Why are our COVID safety strategies different than fall 2020?

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It’s highly likely that the adjective most frequently paired with the word “pandemic” in the past 19 months has been “unprecedented.”

More than 100 years has elapsed since the world stared down a menace of the magnitude of the Spanish Flu, and in that time much has changed. Certainly, basic standards of public health, our understanding of communicable diseases and access to health care have improved dramatically. Likewise, so did human mobility and with it the virus’s ability to leap on a plane and travel across the world in hours rather than months.

Public health experts and medical specialists had no unique knowledge of SARS-CoV-2, the virus that causes COVID-19, in March 2020. They did have an arsenal of time-tested strategies to mitigate the spread and severity of airborne viruses, and few were shy about deploying them all in the early days to “flatten the curve.”

If you were here at UAB this past spring, you saw them: classes postponed, residence halls emptied, many labs shuttered, most workers sent home, cancellation of elective medical procedures, plus masking and social distance requirements, followed shortly by drive-through testing, sentinel testing, daily HealthChecks and temporary remote-work agreements. All in the prudent pursuit of safety.

UAB faculty and staff also developed novel tools to capture data that the experts could use to develop and evaluate the most effective safety strategies and promote well-being. 

Yet, the pandemic continues. Why, then, have we changed those strategies from one fall to the next? In one word: data. We didn’t know then what we know now. Here are five things to consider:

exclamation mark and question mark balancing on a corona virus in front of colorful background - 3d illustration

Public health and infectious disease experts drive our decision-making. 

In the beginning, the scientific community was racing to answer questions about the virus: Can it be aerosolized? How far can it spread, and how long does it linger in the air? How long can it survive on hard surfaces? How much of the virus is needed to infect a person?

UAB erred in favor of safety, and its initial response was to limit the campus presence to only the most essential employees and convene its public health and infectious disease experts to develop a modified business model for the next 15 months.

“UAB is fortunate to have leading experts in these fields whose knowledge and experience enabled us to launch a quick, science-based response to mitigate the early spread of COVID,” said UAB President Ray Watts. “This team has worked continuously to review the data as it becomes available, and we look to them to recommend and update strategies to promote safety throughout our campus and community.”

More data enhances our efficacy.

In the months since the pandemic began, public health databases, our patient experiences and research conducted here and elsewhere provided COVID-specific data to guide decision-making. That data enabled UAB to resume in-person classes and safely return its employees to campus while minimizing risk.

“Our experts have been able to better assess community risks and the effectiveness of our early mitigation strategies and refine them consistent with the science and the incidence of disease,” Watts said. “UAB leadership has made the recommended changes as circumstances evolve. This is the promise we made to you and will continue to keep.”

Close-up of a button that reads "#UABUNITED - I WEAR MY MASK FOR YOU" over a stack of instructions for how to wear and clean cloth face masks at a mask distribution drive-thru in Express Lot No. 4 during the COVID-19 (Coronavirus Disease) pandemic, August 2020.

The most effective safety measures are in place.

Even when we pause the use of a strategy, it is not lost to us. It’s always within reach on the shelf. But science and the social needs of people mean that outbreaks must be managed locally, says epidemiologist Suzanne Judd, Ph.D., professor in the UAB School of Public Health and a key adviser on UAB’s COVID-19 Incident Command Committee. “We certainly pay attention to what is happening in, say, Wyoming; but we need to take action based on what is happening in our own community.” 

In 2020, Judd says, keeping people apart was the simplest response; but now that we know that “not a single case of COVID transmission has been linked to UAB classrooms in which people were masked,” it is possible — and preferable — to meet in person. “People want to get back together to learn, to study, to socialize,” she said. 

In her professional opinion, UAB is observing the most effective precautions against the disease and its spread:

  • Masking when indoors continues to provide the single best protection against COVID after the vaccine.
  • Testing is available for all symptomatic students and employees and those who experience close-contact exposures.
  • For-cause testing is required for unvaccinated employees who have been in an environment in which an outbreak occurs.
  • Isolation suites are available for students who test positive to reduce the risk of spread in the residence halls and classrooms.
  • Individuals who are actively experiencing COVID symptoms are encouraged to stay home and get evaluated by Employee Health, Student Health or their own health care provider.
  • Written guidance is centralized on the UAB United website and is updated as situations dictate.
  • And free vaccines are available on campus all day Monday through Friday for anyone who wants them.

In stressful times, balance is important.

At the onset of the pandemic, UAB launched every reasonable weapon in the public health arsenal. UAB also engaged its technology experts to help devise the fastest and most reliable way to gather information about the incidence of disease and exposure within the UAB community and quickly connect them with student and employee health services. The Guidesafe platform and UAB HealthCheck — and UAB-made test kits — were key innovations that enabled UAB and other campuses throughout Alabama safely to return to in-person classes in fall 2020.

“Public understanding of and compliance with COVID safety measures have improved in the past year, and the vaccine now can provide essential protection for the majority of our faculty, staff and students,” Judd said. “Combined, these enable us to scale back the required daily HealthChecks, except where required by federal regulations, and lean on safety strategies that are most effective while still respecting time and effort required by our employees and students. The same is true for the weekly sentinel testing, which was an early tool to help understand asymptomatic rates of transmission. Now that we know asymptomatic transmission rates are very stable, we can rely on less invasive and less costly measures such as for-cause testing.”

3D rendering Futuristic design of Virus exploding, Destroy The Coronavirus

Individuals are really in control.

 Judd also points out that one thing we have in 2021 we did not have in 2020 is individual knowledge of the measures needed to protect ourselves: how to mask properly and wash our hands, the right amount of distancing needed in group settings and a vaccine to protect against severe disease. 

“The vaccine,” she said, “is a game-changer. It is the easiest to administer and the most successful defense against COVID-19.”

Other safety measures will work, and if all things were equal, they could be as effective as the vaccine, she says. “We saw that in China last year. Aggressive lockdown stamps out the virus but completely removes social freedoms. And not everyone follows the rules. The vaccine, on the other hand, is as effective as all other safety measures combined and does not require vigilance or enforcement,” she said.