BY FRANK E. RITTER AND DONALD A. DONAHUE
By Felipe Esquivel Reed – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=87846813
COVID-19 has disappeared from the headlines, but not from our lives or classes. What steps should we take this fall? We note thirteen. COVID-19 has been declared as endemic, necessitating continuing precautions like those taken against influenza. Campuses continue to be places of increased risk for communicable diseases of all types because people congregate. While some institutions are progressing as if the pandemic was inconsequential this is perhaps true institutionally but certainly not individually. Doubly vaccinated and boosted individuals and the previously infected contract the current version of the disease, and often describe the experience as “miserable.”
While higher education has benefited from immunization mandates against childhood diseases, it has also acted decisively against other threats, such as requiring meningitis and measles vaccinations. The response to the SARS-CoV-2 virus has been as varied as the institutions facing it, influenced by public health considerations, politics, and preserving the “undergraduate experience.”
For faculty and staff, prudence suggests CDC guidelines are only a baseline—classrooms and instructors have particular risk factors. Classroom risks remain not fully known and are difficult to assess given the wide variety of spaces. Relaxed CDC and Department of Education mitigation measures still include mandatory vaccination, and suggest masking, physical distancing, testing, and contact tracing, important actions for instructors who are older and may have underlying health issues.
While the epidemic curve had been trending downward, there will be continued waves this year and the death toll continues to be significant, about four hundred a day, three times the rate of traffic fatalities. The cumulative national toll topped a million deaths months ago. Vaccination has helped enormously, but COVID-19 continues to occur among the vaccinated and unvaccinated, including repeat cases, inflicting long-haul cognitive, neurological, cardiological, and pulmonary complications.
There are simple practices to help protect yourself and your students, families, and communities, irrespective of your institution’s policies, keeping in mind that COVID is often spread from asymptomatic, apparently healthy individuals.
Evidence-based guidelines to help protect faculty:
- Be vaccinated and boosted as suggested by your healthcare provider. Vaccinate your family; flu shot, too.
- Encourage people with whom you interact to be vaccinated; encourage your university to require it.
- The CDC advises you have a greater chance of catching COVID-19 in an unventilated or poorly ventilated space if you have been within six feet of an infected, unmasked person for fifteen minutes or a masked person for twice that. Do not hesitate to mask inside (exposure is cumulative).
- Consider taking supplementary vitamins, such as D and C. Do other things to keep healthy: reduce stress, get outside, exercise, eat a balanced diet.
- If you get sick, and especially if you have underlying risk factors, get tested by a pharmacy that can immediately treat you with antivirals.
- Require the folks you interact with to also be properly masked when the ventilation or their vaccination status is unknown.
- Choose better, easy-to-wear masks (N95, KN95, or KF94). Wear them in higher-risk areas.
- Maintain six feet or more of distance from others, particularly if they may be unvaccinated, infected but asymptomatic, or coughing or sneezing.
- Provide office hours remotely.
- If you have been exposed, quarantine and teach remotely. If you are sick, isolate and look after yourself .
- Pay attention to ventilation: open windows, insist on better ventilation, teach in larger rooms with more space between occupants or outside, whenever possible; and check your room ventilation with CO2 monitors.
- Assist with contact tracing in your classes. Seating charts or daily pictures help. Provide flexible attendance policies for those sick.
- Encourage your university to share information, including detailed numbers about ventilation, infection rates, and contact tracing to help judge risk. Until they do so, stay in a safe place when you can.
Basis of Recommendations
You can diminish your potential exposure by being aware of risk factors. The risk is higher if you are unvaccinated; much lower if vaccinated. Risk increases with time from the last vaccination; how fast is not fully known, thus booster shots are recommended.
Infection risk decreases with more ventilation and more spacing, increases with more people, less ventilation, less spacing. Ventilation in academic buildings can vary widely; most were not designed with reducing airborne disease in mind and many are simply unknown.
The risk is much greater if anyone with COVID-19 is coughing or sneezing, particularly if they are unmasked or unvaccinated.
Age is a major risk factor. Morbidity and mortality are generally greater for instructors who are typically older than students (more so if over sixty-five). The CDC’s risk calculations by age are startling.
The risks of morbidity—long-term effects—are unknown but are significantly greater than for the flu. Many COVID-19 survivors continue to suffer what will likely be severe lifelong health complications.
The new semester’s travel and social gatherings increase the likelihood of exposure. Keep these risk factors in mind, especially if you teach at an institution without vaccine requirements.
Additional Resources
- Oxford medical professor: How to protect yourself from COVID-19
- Background theory and skills to “Stop the spread”
- The US Department of Education suggests that universities without a vaccine mandate should: (a) offer vaccination; (b) mask; (c) social (physical) distance (including outside classes, seats six feet apart, larger rooms); (d) hand-washing, respiratory etiquette; (e) adequate ventilation, routine cleaning; (f) twice-weekly testing when transmission is substantial or high; (g) contact tracing; and (h) maintain healthy operations including communications, support policies, and health equity.
- COVID-19 is respiratory (transmitted by breathing) and not fomite (transmitted by touch)
- 6’ might not be far enough with longer exposure times
- How to improve ventilation including available tools
- Ventilation scientists’ FAQs on Protecting Yourself from COVID-19 Aerosol Transmission
Frank Ritter is professor of IST and of psychology at Penn State. Donald A. Donahue is a senior fellow of the Potomac Institute for Policy Studies and a professor of global health in the Graduate School, University of Maryland Baltimore. Both are Society for Disaster Medicine and Public Health board members.
“Consider taking supplementary vitamins, such as D and C.”
There is no basis for this recommendation. In fact, there’s good evidence against it (e.g., https://sciencebasedmedicine.org/the-effectiveness-of-zinc-and-vitamin-c-on-the-duration-of-covid-19-infections/ ).
That said, taking modest doses of vitamins D and C ain’t gonna kill ya, so you do you. Just don’t pass it off as good advice, or grounded in science.
“Consider taking supplementary vitamins, such as D and C.”
There is no basis for this recommendation, and in fact studies have shown vitamin C to not be useful against COVID-19. Vitamin D is also not useful, unless you were deficient to begin with. (In fact, this is generally true of all vitamins: if you’re deficient, you need more. But when you have enough, more doesn’t help. Like food, water, sleep, and really most things in life.)
In fact, two new studies just came out (BMJ 2022;378:e071230 and BMJ 2022;378:e071245; I’m apparently blocked from entering links in comments) that show that vitamin D supplementation doesn’t help prevent COVID or reduce symptoms even in people who were deficient in vitamin D to begin with. This is the decline effect in action – there was a 2020 study that suggested it could be helpful against COVID for those who were deficient, guiding my initial comment.
And note that unlike vitamin C, vitamin D is fat soluble and can build up to dangerous levels over time if people routinely take large doses, which is easy to do with supplementation.
We thank you for your comments and suggestions. We don’t think we are far apart. John Campbell (retired nursing professor and YouTube blogger with >1M subscribers, someone Ritter follows and who blurbed our book) argues that Vitamin D might be helpful, but see your health care provider. Your comments about about vitamins for those deficient and Vit D being fat soluble are correct (this is also noted in the tutor and book). And you are very correct, many Vit D supplements contain too much and should be cut in size or not taken daily.
Technically, the studies you cite have not shown Vitamin C or Vitamin D are not useful, but only to show that no effect was found in those populations (UK, Norway). They appear to be well run studies.
However, cited on the StopTheSpread.health web site [1] notes in a randomize trial that Vit D is very helpful for those exposed (Mexico).
So, we would update the phrase in point 4 to be “consider … after consultation with your healthcare provider.”
[1] 10.1016/j.arcmed.2022.04.003. June 22. Efficacy and Safety of Vitamin D Supplementation to Prevent COVID-19 in Frontline Healthcare Workers. A Randomized Clinical Trial, Archives of medical research.
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