Decatur Doctors

by Lynne Anderson

Decatur’s Own Healthcare Heroes

Local doctors play key roles in containing COVID-19

WHEN FEAR AND ANXIETY spread almost as fast as the coronavirus itself, Decatur residents got to work to do what they do best: helping one another. Across town and within neighborhoods, we saw something great arising from the confusion and panic — compassion, care and concern from one another. It was as if the city’s residents collectively said “no” to despair and instead tried to search for deeper meaning and connection in the midst of chaos and loss.

Many Decatur residents work at the Centers for Disease Control and have played integral roles working to learn about this distinctive virus and determining safety measures, not only for our small city, but for the entire country. Others are researchers involved in critical vaccine trials at Emory University. But, whether working on clinical trials or trying to halt the spread of the novel virus, everyone has stepped up and played a heroic role in this pandemic, including teachers, parents, first responders, sales clerks in our grocery stores and drug stores, city workers who continued trash pickup and those restaurants who kept their doors open to keep us from going crazy. While we can’t feature every single Decatur hero, we want to at least highlight some very special ones who have been part of a collective effort to learn from the trial and to make lasting connections.


The pediatrician who made a quick pivot

Pediatrician Debby Pollack of DeKalb Pediatrics had college applications and high school grad-uation for her Decatur High School twins at the top of her mind as 2020 began.

Then schools were suddenly closed March 12.

Everything ended that Thursday,” Pollack said.

But the seven-doctor pediatrics practice never closed. Under direction of Jane Wilkov, they shifted to telemedicine almost overnight to make sure all patients could be seen via a physician-patient portal that the practice uses.

“Jane Wilkov was really the one behind this all,” Pollack said. “She was able to pivot so quickly, turning us into an all-well office and doing everything she could to make sure we had PPE, which at the time was daunting because of the shortage.”

The team did not see sick patients in person but instead through telemedicine. Pollack said seeing sick children online gave her details and unexpected insight that wouldn’t be there in an office setting.

“It’s incredibly reassuring” to see a toddler playing during a visit, she describes. It’s a sign that the child is not suffering or in a seriously ill state. She and her colleagues could also tell if a child is hydrated by the appearance of their skin, and they could also see if children were in pain or distress — all signs of symptoms of something more serious.

Despite a “learning curve,” Pollack describes everyone pulling together to make the new condi-tions work. Some days doctors even saw their young patients in the parking lot if internet connection wasn’t functioning.

One challenge was that well-child visits needed to continue, especially for children who need scheduled vaccinations.

“Immunization is very important, and it’s important for children to get their vaccinations on schedule,” Pollack said. The well-only office plan allowed most to keep that schedule.

These conditions required fast thinking and action. Pollack said the practice was plugged into the latest guidelines from the Centers for Disease Control, ongoing research and the ever-changing news about the availability of PPE.

“You have to try to keep a positive attitude,” she said. “The families we care for are all so sweet and appreciative. Even on the most stressful days, there was always a parent or a patient who would make me smile.”

Pollack credits the gratitude she receives from those patients and parents for inspiring her own feelings of gratitude for her life and appreciating more deeply each moment.


The scientist who fast-tracks for a vaccine


Before March, many took for granted the work of physician researchers like Evan Anderson. He leads a team at Emory’s Vaccine and Treatment Evaluation Unit whose work involves planning for and studying vaccines. His work deals with both with immediate threats, such as seasonal influenza, and emerging threats that haven’t crossed the average person’s mind.

The SARS and MERS outbreaks had signaled to researchers like Anderson that other coronaviruses, such as the one that causes COVID19, could also jump from non-human species into humans. When he first heard of the unusual cases of pneumonia that were showing up in December, 2019 in China, Anderson said he felt “very uneasy.” He knew a novel virus that infects the lungs, has no cure and no vaccine spelled trouble.

By March, Anderson’s team and others working on vaccine trials across the nation were in high gear in the hopes of identifying a vaccine that could be tested quickly. Since March 16, Anderson has helped fast-track research for two vaccines, one of which is an mRNA vaccine that was developed by the National Institutes of Health and Moderna. The other is currently in Phase 3 clinical trials by Janssen Pharmaceuticals.

“We’ve benefited from a lot of basic science that was conducted after the MERS and SARS out-breaks,” Anderson explains. For example,
researchers already had identified the spike protein on the surface of the SARS and MERS coronaviruses, which led them to more quickly understand the spike protein on the new coronavirus, SARS-CoV-2.

“A lot of work had been done on both,” he said, “and they are the same family of viruses. This one is not the same, but it is similar.”

There’s more to vaccine development than what goes on under a microscope, Anderson describes. “For my work to move forward, there’s a tremendous amount of work to be done for each study protocol.”

Institutional Review Boards, regulatory requirements, compliance to biosafety rules and recruitment of study participants all take a tremendous amount of time — and all are required by the Food and Drug Administration to ensure that clinical trials are conducted appropriately and safely.

Now that the mRNA study is in Phase 3, or the stage where the vaccine is being given to people to see whether it protects people from becoming infected, there are also patient visits and observation at regular intervals.

“It’s been really exciting,” Anderson said about the work that is also very exacting. He emphasizes his work as part of a broader team of researchers, physicians, nurses and research assistants. Among them is Emory’s Hope Clinic, the clinical arm for vaccine studies on a range of diseases, from HIV to yellow fever. And now, the novel coronavirus.

Anderson praises the clinical trial participants for their courage and their willingness to help humanity by participating in the vaccine trials. “At the end of the day, you can have a perfect trial, but without any participants it won’t work,” he said.

Anderson looks forward as the community, nation and world work together and remain dedicated to the search for a vaccine.

“Having hope is really important,” he said. “We’ve come a tremendous distance since we first heard about the coronavirus. We’ve made lifestyle changes, we’ve socially distanced, and we’ve worked on several vaccines. We will get there together.”


The public health expert who came of retirement

Lynn Paxton was scuba diving last fall, traveling to places like Egypt, Malta and France — and loving every minute of it.

She had worked hard for years before recently retiring. A physician and public health official who had helped to control diseases such as malaria, HIV and Zika, Paxton was “having a wonderful retirement. I loved, loved, loved retirement.”

As borders closed in response to COVID-19, she too, suddenly found herself sitting on the sofa, binge-watching Netflix.

Paxton knew she needed to help. She began by volunteering for the Medical Reserve Corps. With her vast experience, she felt like she could be doing more.

“This really is a once-in-a-generation health challenge,” she said of the havoc wreaked by the virus.

So when Dr. Kathleen Toomey, commissioner of the Georgia Department of Public Health, called and asked Paxton to take the position as District Health Director for Fulton County, she agreed – even though it meant coming out of retirement, possibly for several years.

Paxton said she hasn’t looked back at her retirement life. The great and immediate need to coordinate testing sites, obtain testing and begin contact tracing – all the footwork so essential in public health emergencies – has made her decision clear.

“An old dog like myself has had to learn new tricks,” she said. And, this pandemic has many different unique challenges, starting with the unpredictability of the virus itself. Scientists have learned a great deal about COVID-19, but they do not yet know how to cure it. Researchers around the world have been conducting tests and clinical trials at breakneck speed, resulting in information that doctors and public health officials like Paxton process, analyze and implement.

But one of the biggest challenges Paxton faces in her work came as a surprise. Many of the health measures that needed to be put into place have come to be seen by some of the public as political moves. She compared the response to her time spent trying to stop malaria by saying “I’d never been in a situation where someone refused to use a bed net to prevent malaria.”

In addition to helping to keep coronavirus under control, people have other medical needs.

“There’s more to life than COVID,” Paxton said. “People still need dental services and vaccinations. There is so much need out there.”

Paxton looks forward to one day going back to the skies and the seas for travel and diving. Right now, she knows she is where she needs to be.

“I can have much more impact here than when I was binge watching on my couch,” she said. “The fact that this was such a public health emergency, I really had to answer the call.”