“We need your help. Make proposals to take research into the causes of pulmonary CVVID a step further, ultimately helping patients.” This call was made to the more than 400 medical and biomedical sciences students who attended the kickoff of the Lung-COVID Challenge on Wednesday, Oct. 19. The best idea will actually be implemented by students at UMC Utrecht.
“There is still insufficient biomedical research on the causes of Lung-COVID. There are zero solutions for patients. That is why I welcome the Lung-COVID Challenge. In the unexplored area of this condition, there is a need for many good ideas and pilot projects that will eventually give direction to larger studies.” Speaking is Annelies Bos.
Annelies worked as a gynecologist at UMC Utrecht, but pulmonary CVD recently forced her to put a stop to that. Together with Ellen Bark, she founded the Long Covid Foundation this year. The goal: to raise money for biomedical research into the cause and treatment of Lung-COVID. The foundation will donate 15,000 euros for the implementation of the most promising idea during the Long-COVID Challenge for students.
This challenge is a first. Never before have so many students at the UMC Utrecht participated in innovative interdisciplinary education. Founding fathers are Marco van Brussel and Niels Bovenschen, both education coordinators within the Faculty of Medicine: Marco for the medical students and Niels for the biomedical sciences students.
Niels: “We want to train our students to become professionals who are capable of tackling major challenges in the health domain. We therefore have them work on current relevant case histories, such as Lung CVD. The first principle here is that the patient is central. The second is that students train their academic skills. For example: critical thinking, creative problem solving and collaboration.”
About collaboration, Marco says: “When our students have completed their education, they are faced with complex care and health problems. These cannot be solved from one discipline; they require collaboration with other disciplines and professions. You cannot stay in your own box; you have to know how to bridge to other disciplines and complement each other. That is why we simulate workplace challenges during the study; students learn to cooperate and reinforce each other with the ultimate goal that patients receive better care.”
Niels (professor of research-driven education in the biomedical sciences, affiliated with the department of pathology) and Marco (medical physiologist and associate professor) work from the educational philosophy the New Utrecht School. The ideas are reflected in an interdisciplinary health-challenge that will have its first edition this year and should grow into a tradition. Marco: “It is part of the regular education program, so students receive credits for it.” Niels: “It is important that students are instructed by doctors, other healthcare professionals, researchers, patients and other stakeholders, such as this year’s Lung Covid Foundation. That way, they start to see what is a relevant problem at the moment and what help is needed to be valuable to society.”
That’s exactly how it went during the morning program on Wednesday, Oct. 19. Then the more than 400 students were divided into twelve interdisciplinary groups. These will spend almost two weeks thinking about biomedical research proposals in the field of pulmonary CVD. On Nov. 9, the most promising idea will be announced. Sixteen students will actually carry it out later in the academic year, in the UMC Utrecht’s Bachelor Research Hub. This will also earn credits. The donation from the Long Covid Foundation will cover the laboratory costs.
Ingrid Essenberg, education center policy advisor at UMC Utrecht, is one of three patients with Lung Covid to whom the students listened. She says, “Previously, I was project leader for patient participation in education. In that role, I advocated bringing patients into education, because then students get a better understanding of what a disease does to a person and what it means to the patient when a doctor does or does not do certain things. Of course, I didn’t expect to ever be a patient myself dealing with students in that role. Suddenly I was talking about my own clinical picture and also, for example, that in my opinion my family doctor was taking a too wait-and-see policy.”
Ingrid (45) became infected with the coronavirus this year. She got sick, had a fever for two days, but thought she could return to work after two weeks. “I told the students that I started working from home for a day. That went pretty well. But on the second day, the light from my monitor almost drove me crazy: I couldn’t concentrate and I had to call in sick again. From that day on, I slept a lot and couldn’t tolerate light or sound. After more than two months, the company doctor advised me to see an occupational therapist. He gave useful tips. I now divide my day into three parts: activities where you use your brain, physical activities and rest. I am now working again: three times one hour a week. After one hour, I have to rest for the rest of the day.”
During Ingrid’s talk, students experienced on the spot what the consequences of pulmonary CVD can be for a patient. “Because of all the light and noise, I got shaky hands and a raised body temperature. I also told the students that my heart rate became elevated and I couldn’t think straight. The only benefit of this is that I was able to do something for society: students got context to the medical terminology they learn during training. Yes, I feel it made an impression. Afterwards, some students shot at me: Can I ask you some more questions?”
Equally enthusiastic and energetic, students responded to Niels Eijkelkamp’s contribution. He is principal investigator in the division of laboratories, pharmacy and biomedical genetics. Together with Jeroen den Dunnen, an immunologist at Amsterdam UMC, Niels is conducting research on pulmonary CVD. He says, “If you know how Lung-COVID arises, doctors could treat more specifically and perhaps also apply diagnostics. There are many hypotheses about what causes Lung-COVID. One is that autoimmunity plays a role: antibodies target the body’s own proteins. With experiments, Jeroen and I have found evidence that autoimmunity may be a factor in Lung-COVID. We have shared data about this with students.”
The researchers then appealed to their audience, “How can we use this new knowledge for the benefit of the patient? And also: can we investigate even more how autoimmunity causes Lung-COVID? We hope students can help us take a new step in this research direction. Our advice to students was: think crazy, think out of the box. A professional researcher who has focused on an issue for some time may eventually develop blinders. These talented students from different disciplines are not burdened with that and can look at the topic with an open mind. My co-researcher Jeroen and I hope to soon be able to say: what a good idea, and how strange really that we never thought of it.”
Comments from students reinforce Niels’ expectation that this scenario will be followed. “They asked good questions. For example: what is the relationship between autoimmunity and psychosocial symptoms in lung CVD? There were also promising questions about forms of diagnostics. So promising that I said: I won’t go into that now, because it’s a valuable line of thought for yourself as you take on the Lung-COVID Challenge.”
Annelies Bos hopes the challenge will help unravel part of the complex disease that has also “floored” her. She says, “When my friend Ellen Bark saw that I could still do little to nothing a long time after my infection, she wondered why there is still so little knowledge about Lung-COVID. To cite one example, it took me four days to recover from my attendance at the kickoff of the Lung-COVID Challenge. Research is needed to give patients perspective, which is why Ellen came up with the idea of our foundation. What exactly does this disease entail, what is the pathophysiology and what therapies can be considered?”
Annelies and Ellen also asked the students for another form of help. “Our foundation is new, so we need to work on name recognition. I hope student ambassadors can help us use social media to put the foundation on the map. We also get tips in that area from experts at the Twitter Clinic. They, in turn, can also teach participating students about how to use social media optimally, including for personal purposes.”
Initiators Marco van Brussel and Niels Bovenschen hope that crowdfunding through Friends UMC Utrecht & Wilhelmina Children’s Hospital will raise 15,000 euros to conduct additional research.
