Cara Exten, assistant nursing professor, spends most of her time working behind the scenes as an infectious disease epidemiologist – one who studies the occurrence and spread of infectious diseases in populations over time. For most individuals, the thought of an impending global pandemic hadn’t even crossed their mind, but for Exten, COVID-19 was an opportunity to put nearly 20 years of epidemiology experience to the test.
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As an experienced and respected public health, STD and HIV mitigation expert, and nursing faculty member, she was recruited by the University to lead in the formation and execution of the COVID-19 testing and contact tracing initiatives, as well as other University-affiliated initiatives.
“I felt an ethical obligation to do anything I could to help my immediate community, but also to contribute to the worldwide effort in minimizing the impact of COVID-19. This is what I was trained to do and is why I wanted to be an epidemiologist, to stop infectious diseases from impacting health” said Exten. “As an epidemiologist, I think we all collectively understood it was all hands on deck - we will all do whatever we have to do.”
In March of 2020 when the pandemic first started emerging in the United States, Exten joined a contact tracing initiative that was developed by Christopher Sciamanna, medical doctor, professor of medicine and public health sciences at Penn State, and former Penn State College of Medicine assistant professor, Ping Du. As part of this program, 122 medical students, 14 public health students, and seven nurse practitioner students joined in the contact tracing fight.
“It [contact tracing] was an enormously successful program. We were very effective in getting people to actively participate and comply with our contact tracing program,” said Exten. “Ultimately, we had 65% of cases and 80% of contacts agree to comply, which is 20% higher than published rates elsewhere in the United States.”
In the fall of 2020, Exten began as a co-investigator on Pennsylvania’s Regional Response Health Collaborative Program with Nicole Osevala, assistant professor in the College of Medicine, serving as principal investigator. As part of that program, which was funded by Pennsylvania's Department of Health, Exten and her team were tasked with conducting the contact tracing for nursing home and long-term care facility employees in the south-central region of Pennsylvania.
Additionally, Exten has developed a strong collaborative relationship with John Hayes, Ph.D., professor in the Department of Food Science at Penn State, on his latest research endeavor – a sniff test for rapid COVID-19 screening. This research leverages recent evidence that sudden smell loss is a highly specific symptom of COVID-19 infections, including in people who are otherwise asymptomatic.
With funding awarded from the National Institute of Health, in collaboration with researchers from the University of Florida and Arizona State University, Hayes and Exten are developing several different sniff cards to figure out which type of card is best at predicting if an individual has COVID-19, all without having to leave their home.
Exten hopes to use all of these experiences to add to the field of knowledge about COVID-19, contact tracing, and pandemic preparedness. She hopes to eventually see her work and research inform future clinical and public health practices.