1. Purpose of Regulation

1.1 East Carolina University is committed to promoting the health and safety of all students, staff and faculty, as well as guests and visitors to our campus. Our ability to successfully provide a residential, in -person educational experience depends upon each member of the University community adhering to guidelines adopted for our collective health and safety. Each person as a responsibility to know and act in accordance with all applicable University guidelines and policies as referred to in our Return of Pirate Nation.

1.2 The guidelines provided by this Regulation assist campus health staff within Student Health Services (SHS) and campus administrators prepare for coronavirus disease 2019 (COVID-19) and related issues on campus. These guidelines and protocols are designed to provide prompt detection, as well as effective triage and isolation of potentially infectious individuals, in order to prevent unnecessary exposures within the campus community.

1.3 All members of the university community, including faculty, staff, students, families, visitors, and others must be vigilant in monitoring for symptoms of illness and protect others by staying home when they are feeling ill and following COVID-19 specific screening, exclusion and quarantine guidance, when appropriate.

2. Required Daily Screening by Students

2.1 Regular screening for symptoms and ongoing self-monitoring throughout the day can help to quickly identify signs of illness and help reduce exposure. All University students must carefully monitor their health every day. The following COVID-19 Monitoring Checklist must be considered each day before reporting in-person to any classes or activities at the University:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

This list does not include all possible symptoms, and symptoms may appear 2-14 days after exposure to the virus. Additionally, people with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Please review the CDC guidelines for updates to this list as we learn more about COVID-19.

2.2 Students, faculty and staff should self-monitor symptoms throughout the day. Students who develop symptoms during the day should notify SHS immediately.

2.3 Mobile Device Registration. Students can voluntarily sign up for a tool to assist with daily self-screening requirements through PiratePort and registration of their mobile device. If the screening process indicates COVID-19 symptoms, the student will be provided CDC Guidance regarding self-isolation and a referral to Student Health Services for evaluation, testing, and instructions on when to return to class or university activities. The tool does not maintain personally identifiable data regarding screening information entered by individuals, nor does the tool report responses to the University or any third party. It is merely a tool that will remind students of their daily obligation to conduct self-screening.

3. ECU Community Standards

3.1 Community standards have been established to promote the health of our students, faculty, staff and visitors. We fully expect that everyone on campus will understand and appreciate the critical impact of the COVID-19 pandemic and follow these standards. Our first and preferred approach to assure compliance with these standards will be through public health education and communication. If necessary, however, the University will institute applicable enforcement measures (including disciplinary, legal or other appropriate actions) to address certain violations.

3.1.1 Wash your hands often. Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place, or after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use a hand sanitizer that contains at least 60 percent alcohol. Cover all surfaces of your hands and rub them together until they feel dry

3.1.2 Practice physical distancing. Remember that some people without symptoms may be able to spread the virus. Keeping distance from others is especially important for people who are at a higher risk of getting very sick. Research has shown that transmission of COVID-19 can occur even when individuals are asymptomatic. The University guideline on physical distancing asks students, staff, faculty and visitors to stay at least 6 feet away from other people, whenever possible, in all indoor and outdoor settings. Additionally, individuals should avoid gathering in large groups and avoid crowded areas.

3.1.3 Wear a face covering. In accordance with the University’s Regulation on Face Coverings- Interim, face coverings must be worn in all settings, including classrooms, by students, faculty, staff, and visitors from entering the building to leaving the building and in indoor common spaces such as common building spaces and hallways. Face coverings must also be worn in outside areas when individuals are unable to social or physical distance.

3.1.4 Protect the ECU community. Individuals with COVID-19 symptoms or knowledge of exposure should contact their medical provider and not report to work sites, classes or come to campus (unless your primary residence is on-campus).

3.1.5 Engage in smaller group and virtual settings. Individuals and groups, including student and community organizations, should limit in–person programs, events and social gatherings to the number of individuals specified by national, state and local guidance. On-campus space reservations will be limited to those individuals and groups that abide by this guidance. 'The Reservations Office will enforce social distancing guidelines when honoring reservations requests."

3.1.6 Maintain clean spaces. Clean and disinfect surfaces that are frequently touched, such as your mobile phone, with CDC approved disinfectants.

3.1.7 Follow immunization recommendations. Individuals are encouraged (and may be required in certain circumstances) to remain current on their recommended immunizations that are covered by most health plans, including the annual flu shot.

3.1.8 Provide medical return clearance. Individuals who receive a positive COVID-19 test should provide a statement from their physician to their supervisor (for employees) or Student Health Services (for students) that they have concluded their requisite self-quarantine period and are without symptoms and/or have tested negative before returning to work or classes.

4. Testing and Quarantine/Isolation for Symptomatic or COVID-19 Positive Students

4.1 Student Testing

4.1.1 Testing within the campus community will be completed in accordance with CDC recommendations for those with symptoms, those who do not have symptoms but have come in close contact with someone who has tested positive, and/or those who are in a CDC-defined high-risk group.

4.1.1.1 The CDC does not currently recommend universal testing to inform admitting students or staff into school as viral testing only determines infection at the point in time the test occurs and may miss cases in the early stages of infection.

4.1.2 Certain students may be subject to specific testing requirements based on their affiliation with University activities, including but not limited to student-athletes (in compliance with any conference requirements), and students participating in clinical or experiential learning environments.

4.1.3 If a student tests positive for COVID-19 at another health care provider or facility other than SHS, students should let SHS know by voluntarily completing the COVID-19 Self Report Form, available on PiratePort.

4.2 Symptomatic Students

4.2.1 Students seeking testing, or experiencing symptoms of COVID 19, should be referred to Student Health Services (SHS) for evaluation and/or testing. All students that develop symptoms discovered through daily self-monitoring should contact SHS for evaluation for testing.

4.2.1.1 Students should notify SHS staff prior to or immediately upon arrival if they are experiencing symptoms of respiratory illnesses (cough, runny nose, fever). Additionally, if a university or college official becomes aware of an individual who has developed a fever and respiratory symptoms, appropriate campus health care personnel should be notified prior to arrival at the SHS so that infection control procedures can be implemented.

4.2.1.2 Students should also be aware there may be circumstances requiring additional reporting or screening requirements, including instances where students are participating in clinical environments, field placements, internships or experiential learning environments. Students should be familiar with and inquire about all necessary requirements applicable to their courses or programs.

4.3 Quarantine and Isolation

4.3.1 SHS will follow its procedures for triage, quarantine and/or isolation of students potentially infected with COVID-19. The procedures include evaluation for testing, isolation and quarantine, symptom management information, and coordination with campus administrators (including notification of faculty) to provide academic, residential, or healthcare support to students.

4.3.1.1 Specific student isolation and Quarantine procedures are provided by the Standard Operating Practice (SOP) implemented with this Regulation. Specifically, the Standard Operating Procedures for Symptomatic/PUI and COVID-19 Positive Students

4.3.1.2 This Regulation and any accompanying standard operating procedures will utilize the terms “quarantine” and “isolation” pursuant to CDC guidelines.

4.3.1.2.1 “Quarantine” is used when a person has potentially been exposed to an illness and needs to separate from other people to see if they develop symptoms and become sick.

4.3.1.2.2 “Isolation” is used when someone has symptoms or is confirmed to have an illness. Isolation may be mandated for anyone who tests positive and anyone deemed to be in close contact with a confirmed case.

4.3.2 A packet of information will be provided to the Student by SHS at the time of discharge regarding symptom management, anticipated communication schedule for monitoring, and any needed medications. Information will also be provided to the student about best ways of reducing exposure to other roommates, cleaning, and other steps to prevent further spread.

4.3.3 Notification of test results will be provided directly to the student via phone and/or email, within 24-48 hours after testing is processed or as soon as testing results are available.

4.3.4 For all students seeking testing or evaluation, including any other health treatment, identifiable health information will be maintained in accordance with applicable privacy laws.

4.3.4.1 Students should be aware that because COVID-19 is highly infectious, SHS is also required by law to report student identity to public health authorities.

4.3.4.2 For additional assistance with campus resources, students may execute a consent form to share information related to COVID diagnosis for use of academic and residential support.

4.3.4.3 SHS will share your identity with other professionals/administrators at the University strictly on a need-to-know basis to support your care during your recovery, as allowed by law. The University will share the minimum necessary information about suspected or confirmed COVID-positive cases with those departments and employees with a need to know in order to clean or disinfect facilities, and to provide academic, residential, or healthcare support to students.

4.3.5 If a student presents at SHS for suspicion of COVID-19 and undergoes testing, it could be 24-48 hours before results come back. ECU complies with currently recommended CDC, providing a cautious approach to persons under investigation (PUI) for COVID-19. During the interval between testing and results, the student is designed a PUI should be treated as a presumed/ “suspicious” positive and enter the quarantine plan provided by this Regulation and accompanying procedures.

4.3.6 Quarantine and Isolation Plan

4.3.6.1 All confirmed positive or PUI students should stay at home for the recommended quarantine and/or isolation period. Students should remain away from campus and all ECU activities until released to return to campus by SHS or their personal healthcare provider.

4.3.6.1.1 Notification of test results will be provided directly to the student via phone and/or email, within 24-48 hours after testing is processed or as soon as testing results are available.

4.3.6.2 All confirmed positive or PUI students should adhere to the quarantine plan until released by a medical provider.

4.3.6.3 If the student resides on campus. The University has secured alternative housing that will serve as quarantine and isolation accommodations for undergraduate residential students.

4.3.6.3.1 If a student tests positive and needs to go into isolation, and they reside in undergraduate residential housing, SHS will work with Campus Living to arrange for the student to potentially be placed in a semiprivate room in specific isolation area. This placement may include shared spaces with another student who has also tested positive.

4.3.6.3.2 If a student has been potentially exposed, is awaiting results, and needs to go into quarantine, and they reside in undergraduate residential housing, SHS will work with Campus Living to arrange for the student to move to a private room with a private bathroom.

4.3.6.3.3 During any use of alternative housing for isolation or quarantine, ECU Dean of Students (DOS), Campus Living and Campus Dining will coordinate to provide meal delivery and/or other related to student needs.

4.3.6.3.4 Roommate quarantine protocol is also implemented for all positive and PUI on-campus students, which includes quarantine processing for roommates with possible exposure.

4.3.6.4 During isolation for the infected student, SHS and DOS logistics will do daily checks to monitor symptoms, faculty advocacy, as well as provide assistance for other needs related to academics and campus life.

4.3.6.5 SHS will determine when the student is “released” and able to return to campus, in compliance with guidelines from CDC.

4.3.6.5.1 Current CDC Guidelines provide for release after:

• 24 hours with no fever; and

• Respiratory symptoms have improved; and

• It has been at least 10 days since symptoms first appeared
*** For persons who are severely immunocompromised, repeat test could be considered. For all others a repeat test strategy is no longer recommend except in rare instances.

4.3.6.5.2 These guidelines are subject to revision, as consistent with any CDC guidelines

4.3.6.6 When the student is released from quarantine or isolation, SHS will notify DOS to aid in communication to faculty and assist with other campus-based needs.

4.3.6.7 If the student does not reside on campus, SHS will arrange transportation for the student with the Dean of Students (DOS) Logistics Coordinator back to their place of residence or car that is parked on campus, in order to avoid public transportation and reduce any potential spread to the campus community.

4.3.6.7.1 SHS/DOS would still provide daily communication, symptom monitoring and faculty advocacy.

4.3.6.7.2 Students must be cleared by SHS or their own health care provider before they can return to campus for class or other activities. Students will be expected to provide documentation of a release to return from campus to SHS if they are cleared by their own healthcare provider to return to campus. The release to return must comply with CDC guidelines.

4.3.6.7.2.1 Current CDC Guidelines provide for release after:

• 24 hours with no fever; and

• Respiratory symptoms have improved; and

• It has been at least 10 days since symptoms first appeared
*** For persons who are severely immunocompromised, repeat test could be considered. For all others a repeat test strategy is no longer recommend except in rare instances.

4.3.6.7.2.2 These guidelines are subject to revision, as consistent with any CDC guidelines

4.4 Contact Tracing. SHS, with guidance from and in coordination with the local Health Department, conducts close contact tracing when students, faculty and staff test positive for COVID-19 as provided by the University’s Regulation on Contract Tracing. The county where the employee resides is responsible for contacting close contacts outside of the workplace/campus. SHS works closely with county health departments to identify these close contacts at the workplace/campus.

4.5 SHS Rapid Responses and Surge Care

4.5.1 In preparation for a possible surge event consisting of a high number of suspected or confirmed cases, SHS developed protocols related to the provision of care in the event COVID-19 becomes more widespread, creating increased health care demand. Actions under this surge plan could include:

4.5.1.1 suspending routine care to focus on care for COVID-19 patients and other acute care; and

4.5.1.2 telehealth (and telephone) capabilities to assess and treat patients.