Preparing the campus to prevent a COVID-flu “twindemic”
With flu season upon us, scientists worry about the impact that a “twindemic”—widespread influenza coupled with COVID-19 – could have on the American public.
Marc Lipsitch, a Harvard University epidemiologist, summed up these concerns in a recent Scientific American article: “The worst-case scenario is both [the coronavirus and the flu] are spreading fast and causing severe disease, complicating diagnoses and presenting a double burden on the health care system.”
Others are more optimistic, noting that with so many Americans adopting better health practices because of COVID— wearing masks, social distancing, frequent handwashing—it’s possible we may have a mild flu season this fall and winter.
College campuses that welcomed back their students this fall are particularly ripe for a double whammy. Not only has the CDC reported an uptick in COVID-19 cases among 18-22-year-olds, a recent report estimated that schools that reopened for face-to-face instruction were responsible for more than 3,000 COVID-19 cases per day.
However, there are a number of steps that colleges and universities can take to best guard against a combined COVID-flu outbreak this fall. They include:
• Making flu vaccines readily available to students for longer periods of time at a convenient location on campus. The good news is that many schools are doing this, and health experts at Johns Hopkins University recently underscored its importance and urgency heading into cooler months.
• Continuing with hygiene and public health campaigns that emphasize not only preventative steps like hand washing and wearing masks, but also the importance of getting a flu vaccine. One message that should resonate is that getting a flu shot will ease the burden on an overtaxed health system. Incentivizing students who complete their daily health screenings can also help.
• Being prepared to test for both influenza and COVID. The diseases look very much alike, which is why it’s important to be able to test to distinguish between the two. Correctly identifying and treating the appropriate disease will help prevent it from spreading on campus and in the community.
• Sending out reminders to students that if they get sick, they should not go to class and expose others to the illness. Instead, they should stay home or in their residence hall and call the student health service or use the institution’s telehealth provider. If students start to feel worse or develop more severe symptoms, that’s when they need to receive more in-person care.
• Communicating with faculty and staff that they too should stay home if they think they are getting sick. Some employees feel compelled to report to work no matter what, but no in-person class, lab or meeting is worth it this year. Fortunately, social norms are shifting so that it is now widely acceptable to work from home or attend meetings virtually.
• Being mindful that students are feeling stressed and anxious. In addition to taking care of their physical symptoms, it is vital that colleges address students’ continuing mental health issues. Given that these anxieties can kick in at any time of day or night, it is important to have someone available 24/7 to handle these issues. Some teletherapy programs offer unlimited, on-demand virtual visits that allow students to get medical and mental health support in a matter of minutes, at no cost to them.
Encouraging and enforcing compliance
Getting students to comply with these guidelines is no easy matter. We all have all seen photos of large-scale parties at schools that did reopen, and several schools that initially reopened have reverted back to virtual classes because of COVID outbreaks. Administrators are right to be concerned about whether students will adhere to these types of recommendations.
But at one of our partner schools, Abilene Christian University in Texas, we have seen students making informed decisions when they know where to turn for help and guidance. Following a 90-day campaign in which the school publicized its “Wildcat Care” telehealth program, 90 percent of the students said they were aware of the service. As a result, students utilizing campus health services rose 36% while unnecessary emergency room visits dropped.
Additionally, 46% of the students’ virtual visits occurred after hours and on weekends, underscoring the need for around-the-clock access. And, most germane to the current situation, the Abilene Christian Medical Clinic reduced campus flu incidence by more than 15% during a particularly bad flu season in the 2018-19 school year when compared to the 2016-17 school year.
My advice to school administrators going forward is they should already be preparing for the day when there is an effective COVID vaccine. That includes directly contacting their health care supply vendors—some vendors will have it earlier than others—and letting them know it is a high priority that the school receives a sufficient number of doses once the vaccine becomes available.
It also means making plans on how the vaccine will be provided to the entire campus community. And creative teams should be working now on a public health campaign in anticipation of that breakthrough.
We are living in a time of uncertainty, but it is possible to bring some semblance of order and promote public health with proper planning, messaging and services.
Dr. Alan Dennington is the chief medical officer and co-founder of TimelyMD, a telehealth company that specializes in higher education. Students at partner colleges and universities have 24/7 access to medical and/or mental health counseling visits anytime, from licensed physicians and counselors anywhere in the United States at no cost to them.