As a former Centers for Disease Control and Prevention public health adviser with 25 years of public health experience in communicable disease outbreak response, a current volunteer at the Columbia/Boone County Public Health and Human Services Department and an assistant teaching professor at MU’s School of Health Professions, I am concerned about how MU’s process for COVID-19 prevention and control was represented recently in the Missourian.
Misrepresentations and inaccuracies are certainly understandable; public health is an obscure field that is rarely in the spotlight outside a crisis. However, I feel compelled to explain the fundamentals of communicable disease control for COVID-19 and clear up some potentially upsetting information that has been published since the MU town hall events.
Let’s start with the title of the story: “MU students not required to report positive tests to university this fall.” In the state of Missouri, a positive COVID-19 test is considered a “reportable condition” according to state regulation 19 CSR 20-20.020.
That means any time a lab detects a positive test, the patient’s name and personal details are reported by the lab to the health department as required by law.
Therefore, there is no need for MU students to report their own positive tests. That happens through the reportable condition process. The system does not rely on students or anyone else self-reporting their test results.
Second, the notion that “a person could test positive and we would not get to know on campus” is a highly unlikely scenario.
MU is in the process of hiring a team of case investigators and contact tracers to assist the health department. Once a positive COVID-19 test is reported to the health department, the health department will coordinate with the MU Student Health Center to ascertain if the case is actually an MU student.
If so, an MU Student Health Center investigator will contact the student and begin identifying close contacts. If the case is not a student, the health department will assume responsibility for the case as usual.
The MU Student Health Center and the health department have a long history of successful collaboration, and both the health department and the Student Health Center will be utilizing the same case tracking system, in which all student COVID-19 cases will be flagged.
The fact that student cases could be reported from a variety of labs and providers will not affect the ability of MU and the health department to readily identify which cases are students within the health department’s surveillance system.
Also, since MU Student Health Center will have its own team responding to COVID-19 cases, the health department’s burden will be eased significantly.
In addition, the description of the processes for when faculty have a positive student case in their class was somewhat confusing. To be clear, after the case is reported, a case investigator contacts the student and asks them to identify their illness onset date (if asymptomatic, a testing date suffices).
Once established, the student back-tracks 48 hours from that date and identifies all close contacts — those they touched or were within 6 feet of for more than 15 minutes without a face covering.
Any contacts fitting this description are referred for contact tracing and provided quarantine instructions. This is the evidence and science-based approach recommended by CDC to prevent the spread of COVID-19.
Clearly, if MU in-person classes require 6 feet of distancing between all seated students and compliance with face covering policies, we do not expect that classrooms will represent a major source of transmission for the campus or the community.
If, for some reason, there is a threat of transmission in a classroom, contact tracers will immediately reach out to faculty and fellow classmates. COVID-19 cases are not expected to alert their own contacts, such as their professors. This is solely the job of contact tracers, and any suggestion that a student should perform this role is completely misguided.
This ensures all subsequent communication with contacts is accurate and driven by science, not by fear. If faculty members are identified as close contacts to an infectious COVID-19 case of any sort, they will be instructed to quarantine for 14 days.
MU schools and departments should have a process in place to assure that faculty are enabled to abide by the quarantine direction from contact tracers at the health department.
I hope this information is helpful to the readers of the Missourian in understanding the processes MU and the health department have in place to prevent and control COVID-19 on campus.
Lynelle Phillips is a member of the MU School of Health Professions public health faculty.