Conversations on COVID: Pitching in to help hospitals, health care workers, health officials

When clinical rotations at the Warren Alpert Medical School were paused, third- and fourth-year students found new ways to support Rhode Island’s frontline health care workers fighting coronavirus.

PROVIDENCE, R.I. [Brown University] — As Rhode Island confronts the COVID-19 pandemic, more than 150 third- and fourth-year students from Brown University’s Warren Alpert Medical School are volunteering their time to assist hospitals, health care workers and state health officials.

Based on recommendations from the Association of American Medical Colleges, medical student participation in clinical rotations was suspended on March 17, freeing hours for many students.

white coat“Immediately, the affected medical students started asking what they could do to help,” said Dr. Jack A. Elias, senior vice president for health affairs and dean of medicine and biological sciences at Brown.

The medical students are offering their expertise in multiple ways. To date, 152 students have volunteered to staff the 24/7 COVID-19 hotline for Lifespan, the state’s largest health system. Students assist a wide range of callers, including providers, patients and concerned members of the community.

Other efforts to assist continue to coalesce daily. Physicians based at practices have requested help from students with phone triage. The Rhode Island Department of Health has reached out in search of clinical student volunteers to take on shifts in which they will contribute in non-exposure settings — notifying patients and physicians of test results, investigating exposures, gathering statewide epidemiological data, and presenting histories to clinical experts as they weigh the need for COVID-19 tests.

Beyond direct medical efforts, students are filling a crucial role with everyday tasks — like child care and grocery shopping — for workers who don’t have the time or resources. Alpert Med Resource Aid, a group of students organized to meet these needs, has 90 students willing to volunteer in some capacity, and contracts for volunteers and aid recipients have been reviewed and approved by Brown’s Office of General Counsel.

The students’ efforts are illustrative of a much broader, still nascent effort at Brown to assist the community in contending with coronavirus on multiple fronts. Elsewhere on campus are other examples: conversations with the state on the use of Brown residence halls during the COVID-19 response; an urgent donation drive for N95 masks, gloves and other supplies for health providers; and faculty and other researchers’ expertise offered to state health officials on everything from laboratory testing to epidemiology to data modeling.

Elias said he’s incredibly proud of the medical students for stepping up so rapidly: “Clearly, no matter where they hail from, our students see Rhode Island as their community now and want to serve this community as much as they can,” he said.

In a Q&A interview, four of the medical students spearheading the volunteer efforts — Kira Bromwich, Lindsay Dreizler, Hannah Kerman and Harry VanDusen, who shared their thoughts collectively, in writing — discussed what the volunteer effort will enable health care workers to accomplish, what they wish the public knew about COVID-19, and how the experience might ultimately prepare them for careers in medicine.

Q: Why was it essential to volunteer your time and expertise so urgently?

We feel a responsibility toward our Rhode Island community. And on a larger scale, we feel a sense of kinship and camaraderie with the medical community at large. As typical classroom and clinical activities were paused, we began to look for other ways to get involved. Not only that, but also as future medical providers, we want to be involved now to learn how to respond to a possible pandemic in the future when we are providers. We want to be part of efforts to establish good institutional memory about how to respond during these global outbreaks.

Q: Can you set the scene for what it’s like inside of Rhode Island’s hospitals right now?

Medical students are not currently interfacing with patients due to guidelines released by national organizations. But before being pulled off of rotations on March 17, local hospitals were treating the first COVID patients and gearing up for an expected surge in positive cases. This meant a lot of preparation — taking stock of available personal protective equipment, implementing triage and treatment algorithms, and working to streamline patient care, as well as behind-the-scenes decision making. Some of the concrete changes have included hospital staff wearing masks at all times and restriction of all nonessential visitation. 

Q: What do you hope the volunteer contributions of med students will enable health care workers to do?

The hope is to help health care workers continue to work and care for our community. With changes like school closures, many health care workers are being asked to come into work with children at home. By identifying areas for logistical support like child care, groceries and volunteering at hotlines, we want health care providers to be able to focus on their jobs less burdened by these other considerations.

Q: What has the reception been like, both from hospitals and student volunteers themselves?

Administration and frontline health workers have been very receptive to the ideas students have been bringing to the table. Hospital staff running the Lifespan hotline have had positive feedback about the documents medical students have been working on to streamline calls. Leadership at the medical school and hospitals have been grateful and open to medical student collaboration.

In an unprecedented pandemic, it’s not surprising that there are so many unanswered questions, algorithms to create, procedures to codify. It really feels like being on the frontier of something new and scary, but also an immense opportunity for ingenuity. Medicine is very hierarchical, but times like this bring out a fairly novel type of collaboration among all tiers.

Q: How is this experience likely to change or prepare you for your future in medicine?

This type of pandemic may arise again. It is important as medical students to make careful note of both the successes and missteps made in mounting a response to this pandemic, as these lessons will be truly salient at some future time when we are the providers.

Q: What do you wish the general public could know about the current situation? And what can those outside of the health care profession do to help?

The response in Rhode Island is inspiring. However, the efficacy of our statewide response is severely limited by shortages and deficits on a national level. There are not enough tests. There is not enough personal protective equipment. Our hospitals and providers need the support of the federal government, immediately and on a massive scale.

That being said, as business, industry and individuals are able, they should continue to ask how they can best help locally — which often means staying home. Flattening the curve is not just a buzzword — it’s essential to spread out the impact on the health care system over time. This will keep the general public and health care workers safe. It’s essential to follow the CDC guidelines of good hand hygiene and limiting contact; these will help reduce the burden on the health care system.

In addition, like many health crises in the U.S., this will disproportionately affect more vulnerable populations, especially those with food and housing insecurity. People who have the means should consider how they can support members of their community who may be struggling without work and pay. As much as you can, support local businesses from home.

Q: Are there specific experiences that have impacted you most?

There are so many people who want to help. Community members have called offering donations of masks and personal protective equipment. We have also had many patients offering to 3D-print or knit masks for hospital personnel. We even had somebody call into the hotline asking about volunteering as an EMT. People are scared but they are also finding ways to be generous, flexible and to support their communities.