How the Return Oversight Committee is Guiding Drexel During the Pandemic

Dr. Marla Gold Named Vice Provost for Community Health Care Innovation

Please visit the ‘Drexel’s Response to Coronavirus’ website for the latest public health advisories.

On Feb. 8, Drexel University students, faculty and professional staff were sent a University message recommending “double-masking,” or layering one face mask over the other, when indoors to reduce the risk of infection. On Feb. 10, the Centers for Disease Control and Prevention (CDC) released guidance recommending the same.

How did the University come to that conclusion first?

“There’s a multi-factor way to answer,” said Marla Gold, MD, who is the director of the University’s Return Oversight Committee (ROC) informing and creating Drexel’s response to COVID-19, and, along with Drexel President John Fry, cosigned the Feb. 8 message.  

To get that multi-factor answer, DrexelNow talked to Gold, who is also Drexel’s vice provost for community health care innovation as well as dean emerita and professor of health management and policy in the Dornsife School of Public Health. In the below Q&A, she discussed how decisions — like the double-masking recommendation — are made to benefit the University community, and what sources and experts are consulted when making those decisions.

Q: What is the Return Oversight Committee?

A: The Return Oversight Committee is a group of numerous senior leaders, as well as a representative from the Faculty Senate and myself, that looks at the campus in terms of health and safety protocols related to COVID-19. Its members cover areas across the University, such as HR, academics, Student Health and campus wellness, Student Life, safety and security, Facilities, University Communications, General Counsel and Procurement. There are many other people that are on it.

With COVID, everyone is at risk of infection and we are all affected by the pandemic. And because of that, and because of the impact of the disease coupled with concerns that people had and the sweeping changes that had to be made campus wide in order for Drexel to open in any capacity, we started meeting early on to make recommendations and decisions at the University.

Q: What is the mission of the ROC?

A: The mission of the ROC is to reduce the risk of COVID transmission and infection, and operate the institution in a way that supports the physical and mental health of the people who receive their education with us and those who work here to deliver that education as well as the student life that comes with it. If you think of Drexel as a mini city, the Return Oversight Committee ends up a good deal of the time functioning as a mini health department for our community. The mission of public health is to create conditions in which all people, regardless of their differences, have the opportunity to achieve good health. The ROC works to support those conditions during this pandemic.

Q: Generally speaking, how does the ROC work?

A: The overall ROC meets at a minimum of once a week to discuss health and safety protocols, any issues for troubleshooting and any potential outbreaks in disease. Maybe somebody read something or heard from a peer at another institution of higher education, and we discuss that.

There’s a smaller, workhorse group that meets every morning — our meetings have meetings — to discuss student life and student health. We go over information about cases, what we’re seeing and the nature of any potential outbreak if necessary.

Every single day Anna Koulas [vice president of the Drexel Solutions Institute] and her staff produce a list of articles pushed to us through a special listserv that we all read. It contains condensed information reflecting national trends and information on institutions of higher education related to COVID. So that means every evening, we’re looking over the experience of others.

Q: How does the ROC come up with guidance then?

A: The vast majority of what we do in the areas of science recommendations derive from multiple layers and sources. There are federal, state and local public health authorities; top journals that are publishing constantly on the public health and medical evidence; other institutions of higher education; the National Academies of Science; and our own internal scientists and experts. It’s pretty intricate and we’re constantly looking to see what others are doing and what the science is telling us.

This is a real-time, evolving pandemic. Every time we think we have our arms around one aspect, something new pops up. Look at the new variants, right? You think you know, and suddenly the next thing is happening and we may need to pivot or change a guideline. Most excellent scientific evidence takes time to produce. People often need answers now and we need to make decisions when the science isn't fully in front of us yet. And we could have the best science but public health is not just about having the best science.

There’s an expression in public health: “nothing about them, without them.” And it really means you can have the best ideas for policy, but you have to have an involved and willing public along with the ability to implement. We just have to be realistic. That doesn’t mean that we don’t act. We do things in the best interest of health and safety, and we also have an eye on institutional wellness.

Q: So to break it down — what public health authorities do you work with?

A: A big place where guidance comes from are indeed public health governmental authorities. Because of the way this pandemic arrived, and because of a rather fragmented rollout that occurred among states and local governments trying to move quickly to take care of their own, we experienced delays in a unified response. This just wasn’t the kind of federal guidance that we’re used to seeing in disasters. But we’re lucky. We live in Philadelphia and Philadelphia’s public health department has been cutting edge.

The early guidance that helped us know what we needed to do came from the health department in Philadelphia, and it was specific to institutions of higher ed to show us what we would have to meet in order to have approval to open. That was about occupancy standards, HVAC standards, capping people per square foot of instructional classrooms and much more. The entire campus had to be mapped out for occupancy. We also tried to strike a balance between returning to campus and the message of being safer at home, like determining who were essential workers who needed to be in as we started to slowly open.

There are also national organizations that have some overlap with what we do. As an example, the Philadelphia Department of Public Health gives us guidelines for competitive sports, and the Collegiate Athletic Association and NCAA also put out guidelines for its athletes. And at Drexel, there’s a sports physician and Student Health Director who are part of our work group that meet and look at the latest guidance. The men’s and women’s basketball teams at Drexel have been playing. In the case of those teams, the way they get to play is to be tested daily and we have a whole system for how that happens. If there’s one infection among a team player, the whole team is quarantined and the plans for how to quarantine are already worked out in advance.

Q: What about other institutions of higher education?

A: For months now, Philadelphia’s Department of Public Health and Department of Education at the local level have co-sponsored weekly meetings — they’ve just gone bi-weekly — with all leaders of area institutions of higher education. I’m not the only one from Drexel on that; usually someone from Student Health, often Janet Cruz [MD, Drexel’s director of student health services] herself if she has time, as well as key leaders from Student Life participate. And we’re all listening to the experience of other institutions of higher ed because that helps us understand what they are seeing and hear lessons learned and how to apply them. We share our knowledge and experience.

We also meet regularly with peers from Jefferson, Temple and Penn because we’re urban and much larger and have been dealing with similar experiences related to hybrid education, as well as what to do when testing. We all have many stakeholders. We talk about best strategies for how to be safe, but also the mechanics of testing including the machines we use and processes.

Q: What about working with the Drexel community and Drexel experts?

A: At Drexel, the team is very big, but never big enough — I do want to say that! There’s a combination of volunteers, co-op students, paid individuals, new employees and temporary employees during this time, much like the health department, involved with testing.

We have data — put on the COVID-19 dashboard — coming in weekly about people who have infection in our community picked up through our testing operations. That gives us the picture of the health of the community, which is also a guide. If we see that there are a number of students with infection and it’s tied to a particular place, we’re going to take a look at the big picture and get right on that. Michael LaVasseur [PhD, assistant teaching professor in the Dornsife School of Public Health] works with us on data analysis for our dashboard.

I should mention that at the very beginning of the pandemic, we formed what’s called a Scientific Advisory Group, or SAG, which has very bright and well-versed people in research and practice who read medical and public health journals and are up on the latest science and clinical trials all the time. That’s co-chaired by Chuck Haas [PhD, LD Betz Professor of Environmental Engineering and head of the Environmental Engineering Program in the College of Engineering] and Esther Chernak [MD, associate clinical professor and director of the Center for Public Health Readiness and Communication in the Dornsife School of Public Health].

There was the question of how often do we need to test students, and the answer wasn’t a dart on the dart board. That was based on the test we’re using, its sensitivity, the amount of mask-wearing by the community, the way people are with distance and protocol, the amount of disease — that was all mapped out. Chuck Cairns [MD, Walter H. and Leonore Annenberg Dean and senior vice president of medical affairs at Drexel University College of Medicine] did some scenarios and formulas to come up with what makes sense for the frequency of testing. We follow incoming data to adjust testing strategies.

There have been meetings with the Powelton Civic Association as well as representatives from Mantua. Drexel retains our commitment to civic engagement, and opening the Dornsife Center safely has been absolutely in the forefront. What we would give to be able to be a part of helping to vaccinate our neighbors in Mantua and Powelton village and members of West Philadelphia! We hope to be a part of that if the City has vaccine available for us to use.

Q: There was Drexel’s double-mask recommendation in February that came out before the CDC’s recommendation. How did that happen?

A: We had heard there was some suggestion in our clinical journals — sometimes they’re letters because, as I said, studies take time and we’re not going to see a lot of the large-scale studies for a while — that adding a second layer of filtration to a cloth mask would decrease the transmission and acquisition of particles of virus.

There’s something called the Pennsylvania Health Alert Network (PA HAN) in the Pennsylvania Department of Health, and the network let us know that the B. 1.1. 7 variant first described in the U.K. had been picked up in multiple places in Pennsylvania. We also knew Penn had announced that they had some cases involving that particular variant. Right away, we knew that it was very close by. I had already asked Penn and Temple about mask guidance based on the variants that we were seeing. And then the three of us were moving toward making a recommendation and we discussed things like, if it’s safer, why aren’t we mandating it? We don’t mandate things that we can’t and wouldn’t enforce. We’re not going to check every face of every person to see if there are two masks on it. Sometimes the best we can do is to provide the information and let people know what we think is the safest way to go.

Q: Can you share what the ROC is looking at next?

A: So, the next thing that is ahead is the need to be able to obtain vaccine from the health department and be able to offer vaccine to our employees under phase 1C. We’re looking at vaccine acceptance among members of our community and how much education about the vaccine is needed. I am optimistic that everyone who wants vaccine will be vaccinated by summer if not earlier. We should know more very soon as more vaccine becomes available and the City moves to Phase 1C. We know many are seeking vaccines through other avenues and they should, but we want to vaccinate our community and we are prepared to do so.

We’ve been able to vaccinate many of our 1A population members at Drexel. There’s still more to do, but we’ve vaccinated the majority of them to date with support from the Philadelphia Department of Public Health. The return clinic for shot two just was recently held in Behrakis Hall. We staffed it ourselves and the health department allowed us to hold a vaccine clinic and brought in vaccine for us to use to help with the registration. Drexel volunteer faculty and students did everything in this vaccine clinic and the health department brought us vaccine and did the data entry for which we are so grateful. The College of Nursing and Health Professions, College of Medicine and School of Public Health students volunteered throughout various aspects of the clinic. We had Drexel EMS personnel and help from the Office of Protocol and Special Events and many more people pitched in. And it was pretty amazing. To see joy after so many hard months was so wonderful. We can vaccinate easily 500–1,000 people or more daily as soon as we have the go-ahead from our health department. They are currently working hard vaccinating those in Phase 1B.

Q: How has it been helping to steer Drexel during this pandemic?

A: I have to say, I’m an infectious disease physician and I trained to take care of HIV patients through the AIDS pandemic. It was a very hard time. COVID is something that most of us in our lifetimes have never faced, which is a disease that has impacted everyone more or less at the same time around the world. And the repercussions from it will be many and be with us for decades to come. There’s no shortage of things to look at. It’s noble work, it’s hard work and it’s evidence-informed as much as possible. We know that people are worried and scared and tired, and at the same time we also know that increasing numbers of people are excited and looking forward to coming back. I know I am looking forward to having a more regular, recognizable life! That’s the work of the Return Oversight Committee — we are overseeing the return and doing it in the safest way.

At Drexel, the students and the entire Drexel community have really just been doing an incredible job overall with being as safe as they can be and learning to socialize safely. I just want to say that strongly. And as we’re talking, this part of the term may be the hardest part as spring approaches. Because of winter and snow and cold temperatures, we have been inside and understandably craving to be with one another — craving for a social life. We’re so close to coming out of this. I know it still feels so long but I’m happy to say that infections are low, vaccine is rolling out, people understand to wear their face masks and keep appropriate distance and we are so close, so very close to being together in a setting that feels and looks like a vibrant urban university in one of America’s best cities. We just need to stay the course en route to the finish line.