With 27 Harvard affiliates now reporting positive test results for COVID-19, Harvard University Health Services Director Giang T. Nguyen said his office is working to coordinate with local health authorities and adapting the few in-person services it still offers in an interview Thursday.
As of Sunday evening, the number of Harvard affiliates — including University President Lawrence S. Bacow — who have reported testing positive for COVID-19 has slowly but steadily grown. Still, HUHS depends on the self-reporting of Harvard affiliates to arrive at that count.
Nguyen said HUHS responds to University affiliates who report positive test results but does not get in the way of steps, including contact tracing efforts, taken by local public health agencies.
“If they reached out and said that they were positive, we respond to them and certainly ask if they need any assistance or resources from us,” Nguyen said. “The contact investigation is the purview of the local department of public health in the jurisdiction where the person got tested. That is what the law provides for, so we don't step on their toes.”
He added that the constantly changing testing capabilities, resources, and access — as well as changing guidance from the Massachusetts Department of Public Health — may affect when University affiliates get test results.
“One person might get tested and wait for a week to get results and then someone else might get tested three days later and they find out within two days. It is not always entirely predictable,” Nguyen said. “You will likely continue to see changes in how we deal with things and how we approach testing.”
These realities, Nguyen said, are certainly not “satisfying” to either health care providers or those waiting for their own test results, but are issues that “the entire country is grappling with right now.”
In an attempt to limit the impact of the outbreak on the University, HUHS began providing virtual visits with patients to eliminate unnecessary in-person contact. According to Nguyen, this change generally does not negatively affect the diagnostic process.
“We have been providing many remote visits already and interacting with our patients — for example, talking to them on the phone and assessing their symptoms,” Nguyen said. “Many times the physical exam is a very small part of the diagnostic process. You want to try to focus on getting the most information from a distance that we can.”
If affiliates have COVID-19 concerns, Nguyen recommended that they email HUHS to keep phone lines open for people who are “medically unstable” and who need to immediately contact HUHS to determine their next steps.
HUHS established protocols for affiliates whose symptoms are sufficiently severe to merit a physical exam. All in-person visits are now scheduled, and both staff and patients are asked to wear facemasks to ensure their safety.
“If there is someone who does need to come in to see HUHS, what would happen is that they would be given a specific time to come in, our staff would be prepared to receive them at that time, and all of the necessary protective equipment and precautions would be in place for that evaluation to happen,” Nguyen said.
However, the majority of Harvard students are now off campus and unable to physically access HUHS for an in-person visit, should they need one. Nguyen said if a physical exam is necessary for someone in that position, HUHS can communicate with that patient’s local clinicians. However, he noted that the “vast majority” of cases do not require an in-person exam.
“If they need to have a person actually physically examine them, then that would have to be based on whatever local resources are present,” Nguyen said. “If the patient knows where they plan to go for that other care, there can be communication between our office and the other clinicians so that there’s an adequate hand-off.”
Nguyen said the updated HUHS protocols and guidance were established to maintain the health and safety of staff and patients as much as possible while still providing services.
“The goal is to be able to maximize social distancing in whatever way possible while still taking care of the medical needs of our patients,” Nguyen said.
—Staff writer Fiona K. Brennan can be reached at firstname.lastname@example.org. Follow her on Twitter @FionaBrennan23.