ACHA recommends twice weekly tests, a plan for vaccines

The American College Health Association is pressing the CDC for a late-spring rollout of vaccination among students.
By: | January 4, 2021
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COVID-19 vaccines may not be available to students returning to campuses for a few months, but colleges and universities should start to prepare for their potential rollout now, according to the American College Health Association (ACHA).

The ACHA is calling on the Centers for Disease Control’s Advisory Committee for Immunization Practices to strongly consider allowing students to receive the Pfizer BioNTech and Moderna vaccines before they finish their spring semesters to help prevent spread in a “mass migration event.”

Regardless of when they become available, the ACHA said institutions must start planning and forming task forces to address how they would handle distribution and vaccination for students.

“The arrival of safe and effective vaccines provides promise of an end to the pandemic, though resumption of pre-pandemic operations remains distant,” ACHA researchers noted in the report. “Preparing for COVID-19 vaccination is the next most pressing task, one that will require coordination and collaboration with campus and community partners.”

The recommendations are among several released by the ACHA in its Considerations for Reopening Institutions of Higher Education for the Spring Semester 2021. Based on the experiences of the past eight months, the ACHA said measures such as social distancing, personal hygiene, cleaning and mask wearing are working but that testing must be more frequent and more rigidly scheduled across college campuses to prevent outbreaks. It recommended students be tested twice per week, with turnaround times for those tests being less than 24-48 hours.

Combined with real-time COVID-19 dashboards, robust testing schedules and strong quarantine and isolation practices, many institutions have done well in mitigating spread on campuses. The ACHA noted “there is little evidence to show secondary transmission is occurring either student-to-student or student-to-faculty member in instructional settings where everyone is wearing masks and proper physical distancing is maintained.” It also said outbreaks have been rare on campuses where maskless gatherings have occurred.

“After several months of experience, research, and practical applications, we know more, have learned from early missteps, and are better prepared for spring semester,” ACHA authors said. “For months, institutions of higher education have been in perpetual motion to retrofit facilities, acquire personal protective equipment and cleaning supplies, and educate and train the campus community. United leadership is critical to a sustained and effective response.”

The vaccine timeline

Students in good health are currently in the Tier 3 group for potential vaccination, according to the ACHA. That means they likely will have to wait until late spring or possibly the summer before they can be administered vaccines. However, the ACHA is hoping the CDC’s advisory committee will be swayed to adjust its recommendations.

Though colleges and universities remain at the mercy of those decisions, they should be forging strategies now for what could be a game-changing decision on that rollout.

Creating a task force can be a first step. The ACHA said leaders should “consider reaching across departmental and divisional lines to include key individuals with the authority to deploy resources and those with relevant expertise to dispense, administer, document, or provide support services.” That should include student health staff, communications teams, facilities and risk management, finance, HR and community partners, among others.

There are an extensive number of recommendations for how to actually implement the plan and they are noted within the ACHA’s considerations. From storage of the vaccine to documenting who has received it, college leaders can use those guidelines to formulate a plan for developing a cross-department strategy.

With any luck, students across the country will be able to finish the semester and get vaccinated before the summer.

Responding to the crisis

The ACHA initially released reopening guidelines in May to assist colleges and universities. In the latest updates, researchers pressed higher ed leaders and campus health professionals to continue to prepare for the unexpected and be flexible in their responses to both cases on campus and future strategies around the pandemic.

Aside from increased testing, surveillance, contact tracing and prepping for vaccines, it targeted several areas for consideration that leaders should be ensuring in their overall COVID-19 strategies:

  1. Communication: Higher ed leaders should be direct, clear and transparent in messaging to stakeholders and students on plans or developments. Providing accurate data is essential, and real-time dashboards are a strong way to help show trends on campus. The ACHA recommends leaders “express authority but acknowledge uncertainty. Never over-assure or promise what you cannot deliver.” As for other stakeholders who impart messages across campus, social media updates and campus signage are great ways to reach students.
  2. Facilities: The ACHA says rooms that cannot be properly ventilated should not be used for instruction. It recommends portable HEPA filters in those areas and others where ventilation has not been improved. Social distancing space requirements within classrooms should be frequently monitoring. Though a challenge in the winter in many environments, outdoor classes should be a consideration, and colleges also should consider procuring outdoor heating devices.
  3. Gatherings and events: There may be opportunities for colleges and universities to host social events and reintroduce programming, such as theater performances or smaller gatherings such as speaker series. However, there are many considerations at play, including size of venue, whether events would be better held outdoors or whether colleges can limit attendance by providing virtual options. Larger gatherings still will require approval from local health authorities.
  4. Visitors to campus: The same rules essentially apply as in the fall. If visitors can be limited on campus, it is recommended, since many regions are experiencing spikes in COVID-19 positive cases and campuses have done well to creating bubbles and prevent outbreaks. Though commencements and other ceremonies are essential to institutions, virtual options should be considered when possible.
  5. Recreation and athletics: Colleges considering more physical activity allowance in the spring should follow the same guidelines put forth by the CDC as well as those they have for other facilities’ and staff. The ACHA recommends each athletic or recreation program be considered individually based on risk. All recreation personnel and athletic coaches should be heavily briefed on COVID risks and the benefits of social distancing. And they should all be required to wear masks.
  6. International travel: The CDC recommends all individuals avoid nonessential travel at this time. Because of the risk associated with travel and a lack of vaccinations here and abroad, institutions should have robust policies for any international travel that must occur. Though the ACHA notes that institutions are considering summer and fall 2021 study abroad programs as well as entry for international students, much will depend on decisions, vaccines and spread over the coming months. Colleges should create a “registry for all university-related travel.” Even when travel resumes, the ACHA says “protecting the health of the individual traveler as well as campus and local communities is of paramount importance.”
  7. Mental health: One of the strongest considerations among the ACHA’s guidelines is the continued recognition and availability of mental health services to both students and faculty during the pandemic. Checking “the pulse” of the campus community through surveys and check-ins is important, along with training staff and campus health providers to offer outreach measures and support to those in need.
  8. Dashboards: Are your dashboards not quite as timely or robust as others across the country? It isn’t too late to update them. Aside from trying to make them easy-to-read, the ACHA says it is important to include several categories in them, based on weekly updates at minimum: cases (students and staff), tests performed, positive results, students isolating and quarantining and a comparison to regional COVID tests and positive cases. Institutions also should have “internal dashboards” that track employee and student behavior, testing capacity and available personal protective equipment.