In a normal day, Keren Osman ’92 works with stem cells as a bone marrow transplant physician at Mount Sinai Hospital in Manhattan. 

When COVID-19 patients started appearing on the scene, much of the medical approach and focus was on the respiratory symptoms that accompany the disease. While these are proven to be a part of the impact from the coronavirus, physicians have since identified a host of other issues.

Osman is just one of hundreds of Swarthmore alumni helping to fight the disease. By bringing their expertise in health care, research, economic development, and mental health to those impacted by the coronavirus, alumni are making a difference in the current overwhelming climate of the pandemic.

“I had a conversation with one of my colleagues about a particular set of stem cells that were on the brink of approval for transplantation to treat a variety of illnesses,” Osman says. “We know that these cells help with inflammation and travel to the lungs first, so we wondered whether they might help with the inflammatory process we’re seeing in COVID patients.”

Osman and her colleagues quickly put together an application with the Food and Drug Administration for an emergency investigational new drug (EIND). 

“This is a petition to try a therapy on a compassionate basis for patients with no other options,” she says. “In the early days of COVID, before any clinical trials, there were a good number of emergency INDs granted, including ours.” 

After receiving FDA approval, Osman and her team tried the stem cells on their first patient and then quickly moved on to 12 more.

The first patient died from a pulmonary embolism, but Osman says the disease was likely too far advanced. “The next patient to receive the cells wasn’t as ill and did well,” she says. “We subsequently treated the others and successfully extubated nine and sent them home.”

Working from those encouraging results, Osman and her team petitioned the National Institutes of Health for funding of a larger study. “They agreed, so now we are opening a randomized clinical trial of 300 patients across 20 centers,” she says.

Osman is encouraged by the results of the early Sinai trial. 

“The first 12 were very carefully chosen, so there may have been a selection bias,” she notes. “Could they have improved because of the cells? We don’t know, but no one got sicker and no one had an adverse reaction.”

As a physician on the front lines of the pandemic, Osman has a unique vantage point for how unprepared the country was for such a crisis. 

“It’s impossible to mention that without tying in the Black Lives Matter movement, too. It’s no accident that the movement happened now — it was a pot waiting to boil over.”

‘We Can Track How the
Disease is Evolving’

While Osman approaches the pandemic from the treatment side, Michael Greenstone ’91 is putting his skills to work with testing. 

There are only two surefire ways out of the pandemic: find a vaccine or acquire herd immunity, he says. The latter would require approximately 70% of the world’s population to be infected with the coronavirus, which would take years and leave hundreds of thousands of people dead in its wake. The viable solution, then, is a vaccine.

“The search for a vaccine is obviously ongoing and vigorous,” says Greenstone, the Milton Friedman Distinguished Service Professor in Economics at the University of Chicago. “But in the period until we get there, policymakers must make decisions about how to trade off economic and social activity with health risk based off very little information.”

It doesn’t have to be this way, says Greenstone. “Too often we rely on convenience samples — front-line workers, women arriving to give birth, or people with symptoms — and people who volunteer to take the test,” he says.

Instead, Greenstone suggests, by offering monetary incentives to a random subset of a representative sample, a greater portion of the population would willingly get tested. “Without monetary incentives, too many people decide that the benefits of getting a test are outweighed by the hassle — whether the swab itself, the cost, or the inconvenience.”

To test his theory on monetary incentives, Greenstone and some of his colleagues applied for and received a grant to test this idea in Chicago. 

“We’re rolling out invitations and randomly assigning the incentive,” he says. “The tests can be repeated regularly so that we can track how the disease is evolving and who is developing antibodies.”

The end goal, says Greenstone, is to understand the current prevalence of the disease in the population and use the results to guide reopening strategies. “Until we have a vaccine, knowing the population antibody rate is the name of the game,” he says.

Speaking to the politics of the pandemic, Greenstone — a former Obama administration adviser — says it’s frustrating to be several months into the crisis without a clearly articulated or executed testing plan. “Unfortunately, we are learning exactly how important competence is in protecting our health.”

‘I Stepped Into My Father’s Shoes’

The pandemic has affected some Swarthmore alumni in completely unexpected ways, leading to new chapters in their lives and careers. Patricia Park ’03 is one of them.

Growing up, Park, a novelist and creative writing professor at American University, spent many hours working in her parents’ grocery store in Brooklyn. As the pandemic began to roll across the country, she was hard at work on a second novel as a writer in residence at the Edith Wharton home in the Berkshires. 

“At first, I was more concerned with racism toward Asian Americans than the disease itself,” she says. “But my father is in his 70s and immunocompromised, so I decided to leave my residency and go help out in the grocery store.”

Park admits the shift has been difficult. “I haven’t worked here in a long time and never did it full time,” she says. “But I stepped into my father’s shoes and do a little bit of everything, from the cash register to packing bags and cleaning carts.”

Knowing her COVID exposure is high has led to many sleepless nights, admits Park. “New York state law requires masks, but not everyone wants to cooperate,” she says. “Most comply, but it only takes one or two growing irate or fighting distancing to make it difficult.”

Park’s Swarthmore education helped instill in her a sense of community, she says. “Working in a grocery store, it’s hard to give personalized attention to every customer, but I’ve found little pockets of connection. I look for the humanity in the midst of the pandemic.”

‘I Am Called to This Work’

Park could easily find that humanity in Amanda Orr Harmeling ’73. Even in normal times, Orr Harmeling deals in grief. A chaplain at Mass General Brigham Hospital in Salem, Mass., she is the co-director of the Spiritual Care Department. Now, however, she is called upon to provide counsel to families and patients on a whole different level.

Before the pandemic hit, Orr Harmeling provided her care to patients and staff in both the acute care and psychiatric wings. When COVID arrived, her team split into remote and in-person caregivers, with Orr Harmeling taking up a remote role. 

“I am calling patients, families of patients, families of the deceased, and also providing phone and Zoom support to our staff,” she says. “The pandemic is especially hard on people because it removes human connection at a time when it is most needed.”

Orr Harmeling has become creative in her care with COVID patients and families: “I ask family members to write a bio of their loved one, and then caregivers place it above their beds,” she says. “We also ask for any messages from the families to their loved ones and the staff. It personalizes the patients for the medical staff and lets the patients know their loved ones are thinking of them. The staff will convey messages and jokes to the patients — whatever will lift their spirits and give them a will to live.” 

Orr Harmeling also frequently uses French, Spanish, and German in her work and credits her preparation at Swarthmore for those skills. 

The convergence of the pandemic and the Black Lives Matter movement has shone a light on the common issues of racism and oppression, Orr Harmeling says. “People of color are inordinately impacted right now by COVID,” she says. “My hope is that this moment will lead to transformation, learning, and growth.” She also hopes that soon she can return to the hospital to care for patients in person. “I am called to this work, and I will continue to do it,” she says.

‘This Has Been A Double Epidemic’

Ava Harris Stanley ’72 can relate to the sudden change in direction that Orr Hamerling needed to make back in March. As a cardiologist, COVID has “changed the face of medicine,” she says. “Six months ago, there was no such thing as telehealth in cardiology. Now, it’s the preponderance of our practice.”

Harris Stanley tends to a high-risk population in Chicago, made up of older patients and the chronically ill. As she made the quick pivot to telehealth when the pandemic began. “We need to protect our staff and the people we serve,” she says. “We want to ensure that no one gets sick because of us.”

The learning curve has been steep for both staff and patients, admits Harris Stanley.

“We’ve had to teach people over 70 how to use new software and to swing a camera 180 degrees,” she says. “We’ve had a bit of pushback, but once we get patients on board, there’s a lot we can do with telehealth — it’s easy to see ankle swelling on a patient, for instance.”

Despite the change in her health care delivery approach, Harris Stanley says it serves as a silver lining. “It facilitates clinical medicine when a patient can’t get to you for a host of reasons,” she says. “Fragility, distance, and other factors can make getting to the office difficult. We wouldn’t have arrived at this point were it not for the pandemic.”

As with other health care providers, Harris Stanley has recognized the need for self-care throughout the crisis. “My husband has developed phone meditations that he facilitates,” she says. “I’ve returned to birding, and we’ve gone on many more walks.”

This self-care has become especially important to Harris Stanley as a Black woman and mother to two sons. “This has been a double epidemic, one exposed by cellphones,” she says. “I had to teach my sons at a very young age to protect themselves, and now the world sees why. It’s painful to me.”

‘A Biological Ravaging’ 

In early April, the pandemic caused hospitals across New York City to strain with an overflow of patients infected with COVID-19. Urgent calls for volunteers went out to doctors across the city. “We got hit big time,” says Rajesh Vedanthan ’95, a clinician and cardiologist who is director of the Section for Global Health at NYU Langone Health. Normally, Vedanthan’s focus is on implementation research, global health delivery, and global cardiology. But with the crisis surging, physicians were needed to address care across disciplines. 

“It was an incredibly rapidly evolving situation,” says Vedanthan, associate professor in NYU Langone’s Departments of Population Health and Medicine. “I fundamentally felt like it was the right thing to do to volunteer.”

The risks were real. After discussing the commitment with his wife, Board of Managers member Sujatha Srinivasan ’01, Vedanthan says as a family, they mentally prepared as much as possible. “As long as the institution would do what it could to provide me with protection,” he says, “I would try to minimize the chance of falling ill by doing everything I could, like washing my hands, wearing double gloves, face shields, and all the PPE provided.” 

Close to 95% of the hospital was converted to COVID wards. Under the direction of a hospitalist, Vedanthan worked daily as an auxiliary attending physician responsible for all aspects of care. 

“There was a lot of learning on the fly — but not chaos,” he says about the 7 a.m.-to-7 p.m. shifts. “All of my patients were either confirmed COVID-positive or suspected COVID.” 

The experience was emotionally and mentally draining. His time on the wards, and then a two-week quarantine, meant he was apart from Srinivasan and their two young children for five weeks. 

“Every day I was there, I was hoping I wouldn’t fall sick,” he says. “It’s given me a sense that it’s important to not take small moments for granted, like time with family and friends.” 

As Vedanthan reflects on the past five months, his perspectives on the pandemic have evolved. 

Through the lens of a physician, Vedanthan is stunned by the efficiency of the deadly virus. “Just how amazingly, incredibly powerful and devastating the COVID infection could be to a person,” he says. He witnessed as it “attacked every organ system you could think of. It’s remarkable to see the devastation it could do to a body — a biological ravaging. It’s very silent in the way it is transmitted, but I would say unprecedented in terms of protean and varied clinical manifestations.”

Vedanthan continues to process the impact the pandemic has had in the U.S. — from the health care system, to the economy, to politics. “As an American,” he says, “I feel like we are undeniably the richest nation in the world, and it feels like a tragedy, that it’s taken such a toll on us as a society that was largely avoidable.”

‘Out Under A Bridge’

Justin Tsui ’05 is witnessing the pandemic’s fallout on a vulnerable segment of Chinese Americans in New York City's Chinatown. “It started with four elderly men I spotted out under a bridge,” he says. “I brought them a hot meal.”

Many others have since joined those four, and Tsui has become something of a guardian angel to them. A student enrolled in the nurse practitioner program at Columbia University, Tsui felt compelled to go to work with COVID patients. Because he is immunocompromised, his doctor told him not to work in the ER or ICU. “I found work at a nursing home,” he says.

Today, he balances school, work, and helping with meals; distributing masks, wipes and hand sanitizer; and educating those experiencing housing insecurity how to stay healthy. “I have a lot of support,” says Tsui. “This is my own kind of self-care,” he says. “I was too stressed with worry before I started helping out.” 

Tsui can see his efforts being needed easily until the end of the year, noting that the government’s response to the virus hasn’t been sufficient. 

“I’m worried,” he says, “but hopeful that more people will come out and vote and that we will get change.”

‘100 Countries So Far’

While Tsui’s efforts have been in the public eye, John Anderson ’03 has been making contributions behind the scenes. As a senior economist with the World Bank in Washington, D.C., Anderson helps develop policies on how the institution identifies and finances projects.

His team, the Operations Policy and Country Services unit, doesn’t work directly with governments, but rather sets the rules on how other World Bank teams work with them.

It’s an important effort when it comes to helping developing countries manage the pandemic. As soon as the disease began spreading, Anderson and his colleagues started considering how to best support dozens of governments in their COVID-19 response efforts. “With the exception of developed economies, we can give support to just about any country,” Anderson  says. “We’ve given support to over 100 countries so far.”

The World Bank established a fast-track financing facility and allocated billions of extra dollars in support of developing countries.

“We looked at our internal policies to speed up preparation, review, and approval of projects,” Anderson says. “Normally, projects require six to 12 months for approval. We figured out which steps we could skip to expedite funding.”

Once released, the funding helped the countries increase ICU capacity, purchase PPE, and respond to other emergency needs. The next phase of Anderson’s work will involve the socioeconomic response the countries will need, he says. When he compares the pandemic to other crises he’s addressed during his time with the World Bank, Anderson says he hopes it is “a once-in-a-career event.” His Swarthmore education well-equipped him with the critical thinking and problem-solving skills he needs for his job.

“Those are the most useful skills I have to respond in a situation like this,” he says. “It’s been a privilege to be part of a team that can make a bit of a contribution to a massive effort like this.”