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 prepare.

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

“Many colleges and universities are thinking how do we turn the page institutionally?” says Mortenson. ” ‘How do we take all these informed public health practices and apply them to 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 US is “believed to be low.” More than 7,000 cases have been confirmed in the US as of Thursday, although experts say the number is likely to be higher due to testing restrictions.

Most often, monkeypox is accompanied by a rash that can appear anywhere on the body, including the face, feet, hands, 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 the monkeypox rash, and the vast majority of people affected by the current outbreak appear to be catching it through sexual contact. The cases are mostly 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 can spread. It is possible for close face-to-face contact or indirect contact with the rash to result in transmission, although data indicate this is less common.

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

“No outbreak remains confined to any 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, says Varma, areas to watch are those where students come into close physical contact with each other’s skin, including locker rooms, gyms or even theater groups.

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

At West Chester University, spokeswoman Nancy Gainer says, “The student is in isolation and continues to do very well. There is a plan for them to complete the class remotely and the student will not be returning to campus for the summer.”

On July 28, the ACHA, which represents more than 700 institutions of higher education, sent an email to its members with basic information about the monkey, but more detailed guidelines are still in progress, says Rachel Mack, director of communications at 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 assembling a team of experts to help finalize the topics of primary importance to [institutions of higher education]” Mack says in an email to NPR. “Our goal is to respond to the needs of our members and fulfill those needs as quickly as we can.”

Monkeypox requires a longer isolation period than the coronavirus

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

“This presents a very significant challenge for the individual, who has to cope with that level of isolation, as well as the university, which has to take measures to support it,” says Varma.

One challenge is that most colleges have returned to in-person learning after going fully distance in 2020. Schools told NPR they’re still determining what distance learning will look like for isolated students.

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

When it comes to where students with monkeypox would be isolated, there is great variability across colleges, even in places where schools had segregated housing for students who tested positive for COVID.

“Some are holding the isolation shelter for COVID, or for whatever infectious disease it might be needed for,” Mortenson says. “Others have completely given up their inventory.”

At Lake Forest College, Andrea Connor is working on housing logistics, and she says the school plans to help isolate students if they test positive for smallpox. They will also help students meet basic needs, including groceries 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] isolate yourself”.

In Ithaca, NY, at Cornell University, the campus health unit has published an online resource with information on monkeypox. The school is “developing testing, treatment and isolation protocols for those affected,” says Rebecca Valli, director of media relations. “We are also looking into potential academic impacts and accommodations that may arise.”

Students are concerned about the stigma of monkeypox

Because 99% of cases in the US involve male-to-male sexual contact, according to the WHO, there is a growing concern about stigma and prejudice against the LGBTQ community.

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

Student Liz Cortes, who co-directs the Queer and Trans Student Alliance at UT Austin, says she’s frustrated by the ongoing stigma and is waiting to see if the university will address it. If the school fails, “we would prioritize working with public health officials to provide accurate information and address misconceptions about the virus and our community,” Cortes tells 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 assembled a task force that includes representatives from the LGBT Resource Center. “We’re also consulting guidance from the Centers for Disease Control and Prevention on reducing stigma in monkeypox communication,” 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, don’t currently have the resources for testing.

Lake Forest students must go off campus to be tested at one of five nearby labs, Andrea Connor says. One of those labs is an STI clinic, and if a student is tested there, their insurance may bill it as a test for a sexually transmitted infection, even though monkeypox isn’t considered an STI, Connor says.

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

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

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