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Meet the Organization Dispensing On-the-Ground Covid-19 Guidance to U.S. Health Centers and Clinics

Through the MAVEN Project, infectious disease experts are helping clinics reduce exposure and stretch personal protective equipment.

News

Covid-19

A provider at Florida International University's mobile clinic uses MAVEN Project telehealth services on a computer. (Photo courtesy of the MAVEN Project)
By Talya Meyers

When it comes to Covid-19, Dr. Deborah Gold isn’t afraid to give concrete advice.

“This is not my first rodeo with a pandemic,” she said dryly. “I was a hospital epidemiologist…These are the issues I would deal with on a daily basis.”

Today, the retired infectious disease specialist is on lockdown in San Francisco. And in her spare time – she has plenty of it, she claims – she’s been distilling new research and existing guidelines into digestible, actionable form for clinics and community health centers around the country.

These online information sessions are offered as part of the MAVEN Project, a nonprofit startup that connects safety net providers with specialists and other highly experienced doctors through mentoring, consultation, and webinars. The MAVEN Project allows the health care organizations that serve the country’s most vulnerable people to gain access to new resources and expertise.

Covid-19 has hit clinics particularly hard, said Dr. Lisa Bard Levine, the MAVEN Project’s CEO. Many have had to temporarily close their doors. Others are confronting decreased revenue – they already operate on shoestring margins – and a lack of access to protective gear.

“We’re taking a very stressed, burned-out workforce, and we’re under-resourcing them…not giving them the PPE they need, not giving them the resources they need to survive this pandemic,” Dr. Levine said.

When it comes to information – whether it’s new medical research or on-the-ground guidelines – having too little isn’t the problem, Dr. Gold said. On the contrary, clinics are overwhelmed.

Dr. Gold remembers the day she first began paying close attention to coronavirus coverage in the media: “At the time, I could read absolutely everything there was to read, because there wasn’t that much, and now, it’s like drinking from a fire hose.”

In addition, she said, clinic administrators aren’t always sure how new findings apply to them or how to implement safe procedures.

When it comes to guidance, Dr. Levine said, “the CDC is fantastic, but if you’ve got a question, soup to nuts, about what you need to know about this,” the information sessions will provide it.

In the webinars, which begin with a presentation by Dr. Gold and other physicians and end with a Q&A, clinic staff learn how long coronavirus lasts on different surfaces. What to do if a suspected Covid-19 case walks in the door. What an atypical presentation of the disease might look like. How to carefully preserve dwindling supplies of protective equipment.

“Of course, the guidance is changing constantly,” Dr. Gold said.

That’s precisely the problem for small safety net providers, said Elisabeth Gundersen, one of the nurses who runs the Butte County, California-based pop-up clinic Medspire. There’s such a constant flow of new information that “my head’s spinning sometimes. It’s hard to put that together in a way that’s clinically useful.”

But the MAVEN Project’s information sessions have helped her distill the information she needs to successfully provide telehealth visits and house calls to her patients, many of whom are still struggling to recover after the 2018 Camp Fire, which killed 85 people and destroyed much of the town of Paradise.

“I think the MAVEN session did a good job of picking out the most relevant and current information,” Gundersen said. “Information was tailored for small free clinics…and [Dr. Gold] had some good tips for how to be creative with resources” like scarce personal protective equipment.

“They had options for us to reach out to infectious disease specialists: how to prepare our office, what are the things we should be doing,” said Dr. Reshma Khan, executive director of the Shifa Clinics in Mount Pleasant, South Carolina.

For Dr. Khan, one of the most valuable parts of the information session is the ability to check in with other clinics around the country. “I think the biggest benefit is to have a roundtable discussion, to be able to reach out to other free clinics and see what other people are doing,” she said.

At an April 15 session, held via the videoconferencing app Zoom, Dr. Ramona Doyle, a UC San Francisco physician and former Stanford faculty member, talked about the procedures being used to treat Covid-19 in frontline hospitals.

Dr. Gold explained some of the reasons behind the testing shortages and gave an overview of recent Covid-19 studies.

Throughout the session, a steady stream of questions poured in through Zoom’s chat features, as clinics asked a wide range of both theoretical and practical questions.

Dr. Gold’s experience –15 of her 31 years in medicine were spent as a hospital epidemiologist – is a boon. She knows what needs to be done after an infected patient enters an exam room, and how to keep them apart from a population that just needs standard care.

“I’m too old to be going back to work and seeing patients, so I feel like I can contribute in some ways by doing this,” Dr. Gold said.

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