Creating a COVID-19 bio-secure environment: experience from a medical faculty in Sri Lanka

Abstract

The COVID-19 pandemic has presented educational institutions and educationists with unprecedented challenges with regard to the delivery of high-quality education. The challenges have been greater for the medical education institutions as the students engaging in clinical attachments work in a high-risk environment for COVID-19 transmission and place themselves and their associates at personal risk. The paper outlines the robust and pragmatic framework adopted by the Faculty of Medicine, University of Ruhuna to meet its twin goals of continuing to provide high-quality medical education whilst ensuring health and wellbeing of students. Measures were adopted to minimize exposure outside the educational environs as well as within the hospital and halls of residence. Guidelines were adopted, discussed and disseminated. Suitable personal protective equipment was defined and all students’ inward settings requested to wear them. Unanticipated COVID-19 exposures took place on two occasions and the faculty risk assessment committee quarantined a few students with high-risk exposure within the halls of residence. The ‘protected exposure’ to minimize the risk of COVID-19 provided by the personal protective equipment they wore, prevented many students from being quarantined. All who were quarantined were COVID-RT-qPCR negative on day 14 of exposure. A community-acquired COVID-19 outbreak with 7 students testing positive for COVID-19 in the halls of residence required the Faculty of Medicine to institute the first civilian administered quarantine facility in Sri Lanka quarantining 200 students as first-line contacts and isolating a further 264 as second-line contacts. The administration of the quarantine facility was an unprecedented logistical challenge to the university administration and the academic staff. Meticulous attention to detail and commitment helped the faculty quarantine centre to meet up with all challenges and the 464 students all tested negative on the exit RT-qPCR. This was a zero cross-transmission rate for the infection and was a remarkable achievement for a quarantine facility. Leadership principles specifically aimed at managing crisis situations such as transparent communication, the urgency of action, commitment to core values and empowering all stakeholders formed the crux of the successful measures adopted. It is hoped that the wider lessons emanating from the experiences outlined in this paper will be of value to academic colleagues from similar medical educational settings to create bio-secure, COVID-19 protective environments in their respective institutions.