Neel Nabar reflects on a hectic and ‘surreal’ spring of working to ‘guide intelligent vaccine design’ and more at the National Institutes of Health.
Neel Nabar wrapped up his overnight shift on surgery rotation at Abington Hospital–Jefferson Health and headed home early March 13 to grab some sleep. Dozing off would be the last bit of restful normalcy for a while.
Within a few hours, Nabar—now a fourth-year student at Sidney Kimmel Medical College (SKMC)—would learn that clinical rotations were off due to the burgeoning COVID-19 pandemic.
Then, he got an email from Dr. John Kehrl, under whose guidance he previously researched at the National Institutes of Health (NIH).
“We’re getting started with projects related to COVID-19, and your presence would greatly help,” recalls Nabar of the message from Dr. Kehrl, chief of the B-cell molecular immunology section.
Together, they had previously studied the original SARS-coronavirus (SARS-CoV), similar to the one that was starting to make its infamous global mark.
“Within three days, I was back at the NIH with my credentials and ID badge. All the paperwork had been taken care of,” Nabar shares. “I was asked to lead a small team within the Laboratory of Immunoregulation (LIR) on investigations into COVID-19 pathogenesis and to assist on a study of the viral spike protein that could better guide intelligent vaccine design. It’s incredible how quickly we were able to ramp up on this.”
Before returning to Jefferson Health in early June, Nabar reflected on the important work he did among a talented team of scientists and researchers in Washington, D.C., the educational path that enabled him to do so, and how those efforts could potentially save many lives.
He first joined that group six years ago, as he did his PhD work both through the Jefferson MD/PhD program and the NIH-Karolinska Institute Graduate Partnership Program in Washington, D.C., and Stockholm, Sweden. (He completed his PhD overseas in 2019 and returned to Jefferson.) That experience left him concerned when word started filtering out about a mysterious virus.
It was energizing and rewarding, as we’ve made significant progress and hopefully helped speed up the return to normalcy. –Neel Nabar
“Those of us with previous expertise on coronaviruses recognized how big of a problem this could be,” he says. “The chatter was already picking up in January, that it looked a lot like SARS and that it could overwhelm our hospitals. By March, when it was in America, the leaders in the field had shifted their focus toward this. The thought was, ‘Whatever we do about it now, could take time off the back end.’”
This spring, Nabar worked in one of eight sections of the LIR led by Dr. Anthony Fauci. With the research he’d done studying the pathogenesis of the original SARS-CoV, he and his peers already recognized the threat that coronaviruses like COVID-19 posed societally.
“When the pandemic broke out, the LIR shifted its focus to SARS-CoV-2,” he explains. “As a large, well-integrated group, we do clinical and translational investigations on SARS-CoV-2 epidemiology, vaccine development and pathogenesis.”
Nabar led a small team investigating COVID-19’s pathogenesis and assisted on a study of the viral spike protein to better guide intelligent vaccine design.
Working with “some of the most intelligent and driven individuals I’ve ever met” was an honor and privilege, he says.
“It all felt surreal. While most of the NIH campus was shutting down, our COVID-19-related projects were ramping up to tackle the issue,” says Nabar, who logged seven 14-to-16-hour days a week. “It was energizing and rewarding, as we’ve made significant progress and hopefully helped speed up the return to normalcy.”
Earlier in June, he resumed his clinical responsibilities at Jefferson—he’s working on the hematology service now—but notes that he will continue to provide input remotely for the NIH effort, through his direct supervisor, Dr. Kehrl, who works closely with Dr. Fauci.
“Coronaviruses were not something new for me,” he says. “I had a five-year head start in studying COVID, which appears to be a disease of hyper-inflammation similar to what we’d actually described in our previous work with SARS. They’re 81 percent similar genetically and sequentially. There are only two new proteins in COVID that weren’t in the original SARS.”
I don’t know if we, as a society, have truly grasped the severity of the situation yet. –Neel Nabar
He celebrates both the unprecedented level of cooperation in a normally competitive field and the background he garnered as a Jefferson student.
“It’s uplifting to see everybody working together and sharing information, helping each other out instead of worrying about getting credit for being first,” he says. “My time in Jefferson’s MD/PDH program taught me how to think about problems in a clinical setting and turn it into good science. I learned how to take clinical observations, come up with real hypothesis and effectively test those hypotheses.
“This was an incredible opportunity to do that in real time. This is the most important problem the world is facing. I’m grateful for the training that prepared and equipped me with the skills needed to apply them in such a meaningful way.”
With one eye on what his team needs in D.C., Nabar will now focus on his final four required rotations and six months of elective time at SKMC.
Nabar thanks his “pivotal supporters” at Jefferson who made his work with the NIH possible: Dr. Scott Waldman, MD/PhD program director; Dr. Gerald Grunwald, dean of the Jefferson College of Life Sciences; and Dr. Kathryn Trayes, associate dean of student affairs for SKMC.
Still, he urged vigilant caution, since the pandemic hasn’t disappeared, and there still isn’t a vaccine available.
“I don’t know if we, as a society, have truly grasped the severity of the situation yet,” Nabar says. “Now, it’s about getting the right policies in place to mitigate spread. If we get a vaccine in 15 months, which would be an amazing timeline, it could save everybody maybe a year and a half of their lives.”