Keeping our campus healthy in the age of COVID-19
Managing Our Public Health Protocols
Messiah University’s Engle Center is responsible for guiding the University’s public health protocols. As such, the Engle Center maintains close and effective connections to our local health department and our local healthcare system so that we have the guidance, support and resources necessary for navigating the current pandemic matters as effectively as possible.
Messiah University via the Engle Center is registered with both the Center for Disease Control and the PA Department of Health to receive regular updates and guidance for institutions of higher education and we routinely monitor their websites for new and time-sensitive updates. In addition, the Engle Center has a solid working relationship with the Cumberland County Department of Health (Carlisle Office) and over the past several years, this office has become very familiar with the operations of the Engle Center. They provide guidance on matters related to contact tracing, isolation and quarantine as well as assist us in monitoring COVID-19 within our region.
In addition, members of the Integration Team routinely monitor the Pennsylvania Governor’s site (https://www.health.pa.gov/topics/disease/coronavirus/Pages/Coronavirus.aspx) to make sure that our plans comport with the state requirements and changes in state guidance for schools, colleges and universities.
The online COVID-19 Dashboard serves as a record of Messiah University's COVID-19 campus status for the spring semester, and will be updated each weekday by 5 p.m., beginning on Jan. 4, 2021.
Personal Protective Equipment (PPE)
All students and employees will be expected to consistently wear masks. Everyone is expected to acquire their own cloth masks so that masks can be maintained in a clean and useful fashion. Bandanas and scarves are not acceptable for masks. Students who wish to substitute a face shield for a mask must seek a medical exemption through the Engle Center. The University will provide disposable masks in areas where routinely applying a new mask may be most appropriate.
Certain departments (such as the Engle Center, the Department of Safety, Residence Life, and Campus Events) will have additional PPE requirements necessary for preventing the spread of the virus. The university has developed a centralized Personal Protective Equipment (PPE) ordering and distribution process. All areas on campus reported their anticipated PPE needs in order to assist with ordering. Bulk orders are being placed for equipment and supplies and will be stored at the Lenhert building. As areas need PPE, they will use the OneSource/Unimarket system to “order” the necessary supplies from the inventory. Their order will be filled and they will pick up their order at the Lenhert building.
The Engle Center
The Engle Center functions as a full-service medical center/urgent-care center, right in the middle of campus. Undergraduate students who have chronic medical conditions see the nurse practitioner, who helps to regulate their medications, orders tests and coordinates with home health care providers and specialists. Those who have urgent health care needs such as abdominal pain or cough can often be seen the same day. The Engle Center is equipped and practiced in ordering, scheduling and following up on radiology tests such as chest x-rays and CT. The center also offers 12 lead EKGs, rapid strep tests, rapid flu tests, mono tests, phlebotomy, immunizations, a full service travel clinic and many more services, such as suturing and medication supervision.
The Engle Center is equipped with in-house medication, including common antibiotics. In addition, the center maintains a relationship with a local pharmacy that delivers directly to the Engle Center so that students never need to leave campus for a prescription.
The Engle Center’s primary care provider is Betsey Miller, MSN, FNP-C, Certified Registered Nurse Practitioner. In the state of Pennsylvania, nurse practitioners are recognized as primary care providers. They may diagnose medical conditions, develop and implement treatment plans, order and perform diagnostic tests, prescribe medications, and deliver other health care services, pursuant to a written collaborative agreement with a licensed physician. The collaborative agreement must address the availability of the physician to the nurse practitioner through direct communication or telecommunication, a plan for emergency services, and the physician’s regular review of the charts and records of patients under the nurse practitioner’s care. Betsey’s collaborating physician is Dr Kenneth Harm, MD, and they’ve worked together has primary care partners for over 22 years. Dr. Harm is retired from Good Hope Family Physicians, but remains on staff at Claremont Nursing Home in Carlisle and also remains active in medical work through humanitarian relief efforts. He is available to the Engle Center for consultation at any time by text, email or telephone. In addition, he is available to the Engle Center as backup and has agreed to assist the Engle Center in seeing patients if at any time during the COVID 19 crisis patient volume warrants additional appointment availability.
Our Nursing Staff
The Engle Center is staffed with seven outstanding, highly skilled, registered nurses. All are Bachelor’s prepared and one is Master’s prepared. Four of these nurses have been credentialed through the ANCC in ambulatory care nursing, showing an advanced level of specialization. The nurses see University students on “standing orders.” This means that they are able to see students independently for things like upper respiratory infections, urinary tract infections and other basic concerns. By following predetermined guidelines and protocols, they are able to assess, diagnose and treat upper respiratory infections, sinus infections, ear infections, etc. Health concerns that fall outside of the standard protocols are referred to the nurse practitioner. In this way, more students are able to be seen and the nurses’ full skill sets are best utilized. There is a 24 hour after-hours on-call service that students can call when immediate medical advice or recommendations are needed.
The Engle Center's role in Messiah's response to COVID-19
The Engle Center has been “ground zero” for Messiah University in our fight against COVID-19.
The center has been restructured in order to reduce the risk of spreading COVID-19. Counseling Services and our Dietician have been temporarily relocated to Climenhaga Homestead, as they see medically “well” patients, who should not be entering the physical space of the Engle Center while COVID-19 patients may be present.
Health Center patients have also be separated into two sides of the building: respiratory patients from non-respiratory. There has been a complete re-routing of the building, with separate entrances so that health concerns such as skin infections do not enter the Center at the same time and location as potential COVID-19 cases. Additional steps for reducing exposure have included:
- Temporary discontinuation of self-scheduling via the online portal
- A screening area just inside the door of the well area will be provided so no one with symptoms can proceed past the front area
- A chair/waiting area with awning provided outside of the entrances
- Signage provided outside with clear directions for sick/well
- Waiting room areas limited with minimal seating (3-4 chairs max) with hard surfaced chairs; chairs spaced at least 6 feet apart.
- A triage nurse schedules and runs an advice line as well as screens all patients prior to entry into the building.
Telehealth for Students
In addition, the Engle Center is prepared to reduce the risk of exposure by facilitating a telehealth option for students. Telehealth services help provide necessary care to patients while minimizing the transmission risk of COVID-19 to healthcare personnel and patients. Recent policy changes during the COVID-19 pandemic have reduced barriers to telehealth access and have promoted the use of telehealth as a way to deliver acute, chronic and primary care. Telehealth has also been shown to improve patient health outcomes.
The Engle Center staff utilize Doxy.me, a free and secure telemedicine solution to provide our patients with synchronous remote visits when an in-person visit is not feasible, practical or safe. Doxy telehealth services may be used to:
- Screen patients who may have symptoms of COVID-19
- Provide low-risk urgent care for non-COVID-19 conditions, identify those persons who may need additional medical consultation or assessment, and refer as appropriate
- Mental and behavioral health counseling
- Management of chronic health conditions and medication management
- Provide coaching and support for patients managing chronic health conditions, including eating disorders and nutrition counseling
- Follow up with patients after hospitalization
- Follow up and check in with patients in quarantine and isolation
Messiah students also now have access to FalconCare, which provides free, 24/7 access to the following services anywhere in the United States, 365 days a year:
Medical: On-demand access to a medical provider that can treat a wide range of common illnesses like cold and flu, sinus infection, allergies and more.
TalkNow: On-demand access to a mental health professional to talk about anything at any time.
Scheduled Counseling: Scheduled options to speak to a licensed counselor.
Health Coaching: Access to a nutritional specialist to help students adopt healthier lifestyle behaviors related to sleep issues, weight management and more.
Telehealth for Employees
Employees enrolled in the University health plan have access to virtual medicine that provides 24/7 access to a doctor using a computer, tablet or smartphone for non-emergency care for things such as sinus infections, bronchitis, flu, conjunctivitis, cough, sore throat, etc. To access this benefit, employees should visit amwell.com or doctorondemand.com and follow the instructions to register and download their mobile apps. Employees can use either or both of these services, depending on the availability of virtual doctors in the area; however, because this is structured around an on-call process, employees do not get to choose the doctor who will provide the visit with this benefit. There is no cost for virtual medicine visits through September 30, 2020. Beginning October 1, 2020, the cost is as follows:
- HDHP/HSA: Prior to meeting the deductible, the cost is approximately $59.00 per visit. After meeting the deductible, the cost is covered at 100%.
- PPO/HRA: The cost of the visit is a $10 copay.
As opposed to virtual medicine, telemedicine gives you access to an office visit with your own primary care physician (PCP) during normal office hours if your PCP offers this service. Your physician’s office will provide you with directions as to how to access their telemedicine system. The cost for such visits is based upon the fee structure for office visits. Employees in the PPO/HRA will pay a normal office visit co-pay and employees in the HDHP/HAS will pay the cost of the office visit until the deductible is met.
Special COVID-19 Considerations
The second point of focus was an Engle Center plan for effectively addressing COVID-19 within the University community. The plan focuses on the following key elements:
- TESTING – The Engle Center is prepared with testing. We have a variety of testing options available, including PCR testing and rapid antigen testing for those who are symptomatic between days 1-5. We are closely following the CDC and PA Dept of Health Guidelines.
- PERIODIC STRATEGIC SAMPLING – the University will continue to require testing of the campus at large – either broadly or through strategic sampling as an effort to mitigate the spread of COVID-19.
- SYMPTOM SCREENING - early identification of fever and symptoms is key in minimizing campus outbreak. Falcon Health Check-In allows students and employees to self-monitor their symptoms and report their daily temperature. Our nursing staff closely monitors this screening tool and follows up with those reporting a fever, exposure to COVID or any unusual symptoms.
- CONTACT TRACING – Our team of approximately 30 contact tracers have been trained through the JHU training program. Once a positive case has been identified, a MU contact tracer contacts the case within 1-2 hours.
- ISOLATION/QUARANTINE – Isolation/quarantine housing for undergraduate students is located in Smith A/B and four Oakwood Hills apartments. These spaces are utilized for COVID positive persons, those who have been exposed to COVID-19 and/or those with symptoms consistent with COVID-19 who are awaiting test results. Some students choose to quarantine or isolate at home. A local hotel is sometimes utilized if overflow quarantine housing is needed.
- VACCINATIONS – Symptoms of influenza and COVID can mimic one another, so the University strongly encourages all community members to get a seasonal flu shot. Plans have been initiated for distribution and administration of the COVID vaccine when it becomes. This work will be a collaboration of our department of Nursing and the State Department of Health through ServePA.
Additional Medical Providers and Hospitals
The Engle Center medical staff have privileges to the UPMC/Pinnacle system via PINNACLE LINK online and as such, the preference is to refer to and utilize UPMC/Pinnacle facilities as often as possible. With the established privileges, the Engle Center medical staff is able to access a student’s records in real-time – seeing when they have been admitted, any labs that have been completed, any radiology reports and when a student is discharged. This access to complete information greatly facilitates effective follow up with students once they’ve returned to campus.
While the Engle Center is able to call ahead to any emergency room, privileges with UPMC/Pinnacle allow our medical staff to easily send any pertinent records ahead of the referred student, including their medical history, any medications they’re taking, etc. In addition, the Engle Center maintains a large network of specialists (cardiologists, infectious disease specialists, allergists, ENTs, etc.) to whom students are regularly referred. The Engle Center is fully practiced in making these referrals when a patient’s condition warrants a higher level of care.
Messiah University is fortunate to be within 15 miles of four hospitals: UPMC Pinnacle Health Harrisburg; Geisinger Holy Spirit Hospital, UPMC Pinnacle West Shore Hospital and UPMC Pinnacle Carlisle Hospital.
Testing, quarantine and isolation
Symptom-based testing at the Engle Center
Exposure and Presumed Positive Isolation & Quarantine
For the purposes of this document, the following definitions apply:
- Quarantine is used to keep someone who might have been exposed to COVID-19 away from others. Quarantine helps prevent spread of disease that can occur before a person knows they are sick or if they are infected with the virus without feeling symptoms. People in quarantine should stay home, separate themselves from others, monitor their health and temperature, and follow directions from the health center.
- Isolation - is used to separate people presumed infected with the virus (those who are sick with COVID-19 and those with no symptoms) from people who are not infected. People who are in isolation should stay home until it’s safe for them to be around others.
- Enhanced health and safety protocols - is a flexible term that allows the University to define what specific protocols, beyond the norm, are expected in response to individual student or situational circumstances for mitigating risk related to potential or confirmed exposure to COVID-19. The need for these enhanced protocols is typically identified via testing results and/or contact tracing. For example, enhanced health and safety protocols may include:
- Students being required to temporarily move to fully remote learning
- Students being asked not to leave their residence hall room, except to use the restroom, walk to pick up meals or for medical treatment.
- Requiring testing for COVID-19
- Temporarily restricting visitation protocols in campus residences
- Other protocols as required.
- Note: When communicating enhanced health and safety protocols to students, the University wlll also communicate an anticipated time frame for their duration.
- Close contact – any individual within 6 feet of an infected person for at least 15 minutes of laboratory confirmed or probable COVID-19 patient
- Incubation Period - The incubation period for COVID-19 is thought to extend to 14 days, with a median time of 4-5 days from exposure to symptoms onset.
Undergraduate Quarantine and Isolation Housing
Smith Apartments, Sections A and B and the Climenhaga Homestead have been reserved for on campus quarantine and isolation housing. These facilities have separated entrances from other living spaces and accidental access can be precluded by blocking card access or locked doors. Each person in quarantine/isolation can be designated a room with access to a private bathroom. A total of 24 apartments with 33 bedrooms available is available in Smith. An additional 4 apartments are available in Oakwood Hills.
(Updated in March 2021 to include adaptations for fully vaccinated individuals)
Symptomatic or Exposed Undergraduate Students
When an undergraduate student presents with symptoms there are several important steps following the COVID 19 test. First, the student needs to complete the RESIDENTIAL STUDENT COVID form to provide critical information related to his/her activity on campus and to create a list of close contacts. The form also gives permission for the Engle Center to make appropriate contacts. In addition, the following steps will be taken:
- Quarantine notification is sent and Housing assignment is made.
- Dining is notified and the need for quarantine meals is established. See quarantine meals under the dining plan for additional details.
- The Department of Safety is notified so that the need for nightly checks is established.
- Facility Services is notified so that the need for linen service is established and the need for cleaning of any areas on campus is established.
- The Engle Center will notify the Director of Student Success, who sends an SCC notice to the student’s professors, coaches, supervisors, RA, and RD.
- The Engle Center will initiate contact tracing.
- The Engle Center will assign a visiting nurse to visit the student in person once a day and provide an additional optional telehealth visit.
- An email will be issued to the student from the COVID nurse with clearance instructions and the return to campus/residence date.
- The Engle Center will send a follow up notification via the SCC to Residence life, dining, Dept of Safety, Facility Services, admin, professors, coaches, supervisors etc. when the student is cleared to return to campus living.
Symptomatic Commuter and On-Campus Graduate Students
When a commuter or on-campus graduate student presents with symptoms there are several important steps following the COVID 19 test. First, the student needs to complete the COMMUTER & GRAD STUDENT COVID form to provide critical information related to his/her activity on campus and to create a list of close contacts. The form also gives permission for the Engle Center to make appropriate contacts. In addition, the following steps will be taken
- Commuters and grad students will be sent directly home to begin a quarantine or isolation period.
- For graduate commuter students, the Engle Center will send an email to the Dean of the School of Graduate Studies and the program director.
- The Engle Center will initiate contact tracing.
- An email will be issued to the student from the COVID nurse with clearance and the return to campus/class date.
- For undergraduate students, the Engle Center will also send a follow up notification via the SCC to Campus Events, administration, professors, coaches, supervisors etc.
When an employee presents with symptoms there are several important steps following the PCR test. First, the employee needs to complete the Employee COVID form to provide critical information related to his/her activity on campus and to create a list of close contacts. The form also gives permission for the Engle Center to make appropriate contacts. (See Employee Covid form in the appendices of this document.) In addition, the following steps will be taken
- The employee will be sent directly home to begin a quarantine or isolation period.
- The Engle Center will send notifications via email to: HR, administration, and to the work supervisor.
- If positive, contact tracing will be initiated
- An email will be issued to the employee from the COVID nurse with clearance and the return to work date. HR and the supervisor will copied on the email.
Asymptomatic-based Testing at the Engle Center
Asymptomatic students and/or employees may referred to the Engle Center for testing for three reasons:
- The individual has been identified via the daily Falcon Health COVID Screening App as having been exposed to someone with COVID 19.
- The individual knows of contact with someone with COVID 19.
- The Engle Center identifies the individual through contact tracing.
If the Engle Center determines that the individual should be seen for possible testing, the individual will be scheduled on the RESPIRATORY ONLY side of the Engle Center building and seen by CRNP or RN via standing orders.
Thresholds for further testing and enhanced health and safety protocols
- If there are three or more confirmed positive COVID-19 cases within a 14-day period (or less) on any residence hall floor, the University will require testing for all floor residents, and will implement enhanced health and safety protocols for those students until the test results are finalized and communicated to the students.
- If there are 15 or more confirmed positive COVID-19 cases in a residence hall within a 14-day period (or less) enhanced health and safety protocols will be implemented for the entire hall and the University will consider requiring testing for residents of the entire hall.
- A positive COVID-19 in an apartment requires enhanced health and safety protocols and testing of all apartment residents.
- Contact tracing will determine the need for further testing and quarantining.
- Rosters with 20 or less people – Two or more confirmed COVID-19 cases within a 14-day period (or less) requires team activities to stop/suspend.
- Rosters >20 or more people – Three or more COVID-19 cases within a 14-day (or less) period requires team activities to stop/suspend.
- Fifteen or more positive COVID-19 cases for all of Athletics within a 14-day period (or less) requires all athletic activity to suspend.
- Ten or more positive COVID-19 cases for all of Athletics within a 14-day period (or less) would trigger an assessment that may require some or all teams to scale back to pod participation only.