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Preparing for COVID-19 Thought to Occur Mostly from Person-To-Person Via He American College Health Association Has Respiratory Droplets Among Close Contacts

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Preparing for COVID-19 Thought to Occur Mostly from Person-To-Person Via He American College Health Association Has Respiratory Droplets Among Close Contacts MARCH 3, 2020 ACHA Guidelines Preparing for COVID-19 thought to occur mostly from person-to-person via he American College Health Association has respiratory droplets among close contacts. Although the prepared these guidelines to help college health transmission dynamics have yet to be determined, CDC T staff and campus administrators prepare for currently recommends a cautious approach to persons coronavirus disease 2019 (COVID-19) and related issues under investigation (PUI) for COVID-19. Health care on their campuses. The guidelines are intentionally broad personnel evaluating PUI or providing care for patients so that each institution, small or large, can modify them with confirmed COVID-19 should use Standard based on existing campus and local resources. Moreover, Precautions, Contact Precautions, Airborne Precautions, each institution should seek guidance and coordination and use eye protection (e.g., goggles or a face shield). For from their local and state public health agencies. more information, see the CDC webpage “Interim Please keep in mind that the situation is rapidly evolving. Infection Prevention and Control Recommendations for Additional information about COVID-19 is available and Patients with Known or Patients Under Investigation for consistently updated from the following sources: Coronavirus Disease 2019 (COVID-19) in Healthcare U.S. Centers for Disease Control and Prevention (CDC) Settings” at https://www.cdc.gov/coronavirus/2019- www.cdc.gov/coronavirus/2019-ncov/index.html nCoV/hcp/infection-control.html. World Health Organization (WHO) While the first cases of COVID-19 seen in the U.S. were www.who.int/emergencies/diseases/novel-coronavirus-2019 associated with international travel, local transmission has been documented and more community-associated cases American College Health Association (ACHA) should be expected. COVID-19 is a concern for college https://www.acha.org/COVID-19 and university officials not only because of students, staff, faculty, and visitors traveling to and from COVID-19 Introduction affected areas, but also due to the potential for rapid COVID-19 is a respiratory illness that can spread from transmission in a congregate setting within campus person to person. A novel coronavirus called SARS-CoV- environments. These guidelines provide recommendations 2 is the cause of COVID-19 and the outbreak first for the student health service (SHS), the campus itself, and recognized in China in December 2019. The clinical members of the campus community. spectrum of COVID-19 ranges from mild disease with non-specific signs and symptoms of acute respiratory Student Health Services (SHS) illness to severe pneumonia with respiratory failure and septic shock. Frequently reported signs and symptoms Preparation include fever, cough, myalgia or fatigue, and shortness of Given the international focus of many U.S. colleges and breath at illness onset. The fever course among patients universities and the academic and personal travel of with COVID-19 is not fully understood; it may be domestic and international students, faculty, and staff, prolonged and intermittent. Sore throat has also been college student health services should quickly begin reported in some patients early in the clinical course. Less preparation for potentially infectious patients with commonly reported symptoms include sputum production, COVID-19. Although these preparations may vary headache, hemoptysis, and diarrhea. The incubation significantly depending upon the size and resources of the period is estimated at approximately 5 days (95% college health program, at a minimum, the SHS should confidence interval, 4 to 7 days). Some studies have adhere to basic infection control principles. Per CDC estimated a wider range for the incubation period. Data for interim guidelines, available at human infection with other coronaviruses (e.g., MERS- https://www.cdc.gov/coronavirus/2019-ncov/infection- CoV, SARS-CoV) suggest that the incubation period may control/control-recommendations.html, “Prompt detection range from 2-14 days. There have also been reports of and effective triage and isolation of potentially infectious asymptomatic infection with COVID-19. patients are essential to prevent unnecessary exposures among patients, health care personnel, and visitors at the Based on what is currently known about SARS-CoV-2 facility. All health care facilities must ensure that their and what is known about other coronaviruses, spread is Preparing for COVID-19 / page 2 personnel are correctly trained and capable of The COVID-19 Planning and Response Committee will: implementing infection control procedures; individual Identify the content of staff education and training and health care personnel should ensure they understand and arrange for the training. SHS personnel must be trained can adhere to infection control requirements.” and capable of adhering to and implementing infection control procedures. If possible, a staff member or Establish a Student Health Services COVID- community health care professional experienced in 19 Planning and Response Committee infection prevention and control training should instruct In most college health settings, the first step will be to SHS staff. establish a committee to lead the organizational response • At a minimum, non-clinical staff should be trained on to COVID-19. Health, counseling, and health promotion respiratory and hand hygiene, including cough program leaders should identify individual staff members etiquette, the proper techniques for using alcohol- (and, if possible, alternates) with either expertise in based hand sanitizers and washing hands with soap infectious disease planning and response or a willingness and water, and the use of standard facemasks and to study current CDC and WHO recommendations and social distancing. stay abreast of changing guidelines as the situation unfolds nationally and internationally. A team leader should be • Clinical staff should be trained on respiratory and identified, and specific duties and responsibilities should hand hygiene as well as correct use of personal be assigned to individual team members. Depending on protective equipment (PPE) including long-sleeved the size and complexity of the campus health and well- isolation gowns, gloves, and eye protection (goggles being program, one person may be filling more than one or disposable face shield); proper donning (putting of the committee roles. on) and doffing (taking off) of PPE; disposal of PPE; and the prevention of contamination of clothing, skin, The COVID-19 Planning and Response Committee could and environment during the doffing process. include the following: • Clinical staff should be medically cleared and fit- • a team leader: a medical/nursing staff member with tested for N95 respirator masks and trained in their leadership skills; ideally a clinical or nursing director, proper use as required by OSHA respiratory • an administrative leader in the SHS or college health protection standards. program, Prepare the SHS facility for triage and isolation of • an additional medical or nursing clinician, patients potentially infected with COVID-19. While • a health promotion professional with skills in ideally the SHS will be informed in advance of the arrival population health services and prevention campaigns of a patient with a potential COVID-19 infection, that will • a counseling/mental health professional, not always be the case. Therefore, appropriate measures should be implemented before patient arrival, upon • an information technology (IT) professional or a staff arrival, and throughout the duration of the affected member with a solid understanding of SHS and patient’s presence in the health care setting to protect the campus IT systems, patient, SHS staff, other patients, and visitors. The SHS • a member of the reception staff at the health center, should take the following steps: • an infection prevention and control coordinator • Share information about COVID-19 on the campus • the chief financial officer or a business manager and health services websites and through social • a marketing and communications representative media. Use visual alerts (e.g., posters, flyers) at the SHS entrances and other strategic places inside the • a materials/supply manager SHS (e.g., front desk, waiting room) asking patients • a lab representative to notify SHS staff prior to or immediately upon arrival if they are experiencing symptoms of • an environmental services/housekeeping/facilities respiratory illnesses (cough, runny nose, fever) and management representative, any travel history to areas with documented COVID- • a student member of the campus student health 19 transmission or close contact with an individual advisory committee, and diagnosed with COVID-19 within the past 14 days. • a local and/or state health department official(s), if With more cases of community transmission possible. occurring, COVID-19 must be considered with all respiratory illnesses without an identified source of exposure or an alternative explanatory diagnosis. Preparing for COVID-19 / page 3 • Place face masks, tissues, and alcohol-based hand • Prepare an internal alert system. sanitizers at the SHS entrances and other strategic . Develop a notification roster and checklist. places in the health center and ask patients presenting with respiratory symptoms to don a face mask upon . Include mobile and home phone numbers, pager entry into the facility and follow triage procedures. In numbers, and work and personal
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