March 17, 2021: Community Conversations Transcript

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Joseph Helble:

Welcome everyone. Good afternoon. This is our 24th Community Conversation addressing planning, response, and operations in the time of COVID-19. I’m Joseph Helble, the provost of Dartmouth College, joining you from the Star Instructional Studio in Berry Library on a Wednesday afternoon, but a sunny Wednesday afternoon, March 17, 2021. I’m joined as always by Justin Anderson, our vice president for communications who’s with me in another studio here on campus. And Justin and I are joined today by two guests, each of whom has joined us once before for these conversations: Phil Hanlon, a member of the Dartmouth class of 1977, a professor of mathematics, and as we all know, since June 2013, the 18th president of Dartmouth College. We’re also joined by Joanne M. Conroy MD, also a member of the Dartmouth Class of 1977, an anesthesiologist, and since 2017, the president and CEO of Dartmouth-Hitchcock and Dartmouth-Hitchcock Health.

We’ll follow our regular format with a campus update and then a brief Q&A moderated by Justin so we can then turn to conversation with President Hanlon and Dr. Conroy about their experiences leading two of New Hampshire’s largest employers in the midst of the pandemic this past year. And then, we will end with an opportunity for them to answer your questions directly.

For all of us, one year ago, sometime in early to mid-March, came the moments where for each of us, everything changed. For me, the markers are so closely tied to decisions we needed to make in rapid succession here at Dartmouth. March 2 was the date we formalized the structure of our COVID-19 response task force. March 11 was the date the first scheduled Zoom meeting appeared on my calendar and it was the date the WHO director general declared this a global pandemic. March 13, a Friday, was the date deans Elizabeth Smith, Alexis Abramson, and I met with the arts and sciences and their chairs and associate deans to discuss the need to immediately transition the first half of spring term to online learning.

At that time, that March, in the middle of the month, few of us anticipated the duration of the pandemic, the shutdowns it would ensue, the complete upheaval of our daily lives from work to recreation family, the lengthy separation from family and friends that would follow, the struggles to teach or work or learn from home while for many years of us helping and caring for children, siblings, parents, and grandparents at the same time. And few anticipated the magnitude of the loss so many would experience. At a global level, when I sit here one year later and look at the numbers, they are so sobering. As of yesterday, globally, we have seen more than 120 million people infected with the coronavirus causing COVID-19. More than 2.6 million of those have died. In the United States, as of yesterday, more than 29 million have been infected and more than 500,000 have died. Twenty percent of the world’s total.

But even these staggering numbers can seem abstract. Individual loss, even in our small community, is very real and the sense of isolation caused by our disconnect from one another through efforts to contain the pandemic while we raced to develop vaccines and therapies that cannot be overlooked. Winter, and the year long duration of the pandemic, have made it all that much harder. And then this week, as members of the Dartmouth community know, we also unexpectedly lost a member of the Class of 2024. This is the second sudden loss this community and this class of students has experienced this year. This loss and these losses only add the feelings of isolation and separation that we’re all experiencing.

So, to every member of our community, I hope, and I ask that we all pause to reflect on how hard this has been. How being attentive to our mental health is every bit as important as being attentive to our physical health. That we check in regularly with our friends and our family members, even if it means another Zoom and ask genuinely how they are doing. As close as we are too emerging from this year of isolation and this year of heartbreak, as close as we are to having vaccine available in this country for everyone, there are still reminders that we don’t know what any one of us is facing at any given moment in any given day. Whether it be the death of a family member or a friend or acts of hate or racial bias or gender bias or violence, which are too familiar and in the news again this week.

We need to remember that we are all part of this Dartmouth community that truly sees itself as a community. I’ll be asking us all again today to mask up, to stay distanced, to be attentive to one another’s physical health. And I am asking us all again today to be attentive to one another, to be patient with one another, understanding of one another, and supportive of one another. This has been an extraordinarily challenging year for so many on every dimension. And if we work through this and support one another, the end is in sight. We will get through this as a Dartmouth community.

Let me turn now to an update on our testing, some thoughts on winter term, and a few additional updates for spring and the year ahead. Two years ago in our last or two weeks ago in our last community conversation, I noted that we were at the seventh day of an outbreak, one that had reached 140 cases over the span of a week, but that was starting to diminish at that time. We’d taken steps quickly, shifting to grab and go dining, online learning only, closure of the gym and library, and prohibitions on any indoor gatherings. These measures enabled us to contain the outbreak. And since the lifting of restrictions last Monday, March 8, we’ve returned to averaging roughly one new case per day.

As I said, two weeks ago, hello, in a slip of the tongue a minute ago, saying two years ago, I think for all of us, we know that two weeks sometimes does feel like two years in the midst of this pandemic. This was a stark reminder that even in rural Hanover, we are not immune. The minute we let down our guard and forget about the importance of masking, of staying socially distanced, of avoiding large gatherings ... we’ve seen what happens on other campuses. And we have seen that it also happens here. For us to navigate spring term successfully and transition to a summer where we hope to support even more in-person activity, we need to keep this all in mind.

Let me offer now an update on our numbers to give you a better sense of where we stand. Overall, Dartmouth has now conducted nearly 149,000 coronavirus tests with an overall positivity of 0.2%. Over the past 10 days through yesterday, Dartmouth conducted 8,011 tests and had a total of 10 positives, which is an overall positivity for that period of 0.12%. In terms of trends on other college campuses, for our Ivy peers reporting data for the year 2021, all lie between 0.12 and 1.0%. Our overall level of 0.3% for 2021, and certainly our level over the past two weeks, are therefore well within the range of these peers. Our NESCAC peers are currently reporting positivity rates ranging from 0.04 to 0.2% for calendar 2021.

And our local state university peers, UVM and UNH, are at 0.27 and 0.65% respectively for 2021. Now, as we have announced previously, twice per week, surveillance testing will continue throughout spring term and will be supplemented by antigen testing on arrival for students returning to campus for the start of that term. The testing location will change, however. Beginning this Saturday, March 20, all asymptomatic COVID-19 surveillance testing will be in Leverone Field House just as it was throughout fall term. A reminder that all students and employees are required to complete the daily TSA prior to accessing any Dartmouth facilities, including Leverone for testing.

Now, today is the last day of winter term exams for much of the campus with spring term set to begin on Monday, March 29. As I look back on winter term, I’ve been thinking about the steps we took to increase opportunities for students and employees to be outdoors and to socialize outdoors and to provide some enhanced opportunities indoors. And what I learned just this morning is that the numbers suggest we certainly did. I learned today from my colleagues in the Office of Student Life that indoors 1,237 students checked out study spaces in the Collis Center. Collis managers created and distributed 300 activity kits and s’mores kits to bring spaces to life.

And outdoors in spite of, or maybe even because of the cold and the snow, over 750 people visited Bema Lights during winter carnival. Fire pits and Adirondack chairs around campus were heavily utilized regardless of the weather. Students created not one, but three winter carnival sculptures this year. We hosted 81 separate events over winter carnival. 44 hosted by the council and another 37 by campus partners. There were more than 1,300 free lessons and equipment loans at the winter activity center. There were 90 student- and/or staff- facilitated outdoor programs, hikes, and student led trips serving over 597 participants. The Skiway was well utilized.

And last, but for me, certainly not least, there were over 1,900 skate loans at the ice rinks. And if you think about the fact that the skate rinks were open for about five weeks, that equates to about 50 loans per day, a pretty impressive level of utilization that I was thrilled to see. I’ve already been asked if these will continue next year and while it’s too early for me to make any promises, I suspect that this will not be the last time you hear me refer to the way we embrace winter here at Dartmouth.

Now looking ahead to spring term, as I mentioned last time, colleagues in Campus Services and the Dean of the College area, including Outdoor Programs, are planning things like tents for outdoor socially distanced gatherings; a nine hole disc-golf course, which I understand is currently being designed; e-bikes being available; boat rentals being available at Ledyard; guided hiking and outdoor exploration of the local area being available; equipment for a range of lawn games being available; fire pits continuing with Adirondack chairs as part of Collis outdoors; and based on feedback and surveys from the 2021 and 2024 class councils, we intend to find a way to offer live music perhaps on the Collis Porch as part of Collis Mainstage. Protocols and details are being finalized, but we’re working hard to find a way to offer some live music in response to student requests over the course of spring term.

In addition, in indoor spaces, the Hood Museum will be adding to its offerings first by continuing to host its tiny tours and tiny visits during spring break for any students who are remaining on campus and still approved for building access as well as opening these tours and visits up for faculty, staff, and grad students these next two weeks. And second, starting the week of April 12th, the Hood will expand the times of both programs by adding two key time slots Thursday evenings at 6:30 and Saturday afternoons at 2:30 in response to requests. To sign up for an upcoming tour or visit, head to the Hood’s engage page and keep an eye out as well for campus wide emails announcing these opportunities.

We’re also interested in your suggestions for other opportunities we might provide indoors or out. So, a new email address that sounds just like the old email address, but with spring substituted for winter. Springtermsuggestions2021, that is one word, is now up, running, and ready to receive your ideas for things we can do to enhance indoor and outdoor spaces and provide more opportunity for our community to engage and engage with one another during spring term.

Over the course of the next several weeks, both between the break between winter and spring term and into the start of spring term, our task force will be undertaking review of many of our policies. We’ve received many questions about travel and visitor policies for example, particularly as vaccination becomes more widely available. As task force co-chairs Dr. Lisa Adams and Josh Keniston noted in their message to campus earlier today, New Hampshire state and CDC travel guidelines have changed, but given that the vast majority of the Dartmouth population remains unvaccinated, our travel and visitor policies are remaining unchanged at this time. We’ll be reviewing these policies in the context of vaccination trends, disease trends, federal recommendations, and state guidance for New Hampshire and Vermont. But we do not expect any adjustments to policy to be made prior to April 1. We’ll keep you updated of any developments through messages to the campus and through these community conversations during the early part of spring term.

Over the course of spring term, we also will be reviewing our community expectations documents for undergraduate, graduate, and professional school students in advance of the start of the new academic year, which for undergraduates in most graduate and professional school students is the start of fall term. Health and safety criteria will continue to be the determining factors in the guidelines for monitoring quarantine participation and testing and adherence to campus COVID policies. But we will be seeking feedback from students on areas where clarification would be helpful. And this will be done through a process led by staff in each school. More information on this will follow through announcements to the community at the end of this month.

Finally, let me close with just a few comments on summer and fall. In addition to questions on travel policies and how things may change once an individual has been vaccinated, we are getting many questions about our broader campus operations for the months ahead. I’ve said previously that we expect summer to be a time of transition, and that remains the case. It will therefore be a mix of in-person and remote learning, although the availability of the outdoors and good weather should facilitate far more in-person meetings and conversations. Personally, I’m looking forward to seeing my sophomore advisees in-person and having a face-to-face discussion of their aspirations and plans.

With the promise of vaccine availability, some are asking why we aren’t being more aggressive and committing to being open normally this summer. I hear you and I understand the question, but here I simply ask for the community’s continued patience. The federal government, the president, has said that he is asking that we have vaccination signup open to all adults by May 1 and that we can begin to have some sense of normalcy returning by the 4th of July.

Neither of those, of course, means that we will have shots in arms for everyone by our mid-June start of summer term. This is why I anticipate that summer term will be a term of transition. But as I also said earlier this winter, we are planning for fall term to be a return to a typical in-person residential term.

For the campus community and for our employees, what exactly does that mean? Well, for anyone who would be engaging in fall-term planning in the coming weeks and months, it means that I am asking you to begin that process assuming full, typical, residential campus operations in the fall. There are caveats, of course. If vaccination progress slows, if case counts substantially increase over spring and summer, or if new variants emerge, we will be guided by the data and we will adjust if and as needed.

Which means that planners should also keep their current operating plan in mind as Plan B, reviewing operations from this past academic year and thinking about what you would adjust if we, again, needed to operate in hybrid or remote mode. But to be clear, the intention Is to be operating in typical residential mode this fall, and therefore, for us to be planning accordingly.

We therefore anticipate and look forward to welcoming the class of 2025 in-person on campus. The dean of the College and student life, in partnerships with students, will begin to think through the planning of all of the associated welcome activities, from trips and pre-orientation to our traditional orientation programs which by necessity were virtual last year. We will know more about the operation of these activities in the weeks and months ahead and we look forward to sharing details as those plans develop.

Let me end by returning to what I said at the very beginning of my remarks this afternoon. This year, the uncertainty, the sense of separation, the sense of loss, this has been incredibly hard on everyone. I know it’s taken its toll. Email and Zoom are imperfect venues, but I can see it, I can hear it and I can feel it in the conversations I have. I know how hard everyone on this campus is working, and we are so close to being through this with the accelerated deployment of vaccines that we anticipate over the coming months.

So, I asked everyone, students and employees and community members alike, please continue to mask up, remain socially distanced, wash your hands, avoid large gatherings and get vaccinated as soon as you are able. And please, continue to look out for one another and check in on one another. We all depend on one another. Thank you, and Justin, over to you. Happy to take any questions.

Justin Anderson:

Thank you, Joe, and nice to be with you as always. I would say that, without a doubt, the most popular question today has to do with vaccines and vaccinations. Most of the questions are along the lines of when, when will community members get vaccinated and whether or not Dartmouth will be able to provide those vaccinations.

I’ll give you one question that I think is representative of a lot of what we’re hearing. Will Dartmouth vaccinate soon all of its employees, given that some of us have no choice but to work on campus at least some of the time? And related to that are questions about how we think about vaccinating staff who live in Vermont versus staff who live in New Hampshire given that the vaccines are being rolled out on sort of a state-by-state basis. I’ve just dumped a lot on you, Joe, but I think you get the picture. Lots of questions about vaccines when and how


In addition to all of the challenges than any campus or college or university faces, ours are doubled by drawing our population from two states that have different rules. I mean, Justin, this might be a good question to put to Dr. Conroy as well. But at a high level, yes, Dartmouth is in the process of seeking approval to become a point of distribution for vaccine, and so we are taking steps to do that. And if we are successful, we will be able to be a vaccine provider for our employees. And our hope in doing that is simply to make it easier and more efficient for employees to get vaccinated.

We are asking whether Vermont employees may be able to be vaccinated as part of that. We do not yet have an answer to that question, and we also don’t know if or when we will receive that approval from the state. Regardless, even if we are able to become a POD, a point of distribution, we are bound to follow state regulations for deployment of the vaccine. And so as the states move through their age categorization, we are required to follow those age categories for vaccination.

But the president has directed that age categories for adults be removed by May 1. And so if we are, again, able to become a point of distribution, certainly by May we will be in a position where we can effectively contribute to the vaccination of our community, which I think would be hugely beneficial on so many dimensions. Hugely beneficial in preparing us for summer and for the fall. So I’d say let’s put that question perhaps to Joanne as well and see if she has more to add and more insight from the state. But as of two days ago, that’s where we stood.


And, Joe, just a quick follow-up because I think a lot of questioners seem to think that there may be a way that Dartmouth can get around the age classifications and start dispensing vaccines to our community how we see fit. That’s not something that is an option at all. Certainly not until we get to the point that you referenced President Biden’s call for there to be vaccines available to all adults at some point after May 1.


Yeah. I think, Justin, I may say that you asked and answered, I think you posed the question and answered it nicely. If we become a point of distribution, there are mechanisms for, if at the end of the day there is excess vaccine that has been thawed and not deployed because someone didn’t show up for a test. There are systems that you can use to make that vaccine available to your community.

And as we go to the point, potentially becoming a point of distribution, we will take steps to have ... I don’t know what the system would be. Some localities have used cell phone or texting alert systems, others have said first-come, first-serve to make excess vaccine at the end of the day available. Generally, the number of doses, at least in this part of the country that are available at the end of a testing day, I have heard anecdotally are pretty limited. We will be able to do it in that way. Beyond that, we are bound to follow state requirements for distribution of the vaccine if we are a vaccine distribution site.


Joe, during your introductory remarks, you mentioned some of the markers that we experienced a year ago that we remember as being sort of the beginning of this new normal and the beginning of a change in how we all live. One of the things I remember is introduction of the word de-densification. And we talked a lot about de-densification of the campus.

Well, someone wrote in with a new word, which is re-densification and wondering how we are thinking about re-densifying the campus, particularly as it relates to getting faculty and students in the classroom together more often because that’s where the learning traditionally happens so successfully, but also because of the psychological benefits of being able to gather again in-person with classmates and faculty. How do you think about the re-densification process as we’re moving forward?


Right, so there are different stages to that, Justin, and just quickly, of course, there’s the re-densification of the residence halls, but there’s a re-densification of the academic facilities, the gym, and other facilities on campus. Our intention is to move forward in our planning. We are certainly moving forward with full occupancy.

Now, what does that mean in terms of things like the classroom and libraries? Well, we need to see what the state of progression of the disease is as we approach the start a fall term. We need to see if new variants have emerged. We need to see if the existing variants are being effectively contained by the vaccines that have been deployed. But our intention is at a high level if the entire population is vaccinated, if the studies have shown that the variants that have emerged are effectively controlled by the vaccine, if we continue with masking protocols. We may be able to reduce our social distancing protocols. There’s some modeling studies that have shown this is the case and revert to higher density in the classrooms.

Does that mean full density in classrooms? I don’t know the answer to that question yet, Justin, but it should mean significantly increased density. And so maybe we will reach a point where some larger classes have their lectures done online and smaller sections meet in-person, smaller classes meet entirely in-person. There are those kinds of things we need to think through, but the intention is to have everyone back on campus in the fall and for classes to be delivered largely in-person, or potentially through a hybrid mode if we need to have some reduction in the density of some of our classrooms.


Joe, I know we really want to get to our guests today, so we’ll have time for just one more question. This question comes in from a number of students I think, asking if you would be able to explain the rationale behind not expanding the possibility of pass-fail or NRO in response to request from students to do that based on the challenges that they are experiencing.


Yep. So decisions on grading are the province of the faculty. And this is a question that was put to faculty committees, principally the Committee on Instruction in Arts and Sciences, and given very serious consideration when the request came in from students at the end of the term. And we recognized the reason students are asking. We recognized that the challenge of moving to what was effectively quarantine for most of the last week of classes imposed hardship.

But the faculty felt that the vast majority of the term had already passed. The vast majority of students would benefit from having things graded in the normal fashion. And they felt in their judgment that the best thing to do to allow flexibility was to ask the faculty to allow, well, more flexibility in deadlines and turning in work so that coming out of quarantine students would have the ability to finish assignments that may have been delayed because of the need to impose limited quarantine during that last week when the outbreak occurred.

I know that not every student feels that that was a wise decision. I know some students feel that that was particularly challenging for them. But this is the decision the faculty made and was supported by the deans and supported by me coming from the faculty as being in the best interest of the majority of our student community.

So, thank you, Justin, for the questions. Why don’t we turn now to President Hanlon and Dr. Conroy, and shift a bit to conversations around leading two of the state’s largest institutions in this incredibly challenging year. So Joanne, Phil, good to see you, so good to have you back with us here again today.

Joanne Conroy:

Nice to be here.

Phil Hanlon:

Yeah, it’s great to see you, Joe, and always good to be here, especially with my friend and classmate, Joanne Conroy. And let me just add to what you said earlier, and offer my heartfelt sympathy to the friends and family of Connor Tiffany. He was a bright light. He will be missed deeply.


Well thank you, Phil. So let me start by asking you both just a general question about the year. It was an extraordinarily challenging year for us all. It was an extraordinarily challenging year to be in a leadership position of a large institution. So if you don’t mind, Phil, I’ll ask you first and then, Joanne, I’ll turn to you with the same question. Just take a few minutes to speak to us and our listeners about the most challenging aspects of this transition from business and life as usual to overnight having to reinvent everything, and how you managed through that transition.


Sure. Thanks, Joe, and you put your finger on what I would say was the first of two big challenges, and that was how suddenly this happened. So just over a year ago within the span of 72 hours, we needed to change just basically everything about the way we did our business. Moved to remote learning for our students, to work from home for our staff, to research practices that avoided face-to-face collaboration. It happened so quickly.

Second thing I’d pick out is that there was no playbook, so none of us had experienced anything like this in our lifetimes. What do we do about that? Well, we depended more than ever on science and expertise to help us set our directions. And we needed to constantly remind ourselves and others that this was new and profoundly unsettling to every member of our community. And so we needed to be generous with our empathy and our understanding, as I think you noted earlier, Joe.


Thank you, Phil. And Joanne, how about you managing a comprehensive health system and hospital and hospital system distributed across the state? Can’t have been easy when you had to change practices overnight.


Yeah, great question, Joe. I would say that we had a little bit of lead time ahead of the rest of the country, because the first case in New England actually was up here in Hanover. And on February 28th, we identified the first COVID positive community patient. So we had about two weeks to really consider how we were going to actually approach the pandemic. And as Phil said, there were so many things we didn’t know, and we didn’t know the answers to.

I would say the most impactful thing we did, and we do it for every single emergency, but we set up the incident command. Usually, we have those ... stand up for 48 hours. This one stood up for four to five months and it was composed of 15 to 20 people who had the areas of expertise that were needed to make the decisions that needed to be made right away. And we stepped away as senior leaders and they didn’t ask me about spending $5 million to set up the lab. They didn’t ask me about spending $11 million for PPE. They were given a blank checkbook to make the right decisions, to protect our patients and to protect the organization. And it was amazing how well they made decisions without a lot of information, waiting for the science to appear. And at the same time, steering the organization to a course, to protect the individuals that work here and inform the community.


Great. Thank you. I like the way you described that. I have to say as the chief budget officer, whenever I hear the term blank check, my heart skips a beat, but I understand exactly why you approached it that way.

So, Phil, let me ask you a question now to follow up, coming out of the pandemic. You and I, and the senior leadership team, have spoken about this a bit, but I’d like your thoughts on whether there are changes to the way Dartmouth operates, things that were forced on us this past year that we’ve actually learned from and you can imagine persisting, and us wanting to incorporate post pandemic as permanent ways of operating.


Sure. This is a great question, Joe, an important question, and as much as we all miss the sense of community and the close connection between faculty and students, there are still some aspects of today’s work over this last year that I do expect will endure. And let me mention too, first of all, more flexible working arrangements for our employees. And this is not unique to Dartmouth by any means. Based on national surveys conducted by PricewaterhouseCoopers, we’ve seen a 30% increase in productivity per employee who has worked remotely during the pandemic and 83% of employees in their surveys say that they would prefer to continue with at least one day per week working from home after the pandemic. And so I completely expect that you will see a continuation of more flexible arrangements for working from home, at least part of the time, for many of our employees. And this isn’t possible for all jobs or at all times, but we were already kind of headed down that path of greater flexibility before the pandemic and the pandemic has only accelerated that trend.

And then related, over this last year, we’ve seen a significant increase in using Zoom and other technologies to bring outside experts into our online classes. Some of you may have seen the interview that Professor Jenny Lind conducted with Hank Paulson about the future of U.S.-China relations, last week I think it was. That’s an example. You should have that example in your head. That’s one example of what’s been happening with great regularity in Dartmouth classrooms over the past year. It’s incredibly enriching for our students and I expect this trend to continue and become more prevalent as well.


That’s great. Thanks, Phil.

And Joanne, if I could turn to you, I’d actually like to ask a slightly different, but related question. Surgery is something I imagine you can’t do remotely, but there are other practices, telemedicine practices, that I would imagine have picked up in importance over the course of the past year. Do you imagine those or other practices becoming a more permanent part of the way D-H operates?


So, telehealth is the wave of the future. About 20% of our visits are still done virtually and patients still prefer for many of their visits to do it from the comfort of their own home. Psychiatry is a perfect example. Seventy-seven percent of our behavioral health visits are still done virtually. Their no-show rate is fabulous. And it is something that we have the capability to do, but we had a little bit of, I don’t know, maybe it was just, we didn’t achieve escape velocity to actually really commit to telehealth. We went from a handful of telehealth visits a week to 2,500 a day in less than two weeks. So when we need to deliver care virtually, we can do it and we can do it very efficiently. And our providers were incredibly creative in figuring out how do you prepare not only your average patient that’s pretty technologically savvy to connect with you on Zoom, but how do you connect with the 85-year-old patient that is not that familiar with the technology? And they did a great job doing that for a lot of patients.

I do want to say remote work, just like Phil is experiencing, is here to stay as well. We’re going to have 2,000 people who work, or previously worked, on this campus permanently working remotely. I can tell people that parking is a little bit easier here now. And we have a lot of extra office space, so we can redeploy it for things that maybe are more clinically priorities for us. But yeah, those two things are here to stay.


Now, if I can ask you a related question, Joanne, one of the things that I’ve heard from my faculty colleagues here is that, while the majority of our students miss the in-person, in the classroom, interaction, when we asked them about the quality of the Zoom mediated remote learning, their comments are genuinely positive. And there are some students who have said it’s a minority, but some students who have said, I learn better this way, because I can pace my engagement with the material. I can review things several times and then interact with the professor directly when I need to. And I’m wondering if you’re hearing anything similar around telemedicine. If you have patients who prefer that kind of engagement.


Patients do actually prefer it, but at the same time, they say they want to see their physician. So they do like to come back to have their face-to-face visit. We’re gathering data to understand what the differences are in care delivered virtually versus care delivered face-to-face. And I think if you follow the federal government’s conversation about whether or not to continue paying equally for telehealth visits, they’re also gathering data at a federal level to figure out whether or not this is a form of care delivery that they’ll continue to support in the future. My expectation is they will, but people are looking at the data.


  1. Thank you. So I’m conscious of time and I want to make sure we open it up to those who are listening in to ask questions. So I’m going to ask each of you one final question, and then we’ll turn it back to Justin. And Phil, I’m going to turn to you first. Back in the fall when you joined us, and also you and I in your office or by Zoom, we’ve talked a bit about issues that are on the mind of other university provosts and other university presidents at the time, and that continue to be topics of conversation, things you were collectively discussing. I’m wondering if that’s changed over the course of the past year. What’s top of mind for you and your colleague presidents right now? Are there common themes that everyone’s wrestling with?


No, thank you, Joe. Great question. And even before the pandemic, the number one concern on the minds of university presidents in this nation was student mental health and the pandemic has only rapidly escalated the urgency of this concern. The concerns have skyrocketed over the past year joined by an equally urgent concern about the wellness of our staff and faculty.

So we are, as you know Joe, because you’ve been a leader in this, we’re taking steps to try to respond. We’ve hired five new mental health professionals at Dick’s House, which makes a 50% increase in the professional staff there. Bryant Ford has been named associate dean for community life. The wellness center has greatly increased its online offerings of meditation, mindfulness, and yoga. The house communities have ramped up online and appropriately distanced activities to build community and support students efforts over the winter term, as you noted to promote outdoors activities, will continue on into the spring. And this is all mindful of, we feel for all members of our community who are struggling with the isolation and the loss during this incredibly challenging time for our society and trying to keep everyone well and healthy is a huge challenge.


All right. Great. Well, thank you, Phil. It has certainly been quite the year on so many dimensions. So thank you.

Joanne, let me turn to you with the last question then, before we turn back to Justin and it’s two parts, but they’re related. D-H has been helpful to Dartmouth, certainly providing testing for our symptomatic individuals over the course of the past year. And my understanding is that you’re also providing large-scale surveillance testing for the community at large, the surrounding health care community, some of the regional hospitals. So, can you tell us just a little bit more about the role D-H is playing in COVID testing for the region and also whether you anticipate D-H playing a greater role in vaccine distribution for the region once New Hampshire moves to phase 2B and phase 3.


Yeah. I like to remind people that a year ago, if we were going to do a COVID test, remember we had to send it to Atlanta, to the CDC, and wait for it to come back. It didn’t take us long to figure out that we needed to stand up our own lab, which was one of the first commitments. We have a fabulous director or chair, Wendy Wells and lab director, Mike Harhen, who stood up a really state-of-the-art lab that actually helped not only our regional health network, but we back up the state when the state gets overwhelmed. We put on extra shifts and we can run, I think, close to 1,500 or 2,000 tests a day. And that’s critically important to make sure that people get their tests within 24 hours. If you’re waiting four or five days for a PCR test for COVID-19, that doesn’t help you control community transmission.

We also are doing some variant testing for the state. That’s much more complicated. And so we don’t use it as part of our surveillance, but if the state is ... It has hospitals on alert to identify samples that they believe should be submitted for variant testing. And this may be from a combination of symptoms and/or travel, and/or people that maybe felt they’d already been exposed to COVID and are getting it again.

We also are doing wastewater testing. We had a very generous donor that allowed us to stand up a wastewater testing system, which we use in many municipalities across the state. And the lab that we establish will continue. COVID testing is not going to go away. And the variant testing is only going to get a lot more prevalent. And so we’re investing in something that’s really resourced for the entire state.


Great. Thank you. And what about vaccine distribution quickly?


Ah, vaccines. Very hot topic. So vaccine distributions across the country is both a political, as well as a resource constrained issue. The federal government wants to make sure that it’s distributed fairly among all the states. And they also want to make sure that we address those communities that have been disproportionately affected by COVID-19, and they can be communities of color or congregate communities like nursing homes; 82% of the deaths in New Hampshire were in nursing homes. So the federal government has controlled the distribution to the state and the state has controlled the distribution within the state.

The American Hospital Association has been working with the federal government to try to involve providers more in the distribution of vaccine, but right now we don’t have a lot of vaccine. It has increased by I think, almost doubled in volume, but still it’s a pretty small amount to vaccinate everybody in the state.

My expectation is the once we get access to a greater amount of vaccine, the state will look to providers within the state in order to distribute. Now the J&J vaccine that was recently released, the vast majority of it went to pharmacies, meaning Walgreens and CVS. The federal government believes that this an easy access point for a lot of patients. Already people in Illinois were getting their vaccines at local pharmacies. That has not occurred yet in New Hampshire, but I hope people keep their ears and eyes open for that, because my expectation is that we’ll see more and more of that in the state of New Hampshire.


Great. Thank you. Thanks Joanne. So Justin, we turn it over to you and see what questions are coming in from the community.


Thanks a lot, Joe. And Phil, I’m going to start with a question for you because it actually, it plays off of something that you said in your last response, when you were talking about the isolation and loss that have sort of washed over our community over the course of the last year. And obviously we’re looking forward to getting back in the saddle when it comes to being back on campus and resuming something resembling a normal life. The questioner asks about bringing the community together, a community that has in fact been far apart for so long. So how do you as president, Phil, think about reconnecting with the community and will be welcoming, not just the class of ’25s, but the class of ’24s will be coming together again for the first time in sort of a normal setting. So how do you think about bringing the community together as we begin again, hopefully by the fall or certainly as we go between now and the fall?


Yeah, Justin. Terrific question, and an important question for us because I do believe that part of the differentiation and uniqueness of Dartmouth is the strong community and the sense of bonding that comes from being in this beautiful, sometimes challenging, place together. This is something Joe and I have had an initial conversation about, and I think we will follow up more with the deans in particular and with student leaders. But I think this is a good opportunity to try to challenge our community to say, “Let’s think of some sort of reawakening activities in the fall.” You know, what could we sponsor that would be either academic in nature, or social and community in nature, that would actually do exactly what you’re talking about, which is try to begin the reconnection from a year of having been separated?


Thanks, Phil. I look forward to hearing more about that. Like everyone else I’m excited to reconnect as well. Joanne, as mentioned earlier, ton of questions about vaccines. I think a couple people want to know how you managed to get your Vermont staff vaccinated given what you were just talking about, this sort of rolling out in states. How did that work? How did that work for you, and is there anything that Dartmouth might be able to learn from that?


Yeah. So, byzantine state rules, but when the state first rolled out 1A you had to work in health care in New Hampshire, so they were agnostic about where you lived. The same thing we saw, I think it was 1A or 1B being vaccinated. For example, ski patrol people that were first responders on ski resorts, again, they were vaccinated in the state where they worked, not necessarily in the state that they lived in. And if any of you had been able to be vaccinated at the armory, which has now moved to JCPenney, you would have seen a lot of Vermont and New Hampshire cars in the lines, so they all went by the state regulations.


Phil, if I could go back to you. We frequently get questions on community conversations about Dartmouth athletics and what the plans are. Those are not questions that we can necessarily answer because they’re being decided by the Ivy League, not something that’s being decided internally at Dartmouth. But somebody writes in: Given that the Ivy league has canceled Ivy competition for the spring, will you consider allowing Dartmouth athletes to compete locally? Will you consider any sort of competition for the teams that are supposed to be playing in the spring just to get them out on the field or out there competing again?


Right. Thank you, Justin. First of all, let me say that I think I speak for all of the Ivy presidents in understanding the value and importance to our student athletes of competing, and we really want them to be out there as soon as it’s safe to do so. As you noted, the question of league competition is something that’s decided collectively amongst the eight presidents, not by any one institution. When the presidents decided to cancel the spring term, we did in fact adopt a framework for local competition, and so that does exist. It says, first and foremost, that all state and institutional rules must be followed first. But if they have been, then that gives a set of criteria and conditions under which teams can compete locally. And sort of in recognition of our unique location, it did allow for some travel beyond just a very short bus ride for our institution.


Joanne, if I could go back to you with a question based on something that you said in response to a previous question from Joe. You said that telehealth is really the wave of the future. It sounds like it’s been highly successful, and it’s been more widely adopted than it was prior to the pandemic. Telehealth, telemedicine, is separate from remote working, and so how is D-H thinking about remote working? And realizing that I’m sure there’s a lot of jobs that you can’t do remotely, maybe most, I don’t know, but how did D-H approach remote working during the pandemic? And do you see that being extended beyond the pandemic?


Thanks, Justin. Actually in the beginning of the pandemic, we sent over 5,500 people from this campus to work from home, and only people that were absolutely necessary to deliver care were here. Since then, many of the people have come back, but again, 2,000 people will be permanently remote. Our HR team actually has spent about four months studying remote work and classifying it by job category, and there are certain jobs that will be permanently remote. What’s funny, we get the same response that probably you have received from a lot of your employees, they actually like to work remotely. They’d like to have the flexibility to work remotely.

We have to do two things. Number one, train supervisors to supervise people remotely. You know, sometimes they say, “Well, I don’t know if they’re productive unless I see them.” But if you push people and say, “Well, how do you measure their productivity if you see them,” and they can’t answer that. So that means we have to really think about, “How are people doing their work?” The second thing is, we probably have to have landing spaces so you don’t lose that sense of culture. So people can come back and land together and meet as a group, and then go back to continue their remote work. So it will be a whole new way of working for us, but something that I think expands our catchment area for the people that we can attract and employ here.


Joanne, I bet there’s something we’ve seen that you’ve seen too, which is, even as we sent people to work from home, they’ve found creative ways to stay connected to each other within their offices. They do crave the friendship, the companionship, the …


Yeah. Some supervisors are better at doing that than others, so we’ve got to train our supervisors how to actually manage remote teams.


Phil, I’d like to go back to you. Someone writes in who I think is keeping close tabs on your schedule because they observed that you were teaching, and want to know if you taught in person, and if not, why not.


I taught in the fall, and I taught a more advanced math class on representations of the symmetric group. I will not actually go into a lecture about that right now, although you may want one Justin. I had a small enough class, I think it was 13 or 14 students, that I contemplated meeting in person, and I actually asked the students before the start of the fall term what was their preference. Their strong preference was to not meet in person. They wanted to meet remotely, and they just had deep concerns about spread of the disease, and so they actually requested that we meet online.


That was an interesting challenge because the class I was teaching had a lot of visuals in it, so things that I would normally draw on a chalkboard. So I had to figure out, how do I replicate that online. I found some technological solutions to that, but mostly what I realized is, I needed to prepare it in advance and share it with students. The reason I’m saying this is because that actually I think made me teach better. It took a lot of time, but I had to sort of think about, “OK, if I was going to draw on the blackboard, what would I draw,” and really plan out my lectures more carefully.


Interesting. Thank you for that, Phil. We have time for just one more question, so I’m going to go back to Joanne and probably stick with the subject of the day, at least for her, and that’s vaccines. Actually, I don’t know if you’ll know the answer to this, but a bunch of questions about whether or not students who don’t live in New Hampshire, but will be in New Hampshire, will be eligible to receive vaccines while they’re here, or should they be trying to make arrangements in their home states and get vaccinated there?


Ah, great question. I have to believe we have so many colleges across the state, this is just not a Dartmouth College challenge. This is going to be every single institution of higher ed. The goal is to get students vaccinated somewhere. We usually counsel people to take the vaccine when and where you can get it. I do believe if J&J vaccine, I think Merck has agreed to produce the vaccine in the United States, so we should see an increasing amount of vaccine available. The AstraZeneca vaccine, the FDA has not looked at the data yet, but it’s actually a very safe vaccine even though there’s been a lot of social media about its challenges, that is not backed up by science yet.


You know, when they look at the evidence, it doesn’t change anybody’s opinion about the efficacy of that vaccine. And the Novavax, oh Novamax, vaccine actually looks good as well. So when you think about it, we could have another two new vaccines as well as ramped up production of J&J vaccine. I think it’s going to be a less of a question of state of residence and more of a question of how do you distribute it as quickly as possible. Heads up. We are starting to see some pediatric patients admitted to the hospital here, which we didn’t see a lot of before. So I think people have to reconsider our vaccination hierarchy, because we are starting to see younger kids that are very sick.


Oh, wow. Well, sorry to hear that, but thank you for all that, particularly your insight on AstraZeneca. We look forward to seeing more of that evidence and getting any of that confusion cleared up. Thank you, as I said, for that. And thank you and thank Phil so much for joining us for the last half an hour to take questions. It was extremely enlightening, and you were gracious to give us so much time. So thank you for that very much, and Joe, I will go back to you.


Thank you, Justin. Good to see you as always. And let me echo your thanks to Phil and Joanne for being part of this, and also for your leadership of these two very important organizations in the Upper Valley and in the state over this past year. Your calm and steady approach to incredibly complex situations has been a lesson for us all and hugely appreciate it, so thank you very much. Let me end by just saying that in the face of what’s been a really challenging year for us all and an extraordinarily challenging week for our student community and our community on campus, as I look ahead it feels to me as if we’re at an inflection point.

The slope of the important curves is changing. Infection rates are falling. Deaths are falling nationwide, and also regionally. Vaccination rates are increasing. If we look at our operations winter term, we had a much more aggressive set of opportunities to get students outside. We loosened restrictions, and by and large it worked. And so, as I look ahead to spring, and then summer and fall, I am optimistic that we can make our way through this as a community.

We can move towards more in-person engagement in the summer, and we really can get back to normal residential in-person operation that we all crave by the fall. And I don’t know about you, but I am so looking forward to seeing this community in full-force gathered together on the Green and around campus just six months from now. Thank you everyone. Stay healthy. Stay well. And we look forward to seeing you again at the next Community Conversation in two weeks on March 31. Until then, take care.