UC Campus COVID-19 Testing, Tracing and Case Management Plan

Introduction

COVID-19 has emerged as a global pandemic in the past several months. 

Caused by a previously unknown coronavirus known as SARS-CoV-2, it is capable of spreading quickly through dense populations. The clinical effects range from asymptomatic infections, possibly with unknown long-term consequences, to severe multisystem organ failure and circulatory collapse. Its behavior is not well-understood, yet there are clear patterns emerging. This document is based on those clear patterns and expert guidance from the Centers for Disease Control and our own UC subject matter experts. It will be updated frequently as we learn more about best practices in preventing, detecting, and managing COVID-19.

Disease prevention remains the mainstay of the campus approach to COVID-19.

The three pillars - social distancing, facial coverings and enhanced hand and environmental hygiene - are critically important to keeping viral transmission low on campus.

Just as important, stay home if you are ill (except to visit a health care professional).

Even with perfect adherence to these principles, the virus can escape through aerosol particles and inadvertent lapses, and can infect even the most careful among us, so we must be ready to respond to cases of COVID-19 on campus. This document summarizes the planned approach.

Testing

Individuals to be tested on campus fall into three groups:

  • Those with symptoms;
  • Those who have been exposed to COVID-19;
  • Those residential students or those living in the neighborhoods adjacent to the Uptown Campus who are randomly selected to participate in prevalence testing.

Symptomatic individuals

All individuals will be required to self-screen daily for symptoms of COVID-19 before coming to campus and must stay out of class, work and on-campus activities if they have even mild symptoms. The UC COVID Check app provides a simple way to conduct that self assessment and report any symptoms to University Health Services. UC's COVID Check app is free and easy to use. It can be downloaded through the Apple App Store and Google Play Store. A web-based REDCap survey is also available for those who prefer an alternative to the app.

They will receive timely instructions on next steps, including self-quarantine, testing, and how to make an appointment for medical care if needed.  (see below)

Individuals with exposure to SARS-CoV-2

Testing is recommended as soon as possible for individuals with close contact to confirmed cases of COVID-19. Estimates of viral transmission from a symptomatic person to others in close contact with them vary widely, based on the degree to which the person is infected (“viral load”), the particular behaviors that constitute the close contact, and the immune status of the exposed individual. Current estimates for general populations range from 10-30 percent of exposed individuals becoming infected.

All individuals with exposure to SARS-CoV-2 will be required to self-screen daily for symptoms of COVID-19 and must stay out of class, work, and on-campus activities (see below). It is important to note that even if an exposed individual tests negative, they are required to quarantine (remain out of classes, work and activities) for 14 days from the date of exposure. This reflects the incubation period of the virus, during which a test could still be negative early and become positive later in the 14 days.

On-campus testing

University Health Services can arrange for testing at the UC Health Uptown Campus, 3120 Burnet Avenue (East Campus), which is by appointment only.

Another on-campus testing center, the UHS Testing Center, is located at Commons Edge North, 57 W. Daniels Street. 

Wild Health Laboratory of Lexington, Kentucky, will conduct random surveillance testing.

Students must call UHS, (513) 556-2564, and ask for an appointment for symptomatic or exposure testing. They will be given specific instructions and informed of the costs of this testing, which will be billed to their insurance. Unpaid balances will be put on the student’s bursar account.

UHS will perform appropriate testing to diagnose COVID-19.

In addition, we will be able to perform rapid on-site testing for both strep and mononucleosis. Those results will be available immediately.

All student tests are billed to insurance, except random testing. Students will not be charged for random testing.

Random surveillance testing

Rationale:  We know that a certain proportion of our students may unknowingly be infected with the virus that causes COVID-19. Up to 30 percent of infected individuals in most studies do not experience symptoms.

In order to help keep our campus safer, we will be monitoring our residential students through a program of screening tests beginning the first week of classes. We have also expanded random testing to students living in neighborhoods adjacent to UC's Uptown Campus. Random surveillance testing is conducted by Wild Health Laboratory of Lexington, Kentucky. Their clinical professionals will collect a sample from a swab placed very gently in the lower part of the nose known as the nasal sample. 

This is quite different from the long-handled swabs that have previously been used for testing known as nasopharyngeal (NP) swabs, which can be uncomfortable. Nasal swabs are rapidly replacing this method due to improved patient comfort and nearly comparable results.

The university will partner with our public health partners at the City of Cincinnati Health Department and experts in the College of Medicine to review and interpret results.

The goal is to allow the university to monitor and address real-time trends and make timely decisions on intervention and response. We are committed to keeping the campus as safe as possible, and we know our students are equally committed to the welfare of the entire campus community.

UC’s medical team will continually review the testing plan and make adjustments if needed to provide the best available diagnostic protocol.

Contact tracing

UC will implement robust electronic contact tracing of all individuals on campus who test positive for COVID-19, including faculty, staff and students. This contact tracing related to positive tests or close contact exposures will be conducted by an interdisciplinary team of specially trained faculty, staff and students, led by public health professionals managing the health investigation and follow up.  

Everyone is expected to participate. The university relies on each and every community member to do their part to help keep the campus safe and open for living,  learning, and working. Students will be required to participate if they come to campus or live on campus. 

Using up to date web-based technology and an app known as UC COVID Check, UC community members who are close contacts of individuals with confirmed COVID-19 will receive information by text and phone, with specific education and advice for their situations.

All UC community members who are close contacts of confirmed positive cases will be sent for COVID-19 testing.

The university will work closely with the local health departments on all contact tracing and will rely on their advice regarding best practices for quarantine and isolation.

Case management

Definitions: quarantine and isolation

Quarantine applies to someone who has had close contact with a person confirmed to have COVID-19, but who does not have any symptoms of infection.  They need to be separated for a period of time to be observed for symptoms and to prevent accidentally infecting others. Quarantine lasts 14 days.

Isolation applies to someone who may be infected or has been confirmed to be infected with COVID-19. They need to be isolated to prevent the spread of virus to the community while they are contagious. Isolation lasts 10 days in most instances.

Both are critically important to keeping the campus safer.

Symptomatic (sick) students

Sick students must report their symptoms via UC's COVID Check App or via an alternative web-based survey. The App and survey are free and easy to use. It can be downloaded through the Apple App Store and Google Play Store. The web-based REDCap survey is also available.

The UC COVID Check app provides a simple way to conduct a daily self assessment and report any symptoms to University Health Services

Sick students may call UHS for care at (513) 556-2564. If they have symptoms suspicious for COVID-19, they will be triaged by a nurse prior to scheduling to ascertain student safety. Those with severe symptoms such as significant trouble breathing, passing out or confusion will be directed to the Emergency Department for immediate care. Public safety and EMS will be notified to transport the patient via 911.

Testing can be ordered and completed at the Testing Center. All sick students must immediately self-isolate and follow the directives.

If instructed to quarantine or isolate, it's recommended that students in University Housing return to their permanent homes to do so. If that is not possible due to extenuating circumstances, UHS, Student Affairs and UC Housing will work with that student to provide appropriate accommodations for the quarantine or isolation period. They may continue their classes remotely. Meals will be delivered by Food Services (meal plan required). UC Housing may not be available for all quarantined or isolated students.

ISOLATION GENERALLY LASTS 10 DAYS. University Health Services will provide specific guidance on a case-by-case basis.

Off-campus students will be instructed in how to best self-isolate in their living situations, generally requiring a separate sleeping space and, preferably, a private bathroom. If there is no option for private bath, the room must be thoroughly disinfected after each use by the sick individual.

Individuals with typical COVID symptoms and negative tests will require evaluation by a clinician to determine how long they should remain in isolation once their symptoms resolve.

Current guidelines suggest that it may be safe to discontinue isolation if symptoms have resolved for at least 72 hours, if it is less than 10 days from onset.  University Health Services will provide specific guidance on a case-by-case basis.

There is no requirement for a negative test before isolation is discontinued. The Centers for Disease Control has determined, based on multiple scientific studies, that the vast majority of individuals are no longer infectious after 10 days. There are rare exceptions to this, which will be picked up by UHS and explained on a case-by-case basis.

Exposed students

All close contacts of confirmed cases will be required to quarantine for 14 days, the incubation period of the virus. They will be referred for immediate testing, to determine if there is a cluster of cases around the positive individual.

QUARANTINE FOR 14 DAYS IS REQUIRED EVEN IF THE TEST IS NEGATIVE. This is because the exposed student could have a very low level of virus present at the time of the test, which is below the test’s ability to detect and could become positive over the course of the incubation period.

If instructed to quarantine or isolate, it's recommended that students in University Housing return to their permanent homes to do so. Limited on-campus accommodations are available by a waiver process through University Housing if a student is unable to go home for the 14-day period or if there are other extenuating circumstances. UHS, Student Affairs and UC Housing will work with that student to provide appropriate accommodations for the quarantine or isolation period. UC Housing may not be available for all quarantined or isolated students.

Even when residential students are in quarantine or isolation at their permanent homes, they will undergo active daily monitoring and will not be permitted to return to their usual residence hall until cleared to do so. 

Off-campus students will be instructed in how to best quarantine in their living situations, generally requiring a separate sleeping space and, preferably, a private bathroom. If there is no option for private bath, the room must be thoroughly disinfected after each use by the COVID-positive individual.

Exposed and/or asymptomatic students who test positive

Some students who have no symptoms of COVID -19 may test positive as a result of a contact tracing. Others may be asked to have a test for another purpose and discover they are positive.  

ISOLATION IS REQUIRED FOR 10 DAYS IN THIS CASE. This is because the Centers for Disease Control has determined, based on multiple scientific studies, that the vast majority of individuals are no longer infectious after 10 days.

If isolation is recommended, it is preferred that students in University Housing isolate on campus in special accommodations provided for this purpose. If a student opts to go to their permanent home to isolate, they will be given CDC resources explaining how to do this as safely as possible.  

Off-campus students will be instructed in how to best self-isolate in their living situation, generally requiring a separate sleeping space and, preferably, a private bathroom. If there is no option for a private bath, the room must be thoroughly disinfected after each use by the COVID positive individual.   

Conclusion

The university is committed to meeting the best interest of students while prioritizing their health and safety. In accordance with the Faculty Senate Resolution on Class Attendance and Participation during COVID-19, faculty are encouraged to be flexible with attendance policies and other aspects of supporting academic progress – particularly for students in isolation and quarantine.

Faculty are encouraged to think beyond traditional definitions of attendance and support and provide students with opportunities to make up missed work or do commensurate work. This will allow for a positive student learning experience and a commitment to delivering exemplary instruction. An incomplete grade may be awarded in the event of a student illness, which will provide an opportunity for a student to work with faculty to complete coursework after the semester concludes.