Coronavirus, Exclusives

How Student Providers Are Leaders in the COVID-19 Response On College Campuses

University of Vermont ambulance
A University of Vermont ambulance. (Photo/Ryan Wiklund)

The COVID-19 pandemic has challenged the emergency medicine community to unprecedented extent. Beginning in March of 2020, the United States emergency medical system was met with marked increases in novel COVID-19 cases presenting to emergency departments. The plethora of challenges brought about from the outbreak volumes and procedural demands allowed for many lessons to be learned as we look at a second wave of COVID-19.

It is imperative that higher-education institutions collaborate with on-campus EMS squads as the value that these student providers afford range from assisting with contact tracing to educating their peers on best practices to prevent virus transmission.

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Not to the surprise of many, a rise in COVID-19 cases throughout March and early April of 2020 correlated with a spike in emergency medical services (EMS) calls to service the viral illness. Moving forward, continued adherence to best practices for infection prevention is crucial to prevent future spikes in disease incidence. College campuses, with concentrated populations and dormitories are expected to be hot spots for COVID-19 re-emergence as we “open up” the country. College EMS providers should prepare to serve their communities in the fall and beyond.1

The stay-at-home directive issued to millions of Americans has led to remote work and schooling environments.2,3 As a result, this closure of on-campus operations aided with mitigating transmission of COVID-19 in these higher risk environments that have close contact among students and staff in classrooms, laboratories, dinning facilities and social spaces.

It is imperative to encourage student providers, medical directors, and those involved with EMS operations to continue sustained contact despite their physical distance and use remote modalities of communication. Before the pandemic, many campus providers across the nation had already had robust direct communications to their peers through platforms such as Facebook, Twitter, and Instagram and are well versed in remote meeting and educational platforms such as Zoom and Google Meet. However, the absence of in-person contact compounded with a lapse in social media outreach would hinder these squads’ ability to continue their unique relationships and trust networks on campus. Therefore, using technologies such as Instagram or Twitter, college EMS services can continue to maintain their presence in the campus community as they seek to not only promote educational outreach, but also, to facilitate meaningful engagement with peers during remote operations. Though this social media outreach aids with the COVID- 19 response, it is a component of a larger call-to-action that squads need to embrace.

An additional role of these student leaders will be to work closely with their college administrators that are spearheading the transition to campus action plans. University staff will appreciate the immense benefit that these EMS squads have garnered among students through continued outreach during the pandemic. The respected voice of college EMS squads can aid with the lack of compliance that many universities are concerned with addressing based on preliminary studies. A Stanford University study noted that college aged individuals are disproportionately defying the public health recommendations compared to other age demographics.6 If college EMS squads are successful using these platforms to remain viable, this can provide lessons learned for more general emergency services continuity disaster planning.

College EMS providers also need to stay up-to-date on the latest in COVID information. Using the Prodigy EMS platform, the National Collegiate EMS Foundation (NCEMSF) has provided free continuing education for college EMS providers, many of whom are unable to access continuing educational through their usual routes on campus.4 Recent sessions have focused on COVID, but future ones may focus on other topics to keep college EMS providers ready to report to duty in the fall.

Though many college EMS squads  were not in operation this spring, social media networks continued to serve as ways to share information and ideas on how they can be relevant to their communities. The abundance of social media postings on platforms such as Instagram, Facebook, and Twitter should be highlighted and encouraged going forward as a way to share information and ideas. For example, NCEMSF has highlighted efforts from collegiate EMS squads across the nation that have taken advantage of social media outlets during the pandemic.4,5 The foundation’s social media pages highlight dozens of squads such as Virginia Tech Rescue Squad and the University of Delaware EMS that are resiliently stewarding campus educational engagement at this time. In a few cases, squads are epitomizing their missions of service vis-à-vis remaining in operations despite the closure of many campuses and the spike in caseloads from the crisis. In other cases, even if their college EMS service is not operational, local volunteer EMS squads have quickly onboarded college EMS providers.

The college-aged population is particularly important to reach with public health messaging because this population has been viewed as least likely to comply with social distancing guidelines and therefore at risk of serving as silent spreaders. A recent 2020 study noted that more than 50% of those surveyed between the ages of 18 and 31 years old noted that they were not complying with the social distancing and stay-at-home orders. Reaching this population now is challenging given the fact that these individuals are currently spread out from their universities due to the pandemic. However, starting right now, we need to call for campus EMS providers to make of their pre-existing peer relationships and trust as medical providers and leverage their social media, text messaging and video chatting faculties to provide targeted peer education initiatives to combat mis-information and non-compliance from the college-aged population.

As we begin to “open up the country,” the persisting need for public health educational outreach about social distancing and preventing disease transmission is an imperative initiative to prevent clusters and outbreaks of illness. College campus EMS squads are particularly a valuable asset for COVID-19 outreach on campuses. These volunteer organizations are staffed by students themselves, highlighting the dual roles many volunteer EMS responders have as both medical professionals and peers in their communities. College EMS personnel can use their existing relationship with many of their peers to serve as public health stewards on their campuses. They can have myriad positive impacts through remote mediums of influence. EMS providers can engender a unique level of trust that physician and government and academic public health officials may be unable to garner. Perhaps the college EMS peer education process can serve as a model for non-college volunteer EMS providers to serve as peer educators in their own communities?

“Opening up” college campuses is a tricky proposition due to campus density and prolonged close contact within this population. College EMS squads are well suited to perform campus disease surveillance as campuses re-open. We must call for college EMS leaders to immediately begin to work with college health and emergency management leadership to create and implement an actionable comprehensive processes use EMS call data to identify COVID cases and clusters, which can be used to trigger contact tracing and isolation to prevent outbreaks on campuses.

The unprecedented circumstances that have shifted the daily routines of every American should be met with communal support. Particularly, we should commend the resilience, dedication and civic engagement of frontline college EMS personnel. Looking forward, there is a lot more work to be done as the pandemic response shifts towards disease mitigation on college campuses. As the country “opens up,” the college EMS community must be prepared to play a significant role to promote outreach and response efforts that mitigate transmission of the virus.

References

1. Galvin, G. (2020, June 10). Student EMS Groups Prepare for Coronavirus to Hit College Campuses. Retrieved from https://www.usnews.com/news/healthiest-communities/articles/2020-06-10/student-ems- groups-prepare-for-coronavirus-to-hit-college-campuses.

2. Sen S, Karaca-Mandic P, Georgiou A. Association of Stay-at-Home Orders With COVID-19 Hospitalizations in 4 States. JAMA. Published online May 27, 2020. doi:10.1001/jama.2020.9176

3. Murakami, K. (2020, April 13). Public colleges face looming financial blow from state budget cuts. Retrieved from https://www.insidehighered.com/news/2020/04/13/public-colleges-face-looming- financial-blow-state-budget-cuts.

4. National Collegiate Emergency Medical Services Foundation (NCEMSF). NCEMSF CME Event: Social Distancing Learning for the Collegiate EMS Provider. https://www.facebook.com/NCEMSF/posts/2893105037409244.

5. NCEMSF Home Page. National Collegiate Emergency Medical Services Foundation. https://www.ncemsf.org/.

6. Toledo A. Stanford University: Majority of young people ignored social distancing orders, new survey suggests. The Mercury News. https://www.mercurynews.com/2020/04/14/stanford-university-majority-of- young-people-ignored-social-distancing-orders-new-survey-suggests/. Published April 15, 2020.