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The Global Center for Health Security at the University of Nebraska Medical Center released a pandemic recovery guide in May for higher education institutions to use for strategies on COVID-19 management and preparedness.

UNMC’s Higher Education Pandemic Mitigation and Response Guide contains different policies, practices and procedures for colleges and universities to use for a safe return to campus amid the coronavirus pandemic. UNMC and University of Nebraska Omaha Chancellor Jeffrey Gold said the guide has gone through a number of different iterations and is one of many first response guides the Global Center for Health Security has produced. 

In preparation for the fall semester, the University of Nebraska-Lincoln has implemented parts of the guide into their Forward to Fall Guiding Framework.

Bob Wilhelm, vice chancellor for research and economic development, said the Forward to Fall committee looked at different checklists and guides and chose what to take from them. He said the committee did this by determining UNL’s highest priorities.

However, there are some aspects of UNMC’s guide that UNL will never address, Wilhelm said, like monitoring where people can enter and exit, because it comes down to what UNL’s campus, staff, faculty and students are capable of doing.

“We operate a very large campus with lots of people coming in and out of buildings,” Wilhelm said. “We’re not going to have access control on every door.”

Amy Goodburn, senior associate vice chancellor and dean of undergraduate education, said the framework is about trying to find what will work best on UNL’s campus, in terms of the culture, as well as how UNL is organized physically and geographically and thinking through all those recommendations and how they might apply to UNL. 

The guide contains eight sections that address physical ways the spread of the coronavirus can be minimized to proper use of personal protective equipment and ensuring good mental health as well.

Engineering Facility Controls, Policy and Practice

From an engineering safety point of view, the engineering facility controls are meant to eliminate hazardous conditions or create a barrier between people and the coronavirus, Gold said. The section includes identifying entry and exit points, maximizing fresh air, increasing airflow and trying to limit air recirculation.

Gold said higher education institutions should use high-efficiency particulate air filtration whenever possible because it is easier to increase air circulation and adjust heating, ventilation and air conditioning systems.

“It’s advised to adjust HVAC systems to create negative pressure, but it’s rather difficult to do in most buildings that are not built either as a laboratory or as a clinical facility,” Gold said.

Administrative Campus Controls Policy and Procedures

Gold said when campuses reopen, institutions should limit off-campus visitors and guests in order to ensure safety.

Institutions should also regularly communicate with campus leadership and outside resources like public health organizations, Gold said. Also, creating an office of health security to ensure campus compliance with laws, policies, guidelines and recommendations surrounding the coronavirus pandemic will safely bring students, faculty and staff back to campus, according to Gold. 

Gold said campus leaders should provide frequent updates to students, faculty and staff, which can be done through social media, email or virtual town halls. Gold said it is important to provide multilingual materials that are easily understandable and to have signage that promotes risk-minimizing behavior, like handwashing and how to identify symptoms of the coronavirus.

Many students, faculty and staff do not live on campus, so some of the guidelines may differ compared to those who live on campus, Gold said. 

Higher education institutions can provide information about self-monitoring for symptoms, and in the early phases of reopening, discourage off-campus gatherings of more than 10 people, including social, business or religious gatherings, according to Gold. 

“A lot of this is similar to the recommendations on campus, but a lot of the virus spread that occurs, at least in the working environment or in the workplace, happens in the home environment,” Gold said.

Gold said institutions should provide a standard operating procedure for cleaning, like making sure cleaning staff are properly trained and wearing proper personal protective equipment. The response guide also identifies a list of high touch surfaces, like doorknobs, door handles, handrails or automatic door openers, which should be cleaned regularly and avoided if possible.

The response guide also details active screening recommendations for students, faculty, staff and guests, which includes the use of mobile devices for screening symptoms of COVID-19, according to Gold. 

Gold said he highly suggests using the 1-Check COVID app, which was designed by a team at UNMC, so that individuals can screen their symptoms to assess how likely they are to have COVID-19 and if they need testing. UNL students, faculty and staff can use the app in the fall to assist in self-monitoring.

“It includes what to do if someone tests positive or has symptoms, who to call, particularly if they’re living on campus, how to isolate themselves and what medical resources need to be made available,” Gold said.

The response guide also covers campus physical distancing policy and practices recommendations. These recommendations include decreasing the number of people in spaces on campus like classrooms, athletic events, entrances, hallways and other common gathering spaces, according to Gold. 

Gold said institutions should identify different coordinators for each campus facility for implementing COVID-19 guidelines. This includes maintaining six feet between individuals whenever possible, even in classrooms, according to Gold. 

For classes, laboratories, studio and rehearsal spaces with more than 25 students, Gold said institutions should try to include both remote and in-person opportunities and try to develop accommodations for high-risk students, faculty and staff. 

Institutions should also consider having only necessary research personnel in laboratory spaces, according to the response guide.

Gold said there will be significant limitations on travel, especially international travel, but the limitations may lessen over time. 

Study abroad at UNL is canceled through the fall semester and a decision for the spring semester will be determined at a later date, according to the Forward to Fall Framework.

Additionally, Gold said people are not just being affected physically by the pandemic but also emotionally as well. A significant amount of resources should be made available, Gold said, for people who may be feeling stressed, who may need to talk to someone or who may need help with their mental health.

PCR, Antibody and Serologic Antibody Testing

Gold said testing is crucial for pandemic surveillance and contact tracing. He said the recommendations in the section apply to more than just COVID-19, including the flu. If any student, faculty or staff member is suspected or confirmed to have coronavirus, then any of their close contacts, such as relatives and domestic partners should quarantine, isolate and receive testing, according to the guide. 

“Testing availability will be key as we begin to reopen and as we maintain our openness,” Gold said. 

Personal Protective Equipment Policy and Procedures

Personal protective equipment, with the exception of wearing a mask, is known to be the least effective method of protecting against coronavirus because it relies on the individual, according to the response guide. 

Additionally, there needs to be comprehensible policies and messaging to inform students, faculty, staff and campus visitors to wear face coverings at all times, except when eating or in residence dorms or private spaces, according to Gold. He said the policy should be specific, including information on the frequency of wearing face coverings, mask replacement, properly reusing a mask that is not visibly soiled or contaminated and information on how to properly use a face covering or mask and how to dispose of it, according to the response guide.

Individuals can wear a mask improperly, whether that’s putting it on or taking it off, Gold said, so the recommendations include guidelines about the use of a mask and how to properly put a mask on, safely take a mask off and how to distribute information on proper mask-wearing procedures throughout a campus.

“There’s a proper way of putting on and taking off a mask,” Gold said. “If you don’t do that right, you run the risk of really spreading infection.”

Residence Halls and Campus Living Policy and Practice

Gold said residence halls can be available for students, but social distancing will have to be implemented at all times. For dining facilities, Gold said as long as individuals are there, they should try to use as little shared space as possible. 

In addition, Gold said residence hall staff need to be adequately trained to respond to the coronavirus.

“Make sure they’re aware of signs and symptoms, what to do if someone tests positive, who to call, where to send them and how to isolate them,” Gold said.

Large Group Campus and Community Gatherings Policy

From high enrollment courses to athletic events, to concerts and exhibitions, Gold said attendance should be limited. 

The section, which is divided into four category types, covers on-campus large groups and off-campus large groups, with or without community guests. The guide said institutions should prohibit any type of large group gatherings that exceed 25 people, whether it’s on or off campus. 

Off-Campus Experiential Learning Experiences

Both clinical experiential learning opportunities, like hospital rotations, medical students and nursing students and non-clinical experiential learning, like internships, should be evaluated, according to the response guide. 

Higher education institutions should evaluate off-campus, out of state and international learning experiences to determine if they meet student safety requirements and if they can continue normally.

“It’s all about deferring off-campus learning experiences unless the community is safe,” Gold said.

Co-Curricular Programs and Campus Activities 

Organizations and clubs should provide remote access options for individuals that are unable to physically attend and participate, according to the response guide.

For fraternity and sorority houses, campus recreation and fitness centers, each can be open as long as social distancing and good cleaning practices are being used, according to the guide. 

Institutions should prohibit student organizations from traveling more than 25 miles away from campus or to places that require an overnight stay, according to the guide. 

“If there is adequate control of the virus in Lincoln and this guide is used, it will enhance the safety at UNL campus,” Gold said. “It will never be perfect, but we all share this responsibility to enhance the safety for ourselves and others.”