San Antonio Express-News (Sunday)
A ‘dynamo’ on infectious disease
UT Health San Antonio doctor and researcher pivoted from HIV work to COVID challenges
Dr. Barbara Taylor has dedicated her life to battling infectious disease.
Even though her academic career has mainly focused on HIV research, prevention and treatment, especially in underserved populations, she had the background needed when the COVID-19 pandemic struck.
“When COVID started, all of us continued to do what we do, but anyone in the field of infectious diseases felt called,” Taylor said. “We all stepped forward, and I quickly became a COVID doctor.”
Taylor is an associate professor of infectious diseases at UT Health San Antonio’s
Joe R. and Teresa Lozano Long School of Medicine, as well as assistant dean for the joint M.D./master of public health degree offered by the school in partnership with the UT Health Science Center at Houston School of Public Health in San Antonio.
Taylor, born in Florida, moved to Texas at age 11. She attended Princeton University and graduated with honors in 1995 with two bachelor’s degrees in molecular biology and in politics and international affairs.
She received a Fulbright scholarship to go to the Mexican state of Michoacán, where she spent a year studying indoor air pollution in a small Indigenous village.
“It was really my first experience doing communitybased research in a profoundly marginalized community,” Taylor said. “I had never seen anything like that.”
Her time in Mexico confirmed her decision to pursue a career in medicine — one focused on the health consequences of poverty and the social justice component of infectious disease.
She received her M.D. from Harvard Medical School in 2001 and did her residency at New York-Presbyterian Hospital on Columbia University’s campus. She was hired by Columbia University to do research and clinical care in the division of infectious diseases and worked as an instructor in clinical medicine from 2008-09 and in the HIV clinic at Washington Heights. She also obtained a Master of Science in epidemiology from Mailman School of Public Health at Columbia in 2009.
But starting in 2006, Taylor was spending roughly 30 percent of her time in the Dominican Republic to study HIV in underserved Latinx communities. By 2009, Taylor knew she had to leave
New York and move somewhere she could more easily continue her research. She and her spouse began looking for places along the U.S.Mexico border.
That’s when Dr. Thomas Patterson offered her a job at UT Health San Antonio.
Patterson, professor of medicine and chief of infectious disease at UT Health, said Taylor already had established herself as an outstanding clinician focused on HIV care.
“Since then, (she) has really done spectacular work as a clinician, as an educator, as a mentor and a researcher in infectious diseases,” Patterson said.
Before the pandemic, Taylor taught medical students, worked in the hospital and took care of patients living with HIV and other chronic infectious diseases in an outpatient setting. She also researched HIV and other infectious diseases in marginalized populations.
In 2017, Taylor co-founded and, until recently, served as co-chair of the End Stigma End HIV Alliance, a community-based collaboration of San Antonio HIV and AIDS organizations. ESEHA works closely with the San Antonio Metropolitan Health District.
Dr. Junda Woo, medical director of Metro Health, has known Taylor since 2016, when they worked closely together on the steering committee of ESEHA.
“(She) understands that we ‘experts’ are here to amplify the voices and concerns of people living with HIV — not to take center stage,” she said. “Her enthusiasm, grace and overwhelming efficiency have been key to (ESEHA’s) successes.”
Woo said Taylor also collaborated with Metro Health on a program known as BEST — Breathe Easy South Texas — that offers tuberculosis screenings to at-risk individuals in 20 counties.
But everything changed when the pandemic hit.
In April 2020, medical students nationwide were barred from working in hospitals. Taylorredeployed dozens of them to serve the community.
Taylor’s Metro Health contacts had told her the provider hotline was swamped with 300 to 400 COVID-related calls a day. She organized interested students to staff Metro Health’s hotline calls regarding testing and patient care.
They also staffed the Audie L. Murphy Memorial Veterans Hospital hotline. Later in the pandemic, they worked at vaccine distribution sites.
She also launched a new COVID-19 infectious disease virtual outpatient clinic, a telehealth program through which medical students offered virtual outpatient follow-up for patients who had been discharged.
“Students would call the patients, inquire how they were doing, (whether) they had the supplies and the medicines they needed — and if patients weren’t doing well, then they would escalate the call to residents and fellows who could escalate it to attendants like Dr. Taylor,” Patterson said.
Overall, Taylor’s team helped more than 12,000 patients, Patterson said, and was an important educational tool for medical students. It also helped establish best practices in COVID-19 care.
This group of students later received a new name to encompass all their many activities: the COVID-19 Medical Student Response Team, or Long-CO.
In April 2020, Mayor Ron Nirenberg and County Judge Nelson Wolff convened a health transition team of 18 individuals specializing in infectious disease and public health, community representatives and experts in health equity. Taylor was one of them.
“One thing we recommended was that there be a continued way for community and institutions to collaborate with the city and the county on COVID response,” Taylor said. It was out of that recommendation that the COVID-19 Community Response Coalition, now known as the COVID-19 Community Response and Equity Coalition, was born.
Taylor currently serves as the coalition’s co-chair alongside Metro Health Director Claude Jacobs. Woo also is a member.
Dr. Joshua Hanson, Taylor’s colleague and the associate dean for student affairs at the Long School of Medicine, said he is amazed by Taylor’s ability to tackle a problem in a collaborative and engaging way.
“I’ve always been able to rely on (her) both in terms of hard skills and technical know-how … but also the soft skills of being able to collaborate across institutions, across the city,” Hanson said.
As Taylor pivoted toward working with the COVID-19 pandemic, she put her whole heart into it, he said.
“She makes it look effortless, but she puts a lot of effort in,” Hanson said.
Taylor also has been heavily involved in COVID-19 research as principal investigator of the Novavax vaccine clinical trial in San Antonio, part of the National Institutes of Health’s COVID-19 Prevention Network.
“Clearly, she is a dynamo and a leading scientist in our community’s COVID response,” Woo said. “We are endlessly fortunate to have her in San Antonio.”
The pandemic has been an emotional roller coaster for Taylor. While she’s proud to be part of a team providing compassionate care to people in the worst of circumstances, it’s been hard to watch
San Antonio’s communities of color ravaged by COVID-19.
“The structural racism in our society leads to disproportionately impacted communities of color,” she said. “In a marginalized community, not only am I more likely to get exposed to COVID, but I can’t get a test. I live in a multigenerational household and spread it to others. I can’t get a steroid to treat me.”
But she’s hopeful that in the future, lessons learned during the COVID-19 pandemic will help the medical community serve other marginalized communities disproportionately affected by infectious disease.
“She’s really made the community her focus, (and) she embraces the community and the people in it,” Patterson said. “She really wants to make it a better place to live.”
He added that when speaking with her students over the years, many say Taylor — and her focus on viewing global health through a social justice lens — had a meaningful influence on their early career decisions to go into academic medicine and pursue clinical care for patients in underserved communities.
Taylor said the two biggest challenges she’s faced during the pandemic are uncertainty — and how to handle it.
“We have been dealing with what … was a brand-new virus,” Taylor said. “There was so much that we did not know at the beginning; and when you don’t know about something that could be deadly, that creates massive amounts of stress. And the stress is everywhere.”
She said medical and public health experts should be transparent about what they do — and do not — know. But communicating that has been difficult during the pandemic.
“It is so hard to … do our jobs as communicators of information in the context of incredibly well-funded disinformation,” Taylor said. “It is a deep honor to be useful in this way — and it’s also an incredibly steep learning curve in how to do that well.”
Although COVID-19 cases remain high in San Antonio, the death rate is significantly lower, Taylor said.
“What we’re seeing is the impact of vaccines, and it is amazing,” she said. “We’ve done the groundwork in our communities, particularly in people over the age of 65, to get people vaccinated. And that is something that we should all be really proud of.”
Taylor called it a “scientific miracle” that multiple vaccines were developed for a new pathogen in a single year.
“It gives me so much faith in science and research and the fact that we can do this — and how many millions of lives are saved,” she said.