Both planning for and responding to an unprecedented, worldwide crisis at the same time.
That’s what makes COVID-19 the single-greatest challenge three seasoned experts at the University of Tennessee at Chattanooga say they’ve ever faced. “We’ve been responding at the same time that we we’ve been planning, and that’s not what normally happens. All those planning meetings we were supposed to be in for months—well, they happened, but so did COVID-19,” says Chris Smith, UTC chief health affairs officer and leader of the University’s COVID-19 Campus Support Team.
That team, like much of everything else to do with COVID-19, has steadily evolved since March 12, 2020, when Tennessee Gov. Bill Lee declared a state of emergency in response to the virus. Three days earlier, spring break had begun for UTC students, who, as it turned out, would not return to the classroom for the remainder of the semester. For at least a month by then, Chancellor Steven Angle, his UTC executive leadership team, Smith and Robie Robinson, UTC assistant vice chancellor for emergency services, had been monitoring the threat as a novel coronavirus went from outbreak in China to a global pandemic.
Initial plans to delay the resumption of in-person classes after spring break by one week soon gave way to the decision to take all remaining course instruction online. A Herculean logistical effort to enable faculty to teach and students to learn remotely—while not without some hiccups—succeeded, allowing students to complete coursework and spring graduates to complete their degrees. Meanwhile, even as campus was scarcely occupied while the majority of the UTC workforce worked from home through spring and into summer, University operations continued with a single focus: in-person classes and on-campus housing would resume with the fall semester.
Because COVID-19 showed no signs of being gone by fall, every facet of working, living or learning on campus had to change. Guidance from the U.S. Centers for Disease Control and Prevention dictated health and safety protocols, and Smith was both UTC’s point person on interpreting the application of those protocols and the campus liaison with a statewide UT system task force on COVID-19 response. Named by Angle to a campus task force co-chaired by Executive Vice Chancellor Richard Brown and Dean Robert Dooley of the Gary W. Rollins College of Business to develop a UTC COVID-19 response plan, Smith recruited two colleagues to that team, Dawn Ford and Yasmine Key.
Ford, who has a doctorate in epidemiology, is both assistant provost for teaching and learning and a clinical associate professor in the School of Professional Studies and Health and Human Performance. Having left the University in 2004 after seven years of teaching environmental science courses to run public health emergency response for the Hamilton County Health Department, when Ford returned to UTC in 2011, she brought key experience to managing this kind of crisis.
Key, whose doctorate is in nursing practice, is director of University Health Services, a member of the School of Nursing faculty—and a former student of Smith’s. “Having Dr. Ford with her background—including her experience in public health—available to step in was exceptionally fortunate for the University,” Smith says. “Dr. Key, as director of UHS, was frontline in monitoring and mitigation, and she has reached out extensively to her counterparts at other universities and to the American College Health Association to gather as much information as possible as quickly as possible.”
Smith joined UTC in 2001 as an assistant professor, was named director of the School of Nursing in 2014 and chief health affairs officer in 2019. She says responding to COVID-19 is the most complex challenge of her career. “There’s been nothing before that has so impacted the entire campus from top to bottom. No, not at all,” Smith says. “When we had H1N1 (in 2009), I helped with the initiative to get people immunized, but it was not the mass hysteria that COVID causes now. There was not the level of concern we’re seeing now because it didn’t really have an impact to this campus at that point. By comparison to COVID, H1N1 is kind of like a footnote—not even a full-out ‘event.’ We were very prepared and I ordered H1N1 immunizations for everybody. They said, ‘Order one for each faculty and staff and student and then three more.’ So there were 40,000 vaccines that we used.”
“There’s been nothing before that has so impacted the entire campus from top to bottom. No, not at all,” Smith says.
“And a vaccine was available,” Ford adds. “Because guidelines change, recommendations change, and things so quickly shift, this is a fluid situation that we constantly have to monitor and respond to. I often say it’s like a live animal. It’s just something that continually changes. It can be unpredictable at times, but we have to be prepared as best as possible to adjust to the things that are changing. The way that it changes, the more information that we have about it, the way it behaves. We have to do that on a very regular basis. Nearly daily, really.”
Key says the scope of work involved in trying to account for so many variables—still-emerging science, the particular needs of a college campus, human behavior—has been surprising. “We know a lot about pandemics, and we learn a lot about pandemics just through nursing school and infectious disease, in general, but managing a pandemic has been something far more extensive than I could have ever imagined,” she says. “Every day is a learning experience, and there is no finish line yet. There’s no visible date when we can say we will no longer have to deal with this. That makes it critical that we build a process that’s sustainable and manageable for the long haul, because that’s what we face: a marathon, not a sprint.”
Smith, Ford and Key planned for mitigating the spread of an infectious disease among varied populations on campus—students, faculty, staff and visitors—and advised the small army of their UTC colleagues planning implementation of mitigation protocols in classrooms, offices, meeting spaces, outdoor spaces, dining and campus housing facilities, events, routine building maintenance and cleaning and more.
Securing COVID-19 testing resources, articulating quarantine and isolation requirements, developing a program of contact tracing for the campus community—all those responsibilities remained with Smith, Ford and Key. They worked to develop forms to enable daily health monitoring and reporting by employees and students; an online dashboard to monitor case counts and other key data points; and to advise UTC leadership as challenges to resuming on-campus operations arose. “It’s an incredible amount of pressure, something none of us has dealt with before,” Smith says. “Pressure to get it right, do we call it or do we not? Is it time to shut the doors? Is it not? Understanding the ramifications of the decisions that we recommend. The good news is we don’t make the final call, but we have to provide the executive leadership team with all of the correct information so they can make an informed decision one way or the other.
“Dr. Angle has been very supportive of anything we recommended. There was never any argument, never any challenge to our recommendations or our thoughts. They took us at our word because they knew we’d done our homework, and I think the executive leadership team has had confidence in us and our many colleagues managing these circumstances to bring them information from which they can make good decisions. I feel like the collegiality of the entire implementation team across campus is probably the reason we’re in such good stead as we are now because we believe each other, we support each other, and we know we all have a common goal.”
Smith’s favorable assessment of UTC’s position is partly informed by her role on the UT system task force. “I’ve found it very gratifying on this statewide taskforce when someone will raise an idea and I can say, ‘Oh, we’re already doing that. I’ve said that multiple times in multiple meetings,” Smith says. “One campus was thinking about implementing a COVID notification form like we’d already had for months. We had already identified isolation and quarantine spaces on campus when another was considering that. We already had a deal with a hotel, and we’d worked out transportation.
“We were just so proactive on so many things. I feel like a lot of universities—and not just others in the UT system but across the country—are trying to play catch up, and you cannot play catch up when you’re in the middle of having to make decisions that need a lot of thought. You’ve got to be well ahead of it. You have to be proactive.”
Key concurs. “I can’t imagine taking on this charge without the team we’ve had on board,” she says. “Not just Dr. Smith and Dr. Ford, but so many others who have worked really hard in managing the aspects of what this looks like on our campus. There have been moments in those meetings where I just am so grateful for the team that we have, working collaboratively and as a collective unit for the greater good of the UTC community. The people you have around you are what will make or break an emergency response.”
For now, beloved campus traditions continue to face the limitations of COVID-19. In September, in-person commencement was canceled for fall 2020. Asked what concerns her about the future of the pandemic, Ford says, “What’s next? What’s going to happen as flu season comes?” she wonders. “Are we going to see another spike in cases as the weather gets colder and people start staying indoors more?”
“I think that my anxiety, really, comes from not knowing what tomorrow has,” Key adds. “We’re seeing lower flu activity in countries that are ahead of us in flu season, and the things that mitigate COVID are the same things that mitigate other viral spreads. Hopefully, that will help continue to reduce the numbers of viral illnesses we have throughout cold and flu season, altogether. It’s just really important for people to stay on guard and maintain safety precautions as best as possible.”
Smith cites long-term sustainability as a concern going forward. “Everything that Dawn and Yasmine said is absolutely 100% correct, but I also think about how long we can manage this to the level that we are now,” Smith says. “Sustainability, not only from a manpower standpoint, but from a financial one. The country doesn’t have a bottomless pit of money and, at some point, if we don’t get this under control as a country, we could face a whole other set of problems with the sustainability of our general economy.”