By now, many of the facts are widely known: three students hospitalized for confirmed meningococcal infection in a period of days; numerous other students evaluated in the Student Health Service and the Emergency Room, some admitted to the hospital for observation and empiric treatment pending test results; upwards of 3,000 students dispensed preventative treatment; measles; ongoing communications and updates to students and the broader university community; one very tired Health Service director.
Against this backdrop of well-publicized events comes a welcome invitation from the DP to explain the actions and decision-making processes that the Student Health Service, University and the Health System took in response to this urgent situation. The most important message is that all of the students who were treated for meningococcal infection are out of the hospital and that we have no evidence of ongoing transmission or new cases.
Anticipating and planning for a public-health emergency - whether a single student with meningitis, an outbreak of Norwalk virus or some other mass illness - is something that all college health-service directors do. We operate in a state of continued emergency preparedness; we plan and drill for crises, and we activate our disaster responses more frequently than you might imagine. While the scale of this event was greater than we usually see, past experience with public-health emergencies guided the decisions that were made over the last two weeks.
While it may have seemed that one step followed another, there were several categories of responses and many actions overlapped with one another. One set of actions was to assess the status of affected students, make sure that families were notified and coordinate any support that they needed from the University and notify University administration about a possible significant event. Another task was to confirm the diagnosis, gather necessary clinical details and identify close contacts that might need preventative care and support. A third item was to consult with appropriate authorities to determine what infection control measures should be employed, including the Division of Disease Control in the Philadelphia Department of Public Health and the departments of Infectious Diseases and of Healthcare Epidemiology and Infection Control in the Hospital of the University of Pennsylvania. These actions provided the framework for consultation with University administration and Hospital to finalize infection-control measures and to develop the plan for both implementation of measures and for communication to affected populations and the larger campus community.
The logistical challenges of these actions cannot be overemphasized. We had to identify where and when clinics would be offered, who would staff these clinics, procure supplies, develop processes to move students through the clinics as efficiently as possible, determine how and where to evaluate students with possible symptoms and develop systems to document the assessment and care of all students requesting treatment. We also had to answer concerns of students about whether they needed treatment or assessment, provide updates to the university community including parents and notify colleagues in other institutions whose students might have been exposed.
We are - hopefully - at the end of this event, and I am still astonished at the tremendous response by the University. It took the combined efforts of the Student Health Service staff along with invaluable assistance from the Office of the Vice Provost for University Life, the Department of Fraternity and Sorority Affairs, the Office of the Provost, the Division of Public Safety, the Philadelphia Department of Public Health, the Hospital of the University of Pennsylvania and many others in the administration to accomplish what we did. No single person could have put this effort together; every individual was integral to its success. We appreciate the coverage by The Daily Pennsylvanian for helping to get the word out with timely and accurate information. Special recognition is due to the members of the Medical Emergency Response Team (our heroes in this) who staffed every clinic that we hosted.
Finally, we thank the students whose cooperation, compliance and appreciation made the mass clinics flow smoothly. As in any crisis situation, we are now evaluating the success of our efforts and considering areas for improvement. We welcome your comments and feedback. We hope that it will be a long time before we need to reactivate this particular emergency plan, but if and when that happens, we expect to do even better.
Evelyn Wiener is the director of Student Health Service. Voices of the Administration is an occasional series offering the perspective of Penn administrators on an issue currently relevant to the University community.
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