Mount Sinai's Arnhold Institute for Global Health and NYC Health + Hospitals launch CURE-19

Reviewed by Emily Henderson, B.Sc.Aug 12 2020

The Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai and NYC Health + Hospitals have launched the COVID-19 Unit for Research at Elmhurst (CURE-19). The new initiative will translate data, experiences, and lessons from clinicians at NYC Health + Hospitals/Elmhurst and NYC Health + Hospitals/Queens into research that will address both the pandemic and root causes of health disparities in New York City.

The devastating impact of a pandemic can be significantly exacerbated by longstanding social, economic, and health inequities, an outcome we are seeing in communities across New York and the world. Through CURE-19, we are bringing together extensive resources, expertise, and reach of both the Mount Sinai Health System and Elmhurst Hospital in serving populations that are socioeconomically, demographically, and culturally diverse. The unit will explore how we can not only achieve greater success in combating COVID-19 in these communities, but also strengthen our efforts to address existing health disparities, leading to improved patient outcomes and enhanced pandemic preparedness and response initiatives."

Dennis S. Charney, MD, the Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs of the Mount Sinai Health System

CURE-19 is housed within NYC Health + Hospitals/Elmhurst's Global Health Institute and operated in partnership with the Arnhold Institute for Global Health. NYC Health + Hospitals is the largest public hospital system in the nation, serving the city's low-income, undocumented and uninsured populations. Mount Sinai and NYC Health + Hospitals/Elmhurst have an academic affiliation agreement and joint residency programs, and previously collaborated on training, patient care and research. To date, NYC Health + Hospitals/Elmhurst has discharged more than 1,600 COVID-19 patients.

"NYC Health + Hospitals/Elmhurst and NYC Health + Hospitals/Queens serve as vital safety nets for immigrants and other underserved populations," said Israel Rocha, Vice President of NYC Health + Hospitals and Chief Executive Officer of both facilities. "The COVID-19 pandemic dramatically revealed the extent to which socioeconomic factors and racial disparities in health care negatively impacted our patients and made them especially vulnerable to the virus. We look forward to collaborating with the Arnhold Institute for Global Health on research projects and other programs designed to eliminate these inequities."

CURE-19 has identified three areas of urgent need in Queens to address in collaboration with leaders and experts in the borough's communities:

• Reproductive and child healthcare: COVID-19 has added considerable stressors for pregnant women, from the fear of contracting the virus to managing birth and the first weeks of care for newborns with limited social support. CURE-19 is studying a cohort of affected women and their newborns and engaging community-based organizations to collaborate in improving the care of mothers and children.
• People living with HIV: People living with HIV experience both immune suppression and other social and economic vulnerabilities that put them at high risk for COVID-19. Drawing on extensive clinical and research expertise in shaping HIV-related care in settings including Kenya, Ethiopia, and Russia, CURE-19 is launching phone-based assessments, outreach, and clinical support for people with HIV in Kenya and New York City to evaluate the impact of the pandemic on adolescent and adult physical, mental and social health.
• Social and environmental determinants: Social and environmental factors drive the risk of COVID-19-related illness, as well as the rise in other diseases and conditions from health care disruption during the pandemic. CURE-19 is conducting a large retrospective analysis to assess the impact of air pollution, overcrowding, excessive policing, race/ethnicity, household income, and the environment on the severity of COVID-19. The unit will follow up with long-term studies to mitigate these risks, improving greater resiliency and preparedness.

"CURE-19 is informed by the insight that the true test of any health care innovation is how it impacts practice and policy, and that is what we aim to do," said Joseph Masci, MD, Chair of Global Health at Elmhurst Hospital, Professor of Medicine (Infectious Diseases) at Mount Sinai, and a pioneer in efforts to understand AIDS, tuberculosis, bioterrorism, and Ebola. "Through our local and global work, we have developed core capacities in community-based engagement, longitudinal follow-up with specific populations, and achieving impact through changing policy, practices, and health systems that will enable us to meet the needs of the community."

Rachel C. Vreeman, MD, MS, Chair of the Department of Global Health and Health System Design and Director of the Arnhold Institute for Global Health, said the unit will provide other health systems nationwide and internationally with guidance to enhance the quality and access to the care they deliver.

"The lessons we learn, and the data we gather, through CURE-19 will go beyond equipping us with the fundamentals to deliver more effective COVID-19 therapeutic options to vulnerable populations in New York City," said Dr. Vreeman, a pediatrician and global health researcher with expertise in strategies to combat HIV in sub-Saharan Africa. "We can apply these lessons and the data to make fundamental changes in how we deliver health care and address the issues that have long contributed to the challenges these populations face. Our goal is to open the door to more engagement, better access and improved health outcomes among all underserved communities."