COVID-19 at Tufts: The Index Case and the First 48 Hours

In mid-March 2020, the university announced a series of changes to Tufts’ operations due to the spread of the COVID-19 virus in Massachusetts. For faculty, this meant quickly pivoting to virtual instruction. For students, the changes necessitated rushed farewells, packing belongings, and scrambling to book flights home.  

For Margaret Higham, who was at that time the director of Tufts Health Service, this time period brought the first identified case of coronavirus to Tufts and the need to devise the public health response necessary to protect the health of the community. For our retrospective on the Tufts community's early response to the pandemic, Higham looks back one year and recounts how it felt to be at the center of managing the health and well-being of Tufts' students and faculty at the moment that the COVID-19 virus arrived on the Medford/Somerville campus. 

What was it like at the start of COVID? The first 48 hours, they’re really branded into my consciousness. The phone call at 4:30 at the end of the day from the Massachusetts Public Health department saying this student has a positive test for coronavirus: That was a moment that I hope not to have repeated in my lifetime. 

I liken it to the stages of grief people go through when they're trying to accept a difficult process. Initially, there was denial... shock, bargaining—all happening like in five minutes because I had to go take care of this problem. I shut my door, I took about a minute to just breathe, and then I started making phone calls.  

The university has always had a strong emergency management team and I had been part of that for quite a number of years, and so I knew who the people were on that team, to whom I should turn. I knew how to reach them and I'd been through this process but on a smaller scale before. We did the H1N1 swine flu response; we did a norovirus outbreak, I just figured we could do COVID, too, and, of course, you don't have a choice, we had to do it. 

I started making phone calls and went to our incident command center in the Dowling Hall basement. It was a little bit later in the evening by that time, and in order to get there quickly, I asked that the police send a cruiser to take me down there. I'm not a prima donna; I've never done anything like that before. But I have to get there like yesterday, so can they come get me? They did, and I walked into the incident command room and there were the familiar faces. I knew the head of the police force, the dean of Student Affairs and Facilities, the Emergency Management people; they were all there and we just started deciding how to attack this problem. 

The next phase was figuring out which people were exposed. Who they were, what were their phone numbers, how did we reach them, what we were going to do with them? We interviewed the index case to find out what classes that person had, what groups they were part of, what activities they'd been having—and we found over 130 contacts from that first interview. It's not like we were starting with one or two people: there were 130 contacts!  

We had to figure out a way to collect information from them; we had to figure out where they could stay. This was also happening at that time when Tufts had announced a day or two before that students should not come back to campus after spring break, so everything was in flux. Students were moving in and out, the residential life folks weren't sure which rooms were available and which weren't, and we just tried to figure out a way to get people a place to sleep that night, some food to eat, water to drink. 

In the past, we certainly had had situations in which we'd had to provide meals for students—but not 130. That had never been done and that had to be done right away because guess what? It was past dinner time and people were hungry.  

That was a long night, and, fortunately, again, it's the team that pulls you through. After I left my colleagues in the Incident Command room, I went up to the Dean of Student Affairs office in Dowling Hall. That was the team tasked with getting in touch with these 130 students and I went up there to help them. I walked into their conference room and the Dean of Student Affairs staff is not all that large, but every chair in the room was filled. I realized they weren't just Student Affairs people; they were from Student Life, from Disability Services, from other parts of the university that were there to help the Dean of Student Affairs folks to get the work done. 

Contacting the students was the first step, but we also needed to feed them. The Dean of Student Affairs team bought 130 pizzas and went around, knocking on doors saying, "Pizza delivery. Do you have any food yet?" That's how people got their food that first night.  

The following day, I knew that Health Service needed to contact each of the students placed in quarantine to talk to them about what quarantine was and to find out what help they needed. There were 130 people for us to contact, and [Nurse Manager] Marianne Coscia—who was a lifesaver—and I spent the next 12 hours contacting all those students. They all had a story, they all had a difficult situation. One person was going to be flying to Bermuda the next day. Other people needed to get home to Asia, the airports were closing down flights, and they were wondering how they were going to get home. 

It was just one thing after another like that, just a lot of listening to people and trying to figure out what they needed. It was just an extremely stressful time—and really stressful for the students. Looking back on it, it wasn't perfect, and we made mistakes. There were hurdles that we hadn't anticipated but we handled them as best we could. We were all focused on the goals of taking care of that cohort of students, eventually getting them all home and keeping everybody safe and healthy. 

— as told to Valerie Wencis, A04