Harvard-Affiliated Hospitals and Research Institutes Help Address Coronavirus Pandemic While Facing Resource Shortages

Several hospitals and research institutes affiliated with Harvard Medical School have increased healthcare and research activities to help fight the novel coronavirus pandemic, despite facing resource shortages.

HMS-affiliated hospitals — like many other hospitals across the nation and the globe — must grapple with treating an increasing number of patients even with dwindling numbers of beds and supplies.

As COVID-19 continues to spread, more than 150 Boston hospital workers have tested positive for coronavirus, and the United States now has more confirmed cases than any other country. In collaboration with Massachusetts government officials and other medical schools in the state, the Medical School is considering allowing its fourth-year medical student to opt into graduating a month early to help bolster the ranks of the healthcare workforce.

Meanwhile, research seeking to understand and address the coronavirus pandemic is flourishing in many Harvard laboratories. Though the University directed all research laboratories affiliated with the Faculty of Arts and Sciences — with the order extended to Harvard Medical School, Dental School, and School of Public Health — to wind down activities to only essential functions, the University has allowed vital COVID-19 research to continue.

Equipment Shortages at Hospitals

Harvard Medical School Dean George Q. Daley said in a Friday interview with The Crimson that local laboratories, institutions, and individual sponsors have stepped up to provide additional personal protective equipment, or PPE, to the school’s affiliated hospitals. A survey this week conducted by the U.S. Conference of Mayors found almost 90 percent of more than 200 cities do not have an adequate supply of personal protective equipment.

“We’ve been fielding a tremendous number of very generous offers from alumni and supporters of Harvard Medical School from all over the world really to donate PPE,” Daley said.

Daley said the school gathered the donated equipment in a central storehouse and turned over its management to the Massachusetts Emergency Management Agency.

He also said the hospitals are coordinating the receipt of materials with a central supply network created by the Massachusetts Biotechnology Council, dubbed Supply Hub. Using a centralized database to optimize the distribution of PPE, Supply Hub has allowed supplies to more easily reach Western Massachusetts, where protective equipment is scarce.

“Most of our hospitals have been very effective at being able to maintain supply chains and coordinate the receipt of a lot of this material,” Daley said.

Despite these efforts, many Medical School-affiliated institutions themselves continue to face medical equipment shortages. Cambridge Health Alliance — a Harvard-affiliated public healthcare system — reported a shortage of supplies on its website, where it is seeking PPE donations from the public.

“Like all hospitals during this outbreak of COVID-19, Cambridge Health Alliance is facing a shortage of medical supplies, including personal protective equipment,” its website reads.

At the same time, Cambridge Health Alliance has also had to grapple with the conservation of its existing supply of PPE, spokesperson David Cecere wrote in an email.

“We are pursuing different avenues to bolster and conserve our supplies so that we can meet the critical need and support our frontline staff,” Cecere wrote.

Harvard-affiliated Boston Children’s Hospital is also facing an equipment shortage, though Chief of the Division of Medical Critical Care Michael S.D. Agus said the hospital’s supply is not “critically low” at the moment.

“We’ve already invoked our reuse protocols, which are CDC-approved and carefully designed protocols to minimize the use of PPE to begin with, only to the circumstances where it’s truly needed, and then to have decontamination procedures so that masks and our protection can be cleaned and reused by the same practitioner,” Agus said.

Because health experts expect sick children to require ventilators in lower numbers, Agus said the equipment in the hospital “may be even available for use by adult populations.”

Michael J. Mina, the associate medical director in clinical microbiology at Brigham and Women’s Hospital — another Medical School-affiliated hospital — said supplies of nylon flocked swabs, which are used for testing, are “becoming completely nonexistent.”

“We’re going through multiple channels just to get in touch with manufacturing plants in China,” Mina said. “They’re actually producing a lot of swabs for us.”

Hospital Interventions

Meanwhile, several Medical School-affiliated hospitals have bolstered their coronavirus-related functions and changed certain policies in response to the pandemic.

Massachusetts General Hospital — the Medical School’s largest teaching hospital — has activated its Hospital Incident Command System, which delegates responsibilities in emergency situations.

In addition, MGH announced that it would not allow visitors during the pandemic, “with very limited exceptions” as well as virtual visiting options.

Cambridge Health Alliance wrote on its website that it will provide doctor’s appointments by phone and video.

Additionally, CHA recently launched a drive-through service for coronavirus testing at its Somerville hospital. Due to a limited number of testing kits available, the tests are only being offered to current CHA patients experiencing coronavirus symptoms for the time being — but according to Cecere, CHA hopes to expand the service to the public in the future.

“The service aims to maximize access to tests while minimizing potential exposure of the virus to our patients and staff,” Cecere wrote in an email.

Judge Baker Children’s Center — a Medical School affiliate that specializes in children’s mental health — has closed its Manville School for children with special education needs and moved classes online, according to Christopher Bellonci, Chief Medical Officer at Judge Baker Children’s Center.

“We mobilized quickly to ensure that all the students that we work with had a functional computer that they could access,” he said. “We were set up already to be able to shift to remote teaching.”

“Many of our students and families also struggle financially and so we’ve been providing food to some of those families in need, just as many of the public schools are doing, and our clinicians are reaching out trying to support the families in helping our young children,” he added.

So far, the number of pediatric COVID-19 cases remains lower than adult cases — placing Boston Children’s Hospital in a different position than most other medical centers. Agus said the hospital may experience an influx of patients as other medical centers try to make space for adult COVID-19 cases.

“We are preparing for the possibility that institutions that care for adults and children will be forced on a temporary basis to allocate their pediatric resources to the care of adults,” Agus said. “We are standing ready to care for those kids.”

Beyond patient care, Agus also said the leadership at Boston Children’s is focused on the protection and management of illness amongst its healthcare workers.

“The number of people that are out is extraordinary,” Agus said. “There's never been this much fear of getting a life-threatening illness through any random interaction with either patients or colleagues.”

Coronavirus Research

Many researchers across Harvard’s Longwood medical campus are working on coronavirus-related projects across a wide range of disciplines, including refining diagnostics, developing vaccinations, and predicting public health concerns.

Perhaps most notably, that work includes a long-term collaborative research effort between Harvard-affiliated researchers and collaborators in China, funded by Fortune Global 500 company China Evergrande Group to the tune of $115 million.

At the Wyss Institute for Biologically Inspired Engineering — a Harvard cross-disciplinary research institute — administrators announced they would be “ramping down” most research operations as a part of University protocols.

But coronavirus research at the institute has continued at full throttle. Wyss Institute spokesperson Benjamin Boettner wrote in an email that though researchers are seeking to address the pandemic through a variety of methods, research largely remains in “early or intermediate stages.”

“It will probably take a while before they will be in doctors’ hands,” he wrote.

Wyss Institute Founding Director Donald Ingber said in a press release that the Wyss Institute has been able to “refocus” its efforts to help address the coronavirus, even as other research ceased.

“With our highly multi-disciplinary and translation-focused organization, we were able to quickly pivot, and refocus our unique engineering capabilities on much needed diagnostic, therapeutic, and vaccine solutions, and we hope to be part of the solution for many of the innumerable problems the present pandemic poses,” Ingber said.

Correction: March 28, 2020

A previous version of this article incorrectly stated the material of testing swabs running low in Harvard-affiliated hospitals. They are nylon flocked, not cotton.

— Staff writer Kevin R. Chen can be reached at kevin.chen@thecrimson.com. Follow him on Twitter @kchenx.

—Staff writer Virginia L. Ma can be reached at virginia.ma@thecrimson.com.