Newton Pavilion COVID-19 recuperation unit for homeless patients medical team members at the unit’s opening on April 9, 2020. The team includes staff from Boston Medical Center and other area healthcare providers.

Health & Medicine

State-Owned Newton Pavilion Reopens to Treat Homeless Patients with COVID-19

Facility is a partnership among Boston Medical Center, the city, Boston Health Care for the Homeless, shelters

At 11 am on April 9, a team from Boston Medical Center received keys from the commonwealth of Massachusetts to reopen the shuttered Newton Pavilion adjacent to BMC as a treatment center for homeless patients with COVID-19. By 6:30 that evening, doctors and nurses were treating 15 individuals. A week later, that number had more than doubled to 38 and by April 21 had climbed to 66, as more of Boston’s homeless became infected with the virus (to date, approximately 250 have tested positive and city officials expect more than half the adult shelter population will be tested by week’s end). 

The facility is being operated in partnership with BMC, which sold it to the state in 2018, and Boston Health Care for the Homeless Program (BHCHP), the city’s COVID-19 response team, and several homeless shelters. 

After Governor Charlie Baker announced March 26 that the building would reopen as a treatment center for homeless with coronavirus, getting it ready for patients required two weeks of planning, according to Sarah Arbelaez, BMC vice president of clinical services. In its first week of operation, BMC had set up three 20-bed units on the seventh floor to treat incoming patients, with plans to open two more units on the sixth floor as more testing shows a rise in potential COVID-19 cases among the homeless. Arbelaez says BMC could use as many as three floors to care for up to 200 patients. 

BMC has been working closely with the city’s COVID-19 response team as well with as the Pine Street Inn and BHCHP to understand the medical, psychiatric, and behavioral services incoming patients might require, she says. 

Boston’s homeless population is especially vulnerable during the pandemic. A 2019 city census found 2,348 adults living on the streets and in emergency shelters. Because shelters house people in close quarters, there’s a risk for rapid spread of COVID-19. BHCHP performed tests on 397 people staying at the Pine Street Inn the week of April 6 and found 36 percent positive, WBUR, BU’s National Public Radio station, reported. 

Ravin Davidoff, BMC chief medical officer and a School of Medicine professor of medicine, says the Newton Pavilion will help prevent the spread of COVID-19 by creating a safe space for homeless adults who test positive, but are not showing signs of serious illness. They can rest, receive nonemergency care, and recover in relative isolation compared to on the streets or in a crowded homeless shelter. 

“The virus has unmasked racial inequities in a striking way. It’s disproportionately affecting people of color and those in the lower socioeconomic groups, and also more homeless people,” Davidoff says. “We’ve been able to discharge people from the hospital and have this as a safe place for them to go. Prior to the opening of the building for that purpose, those people would need to be admitted to the hospital.”

Arbelaez says BMC has a team of approximately 100 healthcare professionals who’ve volunteered to work at the Pavilion. They include physicians from BMC and other area providers, nurse practitioners, nurses, medical assistants, operations staff, behavioral health professionals, and information technology specialists.

The services provided there are specific to a nonemergency setting, she says. Doctors and other medical staff are on hand 24 hours a day to monitor patients who have tested positive for the virus. Patients who no longer need emergency care arrive from a hospital or another facility.

If a patient’s condition worsens, an ambulance will transport them to BMC’s emergency department. Otherwise, they can stay at the pavilion until they are symptom-free, and then be released to a homeless shelter.

To make sure the Newton Pavilion was able to open on time, BMC staff from a range of departments—including infection control, nursing, materials management, facilities, and registration—rallied the needed resources and staff. 

A BMC IT team spent three days building a new medical records system for the unit. Donations came in from Stop & Shop (prepared meals), Bob’s Discount Furniture (including recliner chairs for common rooms), and Wayfair (including some beds). BMC contracted with Longwood Security Services, a private contractor with experience working with Boston’s homeless community, to provide on-site security at the site. (The BU Medical Campus public safety department and the BU Police Department continue to patrol the Medical Campus,” says Kelly Nee, BUPD chief and executive director of public safety.) 

“Once we got the keys on April 9, we had our equipment sitting on the loading dock,” says Arbelaez. “We moved it all over to the East Newton Street campus, and we just started stocking rooms and bringing in IT hardware. We started putting up signs and getting everything ready that morning and into the afternoon. The staff—many of us—were doing all of this without even having been in the building for years, just working based on floor plans.” 

Coping with the pandemic is stressful for BMC staff, she acknowledges, not just professionally, but personally, too, as they deal with stay-at-home and social-distancing policies. The tight deadline to ready the pavilion was an additional level of stress, she says, but it’s been incredibly rewarding. 

“Being there myself the first night and seeing the last admission come in at 7:30 pm, that was something. At the end of that, to know that these 15 individuals were able to get upstairs into a warm bed with a warm shower and a meal, and to begin their recuperation, knowing everything that went on behind the scenes, from all the different teams that made that possible—we’re very proud of the work and the people that we work with every day,” she says.