What will it really take for people to go back to work safely again?
A Kendall Square research institute plans to find out by conducting a scientific experiment — on itself.
Amid the coronavirus pandemic, the Ragon Institute of MGH, MIT, and Harvard aims to test the hypothesis that it can return to full operation without endangering its employees by following a rigorous set of steps in a carefully controlled environment. Some potentially burdensome rules will be imposed on staff, but participation is voluntary.
Ragon officials believe theirs would be one of the first workplaces in the country to venture such a plan.
“The hope is that we can basically pave a way to open things up again,” setting an example for others across the country, said Dr. Bruce Walker, a professor at Harvard and MIT who directs the Ragon Institute.
Battling the coronavirus falls right into the core mission of the institute. Established in 2009 with a $100 million donation from Terry and Susan Ragon, billionaire tech entrepreneurs who have since provided an endowment that is now close to $300 million, the institute has taken an interdisciplinary approach to immunology, initially focusing on HIV/AIDS and recently launching multiple COVID-19 projects.
Epidemiologists agree that for the entire nation to return to work, Americans would need what they call “herd immunity.” That means a substantial majority of the population would either need to be vaccinated or be exposed to the virus and develop immunity to it.
A publicly available vaccine could be a year or more away, however. “So the only alternative is to expose people to the virus, and that would be insane,” Walker said. “We have to figure out what can we do to safely get the economy going again before we have the tools that would allow for herd immunity, or before we have drugs that would be curative if people become infected. This is something we can do.”
The Ragon Institute, whose staff fluctuates between 175 and 200 people, is submitting its plan to the institutional review board of Partners HealthCare, which oversees it administratively. The board assesses the methods and ethics of medical and scientific proposals, and it would need to approve the proposal before it could go forward. Walker said he believes the experiment would be allowed under current state guidelines.
“The biggest key for us is we want our people to be safe, that’s our priority,” said Corrie Martin, chief operating officer at the institute, who is working out many logistical and other details for the project at the institute’s Technology Square headquarters. She estimates that it might take a few days to get regulatory approval, as the board might request changes, and the project could begin in a couple of weeks.
To be sure, conducting a high-quality scientific experiment on its own staff “does take somewhat of an authoritarian approach," Walker acknowledged, "and we can do that at the institute.” The way to do it as safely as possible, he said, is by closely monitoring people.
Faculty, researchers, technicians, and other staff who volunteer to take part would need to scrupulously adhere to the parameters of the experiment.
As envisioned in the plan, they will be divided into two or three shifts, with each person choosing a shift, thus reducing the density in the workplace and making 6-foot social distancing possible.
Upon arrival each day, people will need to disclose if they have any symptoms, and they will have their temperature taken twice a day. If symptomatic or feverish, they won’t be allowed into the workplace.
Each morning, staff members will receive a mask, which they will be required to wear at all times. Gloves and hand sanitizer will also be provided.
The hypothesis is that these measures will help prevent infections, and that’s what the institute’s monitoring is designed to prove. Clinicians will test all staff members every week for both the active COVID-19 virus and for antibodies that would show exposure to it, in order to detect infections in people who have no symptoms.
Meanwhile outside the workplace, staff will be asked to wear a mask to and from work and practice social distancing to prevent infection.
Some people may still become infected, organizers acknowledge, but the experiment’s hypothesis is that such infections would come from community exposure, outside the workplace. So if someone tests positive, the institute will sequence the person’s virus and immediately do tracing of the people they’ve been in contact with at work, retesting those colleagues for the virus, Walker explained.
If a second person later tests positive, the institute will sequence that virus as well, and can then check if the transmission was among staff, or a random virus from outside.
Anyone who becomes infected will be quarantined, and can return to work after two weeks if they test negative for the virus twice.
The Ragon Institute is particularly well positioned for such an experiment: It has ample access to diagnostic coronavirus tests because of its own research on COVID-19.
Dozens of staff members have already been classified as essential workers, with the majority of them doing COVID-19 research and coming into the office sporadically, Martin said. So in a sense the experiment has begun informally, and there is enthusiasm from others.
“The reason this works well at a scientific institute is we’re scientists,” Walker noted. “Even people who have been very wary of infection are signing up for this because they believe in the scientific method.”
Even so, when officials discussed the plan with faculty earlier this week, some concerns were raised. Recurring COVID-19 tests with nasal swabs would be uncomfortable, so the institute is vetting the idea of using saliva-based tests, if they are accurate enough. Faculty also want to make sure no coercion is involved in the project, and Ragon officials emphasized that it is voluntary: Staff are being paid now regardless of whether they come in, and that will continue to be the case, so there’s no financial incentive. Many people are already working from home if possible.
“The majority were very excited about being part of this. And I think the biggest piece is that this is voluntary,” Martin said. “You know, we're scientists and future scientists, and people are excited to be a part of something that could actually give visibility to [showing] how do you responsibly come back.”
It remains unclear how many people will participate in the experiment, or exactly how long it will last. It could be three to six months, according to Walker. “Ideally we’ll show we don’t get any infections, and if that’s the case it would be good to replicate” in other places that are well-controlled, he said.
Walker hopes that the Massachusetts Consortium on Pathogen Readiness, a new cross-disciplinary group that he helps lead, could be a platform for expanding to other institutions.
Ultimately, the point is to prove that the institute’s hypothesis is correct: With enough care, infection can be prevented at work.
“We can create knowledge that will help other people,” Walker said. “There are certain things we know and a lot we don’t know about this epidemic. But we can do something with what we know right now.”