Gatepost Interview: Ilene Hofrenning – Director of Health Services

Courtesy of Framingham State

How has COVID-19 impacted your work?

It’s impacted it greatly. For one thing, our clinical work is much different. We’re trying to do things by telehealth as much as possible because it’s important to maintain that six-foot distance as much as we can. If we’re seeing somebody as a patient at the health center, we really can’t maintain that six-foot distance. So, we’re trying to do a lot over telehealth. So, we might do the entire visit over telehealth if we can, or we’ll do the history and talking to the students through either Zoom or telephone, and then have them come in for a physical or a brief checkup, or if it’s something like STI testing or maybe a urinary tract infection, then we’ll have them come in and give us a sample. And then we can get back to them with the results over telehealth as well. 

So, that’s a big change. The other big change is that if we do see anybody in person because of the fact that we are within six feet, we have to be wearing PPE [personal protective equipment]. So, we’ll have the heavy masks on and the face shields as well. Sometimes gloves and gowns, too, depending on what kind of interaction it’s going to be. If we’re getting specimens that could produce aerosols, like if we’re doing a strep throat culture, or the flu culture where the nasal swab goes way up in the nose, then we wear the N95 masks as well with the face shields and everything. That impacts the work because it’s not exactly comfortable wearing those things, and it also feels like it puts a barrier between you and the students. I mean, it’s kind of odd to be talking to someone who’s got all this garb on. 

For people with respiratory symptoms, we are going to be examining them in a different area. We’ve identified room 102 in Foster Hall … And we’ve just had them install HEPA [High-Efficiency Particulate Air] filters. They put a couple of filters in there to enhance the air flow air exchanges with outside air to make it a safer place to work in. So, that’s where we’ll be seeing people with respiratory symptoms, and doing testing as well. 

What is your role in keeping the University running?

We’re, especially me, much more involved with decision-making around campus in terms of how should the campus respond to the Coronavirus – policies around isolation, quarantine, and testing. … There’s a zillion things that come up in terms of questions – how do we handle this? How do we handle that? Eating in the dining hall? What’s the best way to make it safe for students? Helping by setting up the tents outside so people, students, have places to hang out outside where it’s safer as well – thinking about those things and sharing it with other people. 

Another aspect of my role is sort of being in contact with the local board of health, the Massachusetts Department of Public Health MetroWest Medical Center,  just sort of keeping up with what they’re doing and getting guidelines, recommendations, and advice from them as well. Like I said, everything is new. We’re all sort of figuring things out as we go along. … I have a great directors group with directors from other health centers – 40 other directors in the sort of Greater Boston to Worcester area, which has been really great in terms of asking, “Can we deal with this?” “What’s the best way?” and sharing ideas.

What role is the Health Center playing in keeping COVID-19 cases down this semester?

Part of our role is education – talking about prevention, making sure the signs are up saying, “Six feet apart,” and “Wear your masks,” and educating, not only students, but faculty and staff as well. One thing that we’re emphasizing more now is a symptom checking. This week and next week, we’re going to be having a big campaign about how everybody needs to, every day, think, “Do I have X, Y, and Z symptoms that could be signs of Coronavirus?” because it is really interesting how different the symptoms are for Coronavirus. … If you have mild symptoms, we’re just going to test you to make sure that it’s not COVID-19. But that also means that it takes 24 hours to get the results back. So, that means that when we test someone, they need to be isolated for 24 hours just in case it is positive. The likelihood of mild symptoms is it’s probably not [COVID-19] – it’s probably allergies or a cold or whatever, but we just don’t know, and we need to stop any kind of transmission. So, we’ll put someone in isolation for 24 hours, and make sure that it’s not COVID-19. So, education and then early identification of anybody who could possibly have COVID-19, and then the isolation, quarantine, and the contact tracing. So, if anybody’s positive, then we do talk to them and find out about anybody they had close contact with, and then contact those people and put them in quarantine.

Does the Health Center play a role in testing?

We kind of run it, but there are a lot of people helping. We’re the ones who are in communication with the Broad Institute – that’s the lab that does the testing. We also did the training for everybody who’s helping out with the testing. But we have lots of people helping. … We need someone who asks everybody who comes if they have any symptoms because we don’t want anyone who has symptoms coming into the gym and possibly exposing other people. So, we send them over to the health center. Then, we have a number of greeters and traffic flow people who tell people exactly where to go so no one’s confused. Then, we have at least five people who register students in what’s called the “Care Evolve System” – that’s the Broad software system so they can print the labels that go on their tubes. Then, we have five people who observe everybody doing the self-swabbing. So, that’s at least 15 people per shift, and we like to have two shifts. Some people do the whole day, but that’s a lot. So, that’s at least 30 people that we need per testing day. … All around campus, many departments have sent some other people over to work. We have students who are helping out, which has been great. We have at least one of our SEALs helping out. It’s a massive effort with everybody on campus. Last week, … with the 10 students that we had positive from the same dorm, we decided that we needed to test everybody in the dorm. Within 24 hours, we had pulled together another testing session on Friday. So, we had extra volunteers who came in for that, so that was really helpful. We’re the ones who get the results, and then we, of course, notify anybody who’s positive and work on getting them into isolation, quarantine, and finding out who their contacts are. 

Do you have anything else you would like to say pertaining to COVID-19?

I just want to say that controlling the pandemic, keeping the University open, and keeping people healthy is everybody’s job. We all have to do the masking, the social distancing, the personal hygiene, and washing hands frequently. … We also have to feel OK about saying something to people who are not doing it as well – sort of like in an educational way that these are the guidelines, these are the rules, you need to do X, Y, and Z. But the Health Center can’t do it alone. The administration can’t do it alone. We need every single person to really be vigilant. So far, I feel like the fact that we have had no positive test in our last two testing days is really good. I think there are some people who are maybe a little lacking, but I think a lot of people are maintaining the social distance, and wearing the masks. We just really need to keep that up so that we can keep the University healthy and keep it open for the rest of the semester. … My final words are to say, “Thank you,” to everybody who’s really trying as hard as they can, and please keep up the good work and the vigilance because we can do this!