The COVID Czar
This week I am talking to Peter Granick, Associate Vice President Business Services and Chief Procurement Officer for Baylor University (@Baylor), and for the last several months COVID19 czar for Baylor University coordinating their response. Peter was excited to join the Baylor community on their procurement process but found his role changed in the early part of the year as the impact of the SARS-CoV-2 virus brought the COVID19 pandemic to our world and Baylor like everywhere else was sending its students home.
The response to the SARS-CoV-2 virus infection and the COVID19 pandemic have been wide and varied across the world and in the US. Navigating a successful path has been challenging as we struggle to find the truth as we chance science that is not clear and information that is moving in real-time. This requires making informed educated judgments constantly with the best information available.
The early work included incremental steps to improving the facilities and changing protocols for cleaning of the facilities, acquiring additional equipment to support that such as electrostatic sprayers, and thinking about what would be necessary for the fall return of students. As the Pandemic impact expanded Baylor formed its own internal team that started work on what the fall semester would look like under Pandemic conditions. Central to this was the need for a single individual, in this case, Peter, to be in charge of the response and all the areas including
- Contact tracing
- Facilities
- Communications
- Testing
- Data Analysis
- Isolation and quarantine
Supported by an outside team of advisors the group started preparing for the Aug 24, 2020 return of students that included one of the best decisions they made in the fall (and again for the spring semester) to test every student prior to returning to campus. Baylor engaged with EverlyWell who were offering an at-home testing kit that stopped around 150 students from showing up to campus already infected and risking big outbreaks that could have potentially closed the campus but with the added bonus of setting expectations for the community that testing was a requisite for attending college. You can hear about their surge in cases, how they handled this, how they managed their quarantined and isolation accommodation including the need to get the full services and monitor them, and a rapid response team for problem areas.
Compare this to this recently published Morbidity and Mortality Weekly Report (MMWR) report (Fox MD, Bailey DC, Seamon MD, Miranda ML. Response to a COVID-19 Outbreak on a University Campus — Indiana, August 2020. MMWR Morb Mortal Wkly Rep 2021;70:118–122) which reviewed an outbreak in August 2020 on University Campus in Indiana that had implemented a wide range of plans prior to students returning to reduce and mitigate any potential spread of COVID19 in the campus community. Despite these, the campus experienced an outbreak soon after the semester started and the campus switched to online classes and worked to mitigate the outbreak. As they highlighted in their summary the issues and management are complex but require a clear and aggressive focus on control and mitigation
Immediate, aggressive measures to decrease SARS-CoV-2 transmission through enhanced testing, timely contact tracing, provision of adequate isolation and quarantine space, increased screening of asymptomatic persons, and communication promoting adherence to mitigation strategies can help control COVID-19 outbreaks while minimizing disruptions to in-person instruction. This approach is consistent with recommendations for universities with outbreaks to avoid sending students home to avoid spreading infections into local and other communities
You can hear about their incremental dashboard development that has added GPS location-based insights, 3D rendering and includes off-campus location and housing, wastewater analysis (and how they learned from this data), and how this helped mitigate outbreaks in some halls and informed insights on communal areas causing more spread of the disease.
Listen in to hear Peter describe Baylor University’s unique and successful approaches and what you can learn and apply in your own college or business settings. Learn from their journey to find a more economical solution that is now part of their spring semester that includes weekly testing for students, faculty, and staff, and which one insight and change has provided a better path for their spring semester
Life is Short
Nature is Brutal
Epidemics and Pandemics are unsparing
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
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Raw Transcript
Nick van Terheyden
Today, I’m delighted to be joined by Peter Granick. He is the Associate Vice President of Business Services and the chief procurement officer at Baylor University. Peter, thanks for joining me today.
Peter Granick
Thanks for having me, Nick. Glad to be here.
Nick van Terheyden
So I, I always start the show with a little bit of background, I think you’ve got a very unique background that lends a lot of experience to some of the things that you’ve taken on at Baylor. Tell us a little bit about how you arrived at this role, and how much you’re doing a procurement right now at Baylor?
Peter Granick
Well, very interesting question. So my background is, is often procurement supply chain and operations, mostly with fortune 500 companies, Exxon Mobil did some consulting for Price Waterhouse Coopers, and then Thermo Fisher Scientific where I was VP of global sourcing, which was the chief procurement role there for nine years before taking on the global supply chain role, and actually took retirement there and I was bored at home. And my wife looked at me and said, out, so go find something to do. And I always I was always interested in the academic world. So I thought I’d look at academics. And I looked at a couple of universities, procurement roles. And Baylor struck me as having a lot of synergy personally, in that I started with Mobil Corporation, 35 miles down the road and temple. So I actually have friends in the area. And although I’m in Massachusetts, it just seemed like a good place to go. And certainly, one looking for a lot of change, and how they do business and how they move forward, in terms of the back office infrastructure at the university, and I was very intrigued by the individual who I report to Brett Dalton, who’s VP of operations for the university and Brett as a true change agent, and he wanted somebody to help execute and carry that helps. So that’s how I ended up at Baylor.
Nick van Terheyden
So you came in as a procurement person, but your role has flexed a little bit in the last months, I would say almost a year now.
Peter Granick
Yeah, Quite so. So it’s interesting, you know, it started out, kind of in a very, very subtle, slow way, in the spring, last year, long, around March, we shut everything down at the university, send students home, send faculty and staff home. And we started to figure out that the pandemic was real. I do remember sitting there in April, when we had about 96 cases in Waco, and everybody was panicking at that time over, hey, how is this going to spread? And one of the things we decided to start looking at because there still was some staff on campus, we started to look at facilities, and how do we keep facilities clean? What can we do incrementally differently than what we were doing at the time. So things like changing cleaning protocols going out and obtaining electrostatic sprayers for use periodically for reviewing the the HV AC and some of the corresponding filtering, really going building by building looking at how we could maximize fresh air, and then a lot of eh, and s rapid response stuff around room cleaning, and how do we do that? And then how are we going to if we’re lucky enough to come back in the fall? How would we face that from a facilities perspective? So that was really how I started my piece. And my role during that timeframe President’s Council was also they developed a group that they called 824, which stood for August 24, which was our go live open date, the date that they hope to bring everybody back to campus. And so they started making plans working with county health, and really looking at how do we keep students safe in a pandemic, and it began to, to take shape that it was obvious we were not going to get through this in a two to three week period or even a two to three month periods. So they started to really do what they called tabletop exercises where they would look at different pieces around travel around dining around safety around social distancing. Really not knowing where to go, but calling upon experts and looking at what the CDC was publishing, and how do we bring all of that together. And so, along about August, August one, they asked me to take on the role of campus leader for the COVID response, really that included contact tracing in including facilities and management, communications. It included testing, data analysis, and then what do we do for things like isolation and quarantine. And so all of those pieces had different elements. And we needed to put together a whole slew of sub teams to address each one of those avenues. And that’s really how we got we got started with it and how I became engaged with it.
Nick van Terheyden
So fast forward multiple months, I think, you know, I can say, you’ve had ups and downs. But I mean, overall, very successful. I mean, you you opened, I don’t recall if it was August 24, or not, but was it you, you manage to bring students back? It was a moving target. Tell us a little bit about some of the things that you learned, especially in the early days, that really made a big difference in being successful? Because we could look around and see lots of places that were not, you clearly did some things that were right. Any thoughts about where those inflection points were for you? and surveillance? Yeah, I
Peter Granick
think, you know, one of the best decisions we made was right up front testing everybody before they came back to campus. So we went and we looked out on the marketplace at various options, and we settled with everlywell, which is a home kit, tac path, Thermo Fisher based, and we went and literally sent every single student employee and staff a kit. And they took that test, and we were able to weed out about 101 140 950 cases. And so that was quite helpful. And from there, we set the expectation that we also needed to test every week. But we realized at the cost of what was available on the marketplace that it was prohibitive to test every single student staff and employ a faculty member every week, at that point. So what we settled on was testing students at 10%. For those that were residing on campus, and 5%, or those that were residing off campus, that was where we initially started out. We also anticipated that we would have a little bit of a surge at the beginning of the fall semester, what turned out was really a wave. We got hit with over 400 cases in the first week and a half, two weeks of campus. And that created a lot of challenges for us one, what do we do with the students that were ill that we came up with positive so we developed isolation housing very quickly, we went out and actually leased an entire hotel. And we use that as as a staging area for folks that had the virus, as well as several apartments. Within the perimeter of the campus, we went out actually got a whole slew of flats. We ended up we felt we needed around 300 beds, and that’s where we ultimately settled was around 300 beds. We also had to look at what are we going to do with quarantining and then once you quarantine and you isolate these students, how do you actually serve them? How do you actually make sure they’re getting food, make sure they’re getting what they need in terms of work, make sure that they’re not doing things that they shouldn’t be doing, like walking around the hotel and those types of things. So we learned a few lessons there as we went forward. One was putting staff on the floors of the hotels where we had students isolated. That came a little late and we had a little anxiety with the hotel at the beginning. But we learned very quickly and adjusted accordingly as we went through that. And then other things were How do we go in then and clean the rooms of the of those that were identified as being positive one for the roommates who were Then in quarantine, but also to ensure that we don’t have any spread through the rest of the building. So we developed a rapid response team that literally goes in sprays down and cleans everything in the room. And that’s been very successful. And that was a lesson learned as we went forward. And then, as we continue down the path, one thing that became acutely obvious as we went through things is this, the surveillance testing was showing us where we had multiple cases in the same residence halls, or the same apartment complexes around campus. And so we needed to kind of adjust and address both of those a little differently. So the off campus clusters that we identified, we were able to map with a dashboard that we developed, which has since become incredibly complex. And frankly, I think it’s one of the best data analysis tools that we developed in this whole process. And that’s live, you can go on to Baylor’s website and actually see that there’s an awful lot of mechanics behind it, and a lot more flexibility behind what we show publicly. And that enables us to go and really hone in in certain areas. But from a residence hall perspective, what all of that data analysis allowed us to do was to go and find areas of cluster areas. And we were actually able to go back and develop 3d maps of all of our dorms, or residence halls, and identify where right back to the rooms, where we were seeing those clusters developed. So if we had, we have a hall called Martin Hall, it was one of the first ones where we had a cluster. And we looked and we identified that it wasn’t just Martin Hall, it was the fourth floor of Martin Hall wing acts, whatever the wing was, I forgot which one it was. But we were able to actually go in and identify that we had five or six rooms on one wing of the fourth floor, that we needed to go and do something different. So we did what we call, we developed what we called focus testing, we would literally take equipment to the hall. And we would test everybody on the floors that we identified as being concerns areas. And that enabled us to very quickly lock down additional spread, and remove those students and put them in isolation and also quarantine where we needed to. And that ability actually allowed us to go and put a a lid on an awful lot of the spread that we developed, or we saw it developing. And it worked throughout the semester, it really allowed us that flexibility. And that ability to go in and look at the data at that level allowed us to identify exactly where we had issues. What was really interesting also Nick is where we had communal halls, where we were able to go in and identify Hey, wait a minute, not only is this a residence hall where we have a cluster, but we also have communal restrooms. And hey, we need to do something different there. And we need heppa filters have a filtration, we need to go in and spray multiple times a day to knock down the any virus that’s in there. And we need to increase our cleaning protocols. So that became part of our focus area and something that we really pivoted to. And then along about mid semester, I think it was September 28, Dr. Burks came to visit us. And we had the opportunity to spend an hour with her and present everything that we were doing. And the only suggestion she had for the health management team. And I remember this vividly was increase the number of tests you are doing for off campus students and increase that from 5% to 10%. And so we did that. And what began to show was the level of spread outside of the bubble that we had created on campus that we needed to extend that bubble, that dome over the apartment complexes where the students lived. And so we took a very, very direct route, not only identifying using the dashboard that we had developed where those cases were within the last month, within the last two weeks or even within the last week, but it allowed us to go right down to the address level and meet with each of those complexes where we had issues. And what was very telling is most of them had communal areas open so the gyms were open, the saunas were open, the pools were open, the kitchens were open. The lounges were open so they could go and watch TV together. And once we we educated we had discussions with them. We saw a marked change in the in the amount of off campus spread that we saw and most of the options apartment complexes were really willing to work with us on that. So that was just some of the stuff that we we went after. The other thing that was really helpful was we went out very quickly to develop a contact tracing, not only protocol, but a real depth a real roster of volunteers that could assist us in tracking down and interviewing the students and identifying all of those that needed quarantine. And that was something we realized very early on. Literally within the first week that we didn’t have enough volunteers, we ultimately ended up with a ratio of one to 400 which is, I think the CDC guidelines at the time was one to 1200 or higher, even. But we were at wonderful 100. And that helped immensely as we went forward.
So
Nick van Terheyden
those of you just joining, I’m Dr. Nick the incrementalist and today I’m delighted to be joined by Peter Granick. He’s the Associate Vice President of Business Services and chief procurement officer at Baylor University, we were just talking about the COVID response, I think the extensive level of detail, one of the things I want to dive into just a little bit, because I think it’s really significant is this incredible level of granularity that exists in the database and the data. You talked a little bit about it, but you had full on GPS tracking of cases that allowed you to get to sites, locations, floors, and a focus defect. How did you do that? What was involved?
Peter Granick
So we we very quickly realized up front that we are our data analysis was lacking rather severely. And one of the things we felt was, is there a way to actually do statistical analysis around this. And not only that, but to your point, locate the exact location. And I don’t just mean the floor, I mean, the room, the apartment number. And so we started to develop a dashboard, which, which was very elementary, when we started it was, how many tests have we done? How many positives do we have? What’s our number? And then how do we expand that to identifying where we’re developing clusters. And so we began to map out all of the, we use the resources of the university to get a hold of all the maps of the of the rooms, and then of the residence halls. And then we took that to the next level and actually created 3d. So you can literally go in and look at the room number on the various floors. And once we were able to do that we literally changed the questions that we were asking of those that were positive, what’s your room number? You know, how is your roommate, you know, it changed our contact tracing efforts as well. And so that was a that was a huge, positive. And then it literally just matured week over week over week from there, as we realized we needed additional data or things became necessary as we went forward. So even as little as the last few months, we’ve been making changes to it, where we’ve added some things. And then of course, we started looking at wastewater from the residence halls. And we also use the true hotel where we had only folks that were positive in isolation, to develop a base level analysis of the count of virus per shed per person in the hotel, because the only folks in the hotel were those that were positive, and the leadership that we had put on each Florida monitor. And so that allowed us to develop a ground level a base level. And then we took that back and started testing all of the residence halls. And that got added into the dashboard around late October, November. And we started to use that. This is where we learned, we started to use that to direct us to Okay, this whole week, we have an enormous count in the wastewater and it’s showing up, we better go in there and do some testing. And so we would go in and do the testing. And strange things started to happen. The first thing that happened is it correlated perfectly with Martin Hall, we had a big cluster, and the count was off the charts. But the next week, we had a cluster in another Hall. And it didn’t correlate. And we said okay, why? And we started to begin to understand that it was either past positives, or it was folks that were asymptomatic. And so we started to look at the data from that perspective. Okay, when did we When did we have a, a cluster that Plus or a surge in haul? a? And was it a couple weeks ago, three weeks ago? You know, what’s what’s happening there? And when we didn’t find anything there, we started to say, okay, is this a barometer for a future surge? And then can we correlate that so we started to track that data, and that got added to the dashboard. And then we started to do a lot of analysis around how many people were testing, where we’re testing what we’re doing from a search perspective, we began to look at the testing in two different ways. So we looked at it from the qpcr level to the antigen testing, where we had folks go that were symptomatic, so we set up a completely separate test location for those that were symptomatic, where they could go to the health center and get what they needed immediately. So it just started to evolve as we went forward.
Nick van Terheyden
So as you think about the future, project out a little bit and try and assess. And I know it’s difficult, you know, this has been a moving target. I’m keen to understand, you know, if you have quotes for the coming months, you know, perhaps to get back to procurement. And, you know, specifically, if there was anything in that sort of history that go Wow, that was that small insight made a big difference. And if you could change or influence one thing, what would it be?
Peter Granick
Well, you know, the, you know, the one thing that that really struck me, was something that that Deborah Burke said during her visit, Dr. Burke said, ideally, you would want to test every student, faculty and staff member weekly. Because that would allow you to open up to one not wait for a cluster to develop, you would identify the individual cases before they were able to spread it, you would be able to open up to much wider activity and really expand the college experience back to some level of normality for the students and staff. And so that became a challenge for us. And the key to that was figuring out a path to, to actually being able to do that. So we looked at some protocols from Yale from Illinois. And we looked at the price points. And we thought, you know, we’ve got a real opportunity here, because we want to drive to r1. Tier One, what if we invested in our own equipment and develop the lab where we could go ahead and analyze our own tests, and we could partner with the folks that that have been doing the testing for us? Does that get us to a point where we would be able to economically, actually test everybody every week, so that we could begin to open the campus back up to a much more normal environment. And so we did a couple of things. As we were closing out the fall semester one, we put a moratorium on events. So we didn’t want the students getting together collectively and going through things. And that was something that we did on the health management team incrementally, where we looked at it and we said, okay, till February 7, we’re going to go ahead and put this lock down. And the reason we chose the seventh was we wanted to get past any surge in the spring. So when we looked at the spring, we had both the lab going in, where we invested in the equipment to do that a Thermo Fisher amplitude, which allows us to test that the or process about 8000 tests a day. So certainly if if we look at the campus population, we’re using about 3000 tests per day capacity of that 8000. So that allowed us to go in and do things. And even with the investment in the equipment, and the testing of everybody every week, we we were able to go ahead and do it at a cost less than what we did in the fall. So that that truly allowed us to do things a little bit differently. So in terms of your your question directly, the thing that really I’m looking forward to is one, the moratorium ends this coming weekend. So we’re going to be able to open up we’ve been very successful in opening the lab, we had some startup challenges, but we’re getting past that. And we’re to the point where we can test and get results to some folks on the same day, which is what our what we wanted to accomplish as we went through this. So we’re going to be able to open up the campus and begin to start with a lot of events. A lot of things that the students want to participate in. There are a lot of group activities and groups at Baylor over 120 Now that I’m at least aware of all of them have put into two, hey, how do we do this? How do we begin to pull together? And so our focus now is looking at how we can allow them to do that safely. So ensuring they’re socially distance, ensuring they’re going through all the safety protocols we pulled together, and allowing them to begin to convene starting literally, February 8, and going forward. So that’s something we’re looking forward to. And then I’m looking forward to the vaccines.
Nick van Terheyden
I think I think we all are, and I am the hope that that will actually open things up even further. Unfortunately, as usual, we’ve run out of time. So it just remains for me to thank you for both sharing, you know, some incredible insights, I think learning points that people can derive value from and also congratulate you on what I think has been both the learning journey, but also a successful journey for Baylor and the students, faculty and staff. So thanks for joining me, Peter.
Peter Granick
Well, Nick, thanks for having me. I really appreciate it. And I appreciate all the help that you and your accountable health colleagues have provided to help guide us through this process. It’s been it’s been a learning experience for all of us and we certainly appreciate the help that you provided.
