In 2020, All Hands Were on Board at Tufts Responding to the Pandemic
If the spring semester of 2020 was a sprint in the face of COVID-19, the rest of the year was a marathon—or maybe a triathlon, as Tufts responded to a global pandemic unparalleled in recent history.
In March, Tufts quickly brought coursework online, closed residence halls, paused most laboratory research, and halted non-emergency clinical services. The challenges mounted as the pandemic’s duration and severity became clearer.
The toughest thing about the pandemic has been its sheer volume, said Vice President and Chief Information Officer Chris Sedore. “It touched every corner of the university, from facilities to health services, faculty, students, labs—everything.” Getting it right would be “a huge lift,” he said.
As the calendar year wound down, there was widespread agreement that Tufts had, by and large, gotten it right. A Herculean effort involving administrators, faculty, students, and community partners enabled Tufts to continue to be an educator, researcher, and engaged citizen while safeguarding the health of its own community and its neighbors.
Among the biggest unknowns was the pandemic’s economic effect. “We had to try to project the likely impact on enrollment, student services, veterinary and dental clinics, and other operations across our campuses, as well the cost of health and safety measures like testing and masks,” said Vice President for Finance and Treasurer James Hurley. “In addition to serving our own students and employees, we wanted to help the local community.”
Thanks to, in Hurley’s words, the “transparency, engagement, and helpfulness” of colleagues across the university, as well as the finance team’s efforts, Tufts successfully balanced its budget. This required sometimes painful belt-tightening, but avoided large-scale personnel cuts, reductions in benefits, or other severe measures experienced elsewhere. Hurley is proud that Tufts was able to maintain its favorable S&P bond rating, which provides access to capital needed to support key projects.
Two things were never in doubt: Decisions would be based on science, and Tufts would be transparent about its plans, protocols, and progress. Underpinning Tufts’ pandemic-management strategy, said Michael Jordan, A94, M98, the university’s first infection control health director, was a set of early warning indicators for preparedness and prevention and associated performance targets to assess the virus’s prevalence on campus and the university’s success in mitigating its transmission.
Developed over the summer, they served as a decision-making roadmap. “We have data specific for each campus and school. Our flexibility to adapt as the data inform us has been one of our greatest strengths,” said Jordan.
Acing the Test
A pillar of Tufts’ infection control strategy has been frequent mandatory COVID-19 surveillance testing. “One of the things Tufts got right was deciding to regularly test everybody who would be on campus and contract with the Broad Institute to process those tests quickly,” said Sedore, who credits Associate Professor of Mathematics Moon Duchin for developing a test-scheduling algorithm that avoided both traffic jams and periods of inactivity.
A Tufts-developed platform that automatically generates the appropriate test label when an individual taps their ID card is currently being used at five other institutions, with others planning to adopt Tufts’ time-saving technology this spring. Tufts also committed to managing contact tracing and isolation and quarantine of affected individuals, and sharing metrics on a daily dashboard created by Tufts Technology Services (TTS) and housed on a new website created by University Communications and Marketing.
Vice Provost for Research Caroline Genco noted that Tufts is using this expertise to help address the pandemic’s health-care inequities and disparities. Research indicates that testing is particularly important in densely populated environments, but many such communities can’t afford it. Tufts offered free COVID-19 testing to neighbors adjacent to the Medford/Somerville campus and subsequently developed an innovative pooled testing program to make it economically feasible for Medford and Somerville to safely open their public schools.
“President Anthony Monaco came up with the idea and methodology for pooled testing,” Genco said. “We got really excited, and working with TTS we were able to do a pilot test to validate the technique.” Added Sedore, “By sharing our expertise, we lived up to our reputation of being engaged in our community and making the world a better place.”
Overseeing the testing centers themselves was the Auxiliary Services team, which brought its special-events expertise to bear on test logistics, including traffic flow and social distancing in test centers—and stations for hand sanitizer and nose blowing (the last step before nasal swabbing). Varied existing spaces were repurposed as test centers; one of Cummings School’s two test sites is in the Hospital for Large Animals. “It’s the only Tufts test site where you have to watch out for horses,” said Dean Alastair Cribb.
On the Medford/Somerville campus, onboarding of arriving students, including their first surveillance test, took place from 7 a.m. to 6 p.m., seven days a week. August and September were “very, very busy,” said Auxiliary Services Senior Director Jason McClellan, with about 400 people a day coming through the Gantcher Center. “We knew this was a really stressful time for everyone, especially parents of undergraduates with students coming to campus for the first time in the middle of a pandemic. We tried to be as welcoming as possible, make eye contact, say hello—give them a reason to smile during a scary process.”
By year’s end, Tufts had administered more than 266,000 tests. Wait times were typically measured in seconds, not minutes. “Most people were in and out in 90 to 120 seconds,” said McClellan. When wait times at the Talbot Avenue test center increased to 8 to 10 minutes one November day, the team solved the problem within 24 hours.
“I can’t say enough about our own team and our colleagues across the university,” said McClellan, “from Facilities who cleared paths to the test centers when it snowed, to Capital Projects who created new building entrances to accommodate traffic safely, to our partners at Tufts Medical Center who staffed our Boston Health Sciences campus test site, and Brewster and Cataldo ambulance services who assisted in Medford/Somerville and Grafton.”
Safely re-opening the Medford/Somerville campus also required major changes to its medical care delivery system. Health Service Medical Director Marie Caggiano officially started on April 1, 2020—a fitting date, she said. She and her colleagues focused on learning as much as they could about the virus and how to adapt practices to keep themselves and the students safe.
That meant renovating air handling and sanitary systems and splitting the health center so that one side handled respiratory conditions while another addressed other acute conditions and routine care. Clinicians learned to conduct full-service medical visits using a Zoom platform that complied with privacy regulations. Lab technicians used new equipment to conduct rapid onsite COVID-19 and influenza tests.
“The adaptability and flexibility of staff has just been amazing,” Caggiano said. “We maintained high quality of care and developed new systems, all the while keeping abreast of current evidence and making sure everything in our practices was evidence-based. In the fall, we were ready to fly. And we did.”
Tufts had successfully pivoted to remote learning during the second half of the spring semester, but needed longer-term solutions for the summer—when classes were to begin for the schools of medicine and dental medicine—and for the fall. Central Administration collaborated closely with school faculty and staff to assess needs, remodel academic buildings, replace HVAC systems, and create more individual student study spaces. Educational Technology Services and the Center for the Enhancement of Learning and Teaching offered non-stop support on new modes of instruction.
Clinical programs, including those at the School of Dental Medicine (TUSDM), faced unique challenges. A key success for TUSDM, said Executive Associate Dean Mark Gonthier, was ensuring that the Commonwealth of Massachusetts defined students in their clinical years as essential health workers. This designation allowed students to work in the dental clinics under faculty supervision, an educational component needed for the school’s accreditation.
Because decoupling provider stress from patient care is a “great unaddressed need of health-care professionals in general” and the pandemic heightened that anxiety, the school launched an initiative to help students practice stress reduction exercises prior to seeing patients. New training videos explained the proper use of personal protection equipment—TUSDM would invest $540,000 in masks—and a Tufts-developed app prescreened patients before appointments.
When Cribb thanked the Cummings School community for its outstanding performance during the past semester, he praised faculty, staff, students—and animals. “We use a lot of animals in our teaching, and we also have our patients. In normal circumstances, their owners come into the hospital with them, but because of COVID protocols, owners weren’t generally allowed inside. The animals had to go into strange surroundings without that comfort and reassurance. It was difficult for them, for their owners, and for the clinicians. So they all deserve our praise.”
Innovation flourished across Tufts. Tom Malone, executive associate dean at the School of Medicine (TUSM), said the school is enrolling a class of 89—above goal—in a new Doctor of Physical Therapy program that starts in January. Faculty and staff worked furiously over the summer and fall to continue momentum for the program, which will supplement online study with two-week on-campus lab immersions.
He also highlighted the transformation in Summer 2020 of a “mini-med school” for high school students offered through University College and TUSM from a two-week onsite program to 100 percent online. “That was an amazing accomplishment to pull off in such a short time, and the evaluations from students were overwhelmingly positive,” said Malone.
Nancy Bauer, dean of the School of the Museum of Fine Arts at Tufts (SMFA), notes that “we completely blew up our curriculum” while seeing a 23 percent boost in fall enrollment. In-studio group classes weren’t possible, so SMFA shortened and redesigned courses to focus instead on how artists respond during crises and helped students examine “this moment in a way that was protective and empowering.”
The SMFA opened its large studios to individual students by appointment only and turned unused academic and residential spaces into individual studios for its 300 students. (SMFA undergraduates lived on the Medford/Somerville campus, a move that proved so popular it’s being considered for the long term.) Knowing that students might have a hard time buying art supplies, school personnel purchased, packed, and shipped each student everything they would need for their particular classes, from paints to clay. “We put together a box for every single, solitary student,” said Bauer.
Research is a core part of Tufts’ mission, so when many Tufts research labs “essentially closed” in the spring, “it created a lot of anxiety,” said Genco, the vice provost for research.
Research gradually ramped up again in the summer and fall. Still, it’s often more difficult to reduce personnel density in a laboratory than a classroom, because researchers must frequently move from one location to another and exact timing drives experiments. “We’re encouraging researchers to use any down time to apply for grants and write up study results and papers,” she said.
Faculty across the university successfully pursued COVID-19 related work. Tufts’ two-day online symposium on COVID-19 research highlighted the work of some 20 Tufts researchers and featured addresses from the chief scientist at the World Health Organization and the editor-in-chief of the New England Journal of Medicine. Tufts is also part of the team developing Johnson & Johnson’s vaccine, and Cummings School researchers are conducting COVID-19 surveillance testing among animals. In September, Tufts announced that the university will lead a $100 million, five-year program to understand and address threats posed by zoonotic viral diseases, such as SARS-CoV-2, that can “spill over” from animals to humans. A partnership with TMC has offered two rounds of seed funding for additional new COVID-19 research projects.
“Faced with a situation we’ve never before encountered, we’ve had to be creative and we’ve made a lot of progress,” said Genco.
The Residential Experience: Solving for X
“Students were the X factor, the biggest unknown,” said Rocco DiRico, director of government and community relations, as Tufts prepared to bring undergraduates back to campus. Other institutions’ failed attempts to re-open their campuses, sometimes due to poor student behavior, had already made headlines.
One reason this didn’t happen at Tufts, said Director of Residential Life Josh Hartman, is that so many people, from senior leaders to residential assistants, put “thousands of hours” into preparation and planning. “Planning made implementation successful.”
The other reason is the students themselves. “They are trying so hard for the most part. By and large, they care about others and want to be good members of the community,” said Hartman. That desire, he said, is something that Tufts can support, but can’t create from scratch.
With traditional residential events like ice cream socials impossible, the Residential Life team challenged students to create new ways to engage on a virtual or small level. For example, when students wanted to hold a craft night, they dropped supplies outside each room, so each student could use them take part in an online group crafting event. “There is always more that could be done, but all each of us can do is our best and show grace and goodwill to each other,” said Hartman.
Having students back on campus also required Dining Services to morph from an eat-in/sit-down service to an organization that filled online orders for pickup and delivery. “We never dreamed we would reinvent ourselves so completely,” said Dining Services Director Patti Klos.
Following onboarding testing upon arrival on campus, students typically quarantined for 24 to 36 hours and could then order and pick up their own meals. Those who tested positive for COVID-19 at any point isolated for at least 10 days, and their close contacts quarantined for up to two weeks.
Online ordering, common in the commercial world, was new to Dining Services. Klos is proud that “one month and one day from our initial training with the software, 100 percent of how you accessed food service that semester was through the app.”
The menu changed to emphasize dishes that were tasty and nutritious and also traveled well so they were appetizing after delivery. A team member who was a “logistical whiz” divided the campus into sections for maximum delivery efficiency, and the staff climbed endless stairs to deliver 14,000 meals to students in quarantine or isolation on and off campus. “Between takeout and delivery, we provided 500,000 to 600,000 meals, while helping students get the nutrition they needed and protecting the community,” said Klos.
Physical activity, like diet, is an important part of health. While most sports were off the table, Athletics, Student Life, and Facilities worked hard to make the fitness center and pool available when it was safe to do so, said Director of Athletics John Morris. Ninety percent of physical education classes were held, and students played socially distanced recreational sports when the weather cooperated.
Tufts’ coaches and staff supported student-athletes by counseling them on resilience and positive attitude and doing frequent check-ins. Coaches also volunteered “in droves,” said Morris, helping to onboard arriving students, support dining services, and assist students who had tested positive for COVID-19 or who were quarantined as close contacts.
Thanks to donor generosity, Tufts Athletics announced the Future Leader Graduate Fellowship with the goal of increasing opportunities for underrepresented populations to work in leadership positions in the field of intercollegiate athletics. “This was a way we could take meaningful action to support equity and inclusion,” said Morris.
Ultimately, it was the student-athletes themselves who most impressed Morris by putting aside the sharp personal disappointment of competitive seasons lost forever. Members of the baseball, lacrosse, soccer, and cross-country teams regularly met online to examine issues of racism and social justice. Students raised money for charities such as Play for P.I.N.K. and drafted a 13-year-old for the women’s volleyball team through Team IMPACT, which connects college teams and children with chronic or life-threatening illnesses.
“I’m not going to say it’s been all sunshine and roses,” said Morris, “but our students’ maturity, perspective, and ability to express gratitude for what they have been allowed to do, rather than dwell on what they have lost, is staggering.”
Campus and Community
The highlight of the fall for DiRico, who leads community and government relations for Tufts, was when Somerville Mayor Joseph Curtatone and Medford Mayor Breanna Lungo-Koehn praised Tufts’ management of the pandemic in an interview with NPR station WBUR. From the beginning, Tufts had offered pandemic support to its host communities: housing local first responders, health-care workers, and COVID-positive patients; offering cold storage and donating food to hunger-relief organizations; and awarding COVID-19 emergency grants to local nonprofits. Boston, Medford, and Somerville were nonetheless concerned about an influx of students in the fall.
“The challenge we faced,” DiRico said, “was how to reopen a campus when everything around you is shutting down.” Keys to success were Tufts’ comprehensive approach and commitment to managing the “entire spectrum of response,” from testing to isolation, and the university’s commitment to transparent communications.
“We said, ‘Not only are we holding ourselves, including our students, accountable, but every day we will publish on a live dashboard data on our success or failure,” he said. “At no point will you ever be uninformed about the situation.’”
Students—initially DiRico’s greatest source of anxiety—ultimately became a great source of pride. “I would drive around campus and see students wearing masks and distancing. It was heartwarming that these 18- to 22-year-olds were being leaders, not just for the Tufts campus, but for the community.”
A Monumental Communications Challenge
COVID-19 presented a huge communications challenge from the time Tufts confirmed its first COVID-19 positive student in March 2020. “We had to come up with ways of sharing information with faculty, staff, students, and the community that were timely and comprehensive,” said Chief Marketing Officer Jean Ayers.
Working closely with colleagues across the university, the Digital Services group in University Communications and Marketing developed, and later redesigned, a website that serves as a hub for everything COVID-19: information on testing, academics, community messages, good health practices, and resources.
A dashboard created by Tufts Technology Services updates key metrics of Tufts’ progress each day, and FAQs—now numbering 233—address questions on a myriad of subjects and are fed out to other sites. The team developed a process for developing, verifying, and updating all content, never acting as clinicians. TTS, Student Services, and Communications and Marketing also answered countless emails, striving to provide not just facts but also support in the face of concerns and uncertainties.
Bringing students back to campus required a multitude of communications, including individual campus guides, videos to demystify surveillance testing, and lots of signage. The goal was to provide relevant information in multiple modalities.
It all came together, and on September 14, President Anthony Monaco officially welcomed the community back for the fall semester. “That was one of the best days in the last nine months,” Ayers said. “We could see that all of us across the university were committed to doing a great job, doing it for something bigger than ourselves.”
The hard work of staying safe isn’t over. While Tufts’ COVID-19 case numbers and percentage of positive tests are well below levels in greater Boston and Massachusetts, the community must remain “highly, highly vigilant,” said Hartman. “We’ve come this far because people were invested, and they need to stay invested. It’s too soon for a victory lap.”
And for a learning institution like Tufts, there are always more questions to answer and opportunities to do better. How can we maintain the spirit of collaboration and resiliency that has characterized the past months? What new ways can we devise for teaching and learning, for fostering engagement with our community, and for continuing to take the steps to ensure that Tufts becomes what every member of our community would view as an anti-racist institution—all while continuing to reckon with a global pandemic?
And while it’s too far soon to declare victory with regard to COVID-19, 2020 made Hartman hopeful. “Last January, we were talking in a general way about planning for an infectious disease outbreak, but we had no idea that we would soon be shutting down. Ever since, I have always been optimistic about our ability as a university to confront any challenge that comes up. If we put our minds to something, we’re going to do it.”