Public Health Update 8/19/20

From: Tom McLarney, MD
Sent: Wednesday, August 19, 2020 1:45 PM
To: Renee Johnson Thornton
Subject: Public Health Update – August 19, 2020

To the Wesleyan community,

As we prepare to welcome students back to campus next week, I’m happy to report that Connecticut continues to do well with decreasing cases, hospitalizations, and deaths from COVID-19. That said, the unprecedented increases in cases and hospitalizations in most other states in the country are sobering. In addition, the mean age for cases is decreasing, and we’re continuing to learn more about the serious post-COVID syndromes experienced by many young people, including chronic fatigue and hypercoagulopathies (blood clots to the lungs, etc).

During the pandemic, it is important to distinguish between the things we can change and the things we cannot. The unpredictable course of the coronavirus and other people’s behaviors (including those who choose not to wear face coverings and congregate in large groups) are examples of the latter—generally out of our control. The best place to focus our energy is on the things we can control, which come in two parts.

First, Wesleyan is taking a wide range of measures to make the campus experience this fall as safe and healthy as possible for all students, faculty, and staff. Second, we are counting on individuals to take steps to not only protect themselves but to keep others safe and healthy.

Some of the measures Wesleyan is taking include:

Strongly encouraging all students to get tested for COVID prior to leaving home, and adhering to the State of Connecticut’s guidance for quarantine upon arrival in order to reduce the likelihood of an outbreak on campus. (More on that below.)
Following arrival, students will be tested initially twice weekly for COVID through a self-administered anterior nasal swab. This provides the benefit of detecting COVID in the pre-symptomatic or asymptomatic stage, and offers us the opportunity to both isolate the infected student and to quarantine any close contacts (roommates, housemates, intimate partners, and anyone they have been in contact with for 15 minutes or longer at a distance of less than six feet). We will aim to quarantine any close contact who may have been exposed before they are contagious (which typically happens two days prior to symptom onset), thereby greatly reducing the spread of the disease.
A student would be isolated if they either have received a positive COVID test or have clinically-diagnosed symptoms strongly suggestive of the disease. They would be isolated for a period defined by the CDC specifically as 10 days from the onset of symptoms, as long as they are improving and have had no fever for 24 hours without the use of fever-reducing medicines (e.g., Tylenol, Advil). The other criterion for isolation release would be two negative tests 24 hours apart. This criterion is problematic, as many people who have had COVID will continue to have a positive test for up to 60 days post-infection, but it does not mean they are contagious. This is why the 10-day window is used—viral culture studies have demonstrated that viable COVID-19 viruses are no longer present after seven to eight days after symptom onset.
Close contacts of the case, meanwhile, will be placed in quarantine for 14 days. The incubation period for COVID-19 is between two and 14 days (typically around five). If a person shows no symptoms at that time, the chance that they contracted it is very low. Some may ask if a COVID test can be done in lieu of the 14-day quarantine. The answer is no, since a negative test would not rule out an exposure that could progress to COVID in that 14-day time period.

Some of the additional measures Wesleyan is taking include: configuring classrooms, dining, and other areas to allow for a minimum of six feet of social distance; janitorial staff frequently and safely disinfecting and sanitizing areas; frequent COVID testing through the semester, and careful monitoring and contact tracing to help break the chain of contagion; and many classes being offered as a hybrid of in-classroom and online instruction. Much more information about instruction, campus life, returning to work, and health and safety is available on the Reactivating Campus website.

Secondly, it is critically important that every Wesleyan community member does their individual part for our methods to be effective. We thus expect all members of our community to take steps outlined in the Community Agreement for employees, and the Code of Conduct for students, including:

Wearing a mask or face covering at all times: Exceptions include sleeping, being in your room without visitors (roommates are okay), eating, showering, and oral hygiene. This means you must wear a face covering whenever leaving your room to go into the hallway, bathroom, etc., or if you have a guest in your room. Wearing a face covering is inconvenient, at times uncomfortable, but it protects the people around you.

Distancing: It is crucial to maintain that six-foot distance to reduce the risk of infection. At times when you are not wearing a face covering, such as when dining or brushing teeth, it is most important to make sure you practice appropriate social distancing.

Avoiding groups: Use Zoom or another virtual option when possible for study groups or socializing. Most in-person social events and parties will be prohibited. While this is difficult and contrary to the typical campus experience, these are difficult times and one super-spreader event can overwhelm the campus’s ability to care for our students and result in closure.

Preparing for arrival: Though the state has clarified that students may not ‘’test out’’ of Connecticut’s quarantine requirement, Wesleyan is strongly recommending that all students who are able to get tested for COVID prior to leaving home do so within 72 hours of arrival. If your test is positive, please do not travel to campus but seek medical advice from your healthcare provider. This will allow you to recover at home and also prevent potential spread of COVID-19 on campus. We will require documentation from your healthcare provider clearing you to return to campus, which must be consistent with the CDC guidelines.

Move-in: In order to limit the chance of contagion, we are unable to allow anyone except the student into residences. We advise students to pack lightly, bringing only what they need. Travelers coming from affected states will need to comply with the State of Connecticut guidelines.

Arrival quarantine: In order to comply with the state’s latest guidance, Wesleyan is implementing a mandatory quarantine for all students on campus from August 24 through September 7. (Those coming from affected states with high COVID activity or from outside the U.S. who arrive in Connecticut after August 24 will still need to meet the state’s and CDC’s 14-day quarantine, thus their quarantine would extend beyond September 7.) During the period of quarantine, all students will be required to remain in their residences except to pick up to-go meals and to have your twice weekly COVID test done. Students will not be allowed to leave campus during the quarantine. Once a student receives two negative test results, students living in residence halls will be permitted to expand the remaining time of their quarantine to interactions with others living on their residence hall floor or to similar sized groups of “neighbors.” Face coverings and six-foot distancing are mandated.

High-risk individuals: If you have a medical condition that places you at additional risk if exposed to COVID-19, please discuss this with your health care provider for guidance. Distance learning from home may be the safest option.

Being compliant with COVID-19 testing: The University will be testing everyone on campus at regular intervals over the semester. It is important to come to all your testing appointments. If we can identify COVID-19 on campus, we can take the measures to care for that person as well as decrease the risk of spread.

Good hand washing: Please do it frequently.

Stopping smoking and vaping: Both increase risk of bad outcomes with COVID-19. This is excellent motivation to stop habits that hurt your health in normal circumstances.

Complying with travel and visitor restrictions.

Complying with quarantine orders: You may be asked to quarantine at some time during the semester, based on either having COVID-19 or being a close contact with someone with COVID-19. Housing, meals and the ability to continue learning online will be afforded.

Getting your flu shot: Influenza vaccinations will be required to be received prior to January 20, 2021. (Exemptions are allowed as per state of Connecticut law.) Since COVID-19 and Influenza present similarly, it is important to decrease the incidence of influenza. As you recall, both Connecticut and the campus had high flu activity last year. A bad flu season and a second wave of COVID-19 could overwhelm the University and the local health care system.

Disinfecting high-touch surfaces: Cleaning your living space will also decrease risk of exposure.

We all understand that the above rules, restrictions, and advisories make campus life look different than anyone has ever seen. Until preventative medications and COVID-19 vaccines are developed, these are what we all need to do to keep ourselves and our peers and colleagues safe and healthy. These are not easy but need to be done by each and every one of us.

If we all assume that we have COVID at any time and act accordingly to protect our friends and colleagues, we have the best chance of not spreading infection.

Stay well and be safe.

Tom McLarney, MD