Q&A with Dr. Gopal, Assoc. Dean for Health and Wellbeing
What do you think is the most significant change in COVID protocols enacted over the summer?
The most significant changes to our COVID protocols have been in keeping with the landscape of the changes at the Centers for Disease Control, the Oregon Health Authority and Multnomah County. As a board-certified physician, I am always more conservative in terms of infection control than most would be in my role as Associate Dean of Student Health and Well-Being. As we strive for a balance of personal choice and public health at Reed, we are first and foremost a community, and I have witnessed already that “Reedies do take care of Reedies.”
The three significant changes were that:
1) Masking became recommended and not required (as with our nation as a whole).
2) We are no longer doing surveillance testing, as home tests are widely available. We are empowering all members of the community to be responsible for their actions and how they impact others.
3) Our collaborative efforts have shifted to the Emergency Response Team which includes a focused team of individuals to keep up with what our community needs.
Madison Riethman, MPH is, gratefully, still involved and helping us as we meet 1-2 times a week with our director of Medical Services, Timmie Rochon DNP, to keep our finger on the pulse. Reed College has been a model institution in the way we navigated the first 2+ years of the pandemic and we are all learning so much as this virus evolves.
You mentioned during your conversation with OWLs that you had written more for the August email on disease control at Reed that you were asked to cut down. What information did you have to take out of that email?
I loved having the opportunity to chat with the OWLS, as we value their peer leadership and we can never underestimate the value of our student leaders in their ability to make our incoming students feel welcome. I am equally grateful that the Admissions Team honored my request to reach out to new families about the landscape of COVID and tips for incoming students through my lens. This was the first time that this type of communication was done through Health and Well-Being. This is a collaboration that has been very strong in just the short time I have been here. To clarify, I had many items I wanted to convey to our students and I can be wordy! So, in a collaborative fashion, the team was recommending a “5-7 take home messages” for student families to be able to digest small bits and take action. My original version included a lengthy history of what was done at Reed last year, information for each student to reach out to their own health provider if they had a medical history of being immunocompromised, medications that have been in the news and for immunocompromised individuals, making sure families know that the medical providers at the HCC are highly skilled but also not open as a 24/7 infirmary, rather as a primary care option on site, and also empowering families to have conversations about their healthcare before that first paper comes due, they have a sore throat, and they don't know next steps.
I also asked incoming freshmen to bring their own test kits, masks, and information about student health insurance and emergency contacts. I had also mentioned my concern for long-term COVID. I want students to know that we have experts at the HCC and to also know that this is an ever-changing landscape so we do our best for our students.
Do you know why the school has changed to limiting surveillance testing to only symptomatic individuals? Also, what qualifies as ‘symptomatic’? When should one go to the HCC?
Surveillance testing is different from diagnostic testing. By definition, "surveillance" testing means taking all or a representative portion of a population and testing them for a disease to try and monitor whether or not COVID was present in the community. This strategy was used early on in the pandemic to develop a better understanding of the situation. At this point, we have that understanding -- COVID is more or less an endemic presence across the country. As a result, "surveillance" testing is no longer a program recommended by public health authorities. Instead, testing services are being transitioned back to medical providers, like with most other infectious diseases. We have diagnostic testing at our HCC available for our students. I am new to the team so many decisions were, indeed, made as I was just coming onboard. I began part-time and started full-time on August 15. In terms of “symptomatic”- yes, any of our students with acute symptoms of fever, shaking chills, headache, sore throat, loss of taste or smell, shortness of breath, cough, dehydration, pain in muscles should call our HCC or their provider and get tested. As always, reach out through the health portal or via email to the HCC with any positive home test results.
Reed said in its June 17th message that it will “monitor the availability of home test supplies for purchase or through government programs.” What does that mean?
Unfortunately, the federal government’s program providing free home tests was suspended on Friday, September 2nd. However, other testing resources still exist. Most insurance companies are required to pay for a certain number of test kits on a monthly basis; you can go to your company’s preferred pharmacy for details. Oregon Health Authority also maintains a repository of free or low cost testing sites, which can be found online.
The college has purchased a supply of home test kits to be used by students who are in isolation for a positive COVID test. On day 6 of isolation, students can take this test and be cleared to leave isolation if it is negative and they have been fever-free for at least 24 hrs. The HCC is providing this test free of charge to students when they begin isolation.
How many isolation beds are available? How will isolation work if students exceed the number of isolation beds available?
We currently have 15 isolation beds this semester and no one is waiting for a room. We are so grateful to those who tested prior to coming on campus as they are isolating in the comfort of their own homes. To manage these spaces most effectively, those in single rooms may be asked to isolate in place, as was done in the surge last Spring. This semester, we have also started a program where students may potentially leave isolation on day 6 if they test negative and provide that result to the HCC. This means that we can turn over rooms in the isolation dorms more quickly, and should hopefully result in fewer students needing to isolate in place. We have a wonderful team of Residence Life, deans, and medical professionals involved in supporting students with isolation following a positive test, and this same group works together to make real-time decisions about how to manage potential surges.
What is the biggest concern you have about COVID/Monkeypox on campus?
COVID: I am always concerned about long-haul COVID and the statistic that 10-30 percent of individuals who get COVID will continue to have long-term sequelae of fatigue, decreased lung function, clotting issues, chronic headaches and mental health concerns, and the COVID brain- fog. If I could go back in time, I think I would have insisted that the first two-weeks of classes be mask-mandatory but I realize we are a community that has students who have come from different states and countries to join us and they have not been mask-wearing for months. I also realize that most colleges (including Reed) are following the guidance of the CDC and local public health organizations. Like I said, I am conservative in terms of infection control but not much else! My colleague, Timmie Rochon and I predicted a surge in the first few weeks of school and we are constantly making sure that we encourage masks whenever we can. We have such a smart group of students here and I have seen a lot of them in our crowded commons at lunch wearing masks and I loved seeing the flyers requesting masks at O-Ball.
MONKEYPOX: In terms of hMPXV, which is what I prefer to call it, my main concern is to stop the spread, the stigma, and to know one's own risk. I actively took care of many patients during the AIDS crisis in the early nineties and if I could get a message out now, it would be that we must not spread the rumor that this disease can affect only certain populations. Anyone can get hMPX. The risk is highest through direct skin to skin contact and sexual contact. College is often a natural time of great study and exploration so I want our students to be mindful of how this virus spreads. In addition, if one of our students has a presumptive case of hMPXV or a significant exposure, I would want them to know that the incubation period is 6-21 days and the illness itself can last several weeks. Given the duration of the illness, any student who has a confirmed diagnosis would likely have to take a medical leave and I know how that can impact our students in terms of their mental health and their love of academic rigor. There are so many resources in addition to the HCC in the community. We are tracking the availability of vaccines and high risk treatment options for those with concomitant health conditions. Since supplies are very low nationwide, we may not be able to administer the hMPXV vaccine on campus. I was just chatting with a professor who told me about PRISM Health and its rich resources, as an example.
Does the HCC have protocols in place for Monkeypox? If so, what do they look like?
The HCC has hMPXV protocols in place for testing as well as our surrounding clinics and hospitals and Multnomah county. Many of our protocols for programs like contact tracing, isolation, and student support were derived from those we developed during the last two years of COVID.
Will the HCC continue to offer COVID vaccines throughout this semester?
Many of our students have been getting vaccinated since we reopened this summer. Today, however, we just learned that we will transition our current vaccine supply in favor of the new vaccines that will include the new variants that have surfaced. So students can rest assured that when we get our new supply, it will include Omicron variant protection. Again, I have been so impressed with our HCC team.
Let me know if there is anything else you think it would be helpful for students to know as well!
Soon after I took this position I placed Reed in the network nationally as a United States Health Promoting Campus and met with both Dr. K and President Audrey, who are also excited at the possibilities for our institution to adopt the charter as it aligns with our values. My vision is of an ecosystem of well-being with a sense of belonging, honoring place, combining sustainability and our ongoing anti-racism work. My dream is to adopt this charter as early as October. Among many things, I am working to re-imagine peer health education and educators here at Reed. We have been without this support through the pandemic and it would be great to try to bring this back. Our students most definitely would want to be a part of this prospective opportunity to partner with our Health and Well-Being Community goals and guide fellow students in a journey that really looks at how we connect with ourselves and others. And to start, we may need to have a health and well-being section of the paper every quarter :) .