How colleges are preparing for a new public health threat: monkeypox

Andrea Connor has become the “accidental COVID czar” of Lake Forest College, a small school north of Chicago where she serves as dean of students.

“When COVID started, our crisis management team kind of multiplied,” she says.

Now she’s relying on the same team to respond to a new health threat: monkeypox.

“There’s a lot of fear, a lot of worry,” Connor says. “So we want to educate people.” Her team is putting together guidelines detailing the signs and symptoms of monkeypox and what a student should do if they think they might be infected. Monkeypox is much less contagious than COVID-19, but Connor says it’s the school’s job to be prepared.

Ahead of the new school year, colleges across the country are redirecting the tools they developed during the pandemic to deal with the monkeypox outbreak, which the White House recently declared a public health emergency. It’s a different virus, with different risks, and colleges need to adapt, says Dr. Lindsay Mortenson of the American College Health Association (ACHA).

“A lot of colleges and universities are thinking about, ‘how do we turn the page institutionally?'” Mortenson says. “‘How do we take all these public health-informed practices and apply them in a different context?'”

The risk of contracting monkeypox is low, but colleges are starting to see cases

According to the Centers for Disease Control and Prevention, the risk of contracting monkeypox in the United States is “considered to be low.” More than 7,000 cases had been confirmed in the US as of Thursday, although experts said that number was likely higher due to testing restrictions.

Monkeypox is most often associated with a rash that can appear anywhere on the body, including the face, legs, arms, genitals and inside the mouth, the CDC says. But symptoms can also include fever, headache and muscle aches.

The virus is spread through physical contact with a monkeypox rash, and the majority of people affected by the current outbreak appear to have contracted it through sexual contact. Cases are largely concentrated in the gay and queer community, mostly among men who have sex with men. But the CDC says sexual contact isn’t the only way the virus spreads. It is possible that close face-to-face contact or indirect contact with the rash can result in transmission, although data suggest this is less common.

As a result, experts say, everyone should be paying attention to the virus.

“No epidemic remains confined to one social network,” says Dr. Jay Varma, an epidemiologist at Weill Cornell Medical College. He adds that although the virus is concentrated in the gay and queer community, “there’s no biological reason it can’t spread to other groups.”

On college campuses, Varma says observation areas are those where students come into close physical contact with their skin, including locker rooms, gyms or even theater groups.

The virus has already appeared on some university campuses. Georgetown University in Washington, the University of Texas at Austin and West Chester University in Pennsylvania told NPR they had at least one confirmed case over the summer.

West Chester University spokeswoman Nancy Gainer said: “The student is in isolation and continues to do very well. There is a plan for them to complete their class remotely and the student will not return to campus for the summer term. ”

On July 28, the ACHA, which represents more than 700 institutions of higher education, sent an email to its members with basic information about monkeypox, but more detailed guidance is still in the works, says Rachel Mack, director of communications for the ACHA. She says ACHA is now coordinating with the CDC to schedule a webinar, and they are also creating an FAQ document to share with members.

“This is all in the early stages and we are currently assembling a team of experts to help finalize the topics that are of paramount importance to [institutions of higher education]Mack said in an email to NPR. “Our goal is to meet the needs of our members and to meet those needs as quickly as possible.”

Monkeypox requires a longer isolation period than the coronavirus

COVID-19 is usually contagious in less than 10 days, but monkeypox infection can last for several weeks. This means that a student infected with the virus may have to self-isolate for a significant portion of their semester.

“This presents a very significant challenge for the individual who has to come to terms with this level of isolation, as well as for the university which has to make arrangements to support it,” says Varma.

One challenge is that most colleges have returned to face-to-face learning after going entirely remote in 2020. Schools told NPR they are still determining what distance learning will look like for students in isolation.

At UC Irvine, where all classes are back in session, students in isolation are working directly with their faculty members to decide how to learn remotely, said David Souleles, who leads the school’s COVID-19 response team. “Instructors are encouraged to have a plan for such events in advance,” he explains.

When we are talking about where students with monkeypox would self-isolate, there is huge variability between colleges, even in places where schools have had housing set aside for students who have tested positive for COVID.

“Some reserve isolation housing for COVID or any infectious diseases they might be needed for,” says Mortenson. “Others have completely given up their inventory.”

At Lake Forest College, Andrea Connor works on housing logistics and says the school plans to help students self-isolate if they test positive for monkeypox. They will also help students meet basic needs, including food and laundry.

At West Chester University, which serves more than 17,000 commuter and residential students, Gainer says the school is “committed to following CDC guidelines and having students [who test positive for monkeypox] self-isolate.”

In Ithaca, New York, at Cornell University, the campus health department has published an online resource with information about monkeypox. The school is “developing testing, treatment and isolation protocols for those affected,” says Rebecca Vallee, director of media relations. “We also consider the potential academic impacts and accommodations that may occur.”

Students are concerned about the stigma of monkeypox

With 99% of cases in the US involving male-to-male sex, according to the WHO, there is growing concern about stigma and bias against the LGBTQ community.

This bias can have negative public health consequences if it prevents an infected person from seeking treatment and informing close contacts of potential exposure, an important step in mitigating the spread.

Student Liz Cortez, who leads the Queer and Trans Student Alliance at UT Austin, says they are frustrated by the continued stigma and are waiting to see if the university will address it. If the school fails, “we will make it a priority to work with public health officials to provide accurate information and address misconceptions about the virus and our community,” Cortes told NPR in an email.

UT Austin did not immediately respond to a request for comment on how it plans to address concerns about stigma. But the school’s health services website states that “anyone can get monkeypox, regardless of age or gender.”

Some universities are working with student groups to coordinate education and response efforts. At UC Irvine, Souleles says the school has convened a task force that includes representatives from the LGBT Resource Center. “We also consult guidelines from the Centers for Disease Control and Prevention to reduce the stigma of communicating with monkeypox,” he says.

Student privacy is another concern. At many larger schools, including UT Austin, the University of Michigan and UC Irvine, health centers are equipped to test students for monkeypox. But other schools, including Lake Forest, currently lack testing resources.

Lake Forest students must leave campus to be tested at one of five nearby labs, Andrea Connor says. One of those labs is an STD clinic, and if a student gets tested there, their insurance can bill it as an STD test, even though monkeypox isn’t considered an STI, Conner says.

“Some members of our community wouldn’t want their parents to see that on their insurance,” Connor explains. “So there’s a lot of layers there.”

Still, Connor says he remains hopeful for the fall semester.

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