Dr. Eaton Declaration

Case 4:20-cv-00304-AKK-JHE Document 20-1 Filed 04/29/20 Page 1 of 47 FILED
2020 Apr-29 PM 02:33

U.S. DISTRICT COURT
N.D. OF ALABAMA
EXHIBIT 20
CORRECTED
Case 4:20-cv-00304-AKK-JHE Document 20-1 Filed 04/29/20 Page 2 of 47
DECLARATION OF DR. ELLEN EATON
I, Dr. Ellen Eaton, MD, MSPH, hereby declare under the penalty of perjury
pursuant to 28 U.S.C. § 1746:
I. BACKGROUND AND QUALIFICATIONS
1. I am the Branch Director for Special Populations for the Jefferson County
Unified Command Services in response to the novel coronavirus pandemic.
In this role, I am coordinating the public health and medical response for at-
risk groups in the Birmingham area, which has the second largest
concentration of COVID-19 cases in Alabama, second only to Mobile. This
role is also critical because Jefferson County has the largest health
infrastructure in the state, with more hospital beds and, specifically, more
ICU beds than other counties. The public health and medical response in
Jefferson County is therefore of critical importance to the entire state.
2. Additionally, I am Assistant Professor of Medicine at the University of
Alabama at Birmingham (UAB) and Director of the Outpatient Opioid
Treatment Clinic at the UAB 1917 HIV Clinic. I completed my residency in
in Internal Medicine at Stanford Hospital and Clinics, Palo Alto, California
in 2010. I completed a fellowship in Clinical Infectious Diseases at UAB in
2016 and a fellowship in Patient Centered Outcomes. I additionally hold a
1

Master of Science in Public Health with an emphasis on Healthcare
Organization and Policy from UAB (2017).
3. I have worked for seven years with criminal justice involved individuals
through my work as an HIV and substance use medical care provider. In this
capacity, I manage HIV, Hepatitis C, tuberculosis, and other infectious
diseases in persons with varying interactions with criminal justice systems
from jails to parole. I have maintained a dedicated HIV clinic and opioid
treatment clinic in the community for patients returning home from prison
and jail. For the past six years, I have been continuously funded to perform
clinical research on HIV prevention and treatment including criminal justice
involved individuals. My research support comes from the Centers for
Disease Control and Prevention (CDC), Center for AIDS Research, Alabama
Department of Public Health, the Substance Abuse and Mental Health
Services Administration (SAMHSA), and industry. I have served as an
expert on working groups dedicated to infectious diseases and opioids for
both the HIV Medical Association and the National Academy of Medicine.
4. I have written and published on the topics of infectious diseases among
vulnerable people including those with substance use and in the criminal
justice system and on issues of prevention, diagnosis, and management of
HIV and other infectious diseases among special populations. My C.V.
2

includes a full list of my honors, experience, and publications, and it is
attached as Exhibit A.
5. I offer the following commentary based on my years of experience working
with at-risk populations, my expertise in Alabama’s public health and
medical infrastructure, and my review of the applicable CDC guidelines and
medical research regarding the COVID-19 pandemic as a physician and
public health official. I am not being paid for my work in this case.
II. COVID-19 IS A HIGHLY CONTAGIOUS DISEASE THAT POSES

AN UNPRECEDENTED DANGER TO PUBLIC HEALTH IN
ALABAMA
6. Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2). The virus is believed to be
transmitted through respiratory droplets (by coughing or sneezing or through
contact with droplets that survive on surfaces). The virus is highly
contagious: while initial data seemed to show that the average person
infected two or three people (known as the R0 in epidemiology), new
research shows that the average person infects five or six people.1 For
comparison, the average R0 for influenza ranges between 0.9 and 2.1.2

1
Sanche S, Lin YT, Xu C, Romero-Severson E, Hengartner N, Ke R. High contagiousness and
rapid spread of severe acute respiratory syndrome coronavirus 2. Emerg. Infect. Dis. (2020).
https://doi.org/10.3201/eid2607.200282
2
G. Chowell, M. A. Miller and C. Viboud, Seasonal influenza in the United States, France, and
Australia: transmission and prospects for control, 136 Epidemiol. Infect. 852 (2008)
3

7. COVID-19 has been so contagious because it can be spread in a variety of
ways. The primary means of transmission of COVID-19 is thought to be
through inhaling respiratory droplets produced by coughing or sneezing or
through touching of surfaces touched by those droplets. COVID-19 can
survive on plastic and stainless steel surfaces for up to 72 hours and can be
transmitted by a non-infected individual touching a surface containing
COVID-19 particles and then touching their face.3
8. However, COVID-19 may be transmissible even from asymptomatic and
pre-symptomatic individuals.4 The World Health Organization has indicated
that approximately 80% of COVID-19 cases are asymptomatic or mildly
symptomatic.5 Likewise, COVID-19 can incubate in an infected person for
two to fourteen days before they show symptoms.6
9. COVID-19 may also be transmitted from person to person through the air as
the virus has been found to survive in aerosols, specifically the clouds of

3
van Doremalen N, Morris D, Bushmaker T et al. Aerosol and Surface Stability of SARS-CoV-2
as compared with SARS-CoV-1. New Engl J Med (2020)
4
Kimball A, Hatfield KM, Arons M, James A, et al. Asymptomatic and Presymptomatic SARS-
CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility — King County,
Washington, March 2020. MMWR, 3 April 2020, 69(13); 377–381; Guoqing Qian, Naibin Yang,
Ada Hoi Yan Ma, et. al, A COVID-19 Transmission within a family cluster by presymptomatic
infectors in China, Clinical Infectious Diseases, ciaa316, https://doi.org/10.1093/cid/ciaa316
5
Q&A: Similarities and differences – COVID-19 and influenza, World Health Organization,
(March 17, 2020), https://www.who.int/news-room/q-a-detail/q-a-similarities-and-differences-
covid-19-and-influenza
6
Jernigan DB. Update: Public Health Response to the Coronavirus Disease 2019 Outbreak —
United States, February 24, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:216–219
4

moisture created by sneezing, coughing, talking, or flushing a toilet, for up
to three hours.7
10. Most commercially available masks, let alone makeshift masks made of
cloth, cannot effectively filter small particles of coronavirus in the air.8
11. The SARS-CoV-2 virus is deadly. Some patients who contract COVID-19
experience severe illness, including hospitalization, admission to an
intensive care unit, and death. Severe illness is more common in older
patients and patients with underlying health conditions, but severe illness
leading to hospitalization and death can occur in adults of any age with
COVID-19. Underlying health conditions that make patients vulnerable to
severe illness from COVID-19 include: hypertension, cancer, heart disease,
lung disease (including asthma), severe obesity, diabetes, chronic kidney
disease, and liver disease, and any form of a compromised immune system
(for example, immunosuppressive treatments, autoimmune conditions, or
immune deficiencies).

7
van Doremalen N, Morris D, Bushmaker T et al. Aerosol and Surface Stability of SARS-CoV-2
as compared with SARS-CoV-1. New Engl J Med (2020); Zhang Y, Chen C, Zhu S et al.
[Isolation of 2019-nCoV from a stool specimen of a laboratory-confirmed case of the
coronavirus disease 2019 (COVID-19)]. China CDC Weekly. 2020;2(8):123–4.; David L.
Johnson, Kenneth R. Mead, Robert A. Lynch, Lifting the lid on toilet plume aerosol: A literature
review with suggestions for future research, Am J Infect Control. 2013 Mar; 41(3): 254–258;
Yan, J. et al. Proc. Natl Acad. Sci. USA 115, 1081–1086 (2018).
8
Rengasamy S, Eimer B, Shaffer RE. Simple respiratory protection—evaluation of the filtration
performance of cloth masks and common fabric materials against 20-1000 nm size particles.
Ann. Occup. Hyg. 2010 Jun 28;54(7):789-98
5

12. Since COVID-19 emerged months ago, doctors have identified the most
common symptoms: fever, fatigue, coughing, and shortness of breath.
Additional symptoms that some patients experience include aches and pains,
nasal congestion, runny nose, sore throat, or diarrhea. Those who experience
trouble breathing, persistent pain or pressure in the chest, new confusion or
inability to arouse, or bluish lips or face should seek medical attention.9
Because this is an emerging infection, new symptoms are periodically being
reported, such as loss of smell being a possible symptom that may appear in
otherwise asymptomatic individuals.
13. There is no known treatment for COVID-19 and no available vaccine. While
some experimental treatments are being investigated and some have begun
preliminary clinical trials, any treatment or vaccine is likely at least months
away—and possibly over a year—from FDA approval.
III. SOCIAL DISTANCING IS IMPERATIVE BOTH TO PROTECT

INDIVIDUAL PATIENTS AND FOR OVERALL PUBLIC
HEALTH. WITHOUT SIGNIFICANT PUBLIC HEALTH
INTERVENTIONS, ALABAMA’S HEALTH INFRASTRUCTURE
WILL BE OVERWHELMED.
14. COVID-19 has rapidly spread all over Alabama. As of April 13, there were
3,611 confirmed cases in the state with 95 reported deaths. On that date, 104

9
Brooks J. Global Epidemiology and Prevention of COVID19, COVID-19 Symposium,
Conference on Retroviruses and Opportunistic Infections (CROI), virtual (March 10, 2020);
Coronavirus (COVID-19), Centers for Disease Control, https://www.cdc.gov/coronavirus/2019-
ncov/index.html.
6

patients had been placed on a ventilator, and 156 patients had required care
in an ICU bed. The virus has spread to every county in the state. At this
point, there is substantial community spread, meaning that new cases that are
appearing cannot be clearly traced to another infected individual and the
exact source of the infection is unknown.
15. Adequate testing has been a challenge in Alabama and so the confirmed
cases are likely a significant undercount of infected persons. For example,
Louisiana reported 86,929 COVID-19 tests as of April 9 and Tennessee
reported 59,849 COVID-19 tests on the same date. In comparison, Alabama
has only tested 48,387 for COVID-19.10 As we expand testing in Alabama,
we are certain to discover many more cases.
16. Etowah County specifically has reported 110 confirmed cases and 8 deaths
as of April 21.11 There are only two testing sites in the county and a mere
404 tests had been conducted as of April 9. The population of Etowah
County is over 100,000 and because of community spread we should assume
many have been exposed to the virus.
17. The virus has continued to spread exponentially in Alabama, as in other
states. Epidemiological models for the likely course of the virus are

10
Alabama COVID-19 Case Tracking, bamatracker.com (last accessed April 21, 2020)
11
Alabama Department of Public Health, Division of Infectious Diseases & Outbreaks,
Alabama's COVID-19 Data and Surveillance Dashboard,
https://alpublichealth.maps.arcgis.com/apps/opsdashboard/index.html#/6d2771faa9da4a2786a50
9d82c8cf0f7
7

challenging given lack of comprehensive testing. But projections released on
April 1 by the Institute for Health Metrics and Evaluation predicted that
Alabama would have the highest death rate per capita from COVID-19 and
the fourth highest death count in the country. The worst-case scenario
predicted almost 10,000 deaths by mid-May in Alabama.12
18. Again, the COVID-19 virus has no cure and no effective treatment at this
time. The only tool we have to reduce the rates of serious illness and death is
to prevent the spread of the disease through social distancing and personal
hygiene practices. If the virus continues to spread exponentially, thousands
of people in this state will die.
19. Alabama’s health infrastructure is not prepared for the unprecedented
challenge of this virus. Under all possible models, hospitals here have very
limited capacity and will be overwhelmed by COVID-19 patients. Alabama
has 14,790 hospital beds in total, of which 75% are already occupied on a
regular day. In Jefferson County, 90% of its 3,000 hospital beds are
occupied on a regular day.
20. Alabama’s hospital systems have been decimated over the last decade by
hospital closures, particularly in rural areas. In the past eight years, thirteen
hospitals have closed. Rural areas have been disproportionately impacted by

12
Institute for Health Metrics and Evaluation, Covid-19 Projections - Alabama,
https://covid19.healthdata.org/united-states-of-america/alabama
8

closures, with seven of the hospitals closed serving rural communities. The
state has lost hundreds of hospital beds through these closures.13
21. Specifically, Etowah County has 52.9 hospital beds per 10,000 residents.
Facilities in the entire county have fewer than 100 ICU beds in total. There
are over 100,000 residents.14
22. Throughout the state, acute shortages of beds, equipment, and staffing are
projected. We expect peak need in the coming weeks, possibly as soon as
April 23, and expect to need thousands of additional hospital beds, hundreds
of additional ICU beds, and hundreds of more ventilators. Health officials
throughout the state are considering extreme measures, such as setting up
makeshift care facilities in buildings not originally intended for medical use.
In these dire circumstances, every hospital bed, ICU bed, and ventilator is
key.
IV. AT-RISK POPULATIONS ARE ALREADY MEDICALLY

VULNERABLE AND REQUIRE SPECIAL INTERVENTIONS TO
PREVENT SPREAD
23. Observations from China, Italy and the U.S. suggest that heart and lung
disease along with diabetes and obesity predispose individuals to severe
COVID and death. In a retrospective cohort study from Wuhan in China,

13
William Thornton, Another rural Alabama hospital is closing, AL.com, Mar. 2, 2020
https://www.al.com/business/2020/03/another-rural-alabama-hospital-is-closing.html
14
Ramsey Archibald, Where are Alabama’s hospital beds?, AL.com, Mar. 26 2020,
https://www.al.com/news/2020/03/where-are-alabamas-hospital-beds.html
9

48% of hospitalized patients with COVID-19 in the study had a comorbidity,
meaning another chronic disease. In the same study, multivariable regression
showed increasing odds of death from COVID-19 associated with older age.
This early warning has been confirmed across the U.S. and other affected
countries: those with other chronic disease (hypertension, heart/lung disease,
diabetes, obesity, etc.) and of older age are disproportionately at risk for
severe symptoms that require hospitalization and may result in death.
24. COVID-19 has run a similar course in Alabama. In Alabama, those older
than 65 years of age represent 70% of deaths from COVID-19 in the state.
That should not be misunderstood to mean that those younger than 65 years
of age are safe from severe illness or death: it is noteworthy that those ages
19-64 years represent 30% of Alabama COVID deaths.15 Moreover, of
patients admitted to UAB ICUs with severe COVID-19, 12% have no risk
factors for severe disease such as hypertension (Ref: Dr. Sonya Heath. UAB
Medical Grand Rounds. April 22, 2020).
25. Furthermore, in correctional settings, the age of 55 is used to identify older
patients, because of the extremely high level of physical and behavioral

15
Alabama Department of Public Health, Division of Infectious Diseases & Outbreaks,
Alabama's COVID-19 Data and Surveillance Dashboard,
https://alpublichealth.maps.arcgis.com/apps/opsdashboard/index.html#/6d2771faa9da4a2786a50
9d82c8cf0f7
10

health problems among this population.16 I believe the age of 55 should be
applied to ICE detainees for the same reason.
26. In a recent study in the Lancet, the premier medical journal for peer-
reviewed research, for patients over age 50, hospitalization is much more
likely, and a greater proportion of cases are likely to be fatal." For this
reason, I consider all adults over 50 to be high risk for adverse COVID
outcomes when developing best practices and policy related to the
pandemic.17
27. Notably, men represent 60% of deaths in Alabama and national COVID
fatality reports, although the reasons for worse outcomes in men are not
understood at this time.
28. Due to underlying tobacco use disorder in many persons with criminal
justice involvement, we anticipate that lung disease will be quite common
and contribute to adverse COVID outcomes including death in this subset.
Furthermore, comorbid conditions such as heart disease and diabetes are
difficult to control in persons who are incarcerated. Thus, I anticipate that
individuals in criminal justice settings will be particularly vulnerable to

16
Williams, Brie A. et al. Aging in Correctional Custody: Setting a Policy Agenda for Older
Prisoner Health Care. Am J Public Health (2012).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3464842/
17
Verity, Robert et al. Estimates of the severity of coronavirus disease 2019: a model-based
analysis. The Lancet – Infection Diseases (March 30, 2020). https://doi.org/10.1016/S1473-
3099(20)30243-7
11

severe COVID, require intubation and ventilation (life support) and
potentially die from their disease.
V. ETOWAH COUNTY DETENTION CENTER IS UNPREPARED

AND LACKS THE MEDICAL INFRASTRUCTURE TO
PREVENT, MANAGE, AND TREAT AN OUTBREAK OF COVID-
19, WHICH IS AT THIS POINT INEVITABLE.
29. Congregate facilities, which necessarily keep large numbers of people in
close proximity, are breeding grounds for infectious diseases like COVID-
19. In the Etowah County Detention Center, it is not possible for detainees to
comply with the stay-at-home order that directs Alabama residents to isolate
in single-family homes or apartments. Because the Etowah facility holds
hundreds of detainees in group housing units, it is also impossible for
detainees to avoid the gatherings of more than ten people that are prohibited
by public health and state and federal officials.
30. I am specifically concerned about the Etowah County Detention Center’s
response to the COVID-19 pandemic because of the announced purchase of
a fogger machine. Leadership in Sheriff’s office has stated that they have
purchased a fogger machine that is able to sanitize 6,000 square feet in about
ten minutes and that this device will be used to clean cell units and other
areas of the jail.18

18
Dustin Fox, “Commissioners approve emergency funding for Sheriff’s Department, District
Attorney amid COVID-19,” AL.com, April 7, 2020,
12

31. Since at least 2003, the CDC and the Health Care Infection Control Practices
Advisory Committee (HICPAC) have recommended against disinfectant
fogging. The overwhelming scientific consensus of the past few decades is
that studies show both a lack of microbicidal efficacy from disinfectant
fogging and adverse effects on those in facilities where disinfectant fogging
is used.19 In plain language, fogging does not kill viruses or bacteria and so
it does not decontaminate the facilities in which it is used. Worse still, the
hazardous and toxic chemicals used in fogging harm people who work or
live in the facilities that have been fogged.
32. Densely populated congregate facilities like the Etowah County Detention
Center are an enormous epidemiological danger to public health in Alabama.
The individuals detained in the jail—especially those who are at heightened
risk of serious complications from COVID-19—and jail staff, as well as the
public at large, will be better protected from infection if detainees are
released to private homes and allowed to practice appropriate social
distancing and hygiene measures recommended by the CDC and required by
Alabama and other states’ public health orders.

https://www.gadsdentimes.com/news/20200407/commissioners-approve-emergency-funding-
for-sheriffs-department-district-attorney-amid-covid-19.
19
Centers for Disease Control and Prevention, Guideline for Disinfection and Sterilization in
Healthcare Facilities - Environmental Fogging [December 2009],
https://www.cdc.gov/infectioncontrol/guidelines/disinfection/updates.html
13

33. The Etowah County Sheriff’s Office has made public statements insisting
that there is no COVID-19 exposure in the jail. This is not necessarily true.
Alabama is already experiencing substantial community spread. The jail
both contains hundreds of detainees and numerous staff and contractors that
travel in and out of the facility daily who also live in the community and
have inevitably been exposed from community spread. Detainees continue to
be transferred in and out of the facility as well. It does not appear that
individuals in the jail who present symptoms consistent with COVID-19 are
being tested for the virus. Furthermore, it is well documented that as many
as 30 to 50% of individuals with COVID-19 will have no signs or symptoms
of disease despite being infections (e.g. asymptomatic shedding). Under
these circumstances, COVID-19 cases may not be detected until there is
already a full-blown outbreak in the jail with multiple individuals
experiencing serious illness.
VI. ICE’S RESPONSE TO THE COVID-19 CRISIS IS DANGEROUS

FOR DETAINEES, STAFF, AND THE SURROUNDING
COMMUNITY
34. Current policies for social distancing in ICE facilities are insufficient to
address this often asymptomatic and infectious disease. Detainees should not
be sharing a unit and bathroom with others during the pandemic due to the
nature of COVID-19, which spreads on surfaces (bathroom faucets) and in
14

the air. Per CDC guidelines, hand sanitizer or soap should be available to
each detainee before and after meals, toileting, and frequently throughout the
day. Because detainees and staff are maintained in congregate settings, it is
advised that all detainees should receive verbal screening at intake and prior
to any transfer for signs or symptoms such as fever and/or respiratory
symptoms.
35. The medical best practice for COVID-19 is that all persons with symptoms
(fever, cough) be isolated in negative pressure rooms while awaiting a
COVID-19 test. This is because it is believed that COVID-19 is spread
through airborne and droplet particles. Negative pressure rooms are essential
to prevent spread of COVID-19 to neighboring room and staff. All contacts
including staff and roommates must also be quarantined until they can be
tested for COVID-19 as well.20 Individuals who test positive for COVID-19
must be removed from contact with any other detainees and kept in a
negative pressure facility for at least seven days, if not longer, pending
resolution of symptoms.

20
Centers for Disease Control and Prevention, Evaluating and Testing Persons for Coronavirus
Disease 2019 (COVID-19), https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-
criteria.html.
15

36. Furthermore, it is known that 30 to 50% of infected individuals have no
signs or symptoms of COVID-19.21 Thus, many congregate facilities such as
healthcare systems and shelters now require a COVID-19 test prior to
entry.22 The same policy should be applied to detainees who reside in
congregate criminal justice and/or ICE settings similar to hospitals and
shelters. Because it is now recognized that a significant number of COVID
transmissions are spread from asymptomatic persons, it unlikely that
screening based on symptoms alone will prevent an outbreak of COVID-19.
This is likely the explanation behind COVID-19 outbreaks observed in many
criminal justice settings among detainees and staff. Hence more testing is
needed.
VII. THE DETAINED IMMIGRANTS IN THIS CASE ARE HIGHLY

VULNERABLE TO SERIOUS COMPLICATIONS OR EVEN
DEATH FROM CONTRACTING COVID-19
37. The conditions for ICE detainees at the Etowah County Detention Center
limit access to soap, hand hygiene and require close contact with detainees

21
Mizumoto, Kenji et al. Estimating the asymptomatic proportion of coronavirus disease 2019
(COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020.
Eurosurveillance. Vol. 25, Issue 10, March 12, 2020.
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180; Breslin,
Noelle et al. COVID-19 infection among asymptomatic and symptomatic pregnant women: Two
weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am J Obstet
Gynecol MFM. April 9, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144599/.
22
Ramirez, Julio A.; Carrico, Ruth; Arnold, Forest W.; Schulz, Paul (2020). How to Prevent
COVID-19 in Nurses and Physicians in the Hospital Setting: Universal Test-and-Isolate for All
Patients Admitted to Hospitals, The University of Louisville Journal of Respiratory Infections:
Vol. 4 : Iss. 1, Article 6.
16

as part of shared meals and rooming arrangements which make all detainees
at risk for COVID-19 during this pandemic. Furthermore, due to the limited
access to healthcare and routine health maintenance, the lack of a medical
diagnosis does not mean that this population is healthy. It may only reflect a
lack of access to a provider who may diagnose chronic medical conditions.
Just as lack of COVID-19 testing limits our understanding of COVID-19
cases, lack of routine medical care among detainees limits our understanding
of chronic medical conditions and COVID-19 risk factors in this population.
38. The plaintiffs in this case present with personal health characteristics that put
them at risk for severe complications, including possible fatality, from
COVID-19 should they be exposed to the virus in detention:
a. Sarail Michael Archilla is a 44 year old male with hypertension and
chronic asthma. Due to the chronicity and exacerbations of his
asthma, I suspect he has COPD, which, together with his
hypertension, puts him at heightened risk for severe COVID-19 based
on these medical issues.
b. Maxime P. Blanc is a 46 year old male with a history of pre-diabetes,
hypertension, and hyperlipidemia. All three conditions exacerbate
cardiovascular disease, which is a known risk factor for severe
17

COVID-19. I anticipate he is at heightened risk for severe COVID-19
based on these medical issues.
c. Geovanny Castellano is a 60 year old man with chest pain (also
known as angina) and hypertension. Due to his age, male sex and
heart disease, he is at heightened risk for severe COVID-19 based on
these medical issues.
d. Antonio Melquezideth Castro. Mr. Castro is a 38 year old male with
a history of chronic kidney disease due to renal stones and bronchitis.
In addition to his lung disease, which places him at heightened risk of
severe respiratory complications from COVID, his renal disease gives
him a second chronic medical condition further contributing to his risk
of severe COVID-19. I anticipate he is at heightened risk for severe
COVID-19 based on these medical issues.
e. Edson Flores is a 48 year male with diabetes, hypertension and high
cholesterol. This type of multi-morbidity means he is at heightened
risk for severe COVID-19 based on these medical issues.
f. Ray Fuller is a 54 year old male with a history of hypertension and
sleep apnea. Due to a requirement of three antihypertensive
medications, cardiopulmonary disease (sleep apnea), age over 50
18

together with male sex, I anticipate he is at heightened risk for severe
g. Jose Antonio Garcia Rivera (a.k.a. Domingo Castillo) is a 62 year
old male who has a history of asthma. Due to his age, male sex, and
pulmonary disease, I anticipate he is at is at heightened risk for severe
h. Karim Golding is a 35 year old male with a history or asthma. Due to
his chronic lung disease, he is at heightened risk of severe COVID-19.
i. Alex Hernandez is a 49 year old male with hypertension. He is at he
is at heightened risk for severe COVID-19 based on his hypertension
and male sex.
j. Bakhodir Madjitov is a 38 year old male with hypertension and heart
block of unclear etiology. He is at heightened risk of severe COVID-
19.
k. Kenneth Manning is a 61 year old male with a history of prostate
cancer and heart disease. He is at heightened risk for severe COVID-
19 based on his age, male sex, and these medical issues.
l. Landry (Emily) Mbendeke is a 40 year old transgender female
(assigned male at birth) who has hypertension and is HIV-positive.
Her chronic medical conditions including HIV and high blood
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pressure place her at heightened risk for severe COVID-19 due to the
amount of surveillance, medication monitoring, and laboratory
assessment that is required for routine care. When a public health
emergency disrupts already limited medical capacity in a criminal
justice setting, these conditions are exacerbated and predispose to
severe COVID-19 outcomes.
m. Tesfa Miller is a 38 year old male with hypertension, high cholesterol
and bronchitis (chronic). The bronchitis is severe enough to indicate
hospitalization. These chronic medical conditions, especially the lung
disease, place him at heightened risk of severe COVID-19.
n. Allen Roger Olano Esparza is a 37 year old man with hypertension
and kidney disease. He is at heightened risk of severe COVID-19 due
to his chronic diseases, which give him multi-morbidity and
contribute to his risk for an adverse health outcome if infected.
o. Sergio Quito is a 45 year old male with hypertension and epilepsy.
His blood pressure and the uncontrolled nature of his seizures put him
at heightened risk of severe COVID-19 due to multi-morbidity.
p. Joseph D. Soho is a 46 year old male with hypertension and anemia.
He is heightened risk for severe COVID-19 based on these medical
issues. These issues include his chronic medical issues which both
20

affect his physiologic ability to respond to the stress induced by an
acute respiratory infection.
q. Churvin Webster is a 57 year old male with severe asthma and
hypertension. Due to his age, male sex and cardiopulmonary diseases,
he is at heightened risk of severe COVID-19.
r. Randane Williams is a 30 year old male with hypertension and a
heart murmur. Although most heart murmurs are benign, some are
severe enough to cause heart arrhythmias and heart failure in the
context of infection. Because it is known that heart disease
predisposes to severe COVID, this individual is at heightened risk for
severe COVID.
I declare under penalty of perjury that the foregoing is true and correct.
April 22, 2020

Birmingham, Alabama
Dr. Ellen Eaton, MD, MSPH
21

EXHIBIT A
CURRICULUM VITAE
Ellen F. Eaton, M.D.
UNIVERSITY OF ALABAMA AT BIRMINGHAM DEPARTMENT OF MEDICINE

FACULTY CURRICULUM VITAE
PERSONAL INFORMATION
Name: Ellen Florence Eaton, M.D.
Citizenship: USA
Home Address: 423 Windsor Drive

Birmingham, AL 35209
Phone: (205) 821-8551
RANK/TITLE: Assistant Professor
Department: Medicine
Division: Infectious Diseases
Business Address: University of Alabama at Birmingham School of Medicine

Department of Medicine
Division of Infectious Diseases
845 19th Street South
BBRB 206-B
Birmingham, AL 35294-2170
Phone: 205-975-0661
Fax: 205-934-5155
Email: eeaton@uabmc.edu
HOSPITAL AND OTHER (NONACADEMIC APPOINTMENTS):
2020- Present Branch Director, Special Populations

Jefferson County Unified Command Service
Coronavirus Response
2019- Present Director, Outpatient Based Opioid Treatment Clinic

UAB 1917 Clinic
2014-2016 Staff Physician

Emergency Medicine
Birmingham VA Medical Center
Birmingham, AL
Updated: February 12, 2020

EDUCATION:
August 2003-May 2007 University of Alabama School of Medicine

Birmingham, AL
Doctor of Medicine
August 1999-May 2003 Vanderbilt University

Nashville, TN
Bachelor of Science, Magna Cum Laude
MEDICAL LICENSURE:
2013-Present State of Alabama

2011-2013 State of North Carolina
2009-2011 State of California
BOARD CERTIFICATION:
2016 Diplomate, American Board of Internal Medicine,

Subspecialty of Infectious Diseases
2010 Diplomate, American Board of Internal Medicine
POSTDOCTORAL TRAINING:
2014 – 2017 Masters of Science in Public Health

Ryals School of Public Health
University of Alabama at Birmingham School of Medicine
Birmingham, AL
2013-2016 Clinical Fellow Division of Infectious Diseases

Department of Medicine University of Alabama at Birmingham
School of Medicine Birmingham, AL
ACADEMIC APPOINTMENTS:
August 2016-Present Assistant Professor

Infectious Diseases and Internal Medicine
UAB Hospital
August 2014-2016 T32 Scholar, Health Services, Outcomes, & Effectiveness

Research
July 2013-2016 Clinical Fellow

Division of Infectious Diseases

University of Alabama at Birmingham School of Medicine,
Birmingham, AL
July 2011-June 2013 Clinical Assistant Professor of Medicine

Division of Hospital Medicine
Duke University Health System
Durham, NC
June 2010-June 2011 Chief Medical Resident

Clinical Instructor, Internal Medicine
Stanford University Hospital
Palo Alto, CA
Internship and Residencies:
June 2010-June 2011 Chief Medical Resident, Internal Medicine, Department of

Medicine
Stanford University School of Medicine
Palo Alto, CA
June 2008-June 2010 Resident, Internal Medicine, Department of Medicine

Palo Alto, CA
June 2007-June 2008 Intern, Internal Medicine, Department of Medicine

Palo Alto, CA
AWARDS/HONORS:
2006 Alpha Omega Alpha Medical Honor Society
2006 Gold Humanism Medical Honor Society
2007 President, Internal Medicine Interest Group, University of

Alabama at Birmingham School of Medicine
2007 Recipient, Tinsley Harrison Award, University of Alabama at

Birmingham School of Medicine (Chosen by Department of
Medicine faculty as outstanding internal medicine student in
graduating class)
2009 Selected Advisory Committee Member, Alwin C. Rambar-

James B.D. Mark Award (One of two Stanford resident

representatives selected to represent Stanford internal

medicine housestaff)
2010 First Place, Stanford Hospital Quality Improvement Team

Challenge (Developed provider-assessment tools for diabetes
and health maintenance core measures)
2011 Spectrum Intensive Course in Clinical Research: Study

Design and Performance (Selected by Stanford Internal
Medicine Department to participate in weeklong training)
2014 Recipient, Bristol Myers Squibb Virology Fellows

Research Training Program
2014-2016 T32 Recipient, UAB/VA Health Services, Outcomes, and

Effectiveness Research (Provides 2-year stipend to cover
salary and full tuition and fees for an MSPH in Outcomes
Research)
2015-2017 NIH/NIAID Loan Repayment Program Award Recipient
2018-2019 NIH/NIAID Loan Repayment Program Award Recipient
2015 IDWeek 2015TM Trainee Travel Grant
2015-2017 Recipient, Bristol Myers Squibb Virology Fellows

Research Training Program
2016 Semifinalist, Trainee Research Symposium. University of

Alabama, Birmingham
2016-2018 K12 Scholar, Patient Centered Outcomes Research Career

Development Program
2017-2019 Omenn Fellow in Public Health and Health Policy, National

Academy of Medicine
2017 Transforming Success Leadership Development for Women

Faculty, Participant
2018-2020 Gilead HIV Research Scholar
2018-2020 UAB Frommeyer Fellowship
2018 UAB World AIDS Day Poster Competition, 2nd Place

PROFESSIONAL MEMBERSHIPS:
2006-Present Alpha Omega Alpha Society
2005- Present American College of Physicians
2013- Present Associate Member, Infectious Diseases Society of America
2013- Present Associate Member, HIV Medical Association
2015- 2017 Associate Member, Academy Health
2016- 2018 Associate Member, Society for Medical Decision Making
COUNCILS AND COMMITTEES:
2019- Present Infectious Diseases Society of America/HIV Medical

Association, Opioid Working Group, Member. Serve as expert
consultant for clinics and hospitals interested in integrating
opioid use treatment with infectious diseases. Have provided
consultation on hospital management of infectious diseases
and opioid use disorder to University of Miama (Dr. D. Serota),
Boston University (Dr. J. Barocas), University of Maine (Dr. K.
Thakarar), Coastal Telehealth Specialists (Dr. V. Manikal),
University of Nebraska (Dr. N Cortes-Penfield), Yale (Dr. N.
Seval), University of Alabama, Huntsville (Dr. K Ivey),
Vanderbilt University (Dr. C Chastain, K White).
Have provided consultation on Outpatient-based Opioid

Treatment Clinics (OBOT) to University of North Carolina (Dr.
A Shranz) and the UAB Hepatitis C Treatment Clinic (Dr. T.
Overton).
Served as Key Informant for the Medical Evidence-Based

Decisions Project (MED) Report on Serious Bacterial
Infections among individuals who inject drugs. MED is a
collaboration of 21 state Medicaid agencies that fund evidence
reviews and policy analysis. This particular report is a joint
effort with the Curated Library about Opioid Use for Decision-
makers (CLOUD); report anticipated online in late 2020

My research is cited in the UpToDate review of Right Sided
Native Valve Infective Endocarditis and the University of
Nebraska Medical Center’s Institutional Guidelines on
Outpatient Parenteral Antibiotic Therapy (OPAT).

2019- Present Research and Informatics Services Center (RISC) Program

Evaluation Unit, Director
2019- Present UAB Infectious Diseases Division Leadership Committee,

Member
2018- Present Infectious Diseases Society of America/HIV Medical

Association Grants for Emerging Researchers, Clinician
Mentorship Committee (G.E.R.M.), Member
2018- Present The North American AIDS Cohort Collaboration on Research

and Design (NA-ACCORD) Comparative Effectiveness Working
Group
2016- Present Alumni Council, UAB-VA Health Services, Outcomes, and

Effectiveness Research (HSOER) Training Program
2015- Present Program Evaluation Committee, Division of Infectious Diseases

Birmingham, AL
2013-2014 House staff Council, Fellow Representative

Birmingham, AL
JOURNAL POSITIONS:
2015- Present Clinical Infectious Diseases, Reviewer
Journal of Acquired Immune Deficiency Syndromes, Reviewer
Therapeutic Advances in Musculoskeletal Disease, Reviewer
2016- Present Journal of the International Association of Providers of AIDS
Care, Reviewer
Open Forum Infectious Diseases, Reviewer
Vaccine, Reviewer
2017- Present Quality of Life Research, Reviewer
AIDS & Behavior, Reviewer

2018- Present Antiviral Therapy, Reviewer
2019- Present International Journal of STD & AIDS, Reviewer
Journal of Addiction Medicine, Reviewer
Journal of Substance Abuse Treatment, Reviewer
2020- Present Journal of Infectious Diseases, Reviewer
MAJOR RESEARCH INTERESTS:
I am a health services researcher who studies HIV treatment and prevention strategies
related to injection drug use, infectious complications of addiction, sexual health
outcomes in minorities, and HIV health policy.
TEACHING EXPERIENCE:
2016- Present HIV 101: The Basics.Epidemiology of Infectious Diseases

(EPI 605Q). Ryals School of Public Health, University of
Alabama at Birmingham, Birmingham, AL
2016- Present HIV Clinical Features, Pathogenesis and Treatment. HIV/AIDS

and STDs (EPI 621). Ryals School of Public Health, University
of Alabama at Birmingham, Birmingham, AL
2016- Present Attending Physician, UAB General Medicine and Infectious
Diseases Inpatient Service, University of Alabama at
Birmingham, School of Medicine, Birmingham, AL
2013-2018 Instructor, Sophomore Medical Microbiology Laboratory

Birmingham, AL
2013-2018 Instructor, Patient, Doctor, Society. University of Alabama at

Birmingham School of Medicine
2011-2013 Attending Physician, Duke General Medical Inpatient Service

Durham, NC
2010-2011 Attending Physician, Stanford General Medicine Inpatient

Service, Palo Alto, CA
2010-2011 Instructor, Practice of Medicine Course, Stanford University

School of Medicine
Palo Alto, CA

MENTORING EXPERIENCE:
Trainee Period, Role Research Topic(s) Presentations, Publications Current Position

and Funding
Anastasia 2018-2020 Applying Markov Processes to Doctoral Defense 2019 PhD candidate
Hartzes, MPH Modeling Disability
PhD Candidate,
School of Public
Health
Danielle Avila, 2019 to Infectious complications of IDweek 2019 Infectious Diseases

MD Fellow, current injection drug usage Travel Award Fellow
Infectious Research
Diseases Mentor
John 2019 to Geospatial map of HIV risk in UAB Medical Student Research Day MS2, UAB School of
Hunsicker, BS, current persons who inject drugs in Medicine
UAB Medical Research North Alabama 2019 UAB Department of Medicine
Student Mentor Koopman Scholar Award
Joshua 2019 Infective Endocarditis in UAB Medical Student Research Day MS2, UAB School of
Radney, BS, Summer persons who inject drugs Medicine
UAB Medical Research
Student Mentor
Paul St. Clair 2018 - 2019 STIs among MSM at PrEP UAB Medical Student Research Day; MS3, UAB School of
rd
UAB Medical Clinics in the Deep South 3 place award in the Infectious Medicine
Student Diseases section
2018 UAB Department of Medicine

Koopman Scholar Award
2019: International Society of STD

Researchers Conference, 2019
Catherine K. 2017-2019 Patient Preferences related to Posters: 2018 HIVMA Medical

Dodson Research STI/HIV testing 2018 UAB Medical Student Research Student Scholarship
UAB Medical Mentor Day
Student
rd
2018 UAB RIME Week; 3 place
clinical vignette
Oral Presentation:
2018 Annual Red Door Foundation
meeting
Publication:
Sexual Health. 2020
Plos One.2018

Winston Joe 2017-2018 Cost effectiveness of syphilis Poster: MS4, UAB School of
UAB Medical Research screening, cost analysis of a 2017 UAB Medical Student Research Medicine
rd
Student Mentor housing initiative for HIV Day; 2 place award in the Infectious
infected persons Diseases section (2017)
2018 UAB Medical Student Research

Day
Publication:
Int J STD AIDS. 2017
2017 CCTS TL1 recipient

2018 Finalist, Sarah Finley Medical
Student Scholarship
Anna Joy 2017 Cost effectiveness of repeat Publication: MS4, University of
Rogers, MD Research JIAS
H 2016 Tennessee School of
UAB Medical Co-Mentor I Medicine
Student Poster:
V
MD/PhD CROI 2017
candidate s
2017
c IDSA Medical Student
Scholarship
r
e
e
n
i
n
g
In pregnancy
Yaseen Najjar, 2016-2017 Understanding Health-related 2020 Medical
MD Research Quality of Life in persons living Resident,
UAB Interact Mentor with HIV University of Buffalo
Fellow Internal Medicine
Program
Katheryn 2016-2017 Financial Implications of Oral Presentation: IDWeek 2016 General Surgery
Hudak, MD Research Compliance with STI Resident at UAB
UAB Medical Co-Mentor Screening Guidelines in Publications: 2018-current
Student People Living with HIV JAIDS 2017; 74(3): 303-308
Incidence and Predictors of Int J STD & AIDS 2018

Re-Infection with
Trichomoniasis based on
Nucleic Acid Amplification
Testing Results in HIV-
Infected Women
Matt Gravett, 2015-2018 STIs in PrEP Clients Publications: 2018-2020 UAB/VA

MD Association of ART improves CID.2017 HSOER T32
UAB ID Fellow patient-reported depression in International Journal of STD & AIDS. postdoctoral fellow
treatment-naïve persons living 2020
with HIV 2016 UAB Trainee
Research
Symposium,
Semifinalist

Lauren Saag 2015-2017 Association of Mental Health Publication: PhD Candidate

MPH Candidate Service Utilization with ART AIDS Res Ther. 2018 Department of
Boston Adherence Epidemiology
University Vanderbilt University
SOPH
Ali Khalofa, MD 2014-2015 Durability of Contemporary N/A 2017 Medical
UAB Interact Antiretroviral Agents Resident, West
Fellow Virginia Family
Medicine Program
INVITED LECTURES:
1. The Cost of HIV: How Much and Who Cares? Infectious Diseases Grand Rounds.
June 5, 2014. Division of Infectious Diseases, University of Alabama at Birmingham
School of Medicine, Birmingham, AL.
2. Styles and Stages: Understanding Differences in Learning Styles and Generations.
October, 2014 Research and Innovations in Medical Education (RIME) Week
Education Summit, Department of Medicine, University of Alabama School of
Medicine
3. The Durability of Contemporary Antiretrovirals. Infectious Diseases Grand Rounds.
August 27, 2015. Division of Infectious Diseases, University of Alabama at
Birmingham School of Medicine, Birmingham, AL.
4. Styles and Stages: Understanding Differences in Learning Styles and Generations.
April 2, 2015. Geriatrics and Palliative Care Grand Rounds, Department of Medicine,
University of Alabama School of Medicine
5. Immunizing HIV Patients: This is Gonna Hurt. Infectious Diseases Grand Rounds.
March 12, 2015. Division of Infectious Diseases, University of Alabama at Birmingham
School of Medicine, Birmingham, AL.
6. HIV 101: The Basics. August, 2016. Epidemiology of Infectious Diseases (EPI 605Q).
Ryals School of Public Health, University of Alabama at Birmingham, Birmingham, AL
7. HIV Clinical Features, Pathogenesis and Treatment. (September 15, 2016 –

September 2020). HIV/AIDS and STDs (EPI 621). Ryals School of Public Health,
University of Alabama at Birmingham, Birmingham, AL
8. HIV Prevention, September, 2017. Jefferson County HIV Update, The Wynfrey Hotel,
Birmingham, AL
9. The Hospital as a Reachable Moment for Persons who Inject Drugs. Department of
Preventive Medicine Grand Rounds, January 14, 2019.
10. Cost-Effectiveness Analysis & Medical Decision Making. CCTS 2019 Clinical and
Translational Science (CTS) Training Program & EPI 680m. May 29, 2019
11. STI testing preferences of young, black men who have sex with men in Birmingham,
Alabama. Invited Research Presentation. University of Mississippi Medical Center,
February 21, 2019

12. Caring for Infections in Persons who inject drugs. University of Alabama at
Birmingham, Infectious Diseases Update. August 23, 2019.
13. Ending the HIV epidemic in vulnerable, Southern Cohorts. Annual HIV Symposium.
Southeast AIDS Education and Training Center. Nashville, TN. November 1, 2019
14. Cost-Effectiveness Analysis & Medical Decision Making. HA 645. UAB School of
Health Professions. November 14, 2019
15. Eaton EF. Connecting HIV, Hepatitis C, and Opioid Use Disorder: Overview of
current UAB and 1917 Projects. University of Alabama at Birmingham 1917 HIV Clinic,
December 13, 2019. Birmingham, AL.
GRANT SUPPORT:
GRANTS (ACTIVE)
Opioid Use Disorder Health Information Exchange

Funding Agency: Alabama Department of Mental Health
Principal investigator: Erik Hess, MD
Purpose: This proposal will increase diagnosis and treatment of opioid use disorder by
implementing natural language processing to identify OUD within the UAB health
system. Dr. Eaton’s role will include assistance in developing and refining the natural
language processing algorithm by incorporating the outcomes of UAB’s hospital based
cohort with injection drug use.
Role: Co-Investigator
Duration: 1/1/20-12/30/21
Effectiveness of a Smoking Cessation Algorithm Integrated into HIV Primary Care

Funding Agency: NIH/NIDA (R01DA044112-01A1)
Principal investigator: Cropsey, K, Crane, H, O’Cleirigh, C
Purpose: This study will examine the use of a decision-based algorithm to guide
providers in prescribing smoking pharmacotherapy for PLWH engaged in care.
Duration: 09/30/18-06/30/23
Telemedicine for Opioid Use Disorder Treatment

Funding Agency: Appalachian Regional Commission
Principal investigator: Wallace, Eric
Purpose: This proposal is to expand access to support for opioid use disorder diagnosis
and treatment across rural Appalachian states using tele-education to train physicians.
As part of this proposal, Dr. Eaton will be developing and delivering training modules
remotely, using telehealth support, on the intersection of addiction and infections, harm
reduction and HIV prevention.
Role: Consultant
Duration: 1/1/20-12/30/21

Program Evaluation of UAB 1917 HIV Clinic Initiatives

Funding agency:This project is funded via revenue generated through the Ryan White
Part C 6. H76HA257100-6-01 340B program
Principal investigator: Ellen Eaton
Purpose: This program evaluation initiative is quantifying the effects of housing, nutrition,
and social work services for persons living with HIV receiving care at UAB.
Duration: 05/01/18-04/30/20
Gilbert S. Omenn Fellowship

Funding agency: National Academy of Medicine (2000008740)
Role: Principal Investigator
Purpose: This fellowship provides research support and travel funds to attend National
Academy meetings of the Working Group on Infectious Diseases and the Opioid
Epidemic.
Duration: 10/25/17-10/24/20
CDC HIV DETECT

Funding Agency: CDC/Alabama Department of Public Health PS18-1802
Principal Investigator: Sonya Heath
Purpose: The project proposes to expand Universal HIV/HCV screening program to health care
settings and community programs to enhance access to testing, prevention services and care with
a focus on identifying at risk MSM and people with opiate use disorder.
Duration: 01/01/19-12/31/20

Highly treatment experienced persons living with HIV
Funding Agency: Glaxo Smith Kline
Principal Investigator: Michael Saag
Purpose: To evaluate the prevalence and risk factors associated with Highly treatment
experienced persons living with HIV
Duration: 4/26/18-04/25/20
Improving kidney health for African Americans with HIV through optimal
Antiretroviral Therapy Selection
Funding agency: Gilead HIV Research Scholars Program
Effort: 20% (2.4 calendar)
Purpose: This proposal will analyze the association between genetic CKD risk variants
(e.g., APOL1) and antiretroviral therapy outcomes for HIV infected African Americans.
Duration: 06/01/18-05/31/20
Adherence and Effectiveness of HIV Pre-exposure Prophylaxis (PrEP) in the Deep

South: An Epidemic Model Analysis

Funding agency: UAB Frommeyer Fellowship

Purpose: This proposal will support pilot data including adherence measures and an
epidemic model of HIV in Birmingham, Alabama.
Duration: 07/01/18-06/30/20
GRANTS (PENDING)
GRANTS (COMPLETED)
UAB STI CRC Mentored Development Research Award (U19AI113212)
Funding agency: National Institute of Allergy and Infectious Diseases
Principal investigator: Edward Hook, MD
Role: Pilot Study PI
Purpose: This pilot project will provide Dr. Eaton with mentored research experience in
syphilis epidemiology and sexual behavior in MSMs, and will provide foundational training
and support for development of a mathematical model comparing the outcomes of
syphilis post-exposure prophylaxis (PrEP) vs standard “test and treat” care in an HIV
PrEP clinic serving MSM.
Funds: $60,000
Duration: 04/01/18-03/31/19
The Effects of ARV Regimen on Annual Health Expenditures for HIV Care
Funding agency: Bristol-Myers Squibb
Purpose: To understanding Health expenditures associated with comprehensive HIV
care. This project allowed an analysis of financial costs and barriers to HIV care.
Funds: $20,000 (direct costs)
Duration: 08/01/14-07/31/15
Durability and Prescribing Patterns of Contemporary Antiretroviral Agents in

Treatment Naive Persons Living with HIV
Funding agency: Bristol-Myers Squibb
Purpose: To study the durability of contemporary antiretroviral agents. This project
allowed an assessment of the durability of most commonly prescribed regimens in a
treatment naïve cohort of persons living with HIV and the reasons for regimen
discontinuation.
Funds: $25,000 (direct costs)
Duration: 09/01/15-08/31/16
UAB/VA Health Services, Outcomes, and Effectiveness Research Training Program

(T32HS013852)
Principal investigator: Kenneth Saag, MD
Role: T32 Trainee

Funding agency: Agency for Healthcare Research and Quality/DHHS

Purpose: To study the clinical comparative effectiveness of contemporary HIV treatment
regimens. This training grant provides a stipend to cover salary and full tuition and fees
for an MSPH in outcomes research from UAB School of Public Health.
Duration: 08/01/14-07/31/16
Understanding the clinical comparative effectiveness of contemporary ARV

regimens
Principal investigator: Ellen F Eaton
Purpose: Understanding the clinical comparative effectiveness of contemporary ARV
regimens; loan repayment program award.
Funds: $120,000 toward medical school loan repayment
Duration: 09/08/15-09/07/17
UAB K12 in Patient Centered Outcomes Research (K12HS023009);

The clinical comparative effectiveness of contemporary ARV regimens
Funding agency: Agency for Healthcare Research and Quality/DHHS
Principal investigator: Kenneth Saag, MD; E. Eaton (awardee)
Role: K12 Trainee
Purpose: This project will provide resources for mentored research training for Dr. Ellen
Eaton (Mugavero, Primary Mentor) and career development activities under the K12
mechanism. The research element will examine health disparities, comparing HIV
treatment options in a real-world setting through mixed methods research.
Funds: $295,322
Duration: 08/01/16-07/31/18
UAB Center for AIDS Research (P30AI027767)

Principal investigator: Michael Saag, MD
Role: Pilot Study PI
Purpose: The UAB CFAR is organized around 8 cores that provide core services to
facilitate scientific discoveries and the generation of new knowledge by UAB HIV/AIDS
investigators. Particular emphasis is placed upon linking clinical and basic science studies
through the use of shared facilities to translate fundamental knowledge about HIV/AIDS
and its related disorders into clinical treatment and prevention programs. Requesting a
no-cost extension through 5/31/19.
Funds: $50,000
Duration: 03/01/17-05/31/19
BIBLIOGRAPHY
ORIGINAL PUBLICATIONS:

1. Rhee C, Eaton E, Blackburn B, Concepcion W. West Nile virus encephalitis acquired

via liver transplantation and clinical response to intravenous immunoglobulin: case
report and review of the literature. Transpl Infect Dis. 2011;13(3):312-17. PMID:
21235711.
2. Eaton E, Wachter A, Cooper A, et al. Profound neurotoxicity and treatment response

following one cycle of bortezomib therapy in an elderly male with multiple myeloma. Int
J Pharm Technol. 2012; 28:193-92.
3. Khungar M, Eaton E, Hoesley C. Human metapneumovirus treated with inhaled

ribavarin case report and literature review. IJCRI. 2014; 5(12):813–817.
4. Topiwala K, Eaton E, Franco R. Dramatic response to HAART in HIV-induced

hemophagocytic lymphohistiocytosis (HLH). IJCRI. 2015; 6(2):65–69.
5. Eaton E, Kulczycki A, Saag M, Mugavero M, Raper J. Immunization costs and

programmatic barriers at an urban HIV clinic. Clin Infect Dis. 2015 Jul 29. pii: civ637.
PMID: 26224001. PMCID: PMC6276886
6. Eaton EF, Tamhane A, Saag M, Mugavero MJ, Kilgore ML. Cost considerations in the
current antiretroviral era. AIDS. 2016; 30(14):2115-19. PMID: 27088319. PMCID:
PMC5963514.
7. Eaton E, Mugavero M. Affordable Care Act, Medicaid Expansion…or Not: Ryan White
care act remains essential towards access and equity. Clin Infect Dis. 2016; 63(3):404-
6. PMID: 27143674.
8. Eaton EF, Tamhane AR, Burkholder GA, Willig JH, Saag MS, Mugavero MJ.
Unanticipated effects of new drug availability on antiretroviral durability: implications
for comparative effectiveness research. Open Forum Infect Dis. 2016; 3(2):ofw109.
PMID: 27419181. PMCID: PMC4943538.
9. Eaton EF, Hudak K, Muzny CA. Budgetary impact of compliance with STI screening
guidelines in persons living with HIV. J Acquir Immune Defic Syndr. 2017; 74(3):303-
308. PMID: 27787348. PMCID: PMC5303178.
10. Eaton EF, Gravett RM, Tamhane AR, Mugavero MJ. Antiretroviral therapy initiation
and changes in self-reported depression. Clin Infect Dis. 2017; 64(12):1791-1794.
PMID: 28419238. PMCID Submission NIHMS962575
11. Bengtson AM, Pence BW, Mollan KR, Edwards JK, Moore RD, OʼCleirigh C, Eaton
EF, Eron JJ, Kitahata MM, Mathews WC, Crane H, Mugavero MJ. The relationship
between efavirenz as initial antiretroviral therapy and suicidal thoughts among HIV-
infected adults in routine care. J Acquir Immune Defic Syndr. 2017; 76(4):402-408.
PMID: 28749824. PMCID: PMC5659970.

12. Eaton EF, Davey-Mendez, T, Tamhane A, Mathews WC, Moore RD, Saag MS,
Mugavero MJ. Trends in ART prescription, durability and modification: new drugs,
more changes, but less failure. AIDS. 2017; PMID: 29194118. PMCID: PMC6604808
13. Eaton EF, McDavid C, Banasiewicz MK, Mugavero MJ, Knight SJ. Patient
preferences for antiretroviral therapy: effectiveness, quality of life, access and novel
delivery methods Patient Prefer Adherence. 2017; 11:1585-90. PMID: 29075105
PMCID: PMC5609802.
14. Eaton EF, Joe W, Kilgore ML, Muzny, CA. Reverse syphilis screening algorithm fails
to demonstrate cost effectiveness when used for annual syphilis screening in persons
living with HIV. Int J STD AIDS. 2017; 956462417743409.PMID: 29173098. PMCID:
PMC6025800.
15. Saag LA, Tamhane AR, Batey DS, Mugavero MJ, Eaton EF.. Mental health service
utilization is associated with retention in care among persons living with HIV at a
university-affiliated HIV clinic. AIDS Res Ther. 2018; 15(1):1. PMID: 29338735.
PMCD: PMCID5771035.
16. Bengtson AM, Pence BW, Eaton EF, Edwards JK, Eron JJ, Mathews WC, Mollan
K, Moore RD, O'Cleirigh C, Geng E, Mugavero MJ. Patterns of efavirenz use as first-
line antiretroviral therapy in the United States: 1999-2015. Antivir Ther. 2018; PMID:
29424697. PMCID: PMC6085156.
17. Chan L, Asriel B, Eaton EF, Wyatt CM. Potential kidney toxicity from the
antiviral drug tenofovir: new indications, new formulations, and a new prodrug.
Curr Opin Nephrol Hypertens. 2018; 27(2):102-112. PMID: 29278542. PMCID:
PMC6103211
18. Muzny CA, Pérez AE, Eaton EF, Agénor M. Psychosocial stressors and sexual
health among Southern African American women who have sex with women. LGBT
Health. 2018: PMID: 29688816.
19. Eaton EF, Mathews RE, Lane PS, Paddock CS, Rodriguez JM, Taylor BB, Saag MS,
Kilgore ML, Lee RA. A 9-Point Risk Assessment for Patients Who Inject Drugs
Requiring Intravenous Antibiotics May Allow Health Systems to Focus Inpatient
Resources on Those at Greatest Risk of Ongoing Drug Use. Clin Infect Dis. 2018
PubMed PMID: 30165395.
20. Muzny CA, Tamhane AT, Eaton EF, Hudak K, Burkholder GA, Schwebke JR.
Incidence and Predictors of Reinfection with Trichomoniasis based on Nucleic Acid
Amplification Testing Results in HIV-Infected Patients. Int J STD AIDS. 2018
PMID: 30486764
21. Eaton EF, Austin EL, Dodson CK, Heudebert JP, Jackson D, Muzny CA. Do young
Black men who have sex with men in the Deep South prefer traditional over alternative
STI testing. PLoS One 2018. PubMed PMID: 30589854; PMCID: PMC6307723.

22. Eaton EF, Tamhane A, Davy-Mendez T, Moore RD, Mathews WC, Saag MS,
Mugavero MJ, Wyatt CM, Gutierrez OM. Brief Report: Kidney Dysfunction Does Not
Contribute Significantly to Antiretroviral Therapy Modification in Treatment-Naive
PLWH Receiving Initial ART. J Acquir Immune Defic Syndr. 2019 May 1; 81(1):e6-e9.
PubMed PMID: 30865178; PubMed Central PMCID: PMC6456383.
23. Dodson CK, Jackson D, Muzny CA, Eaton EF. Quantitative evaluation on the
challenges and opportunities in the recruitment of young Black men who have sex
with men for sexual health research in the southern US. Sex Health. 2019 Nov 21.
PMID: 31748103.
24. Gravett RM, Westfall AO, Overton ET, Kudroff K, Muzny CA, Eaton EF. “Sexually
transmitted infections and sexual behaviors of men who have sex with men in an
American Deep South PrEP Clinic”. International Journal of STD & AIDS. Accepted
10.2019
25. Seval N, Eaton EF, Springer SA. Beyond Antibiotics: A Practical Guide for the
Infectious Diseases Physician to Treat Opioid Use Disorder in the Setting of
Associated Infectious Diseases. Open Forum Infectious Diseases. Accepted Dec.
2019
26. Eaton EF. "Rapid Start" treatment to End the (Other) Epidemic: Walking the
Tight-rope without a Net. Clin Infect Dis. 2020 Jan 21. pii: ciaa064. doi:
10.1093/cid/ciaa064. PMID: 31960032.
27. Eaton EF, Westfall AO, McClesky B, Paddock CS, Lane PS, Lee RA, Cropsey KL.
“A hospital-based protocol for persons with bacterial complications of injection drug
usage may increase linkage to MAT”. Journal of Infectious Diseases. Accepted
January 3, 2020.
28. Eaton EF, Westfall AO, McClesky B, Paddock CS, Lane PS, Cropsey KL, Lee RA.
“Risk assessment tool predicts Adverse Outcomes for Hospitalized Persons Who
Inject Drugs”. Under Review
MANUSCRIPTS IN PREPARATION:
BOOK CHAPTERS:
1. Eaton EF, Saag M, Mugavero M. Engagement in human immunodeficiency virus care:

Linkage, retention and antiretroviral therapy adherence. Infect Dis Clin North Am. 2014;
28(3):355-369. PMID: 25151561
2. Eaton EF, Hoesley C. Barrier methods for human immunodeficiency virus prevention.
Infect Dis Clin North Am. 2014;28(4):585-599. PMID: 25455315

3. Seval N, Eaton EF, Springer SA. Inpatient Opioid Use Disorder (OUD) Treatment for
the Infectious Disease Physician. The Opioid Epidemic and Infectious Diseases
(In Press)
4. Eaton EF, Vettese T. Management of Opioid Use Disorder and Infectious Disease in
the Inpatient Setting. Infect Dis Clin North Am. (In press)
PUBLISHED ABSTRACTS:
1. Joe WB, Eaton EF. Management of End Stage Renal Disease in Persons Living with
HIV: A Cost-Effectiveness Analysis. Open Forum Infect Dis. 2017;4(Suppl 1):S436.
Published 2017 Oct 4. doi:10.1093/ofid/ofx163.1103
2. Hudak K, Muzny C, Schwebke J, Eaton EF. Screening for Sexually Transmitted

Infections in Persons Living With Human Immunodeficiency Virus (HIV) Leads to
Significant Financial Losses for a Healthcare System Open Forum Infectious Diseases,
Volume 3, Issue suppl_1, 1 December 2016, 1680, doi.org/10.1093/ofid/ofw194.107.
3. Eaton EF, Tamhane A, Prajapati G, Goodwin B, Saag M. (2016). P026 Durability and
prescribing patterns of initial HIV regimens in treatment-naïve patients. Journal of the
International Aids Society, 19.
4. Eaton EF. (2016). Efavirenz-and raltegravir-based regimens cost effective in

US. PharmacoEconomics & Outcomes News, 752, 11-7.
5. Gravett RM, Kudroff K, Westfall AO, Overton E, Muzny C, Eaton EF. (2018). 2271.
Adherence to Pre-Exposure Prophylaxis Is Associated With Sexually Transmitted
Infections Among Men Who Have Sex With Men in the Deep South. Open Forum
Infectious Diseases, 5(Suppl 1), S672. doi:10.1093/ofid/ofy210.1924
6. St. Clair, P, Westfall A, Gravett, M, Rainer, W, Musgrove, K, Hayes, E, Hicks, J, Eaton

EF. Adherence and sexually transmitted infections among MSM receiving care in a
community based HIV PrEP clinic in the Deep South. Sexually Transmitted Infections
95 (Suppl 1), A250-A250
7. Eaton EF, Muzny CM, Ford E. Privacy and Technology for young black men who
have sex with men in the Southern US related to sexual care and research. Sexually
Transmitted Infections 95 (Suppl 1), A358-A358
8. Avila, D, Lee, RA, Eaton EF. The Mortality and Financial Burden of Infective
Endocarditis in Persons Who Inject Drugs in the Deep South. Open Forum Infectious
Diseases 6 (Supplement_2), S97-S98
POSTER PRESENTATIONS:

1. Eaton EF, Tamhane A, Burkholder G, Willig J, Saag M, Mugavero M. (July, 2015).

Durability of Contemporary HIV Regimens in Treatment Naive Patients. Poster
presentation Agency for Healthcare Research and Quality 21st Annual NRSA
Research Trainees Conference. Minneapolis, Minnesota
2. Eaton EF, Tamhane A, Burkholder G, Willig J, Saag M, Mugavero M. (March, 2016)

Unanticipated effects of new drug availability on antiretroviral durability: Implications
for Comparative Effectiveness Research. University of Alabama, Birmingham, Trainee
Research Symposium
3. Gravett R, Tamhane A, Eaton EF. (March, 2016). Effects of ARV initiation on patient-
reported depression in treatment-naïve HIV infected patients. University of Alabama,
Birmingham, Trainee Research Symposium
4. Eaton EF, Tamhane A, Prajapati G, Goodwin B, Saag M. (October, 2016). Duration
and Prescribing Patterns of Initial HIV Regimens in Treatment-Naïve Patients. HIV
Drug Therapy. Glasgow, Scotland.
5. Eaton EF, Gravett RM, Tamhane A, Mugavero M. (October, 2016). ART initiation,
regardless of regimen, is associated with improvement in self-reported depression.
Conference on Retroviruses and Opportunistic Infections. Seattle, WA
6. Joe WB, Eaton EF. Management of end stage renal disease in persons living with
HIV: a cost-effectiveness analysis. IDWeek. San Diego, CA, October 6, 2017
7. Joe WB, Kilgore ML, Muzny CA, Eaton EF. Reverse syphilis screening algorithm fails
to demonstrate cost effectiveness in persons living with HIV. Dale J. Benos Medical
Student Research Day. Birmingham, AL, November 13, 2017
8. Dodson CK, Austin EL, Muzny CA, Eaton EF. Identifying patient-centered sexually
transmitted infection (STI) testing options to reduce HIV/STI transmission in men who
have sex with men (MSM). Dale J. Benos Medical Student Research Day, UAB
School of Medicine. Birmingham, AL, November 13, 2017.
9. Gravett RM, Kudroff K, Westfall AO, Overton TE, Muzny CA, Eaton EE. Adherence to
Pre-Exposure Prophylaxis Associated with Sexually Transmitted Infections among
MSM in the Deep South. IDweek. October 5, 2018. San Francisco, CA
10. Eaton EF, Austin EL, Heudebert JP, Jackson D, Dodson C, Muzny CA, When it
comes to STI testing preferences, young Black Men Who Have Sex with Men in the
Deep South prioritize privacy, trust, and comfort. STD Prevention Conference. August
29, 2018. Washington, D.C.
11. Eaton EF, Saag MS, Mugavero MJ, Lee RA, Cropsey KC. Hospital-based Protocol
links persons who inject drugs (PWID) to HIV prevention services including Medication
Assisted therapy (MAT). National Center for AIDS Research Scientific Symposium.
November 8, 2018. Atlanta, GA

12. Eaton EF, Westfall AO, Saag MS, Mugavero MJ, Lee RA, Cropsey KC.
Interdisciplinary intervention for hospitalized PWID may increase MAT use. UAB
Center for AIDS Research World AIDS Day Poster Competition. December 8, 2018.
13. Wise J, Eaton, EF, Johnson B, Gaddis K, McDavid C, Overton ET, Raper J. Mixed
Methods Evaluation of a Comprehensive Housing and Case Management Initiative for
People Living with HIV. UAB Center for AIDS Research World AIDS Day Poster
Competition. December 8, 2018.
14. St. Clair P, Eaton, EF. Bacterial STI Incidence and Risk among Deep South Men who
Have Sex with Men (MSM) on PrEP (HIV pre-exposure prophylaxis). UAB Center for
AIDS Research World AIDS Day Poster Competition. December 8, 2018.
15. Eaton EF, Saag MS, Mugavero MJ, Cropsey K, Lee RA. Patient Reported PrEP
Adherence in a Deep South Clinic. UAB Center for AIDS Research World AIDS Day
Poster Competition. December 8, 2018.
16. Powers K, Mathews WC, Mayer KH, Eaton EF, Geng E, Moore RD, Mugavero MJ,
Eron JJ. “Longitudinal HIV Care Trajectories in the CNICS Cohort: A Retrospective
Cohort Study". 2019 Conference on Retroviruses and Opportunistic Infections (CROI),
March 4-7, 2019. Seattle, WA.
17. Lee J, Althoff KN, Humes E, Eron JJ, Gill JM, Horberg MA, Crane HM, Kitahata M,
Silverberg MJ, Yehia B, Eaton EF, Gandhi NR, Rachlis A, Moore RD.“Virologic Failure,
Low-Level Viremia, and Viral Blip after HIV Rna Suppression". 2019 Conference on
Retroviruses and Opportunistic Infections (CROI), March 4-7, 2019. Seattle, WA.
18. Eaton EF, Westfall AO, Matthews E, Paddock C, Peter L, Saag MS, Mugavero M, Lee
RA, Cropsey K. “ Interdisciplinary intervention for hospitalized PWID may increase
MAT use”. 2019 Conference on Retroviruses and Opportunistic Infections (CROI),
March 4-7, 2019. Seattle, WA
19. Eaton EF, Westfall AO, Kudroff K, Overton TE, Muzny CA. “Self-Reported PrEP
Adherence in a Deep South PrEP Clinic” 14th International Conference on HIV
Treatment and Prevention Adherence, June 17-19, 2019. Miami, FL.
20. Eaton EF, Muzny CA. Privacy and technology for young black men who have sex with
men (YB MSM) in the Southern United States (U.S.) for sexual health care and
research. 2019 World STI and HIV Congress, July 14-17, 2019. Vancouver, Canada
21. Avila, D, Lee, RA, Eaton EF. The Mortality and Financial Burden of Infective
Endocarditis in Persons Who Inject Drugs in the Deep South. IDweek. October 4,
2019. Washington, D.C.
ORAL PRESENTATIONS:

SCIENTIFIC PRESENTATIONS AT NATIONAL OR INTERNATIONAL MEETINGS:
1. Immunization Costs and Programmatic Barriers at an urban HIV Clinic. Podium

presentation at the Agency for Healthcare Research and Quality 21st Annual
NRSA Research Trainees Conference. June, 2015. Minneapolis, Minnesota.
2. Immunization Costs and Programmatic Barriers at an urban HIV Clinic. Podium

presentation at the Agency for Healthcare Research and Quality 21st Annual
NRSA Research Trainees Conference. June, 2015. Minneapolis, Minnesota.
3. Cost Considerations in the Current ART Era. Podium presentation at the Agency
for Healthcare Research and Quality 21st Annual NRSA Research Trainees
Conference. July, 2016. Boston, MA.
4. Screening for Sexually Transmitted Infections in Persons Living with HIV leads to
Significant Financial Losses for a Healthcare System. ID Week. October, 2016.
New Orleans, LA.
5. Trends in ART Prescription, Durability and Modification: New drugs, more

changes, but less failure. Oral Presentation at the HIV Adherence Conference.
June, 2017. Miami, FL
6. Expert Identified Opportunities to Integrate Opioid Use Disorders and Infectious

Diseases. National Academies Workshop Proceedings. US. Conference on AIDS.
September 6, 2018. Orlando, Florida
7. A 9-Point Risk Assessment for Patients Who Inject Drugs Requiring Intravenous
Antibiotics. IDweek. October 5, 2018. San Francisco, CA
8. Caring for Patients with Infections Related to IV Drug Use. UAB Division of
Infectious Diseases-Update in Infectious Diseases. Birmingham, AL. August 23,
2019.
SCIENTIFIC PRESENTATIONS AT LOCAL OR REGIONAL MEETINGS

1. Eaton EF. Analyzing the STI testing preferences of African American men at risk for
HIV. UAB Decision Science Symposium. June 8, 2018
2. Dodson K, Eaton EF, Austin EL., Muzny CA. Who, What, and Where: Challenges in
recruiting African American (AA) lesbian, gay, bisexual, and transgender persons
(LGBT) for HIV/STI prevention research in the Deep South. The Red Door
Foundation. June 8, 2018. Birmingham, AL.
3. Eaton EF, Agenor MA., Muzny CM. Psychosocial Stressors and Sexual Health
among Southern African American Women who have sex with Women. The Red
Door Foundation. June 8, 2018. Birmingham, AL

INVITED PANELIST AT LOCAL OR REGIONAL MEETINGS
1. Training Grant Alphabet Soup (Ks, Ts, and Other Related Grants): What They Are and
How to Get One. UAB Pathways in Academic Medicine Program Seminar Series.
February 11, 2016
2. “Catching the Research Bug” sponsored by the UAB Department of Medicine

Research Development Group. Presentation to Internal Medicine residents on May 23,
2016
3. UAB Medical Grand Rounds Clinical Pathology Conference, Invited Infectious

Diseases expert. March, 16, 2017
4. "Training Grant Alphabet Soup. “UAB Pathways in Academic Medicine Program

Seminar Series. March 22, 2017
5. "How to find a mentor and project” sponsored by the Internal Medicine Residency
program. Invited to serve on a panel. May 25, 2017
6. "Mentor-Mentee Relationship” sponsored by the Internal Medicine Residency

program. Invited to serve on a panel. November 9, 2017
7. Alphabet soup: decoding Training grants, K awards, and other phrases. Sponsored by
the UAB Medical Scientist Training Program. Invited to serve on panel. January 18,
2018
8. “Networking skills for MD and MD/PhD students” sponsored by the UAB chapter of
American Physician Scientists Association (APSA). February 21, 2018. Invited to
serve on Panel
9. Health services, population health, outcomes and quality research. Quarterly

Residency Research Lunch, Invited to serve on panel. March, 15, 2018
10. CCTS Panel for K08 Applicant. Invited to serve on review panel. March 22, 2018
11. Clinical Research Seminar sponsored by the UAB Department Research

Development Group. Presentation to Internal Medicine residents April, 23. 2018
12. Clinical Investigator Training Program (CITP) sponsored by the UAB CCTS. “How I
got here.” Invited to serve on panel. October 23, 2018.
13. “Finding a research Mentor” sponsored by the UAB chapter of American Physician
Scientists Association (APSA). November 15 2018. Invited to serve on Panel

14. Hacks for navigating early career transitions sponsored by the UAB CCTS. Invited to
serve on panel. May 17, 2019.
15. Work Life Balance. Women in Medicine, Department of Medicine. February 20th,
2020. Invited to serve on panel.
PRESS:
Science Daily. Johns Hopkins Medicine. (2016, June 16). Study underscores ongoing
need for HIV safety net program. Retrieved from
https://www.sciencedaily.com/releases/2016/06/160616120516.htm
In text: (Science Daily, 2016)
HIV Equal Online Magazine. (2018, January 4). Study Finds Increased Rate of Patients
Switching HIV Treatments. Retrieved from http://www.hivequal.org/what-s-
new/study-finds-increased-rate-of-patients-switching-hiv-treatments
In text: (HIV Equal Online Magazine 2018)
Infectious Diseases News. (2018, September 1). Tool identifies PWID who can be safely
discharged with IV antibiotics. Retrieved from https://www.healio.com/infectious-
disease/practice-management/news/in-the-journals/%7Bd0278713-0687-4ee9-
b82d-d01ea7eb4e82%7D/tool-identifies-pwid-who-can-be-safely-discharged-with-
iv-antibiotics
In text: (Clinical Infectious Diseases, 2018)
The Body Pro (2019, January 14 ) Studying HIV and STI Testing Preferences in Men
Who Have Sex with Men. http://www.thebodypro.com/content/81578/studying-hiv-
sti-testing-preferences-msm.html
In text: (The Body Pro 2019)
Cherish Research (February 27, 2020). Overdose and Re-Hospitalization Rates

Following Endocarditis Are Lower for Patients Receiving Medications for Opioid
Use Disorder. https://cherishresearch.org/2020/02/endocarditis-
moud/?_csrf_attempted=yes.
In text: (Cherish Research 2020)
MISCELLANEOUS:
1. Preceptor, UAB School of Nursing Preceptor. August 1-31, 2017
2. UAB School of Medicines Step 2 Clinical Skills Assessment Facilitator. June, 22, 2018
3. Research and Innovations in Medical Education (RIME) week, judge. September 12,
2018

4. Samford Simulation Preceptor for UAB Medical Scientist Trainees. April 11, 2018;
October 30, 2018

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Case 4:20-cv-00304-AKK-JHE Document 20-1 Filed 04/29/20 Page 1 of 47 FILED

2020 Apr-29 PM 02:33

DECLARATION OF DR. ELLEN EATON

pursuant to 28 U.S.C. § 1746:

I. BACKGROUND AND QUALIFICATIONS

Unified Command Services in response to the novel coronavirus pandemic.

concentration of COVID-19 cases in Alabama, second only to Mobile. This

Jefferson County is therefore of critical importance to the entire state.

2. Additionally, I am Assistant Professor of Medicine at the University of

Alabama at Birmingham (UAB) and Director of the Outpatient Opioid

Treatment Clinic at the UAB 1917 HIV Clinic. I completed my residency in

in Internal Medicine at Stanford Hospital and Clinics, Palo Alto, California

in 2010. I completed a fellowship in Clinical Infectious Diseases at UAB in

2016 and a fellowship in Patient Centered Outcomes. I additionally hold a

Master of Science in Public Health with an emphasis on Healthcare

Organization and Policy from UAB (2017).

capacity, I manage HIV, Hepatitis C, tuberculosis, and other infectious

diseases in persons with varying interactions with criminal justice systems

clinical research on HIV prevention and treatment including criminal justice

involved individuals. My research support comes from the Centers for

Department of Public Health, the Substance Abuse and Mental Health

Services Administration (SAMHSA), and industry. I have served as an

expert on working groups dedicated to infectious diseases and opioids for

4. I have written and published on the topics of infectious diseases among

justice system and on issues of prevention, diagnosis, and management of

HIV and other infectious diseases among special populations. My C.V.

includes a full list of my honors, experience, and publications, and it is

5. I offer the following commentary based on my years of experience working

with at-risk populations, my expertise in Alabama’s public health and

medical infrastructure, and my review of the applicable CDC guidelines and

medical research regarding the COVID-19 pandemic as a physician and

II. COVID-19 IS A HIGHLY CONTAGIOUS DISEASE THAT POSES

6. Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory

syndrome coronavirus 2 (SARS-CoV-2). The virus is believed to be

transmitted through respiratory droplets (by coughing or sneezing or through

contact with droplets that survive on surfaces). The virus is highly

infected two or three people (known as the R0 in epidemiology), new

7. COVID-19 has been so contagious because it can be spread in a variety of

ways. The primary means of transmission of COVID-19 is thought to be

through inhaling respiratory droplets produced by coughing or sneezing or

through touching of surfaces touched by those droplets. COVID-19 can

transmitted by a non-infected individual touching a surface containing

COVID-19 particles and then touching their face.3

8. However, COVID-19 may be transmissible even from asymptomatic and

pre-symptomatic individuals.4 The World Health Organization has indicated

that approximately 80% of COVID-19 cases are asymptomatic or mildly

symptomatic.5 Likewise, COVID-19 can incubate in an infected person for

two to fourteen days before they show symptoms.6

moisture created by sneezing, coughing, talking, or flushing a toilet, for up

cloth, cannot effectively filter small particles of coronavirus in the air.8

experience severe illness, including hospitalization, admission to an

COVID-19. Underlying health conditions that make patients vulnerable to

severe illness from COVID-19 include: hypertension, cancer, heart disease,

lung disease (including asthma), severe obesity, diabetes, chronic kidney

(for example, immunosuppressive treatments, autoimmune conditions, or

common symptoms: fever, fatigue, coughing, and shortness of breath.

trouble breathing, persistent pain or pressure in the chest, new confusion or

inability to arouse, or bluish lips or face should seek medical attention.9

Because this is an emerging infection, new symptoms are periodically being

otherwise asymptomatic individuals.

preliminary clinical trials, any treatment or vaccine is likely at least months

away—and possibly over a year—from FDA approval.

III. SOCIAL DISTANCING IS IMPERATIVE BOTH TO PROTECT

appearing cannot be clearly traced to another infected individual and the