Conversations: H1N1
Editor’s Note: In the November+December 2009 issue of the Talking Stick we asked members to discuss how they are addressing H1N1 on their campus. As you would expect, they had plenty to say on the subject; so much that their ideas overflowed the magazine pages and onto this blog. So much that we’re even breaking it into three separate posts. Participating in the Conversation is Mike Krenz, assistant manager for risk management at Texas A & M University in College Station; Gary McLaughlin, business manager for housing at Flinders University of South Australia in Adelaide; Steve Palmer, director of residence life at Western Michigan University in Kalamazoo; Robert Tattershall, director of housing and conference services at Washington State University in Pullman; Dima Utgoff , director of residence services at the University of Alberta in Edmonton, Canada; Joe Gonzalez, associate dean of residential life at Duke University in Durham, North Carolina; Sean Duggan, managing director of university student housing at Texas Tech University in Lubbock; and Bes Liebenberg, coordinator for student support residences at the University of Pretoria in Gauteng, South Africa.
Joe Gonzalez: What steps have your housing office taken to prepare for and respond to the H1N1 situation?
Mike Krenz: We had conversations with Texas A&M student health services, dining services, the vice president for student affairs office, and the university president’s office and came up with a unified solution. This was crucial. Before anything was issued to the public, we made sure we all agreed on the plan and all agreed on the wording of the messages being sent out. This went very smoothly with this approach: (1) Send messages to all faculty, staff, students, and parents; (2) Set up rooms for sick or well students for the purpose of isolation; (3) Set up a sick-tray process with dining services for sick students; (4) Work with student health services to have a flu vaccination clinic as soon as possible; (5) Check all stock piles of masks, gloves, and hand sanitizers, and (6) Educate, educate, educate, and educate some more.
Gary McLaughlin: In Australia we have just gone through our peak flu season, and at Flinders housing we did have several cases of H1N1, including one staff member. We had a meeting of senior management (as soon as we realized we were at risk), at which we determined the course of action we would take, which included identifying medical resources both at the university and off campus and setting up an isolation area, catering services, and ongoing monitoring procedures for infected residents. We ensured that we had a good and easily accessible supply of appropriate prevention items such as gloves, masks, and sanitary hand wash for use when dealing with infected residents. All residents were advised of arrangements that were in place.
Steve Palmer: Here at Western Michigan, we have collaborated with numerous offices including dining services, custodial, facilities, our health center, environmental health and safety, and the entire student affairs division, to name just a few. We have put out numerous educational fliers in the halls, offered programs, and placed information and links on our Web site. We have been able to identify our locales for having to isolate students if they are not able to return home. If students have been diagnosed with H1N1 and live in halls without community bathrooms, and we are able to, we keep them within their own halls where they live in rooms I have designated as conduct hold rooms. These rooms have their own bathrooms. If the student lives in one of our halls that has a community bathroom, we have been temporarily relocating them, isolating them in a hall where there are two floors that are currently offline. Once they are isolated, we have a detailed handout we walk through with them that highlights the importance of isolation, what we as a department can do for them (such as delivering meals, checking in by phone with them at least twice a day, and providing them with a micro-fridge). We have also installed wall-based hand sanitizers in each lobby. We are also keeping a limited supply of masks and forehead thermometers behind our front desks.
Robert Tattershall: I am on the university pandemic committee, so I was informed as the university discussed preparations, and I was able to influence the understanding of our capabilities, and limitations, within the university. Since we have limited space that can be used for isolation and didn’t think isolation made sense once very many people had H1N1 (it’s easy to isolate the first few, but isolating 50, 100, or 200 changes the dynamics entirely), our preparation was geared toward individual responsibility: taking care of yourself, instituting self-isolation, and serving as a backup for residents who didn’t have someone able or willing to help them during the time they were sick.
Our response has been the typical signage about sanitation and self-isolation, hall meetings, preparing our RA staff, buying flu kits, and cleaning touch surfaces. H1N1 hit our campus on August 18 at 2 p.m. when we heard of the first case in our halls. By 5 p.m. we knew of seven, and the number multiplied quickly from there. We developed a process by which residents could voluntarily tell their front desks they were sick, which alerted us to expect a call from them each day by 5 p.m., so we knew they had not taken a turn for the worse. We also had flu kits with thermometers at the front desks so residents could assess when they were well by the CDC guidelines; finally, we created a method for other residents to use the sick person’s ID to get food from the dining centers on the sick person’s card. Interestingly, not that many took us up on notifying the front desks or helping with food needs, in part because the symptoms were not severe (much less so than the average seasonal flu) and because, in most cases, residents already had friends who would go get them food, as needed.
Dima Utgoff: We have prepared a list of questions and answers that we have posted on the residence services� Web site. We developed this list after consultation with a wide variety of individuals, and it was approved by the university’s Public Health Response Team, a group I sit on and which is responsible for managing the university’s response to H1N1. We have in turn tied this list to the university’s main H1N1 Web site.
Gonzalez: In some ways, I feel we had a tremendous amount of dialogue throughout the university and in the end reached the conclusion that only a few steps needed to be taken or could be taken. The main plans that residence life and housing services has made include the following: (1) Setting up rooms to isolate healthy students who are more at risk for severe illness due to pre-existing health conditions rooms to be used if “healthy but at increased risk” students informed Student Health that students around them had become ill; (2) Collaborating with dining services to implement a meal order and delivery system; (3) Providing RAs and residential counselors with thermometers and masks to distribute to residents requesting one; (4) Posting informational posters throughout residence halls; (5) Training RAs about H1N1 (mostly informational in nature), and (6) Keeping hand sanitizer in the restrooms, which we had already put there during a drought two years ago.
Sean Duggan: We developed a one-page statement that was posted to our Web site. We have installed hand sanitizer dispensers throughout public areas in the halls, such as lobbies, entrances, elevator lobbies, and bathrooms. We are running educational public service announcements on our residence life cinema channel. We created bookmarks with the flu information from our Web site and then clipped a hand sanitizer pen (15,000 total) to the bookmark and provided these to all students on campus and also provided the information to others as well. We purchased face masks for anyone to use, as a way to prevent the spread of germs or keep germs away from mouth and nose. We created a packet of information, Q&A’s, for all professional and student staff so that everyone is providing the same information and answering questions appropriately.
We created an ill-student log, to help us with follow-up so that a sick student doesn’t fall through the cracks and not have anyone checking on them. Of course they have to let us know they are sick for us to be able to follow up. We also work closely with our student wellness center, student health, and other offices on campus to address concerns and help students. Since we are 99.5 percent full, we made the decision to work with students as individuals regarding their need to relocate due to roommate illness. If this is what they want to do, we will look to temporarily relocate them to an open space or will create temporary housing in lounges and other places. So far, this has not been needed and rarely requested.
Bes Liebenberg: We have done the following: (1) We had extensive conversations with advisors from the Department of Infectious Diseases in the School of Medicine and the faculty of Health Sciences; (2) Proposed an action plan for curbing the spread of H1N1 among students at the University of Pretoria the plan is subject to continuous review pending the severity of the anticipated epidemic; (3) The Department of Residence Affairs and Accommodation (TuksRes) launched an awareness campaign as well as establishing procedures that can be followed in case of possible infections; (4) Information supplied included clinical signs that can be associated with the disease and to which students should be sensitized; (5) Two dedicated nursing sisters at student health services took responsibility for the initial diagnoses of possible infections; (6) The Department of Infectious Diseases in the School of Medicine developed a scorecard for diagnostic purposes; (7) Resident students were encouraged to go to the doctor or nursing staff at health services at the first sign of flu, and (8) Positively diagnosed students were encouraged to go home for a period of seven days in order to minimize the spread of the infection. We made provisions for students who were not able to go home to stay in isolated facilities for the same period.
Gonzalez: What have been the most difficult challenges your office has faced in developing responses/responding to the H1N1 situation?
Krenz: The most difficult issue is the questions from parents (and some faculty/staff) asking, “What are we (residence life) going to do to protect everyone?” Very few people see the H1N1 response as a “university-wide” response. There are expectations that housing and residence life take care of all of the students, and make sure no one gets ill. Regardless of the answer, some people are not happy and expect more from us.
McLaughlin: Questions from residents (and the odd parent) asking for information on what procedures we had in place and what should they do if they felt ill. How to differentiate between ordinary flu and H1N1 became an often asked question. A medical check would be required to confirm H1N1 or otherwise was the response.
Palmer: A challenge has been, with so many offices involved, making sure that communication is ongoing and consistent. Additionally, with students that we temporarily relocate, the issue of transporting these students from the hall they live in to their relocation hall has been problematic. Finally, despite all of our education efforts, we have some students (and parents) who have shown concerns about ‘sick’ students being isolated in the same building where healthy students are. This has resulted in ongoing education and conversation with parents and students alike.
Tattershall: The public has been reading about H1N1 and assuming pandemic meant deadly, when it has not been to this date. The most difficult challenges have been around the public expectations.
Utgoff: Certainly, the most difficult task was developing the proper communication strategies and much thought went into how to word our FAQ document. We wanted to ensure the answers we were giving were consistent with the university�s main key messages and that we were being very careful to word our information in such a way that it could not be interpreted that we were giving medical advice (but rather referring to medical and other advice being given by Alberta Health and Wellness, our provincial health department). Alberta Health and Wellness in turn gets much advice from the Public Health Agency of Canada, but in Canada, the administration of health services is a provincial, not federal matter so we act on the basis of what our provincial public health authorities tell us to do.
Gonzalez: Responding to concerns, mainly from parents, that our efforts are not viewed as sufficient. Many demands for temporary relocation of sick/healthy students were made and holding to our decision to not do this was difficult at times.
The other challenge that had potential to become significant was unexpected costs that had not been included in the budget. To this point, this has not become problematic, but if circumstances change for the worse it could become so.
Duggan: Trying to keep everyone calm: students, parents, staff, other administrators. Listening to all of their ideas, and taking the time to formulate a reasonable response.
Liebenberg: The most difficult for us has been: 1) To get the seriousness of the matter through to the students; 2) Finding the most suitable way of communicating to the students and encouraging them to report incidents. Many students were so involved with their academics and other commitments that they would rather keep quiet and stay in residence than speak out and go home; 3) The over coverage of the issue in the media created paranoia amongst students and parents.
[...] pages and onto this blog. So much that we’re even breaking it into three separate posts (read part 1 here and part 2 here). Participating in the Conversation is Mike Krenz, assistant manager for risk [...]
I think the important action that most of us have taken is to increase communication to a higher level. This along with several other “crisis” situations have created an atmosphere where there is a greater demand for knowledge as to the actions that are being taken. We have used all the normal communication venues including email, blogs, print, social networking, meetings, programs and video. The campus movie channel has posted updates and utilized videos to inform residents of the status of H1N1 on campus. That seems to be a very effective “constant” communication tool that is minimally administered. The bulletin board aspect is critical, but the video produced by Residence Life Cinema is very effective. It has also been used with RA programming.
I appreciate the information that has been provided and it seems to fall hand in hand with what most of us are doing in response to this situation.