Managing COVID-19
New cloud-based access control platform designed to monitor and manage Covid-19 can help campuses stay open in these challenging times
- By Soumi Eachempati, MD, FACS, FCCM
- December 14, 2020
Schools and universities are faced with an extraordinary challenge
this fall. They need to create plans on preventing, identifying
and managing people with potential Covid-19 infection
and exposure while providing high-quality education.
The task is magnified by having to perform all these tasks
while protecting multiple generations of people with different risk
factors for falling ill. Additionally, the schools have to defend all
aspects of their COVID-19 strategies to concerned parents, teachers,
administrators and the community. These issues need to be performed
with budgets that were likely decreased from the economic
effects of the pandemic.
Traditional, Modern Strategies
Knowledgeable schools have addressed these areas with a combination
of traditional and modern strategies. They introduced physical
barriers like mask wearing, desk spacing and Plexiglas at important
contact points of aerosol transmission. New specialized industrial
cleaning solutions were used to clean. Extra handwashing and sanitizer
stations were placed throughout schools. Maintenance staffand
other relevant people were given an abundance of personal protective
equipment (PPE).
Other intriguing ideas were created to keep sick people out of
schools. To disincentivise some from hiding symptoms of COVIDManaging 19, some schools eliminated mandatory physicians’ notes for absences
and perfect attendance awards. Most schools negotiated with their
teachers to avoid the practice of decreased reimbursement for those
declaring sick days.
Schools with bigger budgets used next-generation cleaning and
hygiene products mainly implemented by other industries. Sophisticated
products have been used to decrease COVID-19-laden aerosols,
including vaporized hydrogen peroxide, ultraviolet-based disinfectants,
new HEPA filters and autonomous floor scrubbing robots.
Perhaps the most important advance has been the creation of
novel electronic products that schools can use for symptom
monitoring and health management. Symptom monitoring has
been universally acknowledged to be a mandatory part of any
reopening program. On the surface, symptom checks screen for
people with possible COVID-19. However, they also educate
everyone on the disease of COVID-19, allow early detection, and
may even indirectly promote safer behavior. Generally, symptom
monitoring has been incorporated into a questionnaire that can ask
about the presence of COVID-19 symptoms. More sophisticated
questionnaires can also ask about symptomatic contacts or
concerning travel histories.
Monitoring Symptons
Schools have been using a wide gamut of products for monitoring
symptoms since reopening began. These products have included
simple paper forms, online products related to Survey Monkey or a
Google Doc, and more complex electronic software platforms. The
type of product that is chosen by each institution depends on multiple
factors including cost, willingness of parental involvement, faculty
buy-in, and local necessity based on COVID-19 rates.
The perfect symptom monitoring tool possesses multiple features.
First and foremost, the product has to capture accurately the symptoms
of COVID-19 to meet state and national requirements. According
to the CDC, COVID-19 has more than 15 possible symptoms
associated with COVID-19 and five of these symptoms warrant
immediate attention. Logically, all of these should be queried in some
form. Better products also have varying weight given to the presence
of more severe symptoms. Other important features of a useful product
would include the capacity for report generation and the ability to
glean information on possible outbreaks.
However, the most important aspect of a school’s symptom monitoring
system is that it is easy to use, and inspires 100% adoption with
accurate, timely information.
Unfortunately, most of the symptom monitoring products fail in
this regard. Many schools use paper or online products where insufficient
information is given. Other products require app download
and password where compliance can be poor. Some products ask for
temperature checks without the ability for a temperature to be
recorded. Some inferior methods allow no data to be entered and do
not prevent the people from going on campus where they can expose
others to possible infection. Accuracy is another issue. In many cases
the students, even young children and not parents, are the ones putting
in the information into the system regarding the presence of
potential symptoms.
Generating Reports
The best symptom monitors are electronic solutions that ensure 100%
adoption. These innovative products would also generate reports
while potentially yielding and storing much more information. The
most logical ones would not need a log-in or password or an app to
download. All these steps would hinder full compliance. The top
solutions would automate many of the features and respond smartly
to the answers. They could then send messages to symptomatic individuals
and provide immediate contact tracing support to protect
exposed contacts. Some of these products could be extremely sophisticated
and even store links to test and vaccine data.
Another immensely valuable feature of the best symptom monitors
would be the incorporation of an access control program. With this
feature, persons with worrisome symptoms or exposures, or someone
who did not provide adequate survey questionnaire information
would not be allowed into school. This safety step could mean the
difference between an outbreak occurring in a school or not.
People with symptoms or noncompliance would be the ones who
would be most likely to spread infection into the schools. Messaging
for severe symptoms could even provide guidance on where to gain
testing, see a physician or give alerts for a period of quarantining.
Conversely, with proper access control, people who satisfy the
requirements of the questionnaire will have an access pass or “smart
card” that allow entry.
Despite these strategies, some people in schools could still statistically
become ill with COVID-19. The main determinant of whether
schools could stay open after this event will be how quickly and efficiently
the schools respond to this situation. The best prepared
schools will have plans in place to manage this inevitable scenario.
The challenges for this event will be to identify the ill individuals,
determine who the additional exposed people were and prevent further
infections from occurring while of course managing the sick
person. Additionally, every community is different. In some places,
the messaging around the event and the ability to demonstrate confidence
that everyone else’s children are being appropriately managed
may also prevent a school closure.
Contain the Infection
After ensuring the safety of the afflicted person, the most important
immediate consideration is containment of the infection. To borrow
some terminology from the disaster management and fire community,
the containment needs to prevent both “horizontal” and “vertical”
disease transmission.
In this analogy, horizontal transmission would be transmission
between individuals of a similar grade and vertical transmission
would be the transmission of the infection to other grades, parents,
siblings and faculty. The prevention of major vertical transmission is
crucial in that this event could open up exponentially far more individuals
who could become at risk and infected.
As the number of exposed people increases, far more need to be
tested, quarantined and closely monitored and the success rate deteriorates.
Containing the infection to the immediate horizontal cohort
and a “bridge” exposure like a sibling, parent or teacher whom can all
be immediately quarantined can prevent a potentially calamitous
spread. So early containment without vertical transmission and only
controllable horizontal transmission of disease could mean the difference
between a school sending a classroom home for a short quarantine
and an entire school shutting down indefinitely.
The best electronic products, like Cleared4Class, will be able to
facilitate this process. Immediate messages can be sent to affected
people. A strategic understanding of the most likely exposed contacts
of each individual who becomes sick will help predict which people
might be harboring asymptomatic infections. The particular understanding
and resources of each situation might lead to surveillance
testing for the most likely contacts of a sick person. A strong electronic
symptom monitor platform could automate this process and
save crucial time with expedient testing and tracing.
Understanding the concepts about transmission and monitoring
individuals with an eye to minimizing risk of exposure will be
immensely valuable to keeping schools open. The most successful
international communities where schools have been able to be kept
open, such as Denmark, have completely bought into this and
created strict “pods” where children learn, play and recess together.
The American school system can study this model and use
electronic tools and other technologies to combat the vital task of
keeping schools open during the next phase of the Covid-19
pandemic.
This article originally appeared in the November December 2020 issue of Campus Security Today.