Azar's visit reinforces Roswell Park, region's role in combating Covid-19

The screen that had Alex Azar's attention was filled with references to a host of diseases.

Influenza. Hepatitis. HIV. Ebola. SARS. MERS.

And of course, Covid-19.

Azar, the U.S. secretary of health and human services, was touring a research lab at Roswell Park Comprehensive Cancer Center earlier this month as part of a daylong visit to Buffalo. A few of Roswell’s leading researchers were showing him highlights of their work, which essentially suggest this: In immunotherapy, the body uses its own defense system to attack cancer cells. Those same research approaches – How can you activate the immune system to attack intruders? – can be applied to deadly viruses like these ones, including Covid-19.

At a time when the heft of the federal government’s resources is being focused on fighting Covid-19, that means cancer centers like Roswell can play a role.

Shortly after his tour at Roswell, Azar sat with The Buffalo News for a one-on-one interview that overviewed the Trump administration’s efforts to fight the virus and, in turn, reopen the economy.

“We're harnessing just the incredible power of the U.S. dominance of the bio-pharmaceutical industry, towards this incredible project of, ‘Can we bring therapeutics and vaccines to market this fall to early next year and also at commercial scale?’ ” Azar said. “You have not seen sort of industrial coordination like this since World War II.”

Azar speaks in broadly sweeping and largely optimistic statements. As a Cabinet secretary, that’s part of the job. For Azar, so too are visits like this one. Since May, he’s been traveling to an average of two cities per week promoting his “health versus health” initiative, which urges people to move from the mindset of staying inside to strategically restarting their lives — if they don’t have pre-existing health conditions that make it unwise to do so, and with ample use of hand sanitizer, facial coverings and social distancing.

“We've got to get away from thinking of this as health versus economy,” said Azar, who both symbolically and practically has been flying commercial to the cities he visits. “It's actually health versus health because we've got to balance the important health benefits of reopening and the health costs of staying closed against the health risks of the coronavirus.”

The effects of the coronavirus delivered a blow this spring to the medical industry and likely by extension, people’s health. The delay of elective surgeries – which were reinstated in Erie County by Gov. Andrew Cuomo on June 3, the day before Azar’s visit – cut deeply into health system’s profits. Vaccinations, medical screenings and regular check-up numbers are all down.

That was a talking point for Azar during a visit to Buffalo General Medical Center and Gates Vascular Institute, where he met with doctors and nurses who are treating patients with Covid-19 and also spoke about cardiac and stroke screening. It came up too at Roswell, where Azar pointed to a 90% plunge in cancer screenings for Medicare beneficiaries across Western New York from March to April.

Roswell Park President and CEO Candace S. Johnson, who accompanied Azar on his visit, acknowledged the drop.

“Time will tell what the effects of all that will be,” she told The News. “Are we going to see people present with larger tumors? Is this going to be an issue in people getting treated earlier, which is what we all desire? I think it's hard to estimate right now what that's going to mean, but I think we're hopeful.”

The visit to Roswell was precipitated by a call between two friends. Michael Caputo, a Republican political operative from East Aurora who recently joined Azar's staff as assistant secretary of HHS for public affairs, was speaking with Paul Ciminelli, the president and CEO of Buffalo-based Ciminelli Real Estate Corp., which is working on a Roswell expansion project in Amherst.

“People are concerned about Covid-19 and they’re not going in for cancer treatments,” Ciminelli recalled telling Caputo, who in turn told Ciminelli that Azar would be visiting different cities to address that issue. The two friends started talking about the idea of getting the secretary to Buffalo.

Johnson and her top researchers took the secretary through their labs, which had reopened over the previous few weeks after being closed for much of the spring. Azar visited with Dr. Kunle Odunsi, who leads Roswell Park’s Center for Immunotherapy, as well as Dr. Igor Puzanov, who is coordinating Roswell’s work on Covid-19 therapeutics with regional partners, and Dr. Pawel Kalinski, who is leading a study that explores whether cancer treatments under development could also work on Covid-19 and other viruses.

Kalinski showed Azar and Rep. Brian Higgins, a Buffalo Democrat whose district includes Roswell, a set of slides that described how the treatment of cancer may relate to the RNA viruses such as SARS, Ebola, HIV, hepatitis, yellow fever, West Nile and Covid-19. They are also studying drug combinations that can activate the immune system’s defenses — something that is useful in treating a virus like Covid-19, and in attacking cancer cells.

“The mechanisms that you can learn by studying what happens in a viral infection and the immune response to that infection has applications not only for that virus infection, but also, in many instances, in designing new and novel therapies for cancer,” Johnson explained after the tour. “It's not a coincidence that every cancer center in the country is very well positioned to look at their own research in a little different way and apply what they know about the immune system to the Covid-19 situation or these viral diseases.”

Higgins, who sits on the House Ways and Means Committee, advocated last month for a $5 billion increase in National Institutes of Health funding for Covid-19 research. Most of that – $4.745 billion – came through as part of the Heroes Act aid package. Funding from the NIH, part of Health and Human Services, is vital for medical centers like Roswell.

“The mark of who you are and how successful you are, is your grant portfolio,” Johnson said.

Most of Roswell’s work is aimed at developing therapeutics that can treat Covid-19, not at vaccine development. (Odunsi does have one study underway that may be helpful for a vaccine.) But Higgins, who is a co-chair of the House’s Cancer Caucus and serves on the Ways and Means health subcommittee, points out the potential long-term benefits of using immunotherapy as a tool for fighting this – and future – coronaviruses.

“That puts Roswell in a strong position to take a leadership role nationally and globally with the goal of helping to develop an immune response,” Higgins said. “Immunotherapy is what is being looked at as the likely vaccine for Covid-19 and I hate to say it, but probably Covid-20 and Covid-21, and 23 and 24. This is with us for a while.”

Covid-19 is still here — and in some areas of the country, the numbers are rising. But as the humidity and heat and openness of the summer sets in, even if the virus numbers quell across the country, it’s not over. The numbers could spike in the fall, or later. Or another virus could emerge, months from now, or years from now.

Azar acknowledges this is an ongoing battle. “It’s very much on my mind,” he said during his interview with The News, which took place in a conference room at Roswell Park.

Azar highlighted a multifaceted strategy for dealing with this virus — and whatever may come next:

• Testing: While testing for common viruses like influenza is widely available, Azar acknowledged that the “testing infrastructure in the United States did not exist … for any kind of novel virus. That really had to be built from ground up.” He pointed to public-private partnerships with science companies that have been developed to ramp up testing abilities quickly. “That's going to make us so much better prepared for any new, novel pathogen that would come along,” he said.

• Stockpile: Azar said the United States’ national stockpile is “going to have 100% of the products needed for a pandemic” and added that the administration is working with private distributors to have a 90-day reserve supply of equipment. An aide later expanded on the supplies that will be stocked: ventilators, diagnostics, personal protective equipment and, when available, therapeutics and vaccines.

• Data systems: The secretary wants to make sure that hospital information systems – including admissions, intensive care numbers and fatalities – are connected and up to date.

“That's all part of preparing for the future, whether it's a second wave in the fall or the winter, or if it's an attack or another naturally occurring pathogen,” Azar said. “I think actually, as hard as this has been, it makes us so much better prepared either for a second wave, or for the future generally.”

Azar, a lawyer and former pharmaceutical executive from Indiana who joined Trump's Cabinet in 2018, described several therapeutic treatments in development. Some rely on plasma with antibodies from the blood of people who have recovered from Covid-19 and are designed to delay progression of the disease. Others, which include some being studied at Roswell, treat symptoms of Covid-19 by trying to alleviate inflammation of the lungs, or prevent strokes that result from blood clotting.

Though Azar was speaking broadly, and not focusing on any one study or treatment in development, health officials are largely hopeful that therapeutics will be available before a potential fall wave of the virus. A vaccine, as has been widely acknowledged, will likely take much longer. But having a range of reliable therapeutic treatments that cuts down on the lethality of Covid-19 is seen as a major step in helping people feel comfortable returning to an adjusted, distanced, face-masked normality.

“Across that range – therapeutics as well as symptomological therapeutics – we’re going to make advances,” Azar said. “These make sense, but you can’t guarantee any one of them will be the one that works. We’re studying them and that will, I think, give people a lot more confidence. You’ll know who's more likely to be at risk, and know that you don’t feel powerless. You feel (like), ‘OK, there’s something for this. If I get it, and get a severe complication, I’ll be able to deal with it.' That, of course, is a goal. No guarantees, but a goal.”

[This article was originally published by The Buffalo News.]