4 ways to lower the risk of a COVID-flu ‘twindemic’ hitting campus

A lack of exposure to the flu virus last year may lead to weakened immunity this winter
Alan Dennington

The threat of a COVID-flu ‘twindemic’ isn’t just a recycled talking point from 2020.

This time last year many public health experts warned of a combined outbreak on campuses that, fortunately, never came to pass. (I even penned an op-ed for University Business on the possibility). As it turned out, influenza infections hit an all-time low in the U.S. while people learned and worked remotely, practiced social distancing, wore masks and frequently washed hands in an effort to avoid COVID-19.

The irony is that college students, a population that largely avoided the flu last year, may now be at increased risk this year as many have returned to everyday campus life activities and social engagements that put them in close proximity with other people—and other people’s germs.

As Georgetown University’s chief public health officer Ranit Mishori recently told The Washington Post, a lack of exposure to the flu virus last year may lead to weakened immunity for those who weren’t able to build up their natural defenses.

The good news is, if an ounce of prevention is worth a pound of cure, colleges and universities are taking steps to guard their campus communities against outbreaks. From the University of Virginia to the University of California system, many institutions across the country have implemented COVID-19 and flu vaccine requirements for faculty, staff and students.

But, what should campus leaders do if severe outbreaks of both viruses strike at once? Here are four steps institutions can implement now to reduce the chances of a “twindemic” and prevent further spread of infection should one occur.

1. Test twice in one visit. Many COVID and flu symptoms are similar, so it’s important that campus health clinics and others providing care to students test for both viruses every time any upper respiratory symptoms are presented.

Loss of taste and smell is a symptom that is fairly unique to COVID, but it is not always a reliable indicator. In some cases, repeated testing might be necessary. As always, symptoms such as shortness of breath warrant more urgent evaluation.

2. Isolate and separate. With quarantine housing available on or off-campus, campus leaders may feel tempted to quarantine students testing positive for COVID or flu in the same designated area, but I do not recommend this.

To prevent further spread—especially among those whose immune systems are already compromised with one virus or the other—I recommend that students diagnosed with flu isolate in their own rooms per usual and COVID-positive students continue to stay in separate quarantine housing.

3. Screen for symptoms remotely. If there’s a silver lining in the last two years, it’s that quality health care is widely available to students on-demand, 24/7. Telehealth screenings conducted either by on-campus providers or trusted partners can allow for early identification and triaging for those experiencing COVID and/or flu symptoms.

Easy access through virtual care can prompt students to seek medical advice when they might otherwise just make the choice to go to class and inadvertently expose others.

4. Plan, adjust, update and repeat. Given what we know about the COVID-flu outlook, I also recommend revisiting campus crisis protocols for dealing with all infectious diseases to make sure student health, residence life and campus life teams are coordinated should issues arise with the combination of any two.

Additionally, administrators should consider what academic flexibility can be granted to students who fall behind in their coursework and/or whose mental health suffers from isolation related to their physical illnesses.

For now, college and university leaders should continue to encourage vaccinations for both flu and COVID, which can help provide a well-protected campus. I join the chorus of physicians and public health experts who are hoping for the best and simultaneously preparing for the worst.

In any case, continual planning and proactive messaging will help students, faculty and staff know what to expect when flu season is in full swing.

Dr. Alan Dennington is the chief medical officer and co-founder of TimelyMD, a telehealth provider specializing in higher education.

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