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Michigan got a crash course in treating COVID. Here's what doctors learned

Just when you think you understand COVID, it changes. It's a very deceptive virus; to keep up with it, it is a challenge,” says Dr. Teena Chopra, corporate medical director for Hospital Epidemiology and Infection Control at Detroit Medical Center and a Wayne State University professor. “And particularly, it is manifesting differently by age, by race, by sex. Very early on, we were able to understand that, particularly in the city of Detroit.” One set of her COVID patients, especially the younger ones, are developing pulmonary embolisms – blood clots that get stuck in the lungs and can be deadly. “They are manifesting as sudden onset shortness of breath,” Dr. Chopra says. “And some of them are showing higher mortalities than others.”  Meanwhile, patients coming from nursing homes (a big part of DMC’s patient population) may not even appear to have COVID during a first examination, says Dr. Chopra. They may not have a fever or chills. “These older patients do not have the same symptoms,” she says. “They don't mount up the same immune response.” Yet many of them are testing positive for the virus. “We are beginning to test every patient coming from a nursing home, whether they have symptoms or not, because we want to assume they have it.”
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M. Roy Wilson: Lessons from Detroit on racial disparity and St. Louis coronavirus deaths

President M. Roy Wilson wrote an opinion piece about the coronavirus disproportionately killing African Americans. “As of Tuesday, there were 3,407 coronavirus-related deaths in Michigan, with 1,622 in one county alone. That county, Wayne County, is home to Detroit, a city populated 80% by African Americans. By comparison, St. Louis city and county account for 175 of Missouri’s 274 deaths. African Americans are disproportionately represented among the victims. Fortunately, both the number of new cases and hospitalizations have reached their peaks in Detroit, and we are now on the downward side of the curve. Yet, few in Detroit have not been personally impacted by the tragic toll of death among friends and family. I believe that there are lessons to be learned from Detroit’s experience that can help mitigate the death toll in St. Louis’ African American community.”
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3 Wayne State students to receive posthumous degrees at virtual graduation event

Wayne State University held its first-ever virtual graduation ceremony on Wednesday to honor its spring 2020 graduates under the social distancing guidelines of the coronavirus pandemic. The virtual ceremony consists of digital commencements for each school or college available online for graduates, family and friends to help mark the occasion. According to the university, there are still plans to hold an in-person ceremony once restrictions are rolled back for public gatherings. President M. Roy Wilson opens up each of the ceremonies by stating, "I know this isn't what you hoped for as you worked towards this day, I didn't expect it either but I guarantee we will remember this for the rest of our lives." Wilson is then joined by messages from the provost and Board of Governors. The ceremonies conclude with speeches from each respective dean, their chosen student speakers and, of course, the conferring of degrees. The university presented three posthumous degrees to students Darrin Adams, Bri’Jon Moore and Dwayne Carrero-Berry. Although students are not together, the university encourages graduates to celebrate the day online by using #MyWSUstory to post photos and memories of their journey at Wayne State. The 2020 celebration website states: "We encourage all graduates to make this celebration their own, whether you want to watch the videos by yourself or coordinate your viewing with family and friends. "
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Man, 53, who died of COVID-19 before graduation gets posthumous degree from WSU

Colleges and universities are turning to virtual commencement ceremonies during the COVID-19 pandemic, and this semester Wayne State University is also paying special tribute to three students who died before graduation. Darrin Adams, Dwayne Carrero-Berry and Bri'Jon Moore received degrees in the College of Liberal Arts and Sciences and were acknowledged during the university's virtual graduation celebration on Wednesday. Adams was 53 when he died from COVID-19 earlier this month. Adams was awarded a Bachelor of Arts degree in sociology. While he studied he worked as a Wayne State custodian for nearly six years. Adams also participated in the AmeriCorps Urban Safety Program and helped board up more than 200 abandoned houses. He leaves behind a son and daughter. Wayne State says the virtual ceremony won't take the place of the in-person commencement, details on which are still being worked out. 
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Wayne State University grants posthumous degree to student who died from COVID-19

Wayne State University granted degrees to a student who died from coronavirus (COVID-19) before he was able to finish his schooling. Darrin Adams was one of three students at the university who recently died. The two others died of other causes while Adams’ death was due to COVID-19. The board took special action to honor all three students who died before graduation. They invited their families to the university’s virtual graduation celebration. "Where there was a real good guy, you know, my best friend. And he inspired me to change my life and go to school,” said Adams’ cousin, James Brown. He said his cousin recommended he finish school and so he did. “Never have I’ve never thought about going to college, but my cousin inspired me to go,” Brown said. “He had changed his life and went to school. You know he had some challenges early on in life. We all did but he overcame.” Brown said Adams had an impressive resume. He was a member of the AmeriCorps Urban Safety Program, and he was also finishing his bachelor degree in sociology. In addition to being a student, he worked for Wayne State University as a custodian for nearly six years. The faculty in Wayne State Department of Sociology unanimously voted to create an $1,000 annual scholarship in honor of Adams.
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'The unknowns' haunt college students, university officials alike

From an abrupt halt to the school year to dried up revenue streams to unprecedented campus safety and culture changes, discussions among the college community have been far, deep and wide. Many surveys have projected a significant number of students may take next year off. A national survey by Simpson Scarborough of 573 high school students who had been planning to attend a four-year residential college in the fall showed that more than half of their families’ finances had been affected by the pandemic. University officials also face uncertainty about how many current students will return this fall. WSU President M. Roy Wilson said as much as he would like students to return, it was "unlikely" they would be back on campus in the fall. The biggest issues for the state, and its universities, are balancing the challenge of testing for the virus without a vaccine and the need to get the economy running again safely, Wilson said during the virtual town hall. "This is a data-based project," he said. "Based on the data, we have divided industries up into low-risk, medium-risk and high-risk. Based on the risk categories, we are looking at how things can be opened up in a safe way."
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COVID-19 testing for anyone draws a crowd in hard-hit Detroit

Detroit residents waited for hours on Tuesday to get free COVID-19 tests at a new facility that for the first time offered testing to people who did not already have symptoms of the disease and a doctor's authorization for the test. Tuesday's tests were the start of a free program for Detroit residents, said Dr. Phillip Levy, professor of emergency medicine at Wayne State University. Even those without symptoms can get tested with a nasal swab for the virus as well as have their blood drawn to test for antibodies. "Detroit is one of the hardest hit areas in the country. It's got some of the highest case loads, some of the highest death rates, so it's really important that we get testing out into the community," Levy said in a telephone interview. "If you're thinking about restarting the economy, it's important to know you are not acutely infectious and you have evidence of immunity," he added. Michigan has been one of the worst hit states, but officials have said the infection rate is dropping. As of Monday, Michigan had reported more than 38,000 COVID-19 cases and 3,407 deaths. Detroit made up the largest portion of those with almost 8,700 cases and 950 deaths. The Wayne State program expects to test as many as 400 people on Tuesday and hopes to do the same every day for the next six to eight weeks, working closely with Michigan as it ramps up its own testing efforts, Levy said. In the Detroit program, the tests are administered by Garcia Laboratories using Abbott Laboratories instruments, Levy said.
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'Crash course': Med students in Detroit help test for virus

City employees make critical visits to the Detroit health department for a coronavirus test. On the other side of the long cotton swab: medical students in protective gear who have volunteered to be on the front line of the fight. “We’ll just go in about an inch, swirl around a couple times,” Michael Moentmann calmly explained before swabbing the nostril of water department employee Leon Wheeler. Moentmann, 23, had planned to watch surgeries as a medical student at Wayne State University in Detroit, but then a highly contagious virus disrupted everything this spring. So he signed up in one of America's hardest-hit communities, testing police officers, firefighters, bus drivers and others who keep the city running. “What better way to launch a medical career than helping with a pandemic? We couldn't do this without them," said John Zervos of Henry Ford Health System in Detroit, who recruited roughly 80 students from medical schools at Wayne State, the University of Michigan and Michigan State University. Lucia Luna-Wong, a fourth-year student at Wayne State, said she didn't hesitate when offered a chance to join a “crash course in public health.” She wants to specialize in infectious diseases. “This is so valuable, from bedside manners to learning about health disparities in the city. This is just an unbelievable experience for me. I'm going to be a better doctor,” said Luna-Wong, 38, a native of Peru.
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Gov. Whitmer urged coronavirus tests for all key workers

Safely reopening Michigan’s economy requires widespread coronavirus testing, which is why Gov. Gretchen Whitmer is pushing for expanded testing and, recently, urged the state’s essential workers to get tested regardless of whether they have symptoms. But if you’re among the 49 percent of the state’s workforce that counts as an essential worker, don’t bank on getting one. Seven of 12 large Michigan health systems queried by Bridge Magazine said they are not yet testing asymptomatic essential workers, largely because they still lack enough supplies — particularly the nasal swabs used to collect samples — to expand beyond testing people who show symptoms such as coughing, fever or respiratory distress.  “We would like to test asymptomatic employees, but it’s not something that currently we are able to do,” said Dr. Teena Chopra, a professor of infectious disease at Wayne State University, who is also in charge of infection control for the Detroit Medical Center’s eight hospitals. “We need swabs, we need reagents, and we need the testing kits that we use to process the samples.” DMC is testing some asymptomatic employees who have had direct contact with COVID-19 patients, and some high-risk asymptomatic patients, such as those being treated for cancer who come in for procedures like bone marrow biopsies. With more  supplies, Chopra said, “the sky is the limit” in how many people the Detroit-based health system would like to test. Gov. Gretchen Whitmer is “right in making the statement that asymptomatic essential workers should get tested, she’s absolutely right,” DMC’s Chopra said.

Wayne State University adds new Endowed Chair in Addiction and Pain Biology

Nationally-recognized substance use disorder researcher Mark Greenwald, Ph.D., has been appointed as the inaugural Gertrude Levin Endowed Chair in Addiction and Pain Biology for the Wayne State University School of Medicine. Greenwald, a Canton, Mich., resident, is a professor of Psychiatry and Behavioral Neurosciences in the School of Medicine. “The honor of the Gertrude Levin Endowed Chair in Addiction and Pain Biology is deeply meaningful to me,” he said. “This extremely generous gift recognizes and endorses a synthesis of two critically important areas of public health – substance use disorders and pain. Taken together, these two disease domains account for more than $1 trillion in annual costs to the U.S. economy.” Endowed funds support the ongoing investigation of solutions to the most complex problems in health care, and enable the WSU School of Medicine to strengthen its mission-driven work to provide high-quality education, deliver exceptional clinical care and pursue pioneering research investigations. The World Health Organization recognizes that substance use disorders, or SUDs, cause significant global burdens, associated with more years of life lost, known as premature mortality, and chronic pain primarily associated with more years lived with disability. The Levin Chair serves as an example of the power of endowment at the School of Medicine. By providing specially-designated resources for research and teaching, endowed positions enable gifted faculty and researchers to excel. Chaired faculty leave an indelible mark on the intellectual and creative life of the entire university. “The past few years have seen unprecedented overdoses and deaths from opioids in the United States and internationally, and these adverse outcomes overlap closely with pain problems and mental health issues,” Greenwald said. “Not to minimize in any way the horrible toll of the current COVID-19 pandemic, which has tragically taken about 60,000 U.S. lives as of today, but since 2016 we have been losing more than 60,000 U.S. lives each year to drug overdose deaths, and the majority are opioid-related. We have a considerable amount to learn about the neurobiological mechanisms that underlie substance use disorders and pain individually, and how they interact to produce the vexing problems that clinicians routinely face. Unfortunately, we also lack safe and effective therapies for many individual substance use disorders and pain conditions.” The Levin Chair will support ambitious short- and long-term plans and actions. Greenwald is planning a comprehensive initiative, nested within the new Translational Neuroscience Institute at WSU. The initiative will encompass a full translational cycle of research, education and clinical care activities founded on existing and emerging collaborations across the campus and community, and across institutions, using a four-quadrant approach. “Fully leveraging the Gertrude Levin Endowed Chair will create change for those suffering from chronic pain and addiction. With research efforts dedicated to cross-disciplinary solutions and treatments for chronic pain conditions, we can positively impact the nation’s opioid addiction crisis,” said Stephen Henrie, associate vice president of Development and Alumni Affairs for the School of Medicine. “The Levin Chair is an integral part of our multi-disciplinary initiatives in brain health, translational research and neuropsychological care. Cross-cutting programmatic interests in the neurosciences, chronic pain, prescription drug misuse, and integrated behavioral healthcare will maintain synergy with existing faculty expertise and activities,” he added. Research and training activities in the basic and clinical neuroscience quadrant will include pharmaceutical development and PK/PD evaluation, genetics/epigenetics, brain imaging and neuromodulation, as well as complementary/alternative therapies. “We already have ongoing projects in these areas. I also hope to explore with colleagues how we can use ‘big-data’ OMICS and modeling methods,” he said. Research and training activities will extend to a second quadrant in the translational cycle that addresses clinical translation, population and implementation sciences, and will include epidemiology, prevention and clinical trials. Greenwald and team have begun to collaborate with scientists, educators and clinicians at WSU, as well as like-minded hospital and industry partners, to develop work capacity. The third quadrant of the translational cycle will involve using scientific evidence to promote treatment and recovery from SUDs and pain conditions in the community and region. The idea is to improve the “cascade of care” for patients that will increase access, linkage, engagement and retention in care for these chronic conditions. Potential partners include several WSU colleges, centers, institutes and departments, the Veterans Administration and other health care entities. The final quadrant will involve evaluating and disseminating results and projecting the influence of these activities into the broader sphere, including collaborations with regional, state and national agencies; public and private insurance providers; fostering appropriate public policies; and training the next generation of clinician-scientists to effectively serve the community. Greenwald’s clinical neuroscience research in the field of SUDs focuses largely on opioid-related problems and the development of treatments such as buprenorphine for opioid use disorder (OUD), with additional brain/behavior studies on cocaine, marijuana and nicotine. “However, my very first publication as a graduate student was on the behavioral assessment of chronic pain patients, and in recent years I’ve returned to conducting research on issues in pain. We’ve already been weaving together research on these areas. Importantly, there does not appear to be a major research center in the U.S. that is explicitly dedicated to the nexus of these two key disease areas,” he said. Greenwald also serves as his department’s associate chair for Research. He leads the Michigan Collaborative Addiction Resources and Education System efforts at WSU to increase the number of certified addiction medicine specialists, and has published works in a variety of academic journals, including a paper in The Lancet on OUD treatment. He has expertise and involvement in the development of novel therapies of opioid addiction, including new forms of buprenorphine, a medication for OUD treatment.
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Counseling offered in video sessions as COVID-19 anxiety builds

Change is often difficult. And when it is abrupt and massive, like the changes being wrought by the coronavirus pandemic, variation from the normal is even harder to accommodate. With face-to-face counseling sessions canceled because of social-distancing rules, mental health professionals in Michigan are resorting to online video sessions. But the full impact of the crisis on mental health is still emerging. “Here, we have a very rapid, immense, huge transition from one style of living to another," said Dr. Arash Javanbakht, assistant professor of psychiatry and behavioral neurosciences at Wayne State University. "It has affected all the different areas of life. And the transition was not planned. It just happened.” Add uncertainty over who is carrying the contagion and who is not, and how long the pandemic will last. Compound it with such a lack of control that staying at home is the only remedy, and conditions for mental health concerns like anxiety and depression are rampant, Javanbakht and other practitioners said. “Today, I was in the virtual clinic and people are stressed,” said the psychiatrist who specializes in trauma, stress and anxiety. His practice has moved online, like many others.
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3 Wayne State students to receive posthumous degrees at virtual graduation event

Wayne State University will hold its virtual graduation celebration Wednesday to honor spring 2020 graduates — including three students who died before completing their degree. The WSU Board of Governors took special action to unanimously approve the conferral of posthumous degrees for the students who died before graduating. The action was taken ahead of a meeting planned for Friday, to allow the families and loved ones of the students to celebrate during the virtual event on Wednesday. The three students — Darrin Adams, Bri’Jon Moore and Dwayne Carrero-Berry — will all receive their degrees in the College of Liberal Arts and Sciences. WSU's virtual graduation celebration will take place at 9 a.m. Wednesday. An in-person event is still planned to be scheduled for a later date once conditions allow, according to the university.
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2 Michigan COVID-19 victims to get posthumous degrees

Darrin Adams donned a green cap and gown and a big smile three years ago when he participated in commencement exercises at Oakland Community College. Adams, who was on OCC's dean's list when he earned his associate's degree, then began studying at Wayne State University, with a goal of earning a bachelor's degree for a career in sociology. But Adams' dreams were cut short when he succumbed earlier this month to COVID-19. He was only a few classes away from earning his bachelor's degree so he and another coronavirus victim, Western Michigan University student Bassey Offiong, are getting their diplomas in spite of their untimely deaths. Wayne State is planning to bestow Adams' degree during its virtual commencement ceremony on Wednesday, in addition to two other students who died of other causes before graduation. The WSU board approved the three posthumous degrees prior to its regularly scheduled board meeting, officials said Monday. During a recent interview, Wayne State President M. Roy Wilson said Adams, who worked as a custodian on campus to make ends meet, had good grades and was close to finishing his degree. "It’s the right thing to do, he was so close and if this didn’t happen, he would have within months gotten his degree," Wilson said. Besides Adams, WSU will award posthumous degrees to Dwayne Carrero-Berry, who will receive a bachelor of arts degree in psychology with minors in Latino/a and Latin American studies and peace and conflict studies. He was diagnosed with a heart disease at the age of 19 and died in December 2017. Former Wayne State student Bri’Jon Moore will receive a bachelor of science degree in psychology. A psychology major, Moore dreamed of applying to nursing programs after she graduated. She died Feb. 4 at the age of 22.
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Commentary: Michigan's research universities involved in COVID-19 fight

Wayne State University President M. Roy Wilson co-wrote an opinion piece with University of Michigan President Mark S. Schlissel and Michigan State University President Samuel L. Stanley Jr. The article highlights the three research universities’ efforts to fight COVID-19. “Michigan needs its great public research universities more now than ever. And we are bringing all of our resources to this fight. Our medical and nursing schools, our engineers and economists, our public health and environment researchers, our psychologists and social workers — we are in this together. It is imperative that the three major state universities that make up Michigan's University Research Corridor — Michigan State University, the University of Michigan and Wayne State University — are at the front lines and in the laboratories battling the COVID-19 pandemic.
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Michigan State, Wayne State planning for online fall classes

It’s only spring, but the presidents of Michigan’s three largest universities are already planning for how their campuses may look in fall 2020, once the coronavirus pandemic has slowed down. For Michigan State University and Wayne State University, that likely means online classes, their presidents said Thursday, April 23 during a tele-town hall meeting. But University of Michigan President Mark Schlissel remains hopeful of having in-person classes, while taking advice from public health officials. At Wayne State University, President M. Roy Wilson said online classes are being developed now assuming it won’t be possible to conduct face-to-face teaching. “(We) would love it if we could open our campus up and have in-person classes. The reality is that that’s unlikely,” Wilson said. “We’re going to plan for having to do it online, and if for some reason something happens and we’re really surprised and we can do it in person, we’ll pivot.” It takes a lot of preparation to put together a strong online course, Wilson said, adding that what was done in the second half of this past semester was not online classes but “remote teaching.” Compared to MSU and UM, Wilson believes WSU will do a little bit better in terms of its risk exposure because it doesn’t have a large hospital like UM or large Division I athletic programs, both of which are major economic sources for UM and MSU. However, that doesn’t mean Wayne State won’t be affected. “There’s no university in this country that is not going to be affected, and many affected severely by the pandemic,” Wilson said.
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Michigan med school residents feel excitement, anxiety as they head to front lines in coronavirus fight

The 2020 graduating class of medical students has been anticipating this season for years. Instead, a spring that traditionally brings recognition and celebration has become a time of stark uncertainty. For students that matched with residency programs in-state, they have watched Michigan rise to be among the top 10 in the nation for known coronavirus cases — a pandemic hot spot, particularly in southeast Michigan. Incoming residents are grappling with an eagerness to join the front lines of COVID-19 care while experiencing some relief that they have a moment to prepare themselves before doing so. “We sit in this limbo,” explains fourth-year Wayne State School of Medicine student Andrew El-Alam, “we’re overqualified students, but underqualified physicians.” El-Alam, who matched in emergency medicine at Henry Ford Hospital, hopes that by his July start the incoming coronavirus cases are at a more manageable level. “I’ve come to terms that this is likely going to be here for a long, long time. But hopefully not at this level,” he said. The vice dean of Medical Education at Wayne State University School of Medicine, Dr. Richard Baker, has confidence in the class of 2020.“This is a heroic time. They will be heroes, whether they want to or not. It’s scary,” Baker said, adding, “This experience for this cohort of students going to residency will probably change them forever. But they’re up to the task.”
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Lethargic global response to COVID-19: How the human brain’s failure to assess abstract threats cost us dearly

Wayne State Associate Professor of Psychiatry Arash Javanbakht and University of Michigan Doctoral Candidate Cristian Capotescu co-wrote a piece regarding the response to COVID-19. “More U.S. citizens have confirmed COVID-19 infections than the next five most affected countries combined. Yet as recently as mid-March, President Trump downplayed the gravity of the crisis by falsely claiming the coronavirus was nothing more than seasonal flu, or a Chinese hoax, or a deep state plot designed to damage his reelection bid. The current U.S. administration’s mishandling of the coronavirus threat is part of a larger problem in pandemic management. Many government officials, medical experts, scholars and journalists continued to underestimate the dangers of COVID-19, even as the disease upended life in China as early as mid-January. The results of this collective inertia are catastrophic indeed. The U.S., along with Italy, Spain, Iran and the French Alsace, is now the site of humanitarian tragedies, the kind we see erupting in the aftermath of natural disasters or military conflicts.
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WSU leaders take pay cuts, donate to fund for students amid COVID-19

Wayne State University leaders will take pay cuts and put them into a student emergency fund to help enrolled students in need of assistance during COVID-19. President M. Roy Wilson made the announcement this week in a letter to the campus, saying that he would take a 10 percent pay cut immediately through the end of the year. Executives, along with the deans of the 13 colleges, would voluntarily reduce their pay 5 percent. The pay cuts will go into Wayne State's Student Emergency Fund, which current students may access to cover emergencies such as transportation, food, utilities, medications or personal tragedy. All students are eligible, Wilson said, but focus will be on providing assistance to students who can't tap into federal CARES funds, awarded earlier this month to colleges and universities amid the coronavirus outbreak to help students with cash grants. Wayne State University was awarded $9.6 million for student aid. "The program ensures that temporary hardships do not prevent students from continuing forward and achieving their dreams of a college degree," Wilson wrote Thursday. "All of our current students are considered part of the Warrior family, and we want to make sure all of our students are eligible for this support."
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UM hopes for students on campus in fall; Wayne State, Michigan State lean online

Wayne State University is "unlikely" to have in-person classes in fall, Michigan State University is planning online classes, but University of Michigan is hoping to bring students back on campus with measures that will lower students' risk with COVID-19. The fall semester projections for Michigan's three largest public universities came Thursday during a Detroit Regional Chamber tele-town hall with WSU President M. Roy Wilson, MSU President Samuel Stanley and UM President Mark Schlissel. Wayne State is looking at opening laboratories for research soon, Wilson said, but having in-person classes is looking doubtful. "All of us, and I am pretty sure I speak for the three of us, would love it if we could open our campus up and have in-person classes," Wilson said. "The reality is that that is unlikely ... so we are going to plan for having to do it online."