Coronavirus Response

March 2024 CDC COVID-19 Guidance Changes

By

On March 5, 2024

In Uncategorized

The (Centers for Disease Control and Prevention) CDC has changed its guidance for non-healthcare workers/non-healthcare settings regarding isolation and masking during COVID-19 infection. Our Infection Prevention (IP), Employee Occupational Health & Wellness (EOHW), Occupational & Environmental Safety Office (OESO) teams want to clarify the impact on team members and patients by sharing the following information.

What does this mean for our team members?

Narrowed definition of patient-facing healthcare personnel (HCP) as follows: Personnel who directly interact with patients (i.e., you come within 6 feet of patients in your daily work) or personnel who work closely with colleagues who directly interact with patients.

Patient-facing HCP guidance:

  • No changes have been made to our current approach for patient-facing HCP with COVID-19 infection:
  • 5-day mandatory isolation then wear a well-fitting mask to complete 10 days after the first day of symptom onset
  • Must be fever-free for 24 hours without fever-suppressing medication AND symptoms are improving to return to work

Non-patient-facing HCP guidance:

  • Team member will self-determine their return-to-work date following these rules:
  • May not work while sick with fever, systemic symptoms, or severe symptoms (i.e. significant cough)
    Must be fever-free for 24 hours without fever-suppressing medication AND symptoms are improving to return to work
  • Upon return to work, the team member must wear a well-fitting mask while around other people to complete 10 days after the first day of symptom onset.

What does this mean for our patients?

  • The guidance does not apply to COVID-19 infected patients’ isolation precautions or duration of isolation while receiving care in inpatient or outpatient healthcare settings.
  • Transmission-based precautions (gloves, gown, eye protection, N95 or PAPR) should still be used by team members when caring for COVID-19 infected patients for the duration of isolation (10 or 20 days).
  • Patients with active COVID-19 infection should continue to wear well-fitting masks when visiting outpatient healthcare spaces or leaving their hospital rooms for required diagnostics/procedures/etc. for the duration of isolation (10 or 20 days).

A Reflection: The End of the COVID-19 Public Health Emergency

By

On May 11, 2023

In Uncategorized

On Jan. 31, 2020, the U.S. Department of Health and Human Services declared COVID-19 a public health emergency, launching what would become a three-year crusade against a new and dangerous virus. Across Duke Health and beyond, the pandemic created anxiety, fear and sadness, while also inspiring innovation, bravery and acts of kindness.

On Thursday, May 11, 2023, the pandemic comes to an official end with the revocation of the public health emergency. Dr. Cameron Wolfe, an infectious disease specialists who served on the front lines of care at Duke, reflects on all that has transpired over the past three years.

Changes to COVID Vaccination Requirements

By

On April 13, 2023

In Community Messages, For Faculty, For Staff, For Students, For Visitors to Campus

Dear Students, Faculty, and Staff,

After careful review of the medical and scientific data, we are changing our COVID vaccination requirements.

We have experienced a steady decline in the number of cases and severity of illness since the beginning of the year. This decline is attributable to two key factors: our community has about 95 percent immunity (through vaccination or previous infection) and weaker variants of the virus evolved that cause less severe illness. As a result, we no longer need to take some of the public health measures required earlier in the pandemic.

As physicians, we strongly recommend getting up-to-date vaccinations against COVID-19, especially for those with conditions that place them at higher risk. The vaccine is still one of the most effective ways of protecting yourself and others. However, we no longer need to mandate vaccinations and/or boosters as a public health measure for those working outside of the healthcare environment. Therefore, effective May 11–when the federal Public Health Emergency ends–current and new students, faculty and staff who do not work in a healthcare environment are no longer required to receive the primary or booster vaccinations. This change is consistent with our peer universities. We will also continue to offer the primary and booster vaccinations free of charge to all students, faculty and staff.

Duke Health–which includes the Duke University Health System, the School of Medicine, the School of Nursing, the Private Diagnostic Clinic, and Duke Health Integrated Practice–recently announced that its faculty and staff are still required to receive the primary series of the COVID vaccination (as required by the Centers for Medicare & Medicaid), but booster vaccinations are  no longer required now. All health science students will continue to follow the same protocols as Duke Health.

We will continue to monitor data and trends. Should any new variants or novel viruses emerge that may create a public health risk for our community, we will consider reinstituting protocols, including masking and required vaccination. And as a reminder, anyone testing positive for COVID should continue to report to Employee Health or Student Health, mask and isolate as required before returning to work, class or academic activities. For more information about the end of the vaccination mandate, including answers to common questions, please visit the Duke Coronavirus website.

Thank you.

Carol Epling, MD, MSPH
Executive Director, Employee Occupational Health and Wellness
Assistant Professor in Occupational and Environmental Medicine

John Vaughn, MD
Assistant Vice President for Student Affairs & Student Health Director
Associate Professor, Family Medicine & Community Health

Cameron R. Wolfe, MD, MPH
Professor of Medicine
Transplant Infectious Disease

Changes to COVID Protocols

By

On March 19, 2023

In For Faculty, For Staff, For Students, For Visitors to Campus, Testing & Reporting

Dear Students, Faculty, and Staff,

As we head into the home stretch of the academic year, we find our campus’ COVID risk to be far less serious than any time during the pandemic. During the last 18 months, we have seen immunity through vaccination or natural infection increase to about 90 percent of our population. This has led to a steep decline in cases and severe illness. As a result, we are making several changes to our COVID protocols.

  • Masking: Masking on Duke buses and vans is now recommended, but will no longer be required. Masks will be available on buses for those who request one. Masking is still required in all patient-care and clinical settings and for anyone who is symptomatic and around others, regardless of location or test results.
  • COVID Vaccination: Duke’s medical experts are currently assessing potential changes in the COVID vaccination policy given the increase in community immunity levels and decline in severity of illness. More information will be shared once decisions are finalized.
  • Surveillance Testing: The last two remaining surveillance test sites ended operation before spring break. Symptomatic testing will continue to be available on campus through Student Health or the Employee Exposure Hotline, 919-385-0431, option 1.  
  • Rapid Antigen Tests: At-home antigen tests are available through the Duke Stores’ Service Desk in the Bryan Center. One test kit per week is available at no charge to anyone with a valid DukeCard.
  • SymMon App: The SymMon app used for reporting symptoms or test results will be retired on April 3. Employees can use the My COVID Link to report symptoms or test results, and students should contact Student Health to do the same.
  • Student Case Management: Formal student COVID case management will conclude on Sunday, March 19. Going forward, students who test positive for COVID should isolate in place for at least 5 days from symptom onset andwear a mask when indoors or around others for 10 days. For nurse advice or to make an appointment with a medical provider, students can call Duke Student Health at 919-681-9355.

As has been the case throughout the pandemic, these changes are based on the data, trends and science. We acknowledge the possibility that a new COVID variant could change the current trends and require us to modify our approach regarding vaccination, masking and other safety protocols. We will continue to monitor and assess global and local data to determine if such changes are needed in the future. Anyone testing positive should continue to report to Employee Health or Student Health, mask and isolate in place as required before returning to work, class or academic activities.

Thank you for your ongoing support and collective efforts during these difficult years. Working together as a community, we have learned, adapted, and overcome so many challenges.

Carol Epling, MD, MSPH

Executive Director, Employee Occupational Health and Wellness

Assistant Professor in Occupational and Environmental Medicine

John Vaughn, MD
Assistant Vice President for Student Affairs & Student Health Director
Associate Professor, Family Medicine & Community Health

Cameron R. Wolfe, MD, MPH
Associate Professor of Medicine
Transplant Infectious Disease

Masking Strongly Recommended in Classrooms

By

On January 16, 2023

In For Faculty, For Staff, For Students

Jan. 16, 2023

Students, Faculty and Staff,

While the Centers for Disease Control and Prevention (CDC) classified Durham in the high-risk category again last week, we are seeing signs of declining trends at Duke and in the community. As a result, masking in classrooms and other indoor gatherings is strongly recommended but will not be required at this time.

Last week, COVID cases in Durham dropped by 40 percent, as did hospitalizations. With your support and preventive efforts, we have also seen our cases on campus drop more than 60 percent in the last week, even with a return to full campus activities. We believe these downward trends will continue and expect Durham to drop below the high community level soon.

Faculty members still have the option to require that students continue to wear masks in their classrooms if they wish to do so, and members of our community who choose to mask should be supported for their efforts to keep colleagues safe. As a reminder, masks are also required on all Duke buses and vans and in all patient-care settings.

In an effort to protect yourself and others around you, anyone who has flu-like symptoms should not go to class or work, should wear a mask, and should get a PCR test to confirm whether your symptoms are from COVID. Testing is available at Student Health or by reporting symptoms through the SymMon app or by caling the Employee Health COVID hotline at 919-385-0429, option 1.

It is also not too late to get a bivalent COVID booster, which is highly effective at reducing infection, reducing transmission and reducing the potential for severe illness.

These efforts will help mitigate further spread of COVID and other respiratory viruses on campus and in our community. Thank you.

Carol Epling, MD, MSPH
Assistant Professor in Family Medicine and Community Health
Executive Director, Employee Occupational Health and Wellness

John Vaughn, MD
Assistant Vice President for Student Affairs & Student Health Director
Associate Professor, Family Medicine & Community Health

Cameron R. Wolfe, MD, MPH
Associate Professor of Medicine
Transplant Infectious Disease

Take Precautions to Prevent COVID on Campus

By

On January 9, 2023

In Duke University, For Faculty, For Staff, For Students

January 9, 2023

Students, Faculty and Staff,

As the spring semester gets underway, we want to strongly encourage anyone with flu-like symptoms to wear a mask indoors and in gatherings with others.

We are seeing an expected surge in COVID and other respiratory illnesses following the holidays and new variants that are proving to be more contagious. In many cases, individuals have tested negative for COVID using a rapid antigen test only to test positive later. Home tests are reliable when positive but may render a false negative result for several days after symptom onset. This means you could be infecting others during your most contagious phase of illness.

Due to increased cases in our community, the Centers for Disease Control moved Durham to its “high risk” category last Thursday. If Durham remains at high risk for two consecutive weeks, we will return to mandatory masking in classrooms until the rating drops below high risk. Faculty members still have the option to request that students continue to wear masks in their classrooms if they wish to do so.

If you have flu-like symptoms, you can get a PCR test at Student health or Employee Health to confirm whether your symptoms are from COVID or submit a symptom report through the SymMon app or by calling the Employee Health COVID hotline at 919-385-0429, option 1.

For those who are not experiencing symptoms, you can get a PCR test at two locations on campus or pick up a rapid antigen test at no charge with a DukeID through Duke Stores in the Bryan Center.

We also want to encourage anyone who has not yet done so to get your influenza vaccine or bivalent COVID booster. These vaccines are among the best ways to protect yourself and others from severe illness.

Thank you and best wishes for a safe and healthy spring semester.

Carol Epling, MD, MSPH
Assistant Professor in Family Medicine and Community Health
Executive Director, Employee Occupational Health and Wellness

John Vaughn, MD
Assistant Vice President for Student Affairs
Director of Student Health Services

This message was sent to all students, faculty and staf within Duke University.

COVID Safety Protocols for the Spring Semester

By

On December 7, 2022

In Duke University, For Faculty, For Staff, For Students, Testing & Reporting, Travel Updates

Dear Students, Faculty, and Staff,

As we enter the holiday season, we want to share some important guidance related to the safety of our community.

First, in addition to COVID, there are a number of respiratory viruses with similar symptoms circulating in our area. If you have symptoms or a known exposure to any respiratory virus (including COVID), please be considerate of others and wear a mask indoors and when in close proximity to other people.

If you have symptoms, you should also get a COVID test rather than assume you have a cold or allergies. A negative at-home antigen test, especially during early onset of symptoms, does not rule out the possibility of COVID. If you have symptoms, you can get a PCR test at Student Health, Employee Occupational Health & Wellness, or another healthcare provider to confirm whether your symptoms are from COVID.

These steps will help greatly in our efforts to reduce the transmission of infectious viruses that contribute to missed classes for students and faculty, as well as staffing shortages for Duke’s campus and clinical operations.

International students and others who need proof of a negative COVID-19 test to travel to their home countries can get a PCR test at one of the on-campus test sites, which are open Monday through Thursday from 9 a.m. – 4 p.m. Please inform the staff at the test site that you need an “exit test” rather than a surveillance test. A link to the test results will be sent by email or text within 24 hours.

In addition, we have established the following guidelines for the spring semester:

  • All students should get a negative COVID test before arriving on campus, preferably within 72 hours of arrival. Test results are not required to be submitted to Duke, but participation is considered as part of the Duke Community Standard.
  • Any student who tests positive should contact Student Health and delay their arrival until cleared by Student Health.
  • Duke will continue to offer limited surveillance testing for asymptomatic students, faculty and staff until Friday, March 10, 2023. The following two test sites will be available from 8:30 a.m. – 3:30 p.m. Monday through Thursday until that time:
    • Washington Duke Inn
    • Levine Science Research Center (LSRC)
  • While asymptomatic testing on campus will end March 10, 2023, testing will continue to be available for those who have symptoms as needed at Student Health or by calling the COVID Hotline at Employee Health (919-385-0429 option 1).
  • In addition, Duke will be securing at-home antigen tests that will be available through the Duke Stores’ Service Desk in the Bryan Center. One test kit per week is available at no charge to any student, faculty or staff member with a valid DukeCard. 
  • Masks will be required on Duke buses and vans for the beginning of the spring semester and will be reassessed later in the semester based on case rates in the community.
  • Due to influenza, RSV and the circulation of other respiratory viruses, masking indoors is strongly recommended for anyone with symptoms, regardless of test results for COVID. Masking also provides a measure of additional protection for individuals who wish to avoid infection by any of the circulating respiratory viruses, so please respect the right of others to mask.

We have had some clusters of COVID in recent weeks from people not masking after a known exposure or a false-negative at-home antigen test. Our hope is to limit such events so that we can embrace a richer and more engaging time together when we return after the holidays. Until then, be safe and enjoy the holidays with friends and family.

Thank you.

Carol Epling, MD, MSPH
Assistant Professor in Family Medicine and Community Health
Executive Director, Employee Occupational Health and Wellness

John Vaughn, MD
Assistant Vice President for Student Affairs
Director of Student Health Services

This message was distributed to all Duke University students, faculty and staff. 

Guidance on Holiday Parties, Gatherings and Travel

By

On November 9, 2022

In For Faculty, For Staff, For Students, For Visitors to Campus, Travel Updates

The following memo was sent to Duke University leaders and managers on Wednesday, Nov. 9, 2022.

TO:       Vice Presidents, Vice Provosts, Deans, Directors, Department Heads, and Managers

FROM:  Carol Epling, MD, MSPH, Executive Director, Employee Occupational Health & Wellness

Matthew Stiegel, Ph.D., Director, Occupational and Environmental Safety Office

RE:       Guidance on Holiday Parties, Gatherings and Travel

As we approach the holiday season, we are closely monitoring new COVID variants that are beginning to gain ground across the U.S., as well as increasing reports of influenza and other respiratory viruses such as RSV. This is a particularly concerning trend as many people plan to travel to other parts of the country and gather with friends and family during the holidays.

We are all ready to return to more normal activities, but we must remember the pandemic is still with us and poses a dangerous threat to many, especially those who are immunocompromised. The most important action we can all take is to get vaccinated for the flu and receive the updated bivalent COVID booster, which not only protects us from severe illness but also our friends, family, and colleagues. We strongly encourage everyone to get a free COVID booster and flu vaccine at one of our on-site clinics or at any other healthcare provider before traveling for the holidays.

While the University allows workplace holiday gatherings, we encourage people to follow safe practices to help reduce the potential spread of respiratory viruses currently circulating. These include practicing good hand hygiene and wearing a well-fitting mask when in close quarters with others unless actively eating or drinking. Outdoor events present a much lower risk for COVID transmission.   While the weather may not be as accommodating in colder months, heated outdoor spaces can be found. Most importantly, if you are sick or have any respiratory symptoms, do not attend gatherings with others.

During the last two years, we have seen staff shortages due to an increase in COVID cases directly related to travel during the holidays. For those traveling using mass transit (airplanes, buses, trains, etc.) during the holidays, we suggest wearing a well-fitting mask to reduce your risk of infection and the risk to others. We also suggest you consider recent exposure before gathering with others, especially those who may be at higher risk for severe illness or complications, and getting a test beforehand.

As we enter the holiday season, we are already in the midst of a surge of flu and RSV. We can take steps to reduce our individual and community risk by continuing to follow these guidelines. Thank you for your ongoing leadership, support, and efforts to keep everyone safe during this critical time.  

Masking Optional in Classrooms Beginning Sept. 22

By

On September 16, 2022

In Duke University, For Faculty, For Staff, For Students

Sept. 16, 2022

Dear Students, Faculty, and Staff,

As communicated earlier, Duke’s masking policy will be guided by the community risk category as determined by the Centers for Disease Control and Prevention. On Thursday, Sept. 22, Durham will have been below the high-risk category for two consecutive weeks, so beginning that day masking will become optional in classrooms.

We recommend that anyone experiencing cold-like respiratory symptoms, even after a negative COVID test, continue to wear a mask indoors until symptoms resolve. Unvaccinated individuals, who are at increased risk for severe illness, are encouraged but will no longer be required to wear masks indoors beginning next Thursday. Please note that any individuals who feel more comfortable continuing to mask should do so and all members of the community should respect the rights of those who wish to remain masked. 

Faculty members may request that students continue to wear masks in their classrooms if they wish to do so. In such cases, faculty should clearly communicate those expectations to the class. Masking helps protect the masked individual, even in the presence of those who are unmasked, so those with concerns – faculty or students – should continue to wear a well-fitted mask in class.

Student who have tested positive or have COVID symptoms should not attend class until they have tested negative or been cleared by Student Health to return. Faculty will work with students to navigate any missed classes.

Masks will continue to be required on Duke buses and vans and in all clinical settings until further notice.

The best precaution you can take now is to get the new bivalent COVID booster, which protects against transmission from the current variants now in circulation. Appointments are being added to the COVID Vaccine website as supply becomes available. Boosters may also be available at your medical provider or local pharmacy.

Medical experts caution that we are not out of this pandemic yet, and we can expect ongoing variants to emerge that may prove more elusive to vaccines and antibodies and could lead to increases in severe illness and hospitalizations. If so, we must be ready to embrace a return to familiar restrictions and requirements, including indoor masking, that have proven effective in safeguarding our community.

But for now, as we take this next step towards more normalcy on campus and in classrooms, we are grateful for the efforts of all members of the Duke community that have allowed us to continue the work of the university throughout the pandemic.   

Sally Kornbluth, Ph.D.

Provost and Jo Rae Wright University Professor

Russell Thompson,

Interim Vice President, Operations,

Emergency Coordinator

New Omicron COVID Booster Shots Available

By

On September 8, 2022

In Duke University, For Faculty, For Staff, For Students

Sept. 8, 2022

Dear Faculty, Staff and Students,

Duke is beginning to offer the newly reformatted booster shots of the COVID-19 vaccine that provide greater protection against the omicron variant of COVID, including the BA.4 and BA.5 subvariants currently in circulation in our community and across the country.

The bivalent booster shots were approved by the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention last week for individuals who have had the initial series of the vaccine. The Pfizer booster is available to those ages 12 and older, and the Moderna booster is available to those 18 and older. Those who recently received an initial vaccine shot or a booster should wait two months before getting the new booster, and anyone who recently tested positive for COVID should wait 90 days after the onset of symptoms or a positive test.

Appointments are available through the Duke COVID Vaccine website for eligible students, faculty and staff. Appointments will expand as Duke Health receives additional shipments of vaccine throughout the month. But individuals should also explore other vaccination options such as local pharmacies or their healthcare provider.

We strongly recommend the bivalent booster shot for those who are eligible to help provide individual protection against severe illness and limit the potential for the broader community spread we typically see during the fall and winter months.

If you have waited to get a booster shot, this is the time to get it. Broad vaccination with this new booster can make a significant difference in finally getting to the other side of this pandemic. Thank you. 

Carol Epling, MD, MSPH
Executive Director, Duke Employee Occupational Health & Wellness

John Vaughn, MD

Assistant Vice President for Student Affairs,

Director of Student Health Services

Gail Shulby, RN, MA, CPPS
Chief of Staff to the Executive Vice President, Duke Health

Cameron R. Wolfe, MBBS (Hons), MPH, FIDSA
Associate Professor of Medicine, Infectious Diseases, Duke Health

Co-Leaders of the COVID-19 Vaccination Planning Work Group

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