At the St. Louis University College for Public Health and Social Justice, staff realized early on that COVID-19 was not going to be the same as the first SARS CoV. Says Special Assistant to the President and Professor of Epidemiology in the College for Public Health and Social Justice, Dr. Terri Rebmann, “My initial reaction was to plan for this on a local and national basis through my work as a researcher, educator and member of the Association for Professionals in Infection Control and Epidemiology (APIC). It was only about a month or two later that I became involved in pandemic planning and response for my university after being brought to the leadership planning meetings by my Dean.”
From the beginning, SLU used a multidisciplinary approach to decision-making that involved leaders, faculty, staff and students. Says Rebmann, “We aimed to make decisions that were evidence-based, mission-centered and values-driven. We put together multiple working groups to discuss the best approach for each decision we needed to make, to ensure we involved the right group of stakeholders for each discussion. We were completely transparent in our plans and protocols and held open fora to allow community members to get their questions answered.”
They created their own internal contact tracing team, led by their public health faculty and staff, co-managed by two MPH student leaders and team members consisting of MPH students. Rebmann says, “We were able to conduct case investigations in less than 24 hours after notification that someone had tested positive. The team monitored the data closely and responded quickly when a trend or cluster was identified. This allowed us to conduct cluster testing and respond rapidly to unusual disease spread on campus.”
They collaborated with local public health officials to develop and implement a modified quarantine protocol that allowed them to take mask use into account when determining if someone was a close contact who required quarantine. “We did this systematically for the entirety of the spring 2021 semester and determined that it did not result in increased disease transmission. We found that this protocol greatly reduced the number of students and faculty who required quarantine, which enabled more individuals to safely teach and attend classes without disruption. It also reduced the burden on our isolation and quarantine housing that we provided to our on-campus students.”
They faced two periods of intense challenge during the pandemic: fall 2020, when a very large number of cases on campus almost forced them to move online, and emergence of the Omicron variant that almost forced them to begin the spring 2022 semester online or late.
According to Rebmann, “We successfully opened on time and stayed in-person for the entirety of the fall 2020, spring 2021, fall 2021 and spring 2022 semesters. We were able to succeed due to our robust response team, evidence-based protocols, mission-centered approach and community members who graciously supported our efforts by following our policies. The other major challenge we faced on campus related to our COVID-19 vaccination requirement policy. In spring 2021, we faced the question of whether to require our employees and students to be vaccinated against COVID-19 for the fall 2021 semester. We used a multidisciplinary approach to determine our vaccination policy. Our university president put together a representative, multidisciplinary working group of 13 faculty, staff and students to assess whether we should require COVID-19 vaccinations or adopt other COVID-19 vaccine policies. That group met on multiple occasions to review the pandemic epidemiology, science behind vaccine safety and effectiveness, and input from our community members that had been collected via a survey sent to all employees, students and parents. After many discussions about the advantages and disadvantages to implementing a vaccination requirement policy and weighing the competing issues of personal autonomy versus expressing our care for one another by being vaccinated so that we could be together safely, free from isolation and anxiety, our working group opted to recommend to our president that we require all students, staff and faculty be fully vaccinated against COVID-19. Our president agreed with our working group’s recommendation to require vaccination and implemented that policy. This decision was met with mixed reactions by our community members. Many were elated by the decision, but others were opposed to the policy. Implementing this policy required our COVID-19 response team to develop protocols for tracking compliance and increase the vaccination clinics we offered on campus. As our president stated in his message to our community about this decision: ‘I close by asking that you remind yourself of all that we were able to accomplish together throughout the 2020-2021 academic year. It involved many sacrifices of our students, faculty and staff. It required us to not give in to anxieties and fears, and instead follow the best scientific knowledge as it became available. One would be hard pressed to find any university anywhere that did it better than we did. Let’s do what needs to be done to be able to say the same at this time next year. It begins with getting vaccinated.’”
Rebmann points to lessons learned: “One of the most important lessons we have learned through this pandemic is that it is critical to follow consensus science, be inclusive in including our stakeholders in decision-making, communicate our protocols to our community members and the evidence behind them, and stay mission-centered in order to gain the support and trust from our community members. We have received a lot of positive feedback from community members regarding our multidisciplinary, evidence-based, transparent and inclusive approach. We will take these lessons forward into our response to other public health challenges we face as a campus, including our preparations for monkeypox virus on our campus.”
Rebmann continues, “The second most important lesson we learned was the critical need for better coordination across the city of St. Louis in terms of higher education’s response to the pandemic. Very early on we set up a weekly meeting between local health department officials and COVID-19 leaders from universities across the greater St. Louis region. This weekly coordination meeting allowed (and still allows, since this is ongoing) collaboration and sharing of best practices and protocols across the city. It improved the communication between SLU and local public health officials, as well as creating a support network for COVID-19 leaders. This collaboration also aided local public health officials who often used our protocols as the basis for their recommendations for local K-12 schools. Our relationship with local public health officials strengthens not only our COVID-19 response by resulting in faster response during times when the university had clusters or other issues on campus, but also has aided the university when we had to quickly develop a protocol for MPV for the fall 2022 semester.”