HUHS Adjusts its Services as U.S. Coronavirus Cases Surge

As COVID-19 cases in the United States skyrocket and the health care system prepares to absorb the shock, Harvard University Health Services is working to adjust its services to keep both staff and patients healthy.

As of Thursday evening, 24 Harvard affiliates – including University President Lawrence S. Bacow – reported testing positive for COVID-19, according to an HUHS website. HUHS Director Giang T. Nguyen said these cases include only those that have been confirmed by lab results. HUHS asks University affiliates to self-report positive test results.

“We’re relying on the self report of our patients, who reach out to us and let us know. And actually the majority of the tests that are being reported in these numbers are people who have been tested elsewhere,” Nguyen said.

Roger L. Shapiro, an infectious disease physician at Beth Israel Deaconess Medical Center, said in the last two weeks, he has had to perform more clinical duties at the hospital, which is beginning to see a significant increase in COVID-19 patients.

More than 2,400 cases of COVID-19 were reported in Massachusetts as of Thursday evening, including more than 160 hospital workers in Boston. Shapiro said that though what will happen in the coming weeks is unknown, Boston hospitals are preparing to deal with a surge in patients.

“We are probably a little behind New York City [in terms of current cases]. And I hope that we don’t have the same level of intensity of that first wave of patients,” Shapiro said. “It’s getting very, very busy. But so far, it appears we are staying on top of things, and able to keep up.”

“I can’t speak for what the situation will be like in one or two weeks — it’s really an unknown right now,” he added.

According to Nguyen, HUHS is taking its own precautions as well as following statewide guidance from government and public health officials. Though healthcare workers are considered essential and therefore exempt from the stay-at-home order issued by Massachusetts Governor Charlie D. Baker ’79, Nguyen said HUHS is still trying to implement measures to reduce the amount of staff at its facilities.

“We have been doing everything possible to ensure de-densification of our facilities,” Nguyen said. “We’re only bringing in a small number of people at a time. People are going to be taking shifts to do that work so that we can minimize the density of staff who are present on-site.”

In order to compensate for decreased in-person services, HUHS began virtual care last week, primarily over the phone. HUHS is still in the process of transitioning to using video for clinical services because it first has to make sure that the service is compliant with the Health Insurance Portability and Accountability Act.

“It took quite some time to go through the legal channels to create a new business agreement with Zoom that is specific to the privacy needs and then also to make sure that all of the protocols are in place to do it in a way that we can ensure not only safety, but also appropriate documentation,” Nguyen said.

Chief of Counseling and Mental Health Services Barbara Lewis said individual CAMHS sessions are available over the phone and clinicians are working to re-establish virtual group sessions once HUHS is able to use Zoom to provide services.

Lewis said providers have been quick to adjust to the transition to virtual services, which were announced to clinicians last Monday and took effect just two days later.

Sarah M. Fortune, Chair of the Department of Immunology and Infectious Diseases at the School of Public Health, said mental health services are particularly important during this “anxiety producing time.”

Some students and clinicians are facing challenges with the transition, however. There are students and clinicians who struggle to find quiet, private places at home and clinicians who now have to look after their children during the day. Lewis said that some solutions to these issues include going for walks during sessions for privacy and or holding sessions outside of traditional hours.

HUHS vets patients from afar before deciding whether in-person services are necessary.

Harvard affiliates who are still on campus are asked to contact HUHS if they suspect they may have COVID-19 to determine whether they need to break quarantine and seek in-person medical attention.

“The act of going in terms of transiting themselves from home to a doctor’s office puts people at risk in the course of their transit to the office and also potentially puts other people at risk when they arrive in the office as well,” Nguyen said. “We want to make sure that folks are coming in only when it is absolutely necessary.”

Nguyen said HUHS will continue to adapt to the constantly changing situation.

“Even if you think about the way we deal with one particular clinical situation two weeks ago and compare that to how we might deal with it today, it might be very different,” he said. “And how we deal with it maybe a week and a half from now will be very different.”

—Staff writer Fiona K. Brennan can be reached at fiona.brennan@thecrimson.com. Follow her on Twitter @FionaBrennan23.