COVID-19 Tracking & Prevention
Health Care Delivery and Behavioral Health
- Engaging Patients in Rescheduling Colonoscopies Delayed Due to COVID-19
- COVID-19 and Acute Medical Care: Impact on Dementia Patients
COVID Treatments and Outcomes
Highlights of Mongan Institute Faculty COVID-19 Research: Population and Healthcare Delivery Science and the Global Pandemic
COVID-19 Tracking and Prevention
Preventing COVID in Staff and People with Serious Mental Illness and Intellectual Disabilities/Developmental Disabilities in Congregate Care Settings
Stephen Bartels, MD, MS
Director, Mongan Institute
Stephen Bartels, MD, MS, is leading a research team to determine best practices to prevent COVID-19 for people with serious mental illness and developmental and intellectual disabilities in congregate living settings and for the staff who provide care. His team has been approved for a $4.9 million funding award by the Patient-Centered Outcomes Research Institute (PCORI). The study team will also work to develop approaches that address COVID-19 health disparities that may be associated with race, ethnicity, and degree of disability.
Dr. Bartels will oversee the study with co-principal investigator Dr. Brian Skotko, the Emma Campbell Endowed Chair on Down Syndrome and Director of the Down Syndrome Program at Massachusetts General Hospital. Dr. Bruce Bird, CEO and President of Vinfen, will lead the community partnerships, involving approximately 400 group homes with 2,000 residents and 3,000 staff across the Commonwealth of Massachusetts.
Six partnering behavioral health and developmental disability organizations will participate in the study (Vinfen, Bay Cove Human Services, Riverside Community Care, North Suffolk Mental Health Associates, Advocates, and Open Sky Community Services), in conjunction with the Massachusetts Departments of Mental Health and Developmental Services, Mass Advocates Standing Strong, The Arc of Massachusetts, the National Alliance on Mental Illness of Massachusetts, the Massachusetts Association of Mental Health, and the Massachusetts Down Syndrome Congress.
COVID Symptom Tracker App and the COronavirus Pandemic Epidemiology (COPE) Consortium
Andy Chan, MD, MPH
Andrew T. Chan, MD, MPH, is leading a research project to identify risk factors for COVID-19 infection and to produce data on their clinical outcomes over the near- and long-term. With emergency funding from the UK National Health Service and the Wellcome Trust, he helped launch a mobile “COVID Symptom Tracker” app that was co-developed by King's College and Zoe Global Ltd. It was deployed in the UK on March 24, 2020, garnering over 1 million downloads in just 48 hours. The US version of the app was deployed shortly afterwards. Click here to learn more about the COVID Symptom Tracker and the COPE Consortium.
Dr. Chan is a Professor of Medicine at Harvard Medical School, Chief of the Clinical and Translational Epidemiology Unit at Mass General, and Director of Cancer Epidemiology at the MGH Cancer Center.
In the media:
La nueva aplicación de investigación de los síntomas del COVID-19 está reclutando a millones de americanos, incluyendo a profesionales de la salud, pacientes de cáncer y sobrevivientes, para vencer la enfermedad (Massachusetts General Hospital)
Simulation Modeling: Clinical and Economic Analysis of COVID-19 Interventions
Ken Freedberg, MD
Travis Baggett, MD, MPH
Andrea Ciaranello, MD, MPH
Krishna Reddy, MD
Mark Siedner, MD, MPH
Building on decades of work assessing the cost-effectiveness of different approaches to preventing and treating HIV, the MPEC team at the Mongan Institute has applied its expertise to the COVID-19 pandemic. Under the leadership of Dr. Ken Freedberg, the Medical Practice Evaluation Center (MPEC) team has built on its simulation modeling expertise initially developed for HIV to create the Clinical and Economic Analysis of COVID-19 interventions (CEACOV) model. CEACOV is a dynamic microsimulation model that incorporates data on the natural history and treatment of COVID-19 to predict the costs and outcomes of different prevention and treatment strategies. Among the many applications of this model include: a demonstration the cost-effectiveness of screening adults in Massachusetts led by Drs. Anne Neilan and Andrea Ciaranello; an assessment of the impact of different strategies for managing COVID-19 among sheltered homeless adults led by Drs. Travis Baggett and Ken Freedberg; a study of testing and prevention of COVID-19 on college campuses led by Drs. Elena Losina and Freedberg; and an analysis of approaches to prevent the spread of COVID-19 in South Africa led by Drs. Krishna Reddy and Mark Siedner.
Observational Data Collection for COVID-19 Suspects/Cases
Ingrid V. Bassett, MD, MPH
Virginia (Jeanne) Triant, MD, MPH
Ingrid Bassett, MD, MPH, James Meigs, MD, MPH, and Virginia (Jeanne) Triant, MD, MPH, are leading an effort to launch observational data collection for COVID-19 suspects/cases across all Partners HealthCare hospitals. This builds on expertise from multiple specialities and will utilize a combination of manual chart review and Epic data extraction. There will be a focus on special populations (e.g., pregnant women, pediatrics, people living with HIV). The team is also working with hospitals throughout Boston to harmonize data for a Boston-wide observational cohort study.
New and updated releases of the registry data are now available to the MGH community and can be accessed here.
Dr. Bassett is Co-Director of the Medical Practice Evaluation Center within the Mongan Institute at Massachusetts General Hospital, an Associate Professor of Medicine at Harvard Medical School, and an infectious disease physician at Mass General.
Dr. Meigs is a Professor of Medicine at Harvard Medical School, a physician in the Division of General Internal Medicine at Mass General, and Co-Director of the MGH Clinical Research Program’s Clinical Effectiveness Research Group.
Dr. Triant is an associate physician in the Division of General Internal Medicine at Mass General and an Assistant Professor of Medicine at Harvard Medical School.
COVID-19 International Dermatology Registry
Esther Freeman, MD, PhD
Esther Freeman, MD, PhD, launched an international COVID-19 dermatology registry with the American Academy of Dermatology (AAD). Through the information collected through this registry, researchers discovered "COVID toes," a potential symptom of COVID-19. For developing this international registry that tracks the many ways COVID-19 manifests itself through the skin, Dr. Freeman was honored as a Patient Care Hero by the AAD.
Dr. Freeman is Director of Global Health Dermatology at Massachusetts General Hospital and Assistant Professor of Medicine at Harvard Medical School.
COVID-19 Global Rheumatology Alliance
Zach Wallace, MD, MSc
Zachary Wallace, MD, MSc, is on the Steering Committee of the COVID-19 Global Rheumatology Alliance, which launched an IRB-approved physician-reported registry to collect cases of rheumatic disease patients infected with COVID-19. There is also a complementary patient-reported experience registry.
Dr. Wallace is a rheumatologist and researcher in the Division of Rheumatology, Allergy, and Immunology Clinical Epidemiology Program and an Assistant Professor of Medicine at Harvard Medical School.
Rapid Acceleration of Diagnostics in Underserved Populations (RADx-UP)
Gina Kruse, MD, MPH
Gina Kruse, MD, MPH, is the Implementation Lab Director on a Rapid Acceleration of Diagnostics in Underserved Populations (RADx-UP) NIH supplement. Led by the Harvard T.H. Chan School of Public Health (Karen Emmons), the MGH Kraft Center for Community Health (Elsie Taveras), and the Massachusetts League of Community Health Centers (Susan Dargon-Hart) and building upon the implementation science research infrastructure of the Harvard Implementation Science Center for Cancer Control Equity, the RADx-MA project aims to create community health center (CHC)-community partnerships to accelerate access to and trust in testing in six of the hardest hit communities in Massachusetts. Partner CHCs include Caring Health Center and the BeHealthy ACO in Springfield, Brockton Neighborhood Health Center, Family Health Center of Worcester, Lynn Community Health Center, DOTHouse Health in Dorchester, and the MGH Community Health Centers. The project will pilot a series of community engaged approaches to address key barriers to testing. At the MGH Community Health Centers, RADx-MA is leading the operations and staffing for a mobile testing van in partnership with Mass General Brigham and a local minority-owned transportation company, DPV Transportation. The van serves the communities of Revere, Everett, Charlestown, Chelsea, and Lynn to get testing to the people and places with the greatest needs.
MGH Equity and Community Health COVID Response Team
Joseph Betancourt, MD, MPH
Aswita Tan-McGrory, MBA, MSPH
Joseph R. Betancourt, MD, MPH, Vice President and Chief Equity and Inclusion Officer at Mass General, is leading the MGH Equity and Community Health COVID Response Team with Joan Quinlan, MPA, Vice President of Community Health. Aswita Tan-McGrory, MBA, MSPH, Administrative Director of the Mongan Institute and Director of the Disparities Solutions Center, is also part of the MGH Equity and Community COVID Response Team.
The MGH Equity and Community Health COVID Response Team is working to assure that all we do to address COVID at MGH has equity and community health as our foundation. The team has workstreams focused on assuring that all communications to patients and employees are in multiple languages, that all clinical interactions have the capacity to meet the needs of diverse and multilingual populations, and that the critical social needs of our communities are addressed.
Click here to learn more about equity in the COVID-19 response. This website page has recommendations for addressing equity in the COVID-19 response, and a repository that has:
Multilingual resources to serve the needs of patients, providers, and employees who speak languages other than English
Resources to support clinicians working with people with disabilities
Community health resources
Articles & Publications:
3-part series on COVID-19 and equity on Harvard Health Blog
In the media:
COVID-19 and Health Equity, Community Engagement Research, and Advocacy
Julie Levison, MD, MPhil, MPH
Julie Levison, MD, MPhil, MPH, is Co-Director of the MGH Chelsea Community Research Program, where she and her colleagues developed a Clinical Research Advisory Board to review COVID-19 research protocols at MGH Chelsea HealthCare Center with attention to equity and cultural and linguistic appropriateness.
Dr. Levison is involved in a number of COVID-19 efforts. She is a member of the Diagnostics Working Group of the Massachusetts Consortium on Pathogen Readiness, an unprecedented, multi-institutional research collaboration that aims to stem the tide of COVID-19 and create a rapid-response system to address future health crises. Dr. Levison is serving on the COVID-19 sub-committee of the Massachusetts Ending the HIV Pandemic Steering Committee, as well as on the Advisory Board of the Infectious Diseases Society of America Research Committee.
Dr. Levison is also a Co-Investigator on a study led by PI Daphne Holt, MD, PhD, Resilience and Prevention Intervention for Health Care Workers.
In the media:
Impactivo, Day Health Strategies partner to support healthcare providers (News Is My Business)
Primary Care Transformation in a COVID-19 World (Harvard Center for Primary Care)
Radiology and COVID Disparities
Efren Flores, MD
Efren Flores, MD, is a member of a COVID-19 research team that focuses on projects at the intersection of imaging findings of COVID-19, health disparities in the pandemic related to social determinants of health, and clinical operations. A key finding has been that Black and Hispanic patients faced more severe COVID-19 and greater lung damage than white patients.
Dr. Flores currently serves as a board-certified staff radiologist in Thoracic and Emergency Radiology at Massachusetts General Hospital (MGH) and is an Assistant Professor in Radiology at Harvard Medical School. Before this position, Dr. Flores graduated from the University of Puerto Rico Medical School and trained in radiology at MGH, a Harvard Medical School affiliate. Dr. Flores’ research focuses on identifying social determinants of health impacting access to care among vulnerable patient populations to guide the implementation of novel health equity programs.
Detection of Unsuspected Coronavirus Disease 2019 Cases by Computed Tomography and Retrospective Implementation of the Radiological Society of North America/Society of Thoracic Radiology/American College of Radiology Consensus Guidelines (Journal of Thoracic Imaging)
Pulmonary vascular manifestations of COVID-19 pneumonia (Radiology: Cardiothoracic Imaging)
Implementation of the Radiological Society of North America Expert Consensus Guidelines on Reporting Chest CT Findings Related to COVID-19: A Multireader Performance Study (Radiology: Cardiothoracic Imaging)
In the media:
Health Equity in the era of COVID-19 (ACR Bulletin Podcast)
Minority Patients Face More Severe COVID-19 (Diagnostic Imaging)
Racial disparity in COVID-19 severity (HCP Live)
Racial/Ethnic disparities in severity of COVID-19 lung disease on admission X-Ray (MassGeneral Hospital Advances in Motion)
Chest x-rays show more severe COVID-19 in non-white patients (Science Daily)
The effect of COVID-19 in Hispanic and Afro-American minority patients (El Financiero Bloomberg)
COVID-19 Mental Health Disparities: Call for Research Participants
Margarita Alegria, PhD
As part of the COVID-19 response, the Disparities Research Unit staff at the Mongan Institute have adapted our STRONG MINDS program for adults 18 years or older who are fluent in English, Spanish, Mandarin, or Cantonese, with symptoms of depression, anxiety, or trauma to participate in this research study. We aim to help adults better handle stress, and lead happier and healthier lives by promoting mental health in these times of extreme uncertainty. We would like to see how COVID-19 is impacting your life and how STRONG MINDS can help you cope with the related stress.
Eligible participants who speak any of the study languages may receive at no cost 10 individual psychoeducation sessions and referral to services by a care manager. The sessions will introduce you to skills that may help you manage unhelpful thoughts, strategies to practice self-care and mindfulness, and ways to maintain a more positive outlook on life. If interested, please contact Dr. Larimar Fuentes in English or Spanish at 617-643-0514 or 617-755-0763, or Liao Zhang in English, Mandarin, or Cantonese at 617-417-4783.
Dr. Maggie Alegria is Chief of the Disparities Research Unit and a Professor in the Departments of Medicine and Psychiatry at Harvard Medical School.
In the media:
Frontline Clinician Resilience Program
Elyse Park, PhD, MPH
Karen Donelan, ScD, EdM
Elyse Park, PhD, MPH, is leading the Frontline Clinician Resilience Program, which helps Partners HealthCare employees develop resiliency skills to adapt to the additional burden COVID-19 has placed on the medical system and its constituents. This program offers one-hour sessions that are held twice weekly for 4 weeks via Zoom to help those providing direct care to patients with much-need stress management, self-care, and resiliency tools during the COVID-19 pandemic. Partners HealthCare physicians and nurses can register for the groups at the Benson-Henry Institute website by clicking here.
Karen Donelan, ScD, EdM, and Christine Vogeli, PhD, are partnering with Dr. Park on behalf of Partners Population Health to conduct a pre/post assessment.
Dr. Park is an Associate Professor of Psychiatry at Harvard Medical School, Associate Director of Survivorship Research and Psychosocial Services for the Mass General Cancer Center Survivorship Program, Director of Behavioral Sciences at the MGH Tobacco Treatment & Research Center, and Director of Behavioral Research at the MGH Benson-Henry Institute for Mind Body Medicine.
Dr. Donelan is a senior scientist at the Health Policy Research Center within the Mongan Institute at Mass General, Director of the Survey Research and Implementation Unit in the MGH Division of Clinical Research, and an Associate Professor of Medicine at Harvard Medical School.
Dr. Vogeli is an Assistant Professor of Medicine at Harvard Medical School and Director of Evaluation and Research at Partners Population Health.
Christine Vogeli, PhD
Health Care Delivery and Behavioral Health
COVID and Home-Based Care for Elderly and Seriously Ill Adults
Christine Ritchie, MD, MSPH
Christine Ritchie, MD, MSPH, is co-leading the Home-based Care Workgroup with Judy Flynn of Partners Home Health as part of Partners’ Covid Continuum of Care response. This Partners-wide effort includes: 1) Adapting infection control guidelines for all home visits (including people who are immunocompromised, frail elderly, and other seriously ill adults); 2) Creating an inventory for all programs that involve visits at home to optimize coordination and workflows; 3) Developing frameworks for triaging all home visits; 4) Developing capacity strategies to accommodate outflow from hospitals; 5) Engaging an environmental scan of national guidelines and best practices; and 6) Optimizing Communication (clinician, patient), dissemination.
Dr. Ritchie is the Kenneth L. Minaker Chair in Geriatrics and Director of Research for the Division of Palliative Care and Geriatric Medicine at Massachusetts General Hospital. She is a board-certified geriatrician and palliative care physician and conducts research focused on optimizing quality of life for those with chronic serious illness and multimorbidity. She co-leads the NINR-funded Palliative Care Research Cooperative and the national Home-based Primary Care and Palliative Care Consortium, which seeks to improve our understanding and care of the homebound population. Dr. Ritchie is the Director of the Center for Aging and Serious Illness Research at the MGH Mongan Institute.
Impact of the COVID-19 Pandemic on Tobacco and E-Cigarette Use in Multiple Populations
Nancy Rigotti, MD
Gina Kruse, MD, MPH
Doug Levy, PhD
Joanna Streck, PhD
Cigarette smoking is a risk factor for severe COVID-19 disease. The pandemic’s financial and psychosocial disruptions have likely altered tobacco product use. Understanding smokers’ responses to the pandemic is needed to assess its full public health impact and to guide public health messages and interventions.
Investigators at MGH’s Tobacco Research and Treatment Center, directed by Dr. Nancy Rigotti, have conducted a series of studies to assess the pandemic’s effect on smokers’ and vapers’ health risk perceptions and tobacco use. Dr. Sara Kalkhoran, assisted by Drs. Rigotti and Doug Levy, surveyed a national sample of over 1000 U.S. smokers and vapers. Drs. Rigotti and Gina Kruse conducted a mixed-methods (quantitative and qualitative) survey of recently hospitalized smokers. At the MGH community health centers, Dr. Joanna Streck surveyed tobacco use among a vulnerable population, individuals receiving medical treatment for opioid use. Response to COVID-19 varied. Approximately one-third of smokers increased their tobacco use as a response to pandemic-related stresses. Others reduced or quit smoking, especially those who felt more strongly that smoking made them vulnerable to COVID-19.
Abstracts presented at the 2021 Annual Meeting of the Society for Research on Nicotine and Tobacco, February 2021:
Kalkhoran S, Levy DE, Rigotti NA. Smoking and vaping among a national sample of U.S. adults during the COVID-19 pandemic.
Rigotti NA, Chang Y, Regan S, et al. Effect of the Covid-19 Pandemic on Perceived Risk, Attitudes and Behavior of Cigarette Smokers Previously Enrolled in a Smoking Cessation Trial.
Streck JM, Kalkhoran S, Rigotti NA et al. Effect of the COVID-19 pandemic on perceived risk, attitudes and behavior among cigarette smokers and nicotine e-cigarette vapers in medication-assisted treatment for opioid use disorder.
Joyce AA, Styklunas GM, Rigotti NA, et al. Quit Experiences among Primary Care Patients Enrolled in a Smoking Cessation Pilot RCT Early in the COVID-19 Pandemic. Int J Environ Res Public Health. 2021 Jan 24;18:1011. doi: 10.3390/ijerph18031011. PMID: 33498834; PMCID: PMC7908271.
Sara Kalkhoran, MD
Breast Cancer Screening, Diagnosis, and Treatment During COVID-19
Led by Erica Warner, ScD, MPH, this study is being conducted in partnership with breast cancer organizations including Dr. Susan Love Foundation for Breast Cancer Research, SHARE, Survivingbreastcancer.org, Sisters Network Inc., the African American Breast Cancer Alliance, and through ResearchMatch.org. Individuals were eligible for this study if they:
Receive routine breast cancer screening; OR
Are undergoing diagnostic evaluation for breast cancer; OR
Have ever been diagnosed with breast cancer.
Participants are asked to complete a 10-15-minute REDCap survey which collects information on respondent demographics, breast cancer screening and diagnosis, the extent to which care has been changed, delayed, or cancelled because of COVID-19, personal protective practices, extent of worry about financial and health implications of COVID-19, and use of telemedicine. The surveys are available in English and Spanish and will be open through the end of June and are available here:
Dr. Warner is an Assistant Professor in the Department Medicine at Harvard Medical School and an Assistant Investigator at Massachusetts General Hospital where she conducts epidemiological research on cancer in the Mongan Institute’s Clinical Translational Epidemiology Unit.
Erica Warner, ScD, MPH
Engaging patients in decisions about rescheduling colonoscopies delayed due to COVID-19
Karen Sepucha, PhD
Leigh Simmons, MD
Principal Investigators: Karen Sepucha and Leigh Simmons
Co-Investigators (from MGH): Steve Atlas, Sanja Percac-Lima, James Richter
As the initial surge of patients with COVID-19 recedes, one pressing issue facing health care systems is how to manage the large and growing backlog of screening tests and elective procedures. To further complicate matters, public health officials warn that further waves of infection may occur over the next 12-18 months, and each may cause additional restrictions on capacity, increasing backlogs and delaying needed care even more. Managing demand with reduced capacity while planning for additional shutdowns represents a key new challenge for health care delivery systems during this crisis. Moreover, even if there is capacity, many patients may feel differently about the value of seeking healthcare, including cancer screening, until an effective treatment or vaccine for COVID-19 is found.
In this PCORI-funded study, investigators will examine the distribution of patients’ preferences for rescheduling a screening or surveillance colonoscopy that was delayed or postponed due to COVID, and factors associated with those preferences. Then, we will study whether shared decision making tools and training will increase patients involvement in decisions, increase their intention to follow through with some type of colon cancer screening, and reduce decisional conflict. There are many challenges to resuming healthcare during this crisis, and this study will address important research questions about how to do this in a safe, equitable and patient-centered manner.
Dr. Sepucha is Director of the Health Decision Sciences Center and an associate professor in Medicine at Harvard Medical School. Dr. Simmons is Medical Director of the Health Decision Sciences Center and an internal medicine physician at Massachusetts General Hospital.
COVID-19 and Acute Medical Care: Impact on Dementia Patients
John Hsu, MD, MBA
John Hsu, MD, MBA, received an NIH supplement for a study that will address two aims:
To examine the impact of the COVID-19 demand shock on acute medical care received in the Emergency Department (ED) or hospital; and
To examine hospital responses to the demand shock and their impact on clinical event rates.
Dr. Hsu is Director of Clinical Economics and Policy Analysis Program at the Health Policy Research Center and Associate Professor of Medicine at Harvard Medical School.
Treatments and Outcomes
Adverse and Allergic Drug Reactions related to COVID-19 Treatments
Kimberly Blumenthal, MD, MSc, is collaborating with informaticians at Brigham and Women's Hospital to study adverse and allergic drug reactions related to COVID-19 treatments across Partners HealthCare hospitals.
Dr. Blumenthal is Co-Director of the Division of Rheumatology, Allergy, and Immunology Clinical Epidemiology Program within the Mongan Institute at Massachusetts General Hospital.
Kim Blumenthal, MD, MSc
Gastrointestinal Symptoms Predictive of COVID-19 Infection Risk and Severity
David Drew, PhD
David Drew, PhD, and Long Nguyen, MD, MS, received the American Gastroenterological Association-Takeda COVID-19 Rapid Response Research Award from the AGA Research Foundation. Their research project will test their hypothesis that gut microbial communities mediate the relationship between GI symptoms and the varied clinical presentations and outcomes among patients with COVID-19.
Dr. Drew is Director of the Biobanking in the Clinical and Translational Epidemiology Unit (CTEU) and the Division of Gastroenterology at MGH, Instructor in Investigation in the CTEU, and Instructor of Medicine at HMS.
Dr. Nguyen is an Assistant in Medicine and Gastroenterology at MGH and Instructor in Medicine at HMS.
Long Nguyen, MD, MS