Tim Rowe started getting nervous last February.
The founder and chief executive of the Cambridge Innovation Center, a co-working company, had heard from CIC’s Tokyo office about the emergence of a novel coronavirus.
Soon, the 20-year-old company had to shut down offices in various cities, along with much of the rest of the business world. Like many other companies at the time, CIC began placing large orders for personal protective equipment while brainstorming how it would socially distance clients in a space that was designed to bring them together. (Co-working offices allow individuals and companies to work in shared space spaces.)
CIC knew early on that things like face masks and floor stickers might not be enough to encourage people to return to the office, so the company, which aims to foster innovation, began innovating itself.
“It occurred to us that [COVID-19] testing might be a good solution,” Rowe said. As CIC began researching how it might offer tests, other companies also expressed interest.
“Folks in the community were like, ‘If you can figure that out for you, could you also do it for us?’ ” Rowe said. “That’s when we started wrapping our heads around actually having a business to do this.”
At the same time, one of CIC’s clients, the health care consultant Nikhil Bhojwani, was percolating a more expansive testing idea alongside a renowned surgeon and writer, Dr. Atul Gawande. They believed the nation, not just Cambridge, needed an online marketplace for COVID-19 testing so that schools, businesses, and communities could connect with labs to access inexpensive tests. The problem wasn’t a lack of resources, but a lack of coordination, they wrote in a Harvard Business Review article published over the summer.
“This is a classic many-to-many problem,” they wrote. “There are many organizations and communities that need tests, and there are many organizations involved in delivering tests. And we lack a mechanism to bridge this many-to-many complexity.”
Rowe said that Bhojwani connected him with Gawande to discuss CIC’s becoming “a possible implementer of this big idea.”
“We were thinking small, and as is often the case, Dr. Gawande was thinking big,” Rowe said.
On June 4, CIC incorporated a subsidiary called CIC Heath, cofounded by Rowe and Gawande. CIC shifted about a quarter of its 350-person staff to the spinoff, which initially focused on testing. (Gawande does not receive compensation for his work at CIC Health).
“Dr. Gawande has a lot of relationships, he knows everyone, and he opened a lot of doors,” Rowe said. “We walked through them and started to master the process of testing.”
While training its employees to run COVID-19 testing sites, CIC Health also began rapidly expanding its team with heath care experts, including Rachel Wilson, former chief operating officer of the physician network Atrius Health. Since performing its first test in August, CIC Health has set up dozens of sites across New England, administering close to 700,000 tests for its co-working clients and the public. The company has about 90 employees and is still hiring.
With the testing operations ramping up, Rowe said, it became clear to CIC Health that the country would soon face another logistical hurdle: vaccinations. The Pfizer-BioNTech vaccine was authorized in the United States on Dec. 11, but there were concerns about how it would be distributed, stored, and administered. Rowe said people had been asking him for weeks whether CIC Health would play a role in the effort locally.
“It sort of struck us that, actually, maybe we have the skills to do this,” he said. “Securing a site to do any kind of medical thing is pretty complicated from a legal, contracting, and insurance standpoint.”
Wilson said that a week later, on Dec. 18 — the same day the Food and Drug Administration cleared Moderna’s vaccine for emergency use in the United States — Gawande called Betsy Nabel, president of Brigham and Women’s Hospital, where he is a surgeon, to ask how CIC Health could be a part of the state’s mass vaccination effort, possibly setting up operations at Gillette Stadium in Foxborough.
“The Brigham and Women’s Hospital and [Massachusetts General Hospital] as a whole jumped on right away, and the state was thrilled that we were all partnering,” Wilson said.
Rodrigo Martinez, chief marketing and experience officer of CIC Health, said the company started planning the vaccination site “in a matter of hours.”
With a green light from the Kraft family, which owns Gillette, CIC Health began transforming the stadium’s vast Putnam Club area, often used for hosting large events, into a vaccination site. The freezers behind the concession stands were checked to make sure they could safely store the vaccine, made by the Cambridge biotech Moderna. Tables and chairs were rearranged into makeshift vaccine administration stations. And CIC Health tapped the event management company that runs the Boston Marathon, as well as the medical service provider at Gillette Stadium, to assist.
On Jan. 15, just 28 days after the phone call from Gawande to Nabel, CIC Health’s mass vaccination site was up and running, administering shots to hundreds of people eligible to receive them in the first phase of the Massachusetts vaccine rollout.
“This is the first time we’ve put something together so fast,” Rowe said. “When you are doing something new and critically important, and people’s lives are at stake, the tension level, anxiety level, the thrill . . . it is pretty significant.”
During its first week, the Gillette site was expected to vaccinate 500 people per day, but by the end of the week it had scaled up to 1,500 daily. It will soon ramp up to 5,000.
Of course, CIC Health employees don’t poke people in the arm, swab noses, or provide medical oversight at any of its sites. That’s left to contracted physicians and hospital employees. But as it did with testing, the company acted as what it calls “connective tissue” between people and the services they need, Martinez said.
“It wasn’t that labs didn’t have capacity to do testing, and it wasn’t like people didn’t want it. What was missing was the bridge,” he said. “We built that. It is operations, logistics, the information and communication strategy, a well-designed guest experience, and we have applied that now to the vaccinations.”
Paul Bleicher, a consultant to health care companies, said CIC’s push into testing and vaccinations is “about having the capacity to do something and stepping up to the plate.”
“It doesn’t fit my view of what CIC has done in the past . . . but we need all hands on deck,” he said.
He added that managing logistics and creating an experience are “not necessarily medical skills,” and that Gawande’s involvement should go a long way to inspire confidence in the effort. “He is a trusted figure,” Bleicher said. “There could not be a better person to be thinking about these sorts of things.”
The state announced last week that CIC Health will also run a mass vaccination site at Fenway Park starting Feb. 1, with a goal of delivering 1,000 shots daily. Rowe said the state picked both locations and that CIC is “in a variety of conversations” about opening more.
“You could build a site that helps 100 people a day, or 200, or 5,000,” he said. “But if you are trying to get six million people in Massachusetts vaccinated, it is a no-brainer to build very large sites.”
Rowe said he initially thought the state might hesitate to give the fledgling CIC Health permission to run its only mass vaccination centers.
“I thought they would be like ‘Who?’ ” he said. “But we have been supporting innovators and startup companies for two decades in Cambridge,” he said. “It was pretty gratifying how many folks had a previous connection to CIC. It was more of a ‘Oh, that makes sense.’ ”
As for what’s next at CIC Health, Rowe said he and Gawande “want to focus on the here and now,” but they have identified about half a dozen areas of health care where the company’s model could prove useful.
“We see incredible urgency to get vaccines out,” he said. “If you do the math, you might need 10 sites the size of Gillette to suggest you could vaccinate the entire state in several months. That is doable, but you have to actually do it.”