At the George Washington University Milken Institute School of Public Health, Dean Lynn Goldman saw the warning signs early on. “I actually realized this in January 2020, as reports were coming out of China. I had experienced (at another university) the response to SARS and recognized that at my university, we were woefully underprepared for any threat of that magnitude. I at first expected this to be much like SARS, meaning that, as a university in a large metropolitan area with many international travelers, we were at risk. I called on our head of emergency management and the two of us set up a public health committee that had its first meeting in February 2020.”
“Like most universities, the George Washington University (GW) switched to online instruction during spring break (March 2020),” Goldman says. “We also knew that we had to move quickly to protect health care workers who were on the frontlines of the evolving crisis. First, here at Milken Institute SPH (a project led by Dr. Cindy Liu), we launched a pilot study aimed at shielding health care workers and then we transformed that to a larger project, one that would ultimately become a large-scale testing protocol for the entire campus. Our public health infectious disease experts (especially Dr. Chris Mores) reached out to the GW Hospital to help them establish PCR COVID testing when none was available from DC health and prior to commercial availability of test kits and test orders.”
Two important efforts taken at the Milken Institute were surveillance and risk mitigation. Goldman says, “Mandatory periodic (weekly) COVID-19 virus testing as well as daily symptom monitoring for all on-campus students, faculty and staff took place. We worked in concert not only with GW’s emergency response team but with virtually every office across campus to devise and implement other safety measures like communications and messaging, mask-wearing, social distancing, systems to verify testing and (eventually) vaccine strategy, new staff and faculty policies and training, and many more.”
“The end result? GW was able to stay one step ahead of the virus and prevent its spread. We were fortunate to also have schools of medicine and nursing but also experts in building ventilation and health communications to participate,” Goldman says.
One of the biggest challenges, Goldman says, was reacting to an emergency so unprecedented. “Our university, like all of US society, was not prepared in the first place. At GW, none of our systems were designed to support pandemic care, communications and operations. Our data systems, both for the university and student health, needed tons of work in summer 2020 so that we could manage the health of our population.”
“All had to pull together in the same direction and much time and effort was required to coordinate across a community that included a multitude of offices that were not used to working together. This level of cooperation was facilitated by an excellent on campus EOC and I am proud of our role as a member of that team. On top of that we had to manage relationships with a community that was fearful that members of our student body (in particular) were spreading COVID,” Goldman explains.
The response to the pandemic has implications for the state of public health in the US as a whole. Goldman says, “First, public health is chronically underfunded and underprepared. A short-term infusion of money and people will not fix it. We need to see a much longer-term commitment to public health capacity at local, state and national levels. Federal authorities need to be strengthened to allow for clearer and more consistent direction when we have a national public health emergency. Public health research needs to be much stronger and the role of our schools and programs better understood not only by policymakers, but by the agencies themselves. The gaps in our research and how slow we were to apply the public health science we already know (such as around spread and control of aerosols, vaccine hesitancy, and issues around chronic disease and health disparities risks) highlighted the lack of understanding by policymakers of public health science and research and the need for more support.”