in Washington state, that an infected person infected 55 of 62 people in the choir.

Dr. Clay Marsh:

Ultimately, we know if you're out and nobody's wearing masks and you're in a crowd, or if you're sitting in an inside place and not spaced appropriately, yeah, you have a risk of getting the virus. I think that we know the trade-off and getting people back outside again and reopening the state is the risk of virus goes up.

Speaker 1:

Marsh says he doesn't want people to be scared. Most people who are infected will recover and vaccines and other treatments are in development. Until medicines are readily available, though, safety measures help bide time to flatten the curve so the healthcare system is not overwhelmed.

Dr. Clay Marsh:

Certainly, as we get drugs and a vaccine, those will start to mitigate the need for more personal protection, but I think at first, it's going to really be smart for people to come back out and want businesses to open again, but it's going to be smart for people to continue to protect themselves.

Dr. Clay Marsh:

We've had a lot of support from West Virginia University and the Guard to do innovations, like the new type of masks that are being made in the prison industries, new gowns. With Dr. Laura Gibson's leadership and Dr. Pete Perrotta and others, we're starting to develop a COVID viral test. Peter Stoilov has led that particular project. Heath Damron's leading a project to create an antibody test that we can use. That will be the first antibody test available to us in the country to do quantitative, to tell how much antibody people have, the quantity of that, which is fantastic. We have Gene Cilento in engineering making swabs. The university has been very, very active.

Dr. Clay Marsh:

Sally Hodder, who is the director of the Clinical Translational Science Institute for the state, has come up with a group that's doing reproduction numbers to help us understand how quickly the virus may be spreading in the state of West Virginia and in the county. That's really helpful because we can watch and see, is the spread of the virus picking up in certain areas? That will help us test those areas and look at those areas.

Dr. Clay Marsh:

But also working with DHHR, the state bureau of health that Commissioner Cathy Slemp leads and DHHR's Secretary Bill Crouch leads and Deputy Secretary Jeremiah Samples is coordinating, then with National Guard's General Major General Jim Hoyer and his team. It's really an incredible collaborative relationship.

Speaker 1:

Marsh says implications of the novel coronavirus for West Virginia became apparent when the virus spread to Italy, as the populations share similar characteristics. Residents in both territories tend to be older, more likely to smoke, and more likely to have chronic medical conditions.

Dr. Clay Marsh:

When it really struck home, I think, is when the virus spread to Italy. As we look at our population, which is older and less healthy and smoking and perhaps with chronic medical problems, Italy's population resembled ours in many ways. In Northern Italy, particularly, which is a really rich, sophisticated part of Italy, they did not start with the physical distancing, they didn't really go to staying at home, and they got surged by the raid of spread of the virus, which was very rapid. It overwhelmed their health system to the point where eventually, they said, "If you were over 60 years old, you didn't get a ventilator." You didn't get an opportunity to get better.

Speaker 1:

With West Virginia University's spring break looming, university officials looked closely at the situation in Italy. Leadership began serious conversations about the health and safety of the campus and community. If students were to resume in-person classes after domestic and international travel during spring break, they also had to consider the logistics of shifting to online learning and remote work, as well as the financial implications of doing so. As the state's land-grant university, WVU leaders know that that designation carries responsibility. The university in many ways must lead the state. The COVID-19 pandemic was no exception, as President Gordon Gee and his leadership team ultimately made the decision to close the campus for the spring semester.

Dr. Clay Marsh:

It was really remarkable how people came together. The other thing that's really striking to me is how the spirit of West Virginia and the university exemplifying the spirit of the state really came out. We're a state and a university that is purposeful, but also, we solve problems. There wasn't complaining and whining and, "Oh, my god, we can't do this," there was just a feeling of, "Sure, we'll get it done. We'll figure this out. We'll create these new paths that we need to take because we care about the students and we care about the university," so it was really quite an amazing community that really rose all at once together. That was really, really inspiring to me.

Speaker 1:

Looking back, Marsh said the decision was the right one. Physical distance saying, and staying home has been a critical factor in reducing person-to-person spread and slowing the surge of the virus. The university recently announced students will return to WVU's three campuses to begin fall classes on August 19th. Students will remain on campus, however, with no fall break through November 24th. Instead, they will depart for Thanksgiving break, but they won't return for the rest of the fall semester. There will be one week of online instruction following Thanksgiving break with finals also conducted online. Spring classes will begin on campus on January 19th, continuing again with no spring break through April 30th and finals will be on campus from May 3rd to the 7th.

Dr. Clay Marsh:

The commitment that Gordon and the leadership team made is that we want to continue to educate our students, we want to give our students the safe experience that is as part of the maturation that college and going to a great university gives you with the richness and the diversity of not only the classes and the teachers but of the other people here. I know that Gordon, who is the most experienced university president in the country, has a wealth of perspective on how we could do this. His commitment was, "We're going to get the university open, but let's approach it the safest possible way."

Dr. Clay Marsh:

Certainly, people like Rob Alsop, who is really been spearheading almost all of the operational work, getting 40,000 masks and Gators here and helping with his team, David Beaver and other people to help make sure that the campus has all the supplies, cleaning, the plexiglass separators. Maryanne Reed is our provost who's gotten with all of our faculty to really reshape how we've taught online for the remainder of the spring semester and now coming back in. It's been an incredible job. I can name many other people, too, but I think it's just been an incredible job by so many people.

Dr. Clay Marsh:

Then Jeff Coben, who is, who is an emergency room physician, but also has a Master's in Public Health and is the dean of our Public Health School has really been great at helping organize with the university leadership, a lot of the operational details and strategies that will be necessary to get our students back in safely, including the commitment.

Dr. Clay Marsh:

This was Rob Alsop and Jeff Coben, but the commitment to test all of our students coming back in for the COVID virus and to help test all of our faculty and all of our campuses and to try to create the ability to do contact tracing, just like we're doing with the state here at the university, to have a collaboration with the local health department, with Lee Smith, who's fantastic, his team with the university and Jeff and other folks, to be able to identify and then do the contact evaluation of students or faculty who may ultimately have the COVID infection. Then also, to start to work with our hospital system and our community to make sure that we are doing the things to try to make sure that this is safe, not only for our students and our faculty and our staff and our West Virginia University and WVU Medicine employees, but also for our community.

Speaker 1:

For students and parents who may be concerned about the return to campus in the fall, Marsh says the university is doing everything possible to make the transition safe for everyone.

Dr. Clay Marsh:

We have gone to what I consider pretty extraordinary lengths to make sure that our campus is going to be safe for all of our students and our trainees, but also all of our faculty and staff. We also are committed to helping make sure that this is safe for our community. One of the insights that I've been able to get as the person who's leading the efforts in West Virginia around the COVID pandemic is the fact that we are borrowing a tremendous amount from our university for our state efforts, so we will bring the same sort of capacities and the same sort of strategies to the university and to Morgantown that we're bringing to the state.

Dr. Clay Marsh:

We have a really good team of people. We have, I think, a very good plan. We have a very good educational plan to help people learn how to protect themselves with the virus, because a lot of the responsibility lies with the person, whether it's the students, the graduate student, the professional student, the undergraduate student, the staff, the faculty, then we're all responsible for our own good health and we will absolutely train and teach people how to do that.

Dr. Clay Marsh:

But we also know that this is a pandemic and this virus infects people, even if you're being super careful and ultimately, what we plan to do is that we have a plan that if you do get infected with a virus, that we will have you assessed medically. We'll make sure that you are taken care of, that we also keep you from infecting anybody else and identify anybody that you might've come into contact with. We will then test and isolate them. We will also keep a close eye by testing in a surveillance way to make sure that we're keeping an eye on what could be brewing inside the university and to give people the access to that testing.

Dr. Clay Marsh:

I think if you look at West Virginia, the governor's talked about this a lot, we're right in the middle of two-thirds of the country's population and what Gordon Gee says is God's time zone, the Eastern Time Zone. Many states around us have had a tremendous amount of COVID infection and many, many deaths from COVID and we have done very well. I think that the spirit of our people, the position of our state, and the, I think, expertise of the people that are helping oversee our response is been exemplary. I think that's been a great reason why we've been so low in the number of deaths and so low in the number of people who've tested positive for COVID-19.

Dr. Clay Marsh:

We'll bring that same capacity and that same rigor and that same excellence to monitoring and helping the university stay safe as well, so I feel very confident that we will be a very, very safe university. If you decide you want to come back to a university, then we will do a good job taking care of you, but we also know that in this pandemic time that people will get infected, we do know that as we reopen the state, people will get infected, and we also have a great healthcare system.

Speaker 1:

To be a part of the leadership team on both the university and a state level has been a privilege, Marsh says

Dr. Clay Marsh:

Anybody who's a leader, really, if you do your job right, you're really a servant. To be able to be part of this leadership team that I think is together at a very important and perhaps transformational moment, not just for our state or our country, but really, for our world. It's been quite a privilege.

Speaker 1:

Dr. Marsh is confident that the West Virginia University and West Virginia community can keep moving the state forward, utilizing the guidance that officials offer.

Dr. Clay Marsh:

We know that the secret sauce to why we've been doing so well in West Virginia is because people have bought in, they trust that the information that we're giving them is the information to the best of our ability. We're not infallible. Certainly, if I looked back two weeks ago at almost everything I've done, then I would have learned since then, I might do it differently, but if your intention's right and if your heart is right for what you're doing, I think people really get that.

Speaker 1:

Dr. Marsh will continue to serve the state of West Virginia through the rest of the pandemic, but to him, serving the state is a personal mission that fuels everything he does. If you have a question or comment for Dr. Marsh, consider following them on Twitter with the username @claymarsh, C-L-A-Y M-A-R-S-H. There, you will be able to read his blogs, which offer additional insights, see articles he references in the governor's daily press briefings, and get replies to questions you and others may have.

Speaker 1:

If you're interested in learning more about West Virginia University's response to the COVID-19 pandemic, visit coronavirus.wvu.edu. Follow us on social at WVU Health on Facebook, Twitter, and Instagram. Make sure you subscribe to this podcast on your favorite podcast app to get the latest episodes as they're released.