An American College Health Association task force chaired by former executive director of the University of Georgia University Health Center has released guidelines for universities to return to in-person classes in the fall in the COVID-19 era.
Dr. Jean Chin currently teaches clinical skills as a part of the Augusta University and UGA Medical Partnership. Chin said that although she works for the medical partnership, she is not involved in UGA’s plan to reopen, and the task force guidelines are recommendations of what schools should do to minimize risk from COVID-19 as in-person classes resume. She currently chairs the ACHA COVID-19 Task Force, which published the guidelines.
The recommendations provide considerations to minimize the risk of COVID-19 infection, particularly in a possible second wave of infection as students return to campus in the fall.
The guidelines are based on current information about COVID-19 and are broad for universal use, completely dependent on whether the institution will have the resources to implement everything. Chin said the team had good knowledge of transmission, public health practices and phasing criteria as the pandemic grew and already had background information ready.
The University System of Georgia plans to resume in-person instruction during the fall 2020 semester. UGA plans to begin a three phase reopening plan on June 15 that will end with students, faculty and staff returning for the fall.
Recommendations for in-person instruction include a limitation to fewer than 30 people in a single classroom with social distancing and creating multiple sections for classes. Laboratories, clinical experiences and performing arts classes should be at a higher priority to be in-person, according to the guidelines.
The ACHA’s facility considerations includes maintaining 6 feet between workstations and workers, placing plexiglass or other barriers where people must face each other and in high traffic areas, removing chairs and desks to ensure proper physical distancing in conference and waiting rooms, and making face coverings and sanitizing supplies.
For housing, the ACHA ideally recommends a single resident per room, the requirement of face coverings in common areas such as study rooms, restrictions on events and social activities, and enhanced cleaning throughout each residential building, according to the guidelines.
On-campus dining services also present a large risk for the spread of COVID-19. The recommendations include requiring all dining faculty to wear face masks and gloves at all times, all students and diners to wear face masks while in the facility while limiting the number of people dining at the same time.
Access to buildings by appointment, specific dining times for groups, floor markers for lines, appropriately spaced chairs and tables and eliminating buffet-style, or self-serve food stations should also be considered, according to the ACHA’s guidelines.
The new normal
Chin’s team had Centers for Disease Control and Prevention guidance and she said their broad statements made it easier to translate into a college health setting.
According to the guidelines, until a vaccine for COVID-19 is available and widely used, “physical distancing, viral testing, isolation, quarantine, and contact tracing” are key strategies to control the spread of the virus. The ACHA recommends campus experts and public health officials should collaborate in order to inform and advise campus leadership on resuming operations safely.
The guidelines highlight the importance of protecting the most vulnerable students such as those who are immunocompromised, undocumented or homeless by possibly ongoing physical distancing for a longer period of time.
Campus leadership should have an incident command structure, an effective surveillance system and partnerships with local public health and health care organizations, according to the guidelines.
In order to mitigate a second wave of infection, the ACHA advises health centers to have immediate viral testing for all students, faculty or staff with symptoms, case management of all people with COVID-19 and syndromic surveillance, which provides public health officials with a timely system for detecting, understanding and monitoring the disease.
Reliable and accurate antibody testing, as well as future large scale delivery of COVID-19 vaccines, are also part of the guidelines. Antibody tests tell people whether they have had the virus after they don’t have an active infection.
According to the guidelines, the new normal for campuses should emphasize the importance of public health practices including hand hygiene, social distancing, proper cough and sneeze etiquette, frequent disinfection of common and densely populated areas, temperature checks and wearing face coverings in public.
The resumption of activities should be gradual and phased on local public health conditions. The return to an active on-campus environment is dependent on high accessibility to testing, contact tracing and isolating exposed students, staff or faculty.
Chin does believe that every pandemic expert is anticipating a second wave but nobody knows how severe it is going to be or when it is going to be. If a surge occurs, institutions should have a backup plan such as to move classes back to online instruction.