By KATHLEEN NELSON
If you can resist the urge to make a pun, you'd say that Bon Secours Mercy Health is doing its part to make people feel safer on the pathway to normal. If you can't resist, you'd add that the system has a nose for this sort of thing.
Miles, a Labrador retriever, is one of the trio of American K-9 Interdiction dogs training to detect the scent of COVID-19 in humans. He is shown sniffing a fresh sample in a work space at Bon Secours Mary Immaculate Hospital in Newport News, Virginia.
Courtesy of AK9I
Three of its hospitals in Virginia have joined a study to determine dogs' abilities to sniff out COVID-19 in humans. The hospitals are partnering with American K-9 Interdiction, which usually trains dogs and their handlers to detect explosives and narcotics.
"We want to get the country back to some sense of normalcy and figure out if the dogs can help," said James Overton, AK9I's director of marketing and business development and one of the dog handlers in the study. "We knew we needed to partner with a health care system that had access to COVID patients."
Based on previous research, the dogs seem up to the task. Canines can sniff out cancer, epilepsy and diabetes because of their ability to detect changes in volatile organic compounds in sweat and saliva. In the last year, researchers in Paris and at the University of Pennsylvania conducted proof-of-concept studies indicating that dogs could detect COVID-19 infected individuals through a change in the infected person's volatile organic compounds. Based on the research, dogs have been used recently in pilot projects for COVID screening at airports in Dubai and Helsinki as well as Miami Heat games. AK9I wanted to verify the findings and put all the pieces together for itself starting with its own research and eventually placing its dogs in a suitable venue.
Selected because of his relatively calm demeanor, Blade, a German shepherd-Belgian Malinois mix, is participating in a study to determine whether dogs can detect COVID-19 infected individuals. Blade may go on to work sniffing the crowds at an airport or sporting event to identify people who may be infectious. He is shown here at AK9I's facility in Carrsville, Virginia.
Courtesy of AK9I
Overton estimated that AK9I invested $100,000 in man and canine hours in the project between May and August. The group selected three dogs — Labrador retrievers named Miles and Dexter and a German shepherd-Belgian Malinois mix named Blade. The trio had begun training in explosives detection. They possessed a relatively calm demeanor that was suited to the COVID detection study and later to working in an environment full of people and distractions.
The scent from samples deteriorates rapidly as they dry out, so AK9I needed a partner willing to collect saliva samples from COVID-positive patients and provide a space for the dogs to train nearby. Overton's request to the Eastern Virginia Healthcare Coalition led him to Bon Secours Mary Immaculate Hospital in Newport News, Bon Secours — Southampton Medical Center in Franklin and Bon Secours Rappahannock General Hospital in Kilmarnock.
"They're so great to work with," Overton said. "Everyone from the nurses to the executives is on the same page. And everyone loves dogs."
Among the dog lovers is Jan Phillips, vice president of nursing and chief nursing executive at Mary Immaculate, whose family includes two Scottish terriers, Boswell and Piper.
"For so long, we've been seeing the bad side of COVID and reacting to that," Phillips said. "If there was an opportunity to be proactive and demonstrate a positive outcome, I thought it was important to be involved. And as a faith-based organization, we have a mission to improve health. This was a chance to live our mission."
She assumed responsibility for asking for and collecting saliva samples from COVID-positive inpatients who were not in the ICU of the 123-bed facility. Of the dozens she asked to participate, just two declined. Many provided samples multiple times. Phillips insisted on patient anonymity; the only information given to Overton was whether a sample was positive or negative. Staff volunteers provided negative samples.
"So many of the patients were interested. They would say, 'If something good can come out of it, then I'm all in,'" she said.
To eliminate time for transporting the samples, the dogs worked on-site at each of the hospitals. Samples were placed on gauze that was then positioned at the far end of a tube. Overton and his partner would bring the dogs to the room, guiding the dogs from one tube to the next. The dogs were trained to sit and stare straight forward in front of a positive sample.
The process was quick; Overton estimated that the dogs could move through a dozen samples in a minute. Through about two months, the dogs correctly identified about 90% of the samples.
What the nose knows
In mid-August, AK9I set up a blind peer review at Mary Immaculate, where a pair of veterinarians not associated with the study set up the samples. In the earlier phases, Overton and his fellow handler knew which samples were positive and which were negative. This phase eliminated the possibility that the handlers could give the dogs unintentional cues. In addition to the veterinary observers, Overton invited the hospital staff. Each of the dogs correctly identified 100% of the positive and negative samples.
"We went into this skeptical of whether the dogs were able to do this," Phillips said. "Watching this amazed all of us. There is a lot of buzz now about how incredible these dogs are at their ability to discern positive and negative."
But considerable work remains. "We've been able to answer yes, dogs can discriminate between positive and nonpositive samples," Overton said. "But how long does the person have to be infected before the dog can detect it? What if the person has flu or bronchitis: can the dogs discriminate? We don't know if other viruses or respiratory illness cause the same reaction."
Working the crowd
To answer these questions, AK9I will use its initial findings to seek additional funding. Both Overton and Phillips agree that the dogs could be most useful where large crowds gather for extended periods: airports, stadiums, subways, museums and event venues. Identifying potential positive cases for isolation and further testing would provide the crowd an added layer of peace of mind that reinforces proof of vaccination.
"I don't know how soon that will happen," Phillips said. "But I told James I hope the next time I'm standing in the TSA line, if I see him with Miles or Dexter or Blade, I'll feel safer then."
As AK9I seeks further funding, Bon Secours Mercy agreed to provide samples so the dogs could continue to train, which is necessary to keep their noses sharp.
"The folks at Bon Secours are so busy with the virus resurgence, but to them the study seems like a change of pace and an opportunity to be proactive," Overton said. "They've been terrific partners."