- Happening now on The Rundown.

- People I think don't realize how cutting edge research in Montana is.

- I think it's very gratifying that a little lab in a little corner of Montana is playing such a major role.

- Vaccines are really the most effective medical measure we have, like period.

- I'm Jackie coffin and The Rundown starts now.

The Rundown is made possible by the Greater Montana Foundation encouraging communication on issues, trends and values of importance to Montanans.

Welcome and thank you for joining me for an episode of The Rundown that's a little bit different this week.

This week instead of legislative affairs and Montana politics we're gonna be talking about the COVID-19 Montana's vaccination effort.

This week, we crossed two huge milestones in the COVID-19 vaccine effort.

The first the vaccine is now available to all Montanans ages, 16 and up.

If you would like to get a dose you can contact your local health department.

Usually the best way is by going to their website and following the directions to sign up.

The second big milestone is Montana has now administered 500,000 doses of the COVID-19 vaccine.

Now I want to revisit a story that I started working on last summer that took me to laboratories across the state of Montana and introduced me to some of our state's most brilliant scientific minds all on a search to understand COVID-19 and how we could ultimately stop it.

My story Search For The Cure aired on Montana PBS on December 17th and you can watch the entire hour long program on montanapbs.org.

Now, as we pass vaccine milestones and return to a new normal, I want to introduce you to some of the Montana scientists who made that point.

(upbeat music) - A dangerous virus is spreading rapidly in China and US officials are very worried that it could come here.

- As COVID-19 grew globally, spilling into every country and moving towards Montana scientists in every corner of the state, readjusted their sites on the new pandemic trying to figure out what it was and how to stop it.

- The people that say no one saw this coming that's nonsense because a lot of people saw this coming.

- They're waving the red flag, but nobody's listening.

- As a expert we know it would be coming, but you're still (indistinct) still surprised when it happens.

- As a person and a journalist I love and am fascinated by science.

I grew up in Montana scientific community.

My dad is a professor of molecular genetics and my step-mom is a professor of neuropharmacology both at the University of Montana and as COVID-19 hit spread gradually and then like wildfire it felt natural for me to look to Montana scientific community for answers.

- There's no question, Montana scientists are at the cutting edge of this.

- And this took me down a thrilling path on the search for the cure.

- (indistinct) this pandemic, we need three things.

We need antivirals, so drugs that will eliminate the virus.

We need vaccines, and we need better diagnostics - Detection, vaccines, treatment.

Detection, vaccines, treatment.

These are three of the main boxes Montana scientists are trying to check with hundreds of hours in the lab because the three together lead to the ultimate goal prevention.

- Everyone has a sense of urgency that we need to get this virus under control.

- It's a race against time, and it's also a race to make sure that we develop something that's safe and effective.

- Before we get too deep into any of the work being done.

Let's assess what we're dealing with.

First, what is a virus?

A virus is a microscopic pathogen that is constantly searching for a host to replicate in and takeover.

Viruses cannot grow without a host because they're not even a complete cell.

They're just a tiny little package of nucleic acid and either DNA or RNA.

Every living thing in the world has DNA and RNA.

DNA writes our genetic code and RNA translates that code into action.

Whether viruses are alive is kind of a gray area while they contain some of the elements that constitute life like DNA or RNA they can't do anything with it unless they find a host organism, a plant, an animal a person, and use ourselves to replicate itself which ultimately destroys the cells.

So instead of thinking of viruses as little creatures it's more like a microscopic Android trying to take over our cells.

One host is not enough for a virus and it will spread to host after host, after host, after host, maybe through a sneeze, a cough, a simple touch, or even inhaling and exhaling using saliva and water droplets as its mode of transportation and the mouth eyes, nose and respiratory system as its way into a new body.

When a virus travels this way, it's aerosolized or airborne.

And the way to block it from spreading host to host is covering coughs and sneezes, washing and sanitizing hands and shared surfaces and blocking its entrance into the new hosts respiratory system, using masks or face shields.

Not every virus can travel this way.

Ebola and HIV travel through direct contact with infected blood and bodily fluid.

As we all know, SARS-CoV-2, a Corona virus can and that's what we're dealing with now.

To touch on taxonomy SARS-CoV-2 is the name of the virus that causes the disease COVID-19.

But where did it come from?

How does a virus managed to infect 72 million posts in every country and territory in the world?

We can find the answers in Bozeman.

- Viruses exist everywhere, just like bacteria they're in the air, on surfaces and water everywhere.

- A virus can't run, it can't walk, it can't fly, it can't crawl, they don't come after us, they fall into us and they generally fall into us because of things that we do more than things that they do.

- Digging deep down to the roots of global pandemics and infectious disease are David Quammen and Devin Jones.

Jones is a PhD candidate at the Bozeman Disease Ecology Lab run by Dr. Raina Plowright on the MSU campus.

- I ended up here because I was really interested in bat health.

I study the gut microbiome of flying foxes in Australia.

- David Quammen is a renowned science journalist and best selling author who has tracked infectious disease for more than 20 years.

- I, for many years covered ecology and evolutionary biology and then about 20 years ago, I got interested in emerging viruses, scary new viruses that come out of wild animals.

We call those zoonotic viruses.

I got interested in them because I was walking across the Congo on an assignment for National Geographic with an American explorer conservationist.

And we walked through Ebola territory for a stretch of 10 days.

- To source the origins of a global pandemic Jones and Quammen say you need to understand a process called spill over.

- Spillover is the movement of a pathogen from one animal into another, so that can be an intermediate host.

So like the SARS-1 in China, we see that that coronavirus moved from bats into civets and then from civets into humans.

So that was where multiple spillover events.

So it spill over into civets and then spill over into humans.

So (indistinct) our lab studies the process of spillover.

So what are those drivers that make spill over occur in the first place?

And there are a lot of barriers that a pathogen has to go through in order to spill over into a new host.

And so we study those different layers and how those layers either align or don't in order for that pathogen to spill over.

- SARS-CoV-2 spilled over from bats, a frequent mammalian host to viruses.

- Bats seem to carry more than their share of viruses that can get into humans and cause trouble.

There's a whole sequence of dangerous viruses that have come from bats as the reservoir hosts the species in which they live when they're not infecting humans.

And this virus is only the latest of those probably Ebola we don't know that for sure, Marburg virus, Nipah virus in Malaysia, in Bangladesh Hendra virus in Australia, the original SARS virus coming out of China in 2003 others as well.

What is it about bats?

Well, first of all, bats are a very very diverse order of mammals, one in every five species of mammal on earth is a species of bat.

- But bat should not be blamed, say Quammen and Jones they're losing habitat to development and deforestation and we humans are putting ourselves right in the path of wild animals and new viruses.

- Emerging infectious diseases are at this point mostly zoonotic and they're spilling over more frequently over time.

And so we think that most of that is due to land use change.

But yeah, so there are teams of scientists like in PREDICT in California and EcoHealth Alliance researchers for example, have been studying coronaviruses and bats for a long time, like decade plus and they have previously identified coronaviruses as a high-risk virus for with pandemic potential and so there's kind of they're waving the red flag but nobody's listening.

And so then when it happens people are like, oh, suddenly it's really important to study these bats and their ecology and things like that.

And at the end of the day, I think too it's really important to note that bats aren't the problem that people have sort of invaded their space and taken away their resources to where they have nowhere else to go and they have nothing left to eat.

And so that causes like nutritional and reproductive extra reproductive stress that might increase viral shedding, pathogen shedding, and increase the likelihood of these sort of zoonotic transmission events.

- Bats carry viruses, how do those viruses get into humans?

It's not that because bats are looking for us.

It's not because those viruses are looking for us neither.

It's because we go looking for them.

We invade bat habitat, we disturb bats in various different ways, cutting down forests, harvesting guano from caves.

If we leave those trees alone if we leave those forests alone, if we stay away from bats then bats will be better off and we will be better off too.

- As for Quammen's 2012 book "Spillover" it is eerily (indistinct) eight years later.

- And at the end of that book, because I was listening to some very smart disease scientists I put together what they were saying in answer to my questions and essentially predicted COVID-19 they I asked them, is there a next big pandemic coming?

They said, yes.

What does it look like?

Well, it'll be caused by a virus, a new virus new to humans coming out of a wild animal.

What kind of a virus?

Well, one that evolves relatively quickly such as an influenza or a Corona virus.

What kind of a wild animal?

Well one that's known to carry viruses that can infect humans very possibly a bat.

Where might this spillover happen?

Where might this pandemic begin?

Well possibly in or near a wet market or someplace where wild animals are exploited for food, for instance, in China.

So that was in the book in 2012.

And as a result of that I've been getting a lot of calls this year.

(soft music) - Now we know what a virus is, how it infects a host and how it turns from something carried by a bat into a widespread human pandemic.

So how do we stop or at least control it?

Detection, vaccines, treatment.

- Gnostics that aren't, you know, a multiple day turnaround time.

We need diagnostics that are cheap, accessible point of care, easy to use all of those things in one convenient package.

And we're trying to deliver on that.

- On the MSU campus in Bozeman, we enter the labs of Dr. Blake Wiedenheft and Dr. Seth Walk, both Dr. Wiedenheft and Dr.

Walk are finding ways to trace COVID-19 in individuals and in the community through the gut.

- When the COVID pandemic started we got involved in a couple of different ways.

The first thing that we started doing was testing wastewater for the prevalence of SARS coronavirus.

And the reason that we got interested in that is that there was an early report that not only is SARS coronavirus transmitted through aerosols and thus the importance for face coverings but it's also transmitted in feces.

Wastewater provides a health record of the community in real time.

So with a single test we can get a sense for what the prevalence of the virus is in the community at any time and we can monitor that overtime.

Is it going up or is it going down and the results from those wastewater tests near what's happening in the community, but they do so in a way that provides us that information before we can get it any other way.

- We began developing some protocols early on in the pandemic and in the US here around May there was a push to look for SARS-CoV-2 the virus that causes COVID-19 in wastewater.

And we collaborated with Blake to get those protocols up and running at Big Sky, in West Yellowstone and then later on at Three Forks.

we did some research in the lab to try to make the protocols better and more sensitive, develop some techniques there.

- Access to widespread testing was an early failure of the US COVID-19 response.

Now drive through testing is being done at hospitals fairgrounds, college campuses, including MSU and UM but better diagnostics are still in demand.

- Vaccine is coming, it's getting rolled out but we still need to be aware that if folks are symptomatic or they're asymptomatic but test positive, they need to isolate they need a quarantine to really stop that transmission chain between individuals.

So detection is at the heart of that.

It's the first thing that we can do but it's really that, you know, what what result or what that result triggers, what activities and actions and that's really what stops the disease and lets us bend the curve or flatten the curve as they say.

- The research institutes we are visiting in this program are not limited to any specific aspect of COVID-19 research between detection, vaccines and treatment.

All of these research institutes feature a wide array of work being done by a lot of scientists too much in too many to fit into one program.

126 miles North of Bozeman all three of our silos of prevention are under the microscope at McLaughlin Research Institute in Great Falls.

- McLaughlin Institute is a private non-profit institution.

It's been in existence since the late 50s as a relatively small nonprofit research institution the strengths of the institute include the fact that we're we can be very nimble.

We were of course like scientists all over the world very interested in helping and trying to do our part in finding, developing technologies and of Montana develop the infrastructure to do the to meet the requirements for this challenge and things like increasing our testing capacity being able to do research and developing vaccines and potential drug therapies for the disease for COVID-19.

We do a lot of genetic work with mice.

- An important thing to discuss in the role of scientific research is the use of animal models.

- Mice have been over the past decades, have evolved to be arguably the most important model organism that kind of bridges this gap between basic research at the bench before it can be brought into clinical trials in humans.

Mice serve is an excellent model because although obviously they're a very different organism.

They, we share an enormous number of genes in common.

- In animal models, scientists are able to replicate the virus and keep up with it in real time.

As the virus mutates and new forms of detection, vaccines and treatment are tested for effectiveness.

At McLaughlin Dr. Kavanaugh took me on an immersive tour to see their work in progress.

I went into labs, I went into the main mouse rooms.

I met scientists working on editing mice genomes to create a mouse model on the cutting edge of COVID research.

In Great Falls we crossed from detection to treatment.

Treatment in COVID-19 is a pretty broad concept and umbrellas a lot of options being explored.

Unlike bacterial infections, viral infections can not be treated with antibiotics.

Antibiotics are able to kill the bacteria making you sick antiviral treatments in your body from being able to carry out its work of spreading to and destroying yourselves.

Antivirals, don't stop you from getting the virus.

They just stop the virus from making you as sick.

Common antiviral you may have heard of is Tamiflu which is used to treat influenza.

One being explored for the treatment of COVID-19 is Remdesivir approved by the FDA in October and already being used in Montana hospitals.

Detection, treatment, vaccines.

- Outbreaks like this really show that vaccines are really the most effective medical measure we have, like period.

- Before COVID 19 was even confirmed in the United States Montana scientists were already trying to develop a vaccine for it.

And for that, we head first to Hamilton.

- Rocky Mountain Laboratories or RML is part of the National Institute of Allergy and Infectious Diseases, which is in part one of the 27 institutes and centers of the National Institutes of Health located mostly in Bethesda, Maryland.

Our director is Dr. Anthony Fauci.

And if there's anybody in the state of Montana or anywhere else that hasn't heard of his name before I would be a little bit surprised.

- Rocky Mountain Labs is one of the 13 biosafety level four labs nationwide meaning it can secure some of the world's worst pathogens that are airborne very fatal in humans and have no known cure.

My visit to Rocky Mountain Labs was on a hot day at the end of July, but I was lucky to get a tour with RML associate director, Dr. Marshall Bloom.

- It's a historical incident that brought infectious disease research to the state of Montana and to the Bitterroot Valley.

- Over the next 120 years, RML scientists would take on major roles in fighting emerging disease like Lyme disease, prion diseases like mad cow and chronic wasting and very notably the 2014, 2015 Ebola outbreak in West Africa.

It also includes other Corona viruses that caused diseases familiar in our collective memories the first SARS outbreak in middle Eastern respiratory syndrome or MERS.

- It was that experience that put us in such a good position to shift from the studies that they were doing to look at this new emerging infectious diseases SARS-CoV-2 and Dr. Munster, and some of his colleagues here at Rocky Mountain Labs notably Dr. Emmie de Wit because they had worked on middle East respiratory syndrome virus and SARS what we now call SARS-CoV-1 or the SARS that circulated around 2002 and 2003.

They were tuned in to the fact that there might be another Corona virus coming down the line sometime.

And as a consequence, when the first reports of a new infectious disease popped up in China and the sequence of that virus was published so rapidly Dr. de Wit, Dr. Munster and others, they were ready to go.

And within a period of a couple of weeks before there was ever a case in the United States and before there was even any virus available to work within the United States they had laid out a very sophisticated and very important research plan to study this new pandemic virus.

And boy were they right.

It turned into a big deal.

- Poised to respond to the pandemic was head of the RML virology unit, Dr. Vincent Munster.

Dr. Munster tracks deadly viruses, and works with partners across the globe to stop them.

- Typically within my lab, we look at a lot of different things and most of the things are actually quite fundamental.

So we kind of studied the genome.

We kind of studied different changes in the genome of viruses and see how they become potentially more transmissible.

We do a lot of fieldwork for instance in Africa where we look at natural reservoirs.

So in this case, we immediately started realizing that we completely shoot focus on public health and that's what we did and we have a long-standing collaboration for instance with the Jenner Institute in Oxford.

So as I already explained a moment (indistinct) sequences so that genetic information that blueprint, so to speak of that virus came out.

We immediately started communicating with my colleagues at Jenner who are from a very well-renowned vaccine institute and they started making vaccines based on that information.

On our end, we started really working and getting all the tools together to test those vaccines.

So the moment they actually got the first vaccines they got transported here to Montana.

We tested the vaccines here in the lab.

That data was then immediately shared back to the UK.

They started what they call phase one and phase two clinical trials.

So the first human experiments.

So they are now finalized, although it originated from Oxford University that vaccine is now licensed to AstraZeneca.

- Detection, vaccines, treatment.

When a virus enters our body it begins to multiply very, very fast.

Billions of infectious viral particles start attacking millions of ourselves, making us very sick.

Our body's immune system recognizes something isn't right and begins to fight back by producing antibodies, antibodies block the virus from taking over and destroying cells.

But if our immune system hasn't seen the virus before it can take a few weeks for it to reach full speed and produce enough antibodies to stop the virus.

Basically it's a race between the virus and the immune system.

If our immune system wins the race we recover.

If the virus keeps winning we can be ill for several weeks or even die that's where vaccines come in vaccines help our body win the race.

The majority of vaccines take dead or weakened virus and expose them to your body in levels the body can withstand triggering your body to create antibodies so when the actual virus rolls around your body is ready to fight it off.

These are traditional vaccines.

In the race to find a COVID-19 vaccine we are seeing for the first time a different type of vaccine that instead of using dead or weakened virus uses the viruses genetic code to jumpstart your immune system, into making the antibodies without any exposure to the virus.

Vaccine based immune memory can last for years or even decades but as many of us know from flu vaccines sometimes it only lasts a short amount of time and we need a new vaccination or a booster vaccines are the quickest, safest and most effective way to build a defense against a deadly pathogen.

- Without question with the exception of clean water vaccines have saved more lives than any other medical invention in history.

It's clear that they're effective.

It's clear that they're safe and we need to continue making sure that vaccines are safe when they're administered on a wide scale like this COVID vaccine will the emphasis has to be on safety - At the University of Montana in Missoula, Dr. Jay Evans Lab focuses on taking vaccinations and making them stronger and more effective.

- The Center for Translational Medicine was started by our group about four years ago.

When we moved from GlaxoSmithKline up here to the University of Montana, with the idea of helping university researchers, move inventions and discoveries that happen here at the University of Montana, from the research labs to the clinical space for helping people.

Our unique niche is what are called adjuvants in delivery systems.

It's ways to deliver a vaccine that enhances the immune response through bold delivery, how you deliver the vaccine as well as immunostimulants or adjuvants that are added to the vaccine that boost the immune response in very specific ways - Dr. Evans Lab was able to respond to COVID-19 almost immediately tapping into a recently awarded NIH grant and turning the funds from one vaccine project to another.

- Our group has been working on the COVID-19 vaccine since February, pretty soon after the outbreak in Wuhan China and it became evident that this was gonna be a worldwide problem, we started discussing with the National Institutes of Health ways that our group can help advance vaccine discovery and development around COVID.

Our group's been working on vaccine research for over 30 years.

So we have a lot of experience in the area and here at the University of Montana, we have about 45 people working on our vaccine discovery and development team.

So it was a pretty natural transition for us to move over to start working on a COVID vaccine.

- With the work done by scientists across the globe including Montana vaccines against COVID-19 emerged in an unprecedented amount of time.

- It's incredible, it's incredible.

- It's really just a testament to the people how people have worked together, both government agencies and universities and large companies to make this happen.

- New vaccines come with a lot of questions.

Will this work?

Is this safe?

What will it do to my body or to my kid who wants to be a Guinea pig for some new science experiment?

Well, I do.

- Comes a little poke.

- On September 4th, I got up early and drove from Missoula to Bozeman jumping at a last minute chance to participate in the Pfizer vaccine trial.

Pfizer, a US-based pharmaceutical Goliath known for creating Viagra is one of the leaders in developing a COVID-19 vaccine and was in need of 44,000 human participants to sign up, to try out the experimental vaccine and phase three human trials.

This includes about a hundred Montanans in a trial being conducted out of Bozeman Health.

To my knowledge, it is the only COVID-19 vaccine study happening in Montana.

To qualify for the study, I had to be in relatively good health, not immunocompromised or pregnant and not participating in any other types of trials, check, check, check, check.

The study is a two year commitment that five of the six visits are blood draws, which monitor the level of antibodies the vaccine creates in my blood and how long they last.

These are some of the main questions Pfizer is trying to answer in this study.

Is this vaccine effective in preventing COVID-19?

How long does it take to work?

And is it safe once it's actually in humans?

My first visit was a blood draw and my first shot.

An important note is that Pfizer study is a one-to-one double blind study which means that for every one vaccine administered one salt-water placebo is administered as well.

Double-blind means neither I nor the physician giving it to me knows what I got.

Bozeman Health and the vaccine research team gave me permission to shoot this video.

I might not look, I do a little bit better with shots that I don't look.

- I'm gonna ask you not to look 'cause Pfizer is very particular even though this is totally (indistinct).

- Oh, right, of course.

- They don't want you to get even the least clue what you've got.

- What I have.

- So comes a little poke.

And we're done, bandaid on that.

- Oh, that was easy.

I kept a video log of my experience as it went on.

- Hello, everyone I wanna do a two week update since I got my first dose of the Pfizer COVID-19 trial vaccine, I feel fine.

- So I am sitting in my car outside of Bozeman Health Hospital.

I just got the second round of my COVID-19 vaccine, this arm, same arm I got the first shot in it's a booster three weeks to the day after I got my first vaccine a booster is part of RNA vaccines.

It's required any, if this vaccine goes to market other people have to get boosters of it too.

My next appointment is in a month and I will be getting a blood draw and the next three appointments after that will be blood draws too all the rest of the ones will.

And all it's looking for is COVID-19 antibodies in my blood to see if these vaccines were effective in building antibodies.

One thing about that is even if I do is it enough antibodies to prevent me getting sick with COVID-19?

That's one of the big questions with these vaccine trials still a lot of information we don't know, but we're learning as it goes.

- So I'm here waiting to get my COVID test sitting outside in the parking lot in my car on Friday today's Sunday on Friday I started feeling like a little (indistinct) sort of along the lines of maybe seasonal changes, it's fall here in Montana's so now it's cold and I get a cold this time of year, pretty frequently.

Then yesterday morning, Saturday I woke and I didn't realize that at first and I was drinking a cup of coffee and I thought this coffee has absolutely no flavor.

And that's kind of when I realized I didn't have any I had like lost my whole sense of smell and taste.

So I went and brushed my teeth.

I couldn't taste the toothpaste.

And then all day I just couldn't smell or taste anything.

So I figured I'd come and get tested because although I'm congested, I can still breathe through my nose.

So losing my sense of smell and taste it was very strange and concerning to me.

I don't know if I've been exposed to anyone with COVID not to my knowledge, but I travel a lot for my job.

You know, I go to grocery stores and my office is on campus.

So it's, could be anywhere.

It could be an exposure from anything or it might just be a cold and hopefully my test results come back negative, I guess that would be great.

And I'll let you know.

- So I just got off the phone with the clinic and I did test positive for COVID.

I don't know when and where I contracted it and they told me they're gonna contact me in a couple of days to begin contact tracing.

- Fortunately, I had a case that did not turn into a hospitalization or death, and I feel really lucky for that.

- Pfizer has since decided to unblind the study letting participants know what they got.

In February, my study team called me and told me I got the placebo and offered to vaccinate me, switching me over from the placebo group to the vaccinated group in the study.

They also told me something interesting because I got COVID-19 my data point was one of 174 out of the entire study selected by Pfizer to be published in The New England Journal of Medicine this fall and submitted to the FDA in the case for approval.

What my COVID-19 case showed was that people in the placebo group were contracting the virus while people in the vaccinated group were not.

- The first shipment of Pfizer vaccines arrived in Montana on December 14th and later that afternoon, I witnessed the first doses being administered to six healthcare workers at Bozeman Health.

And honestly, I felt really emotional.

- Receiving the first dose is Dr. Andrew Sullivan one of our pulmonologists and intensive care physicians.

(people clapping) - A year after SARS-CoV-2 spilled over wreaked havoc and changed all of our lives exhausted and relieved healthcare workers are getting their first shots.

- My name's Eric Lowe, I'm the medical director for the emergency department at Bozeman Health Deaconess Hospital.

And I've also been working on the incident command team here throughout the COVID-19 pandemic.

Today was a very exciting day.

We as hospital system, we received our first doses of vaccine, the Pfizer beyond tech COVID 19 vaccine.

And we were able to administer our first six doses this evening, emotionally it felt fantastic to see this finally come to fruition.

It's been a long, it's been a long year, and I think for everyone everywhere it has.

But speaking for the emergency department in particular it's been a tough year dealing with constant change and uncertainty and the unknown and the fears that go along with that are grinding and to do that day in and day out for a month, month upon month without a clear end has made for a very long year.

Well I think this is something that really should be celebrated to think about how many people's efforts went into getting to this point is kind of daunting from the scientists to the airlines that we're delivering this to the delivery people to, it really took all of us to get to this point.

It's felt like we're in a long dark tunnel and now it feels like there's a light at the end of that tunnel.

(upbeat music) - The Rundown is made possible by the Greater Montana Foundation, encouraging communication on issues, trends, and values of importance to Montanans.

(soft music)