Q’s With Dr. Andrew Bazos & Connor Fitzpatrick: CrowdRx Pivots To Help Reopen Venues

– crowdrx

CrowdRx Managing Director Dr. Andrew Bazos has been providing medical services at large events since he treated an injured baseball fan at Yankee Stadium while still a medical intern at Columbia-Presbyterian Medical Center. That bit of Good Samaritanism led to a job as house physician with the Yankees, who recommended his services to Madison Square Garden in 1989 and led to the establishment of Sports 

& Entertainment Physicians, PC, the precursor of CrowdRx.

Executive Director Connor Fitzpatrick combines his background in emergency medical services with his extensive experience in healthcare operations to build strategic partnerships with venues, sponsors, and clients. Fitzpatrick has served as Medical Operations Director for some of the world’s largest events including Burning Man, the U.S. Open,  Madison Square Garden, Chase Center, and Yankee Stadium. He’s also guest faculty for the International Association of Venue Managers and their Academy for Venue Safety 
and Security.

With large events paused, CrowdRx has expanded from mitigating and treating onsite medical emergencies to offering solutions for safely reopening events in the face of the coronavirus pandemic. Its CrowdRx Go! program was developed with just that in mind, with comprehensive Center For Disease Control and physician-guided policies and procedures designed to open public spaces quickly and safely. 
Pollstar: How has the business of event medicine changed over the years?

Andrew Bazos: There’s specialized medical needs when you get large groups of people together and as the standards and society’s expectations went up, it’s gotten us to the last few years when we’ve had to consider things we never thought we would such as mass casualty disasters like active shooter situations, needing more defibrillators, and with everything now being filmed our response time and our policies and procedures are continually under scrutiny. We’ve standardized protocols across the industry based on the type of entertainment, the type of venue – indoor, outdoor – age groups, alcohol being served, all those factors go into guidance and staffing at these events. 
How is CrowdRx applying that knowledge base to the present COVID crisis?

Bazos: Fast forward to now when events are stopped, we are using our same medical- and science-backed thinking to restart them in a safe fashion. We’re able to get testing, working with some of the early agencies to get the testing, that I think is ultimately going to be able to get venues open safely. But we’re also using it to understand the technology surrounding thermal screening, oxygenation checks, etc., which is what we’re going to be doing until we get better testing ready. Then, finally, using some of the science about how the disease spreads so we can make some recommendations about spacing within the venues and, when someone does get sick, give advice on quarantine, returning to work, and helping some of these human resources departments at these venues which are really under duress right now because of this crisis. 
Dr. Andrew Bazos – Dr. Andrew Bazos
Dr. Andrew Bazos
Courtesy CrowdRx

Everyone’s concerned that if a future outbreak can be traced back to a concert, it could set the entire industry back to step one. What’s your strategy for mitigating that risk?

Bazos: Toward that end, we’re trying to give the venues the ability to put it on us to come up with a medicine-backed consensus plan for when problems happen – and no one’s going to be perfect in this recovery, it’s not going to be without hiccups. But when a hiccup occurs, no one’s going to say, “Gee I’m going to blame, say, Chase Center because they sat people every other seat when the Yankees sat people every third seat.” 
It should not be the individual venue or team making the decision; it should be a policy set by a third party and that’s where the CrowdRx Go! program came about. To set industry standards and encourage people to criticize and discuss and add their two cents, so we can move forward. What we’re seeing now is each team, league or venue is trying to come up with their own plan and wondering and worrying what everybody else is doing, and then there’s the overlay of states and municipalities weighing in with their thoughts. We’re trying to pull the industry out of that paralysis with uniform standards for all of our venues, big and small.

With some states loosening restrictions, we’re seeing movement to open some small venues as well as finding other solutions like drive-in concerts.
Connor Fitzpatrick: What I can say is we’re working with a couple groups that are doing drive-in concerts right now. People are eager to get back so there’s certainly a lot of different ways to implement plans. Part of what we’re doing at CrowdRx, and it’s a comprehensive program, is we’re looking at things on the detection side, on the screening side, but also complex things like disinfecting plans for the venue, crowd spacing, all of those things. 
We’re hearing about thermal checks and UV and disinfectant stations for fans to pass through and even suits for them to wear. How practical are these various ideas for fan experience?

Bazos: I think even masks are going to be difficult. Even spacing – part of the reason you go to a show is to be around other people and to cheer, shout and sing. On top of that, Americans love to eat and drink at these events. Everyone does. You have to take your mask off to take a drink of beer. You visit the six-foot rule; it’s quite antiquated and applies better to crowds where you’re not wearing masks. As we’ve all read in studies recently, the virus can spread on particles much farther than six feet. 
Society needs to set its own personal risk level and that has to be overlaid on top of the physical space, and the business people making the ultimate decision have to put that in their formula and come up with a plan. But that’s going to require standardization; it’s going to require testing of some sort and if we can get an instant saliva test that we can do at the gate, that would solve many if not most of the problems. 

They have instant saliva tests already? Seems like testing and other technology is ramping up quickly.
Connor Fitzpatrick
Courtesy CrowdRx
– Connor Fitzpatrick

Bazos: They are under development. A lot of people are asking us to write plans for their opening and the first thing I say is, we’ll write a plan if they’re opening today but expect that in a week it could change dramatically, based on technology. Right now, we’re advocating thermal screening, which everyone is doing but, more importantly, the latest innovation is to also add oxygen saturation and heart rate screens because oxygenation levels have shown to be very closely correlated with the early disease. Many people can have early lung function affected without feeling it. But then you take a few seconds to put your finger in the pincher and you see a low oxygen rate and if there’s not a reason for it, that raises issues. Then our CrowdRx screening people have a set of questions we would ask to screen the patient further. If there’s no comfort that there’s no infection, that person would not be allowed into the event.
How quickly would you be able to get people through the turnstiles with thermal screening, questionnaires and such?

Fitzpatrick: There’s face pass and fever screens, two high-level methods, where there are thermal cameras that can screen up to 5,000 people an hour per camera, as people walk by, and there is no questioning. 
There’s more information on the website [CrowdRx.org] about that model. The second model is interesting in that we can display questions on a screen that can be mounted on a wall. The issue obviously is that people have to be directed to that device as they walk up to it, and it requires constant cleaning. But you walk up to the device and it knows you’re there, it takes your temperature, and we clear you into the building. Thermal imaging is one step in the screening program in the venue but it’s effective for detecting above normal temperature for people entering. 

Would there be different models for indoor and outdoor shows?

Bazos: There are arguments both ways on indoor vs. outdoor, because of the fresh air outdoors and the breeze could carry the virus in one direction. Indoors, we’re counseling on ventilation systems; increased ventilation and higher-level filtration is helpful. But ultimately there’s going to be an incremental risk in going to an event. And we’re there to make it as low as possible and with more testing we can get that risk lower and lower and ultimately eliminate it as much as possible. There’s always a risk but our goal is to minimize it as much as possible.
Is the presence of alcohol sales a higher risk given human behavior?

Bazos: All these plans will depend on the behavior, which would be monitored by security that will have very low tolerance for bad behavior. I do have confidence in the public to realize the special privilege of being able to return to these kinds of events and be quite responsible. I think we’ve seen in society that people have become more patient and appreciative of even a cold takeout meal. 

Who have you been consulting with nationwide or even in the global medical community?

Bazos: There’s a wide variety of clients, so we get a lot of calls including from regulatory bodies. Calls that we didn’t get in the past, from factories and distribution centers, global shipping companies, stadiums, arenas, sports leagues, casinos, you name it.

Larger companies like AEG or Live Nation would seem to be able to establish a uniform policy throughout a portfolio but if someone calls inquiring about your services, how do they begin?
Fitzpatrick: Certainly, we are working with some large companies but we work with the smaller ones, too. We can tailor the needs of a smaller, 1,000-person performing arts center all the way up to a major international group. We break it down by hour; physician-led, they can meet with our consultants by the hour or we can answer questions and go over documents and see what they have already, or we can go as complex as having our entire team write up plans for them from the ground up. This is a pandemic and having the peace of mind with a trusted organization is something I think we can give them. We’ll tell them the good, the bad and the ugly.