The quickly expanding COVID-19 outbreak in the United States is soon expected to outstrip the capacity of our hospitals, as in Italy, where they have resorted to makeshift tents, hallways, and parking lots. When this happens, colleges and universities must take a leadership role in relieving this unprecedented stress on our health care system.
Most colleges and universities have sent students home in order to “de-densify” their campuses and reduce the potential for community spread. As a result, universities currently have a surplus of residential capacity with well-developed infrastructure — Wi-Fi and IT networks, dining services, and the ability to zone off residential areas for different purposes. These campuses are well situated to relieve stress on local hospitals as they reach peak capacity due to the COVID-19 outbreak.
Recently, a Tufts University undergraduate who had tested positive for COVID-19 unintentionally exposed other individuals to the virus, all of whom have been tracked and asked to self-isolate. From our experience responding to this need for students to self-quarantine and working with our affiliated hospital, Tufts Medical Center, I have identified five actions that colleges and universities with significant residential capacity should take now to help our communities. Tufts University is prepared to take these steps and has informed local health care leaders and the mayors of Somerville and Medford that they can count on us to help address their needs. I hope my fellow higher education leaders will also take these steps.
▪ If you have trained military personnel, retired executives, or government leaders in your academic or local community, engage them for operations and communications advice. At Tufts, we have enlisted the help of military fellows, graduate students, and faculty at the Fletcher School to assist. Their training and field experience with both military and civilian populations can be helpful in setting up campus operations during the outbreak. Establish an incident command structure to oversee management and communications. The important logistical decisions you make now will affect how you operate when the COVID-19 outbreak has affected many more in the community.
▪ Identify all residential units on campus that can be used for self-quarantine, both individual rooms with private bathrooms and suites with multiple bedrooms connected to one bathroom. Rooms with external access to the street or open areas are particularly valuable. Prepare a secondary list of all dormitories where patients could be housed in rooms along corridors with assigned individual bathrooms. And take steps to prepare your dining logistics, including a backup dining hall, instituting a total clean in-between meals; increasing capacity to deliver meals to isolation units; and recruiting local small businesses to help provide meals to ensure redundancy.
▪ Help your local hospital. Hospitals are experiencing difficulties placing their current inpatients in rehabilitation centers due to fear of the impact on their elderly patients with serious medical issues. This contributes to the insufficient number of inpatient hospital beds available for incoming COVID-19 patients. To free up vital space at Tufts Medical Center, we have offered some of our residential units for patients who require non-essential medical rehabilitation services such as post-operative physical therapy. Hospitals are also likely to experience a shortage of personal protective equipment, laboratory supplies, cleaning supplies, and other key materials. Universities, particularly university research laboratories, could provide supplemental supplies. Even in small quantities, these will be important.
▪ University parking lots can become drive-through triage centers for testing and evaluation of patients reporting symptoms, similar to the efforts in China to separate evaluation from traditional emergency services. Prepare to use your open spaces and gymnasiums as field hospitals. Coordinate with your local disaster incident officials to inform them of your capacity to help triage and house individuals needing isolation or evaluation for hospitalization.
▪ Engage members of your alumni, faculty, and student body who may be able to assist online with particular tasks, as well as provide financial support if required.
Coordinating with the health care sector is complicated, but the need will soon become pressing. The steps we take in the next two weeks to limit the spread of COVID-19 will determine our mortality rate. Families practicing self-quarantine with vulnerable members has not worked effectively in Italy, China, and other countries.
We urgently need the capacity to isolate potential cases away from their families soon after diagnosis in order to slow the spread and protect families and communities. Colleges and universities must step up and partner with local and state authorities to aid in the fight against COVID-19. And they must make plans to do so now.
Dr. Anthony P. Monaco is president of Tufts University.
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