Case Management Guide

Introduction

The purpose of this document is to provide the campus with a general overview of the University’s Case Management process for COVID-19, so that our community can anticipate the general steps/actions of a case that they may be involved with. Please note that this document does not cover every detail or step of the process, which, at times, may be altered for the entire campus or on a case-by-case basis, following best practices or to better address unique variables of each case.

The University community is also encouraged to review three other documents that are essential to mitigating the risks connected the COVID-19 pandemic:

• Covenant of Care
• COVID-19 Safety Plan
• Wellness Guide

Stay up-to-date with University cases via our dashboard.

The Case Managment Guide has the following sections

• Overview
• Symptom/Exposure Monitoring
• Symptom/Exposure Assessment
• Potential Case Review
• Case Type Specific
  • Pending Cases
  • Quarantine Cases
  • Probable Cases
  • Isolation Cases

Overview

The University’s Case Management process involves the following:

1. Campus wide monitoring of symptoms and exposures
2. Assessment of symptoms/exposures for potential cases
3. Review of potential cases - which will then be assigned as an open case status or closed
4. Open cases are then managed through the appropriate individual processes: Pending, Quarantine, Probable, or Isolation.

It should be noted that individuals may be ill for reasons unrelated to COVID-19. At minimum, individuals with a non-COVID-19 related sickness should also remain home until they have been without symptoms for 24 hours.

Communication
Individual case communication will be conducted via phone or email. The campus is encouraged to save this contact information for the COVID-19 Case Management Team to be able to identify, share and quickly respond to any case related information.

Email: covid19@andrews.edu
Phone: 269-815-8892 (call or text)

If the Case Management Team is unable to reach an individual in a timely manner, they may then reach out to the individual’s academic advisor/chair, Student Life dean, or supervisor (as applicable) to help facilitate a timely response and intervention. While some cases may require same-day contact of the individual, other case-related communication should occur within the first 48 hours. To assist with contact trace efforts with a potential COVID-19 case, the Case Management team may also make contact with event organizers, faculty, Student Life deans, and/or supervisors to identify potential close contacts.

Faculty will be alerted to a student’s ability to attend in-person classes via the faculty’s class roster in iVUE, where each student will be listed daily as cleared or not cleared to attend in-person classes. This updated status will be based on both the student’s participation in the semester’s baseline COVID-19 testing as well as the student’s status in a COVID-19 related case (such as being in isolation or quarantine). Student’s who are out of class for being sick with a non-COVID-19 illness should communicate directly with their faculty.

Faculty/Supervisor Communication: If an individual is directed to not attend class/work through Campus Clear, it is the individual’s responsibility to take a screenshot of their Campus Clear directions and send the screenshot to his/her faculty/supervisor. 

Symptom/Exposure Monitoring

Campus-wide monitoring of symptom/exposure can occur through any of the following methods:

• Campus Clear
• COVID-19 email or phone
• On-campus testing
• Third-party reports

The primary method for monitoring and mitigating risk is the campus wide use of Campus Clear. Students and employees who are either on-campus or remote while living in the local Michiana area are required to screen and report any symptoms or exposures using Campus Clear.

This screening should occur daily (including weekends/holidays) and be completed, at the latest, prior to the Campus Clear data being collected, which occurs daily at 3:00 pm.

Depending on the symptoms/exposures reported in Campus Clear, the user will receive different directions:

 

Level	Attend Class/Work	Access Dining Services	Monitor Symptoms	Contact Case Management	Pursue Testing	Isolate Immediately
1	Yes	Yes	No	No	No	No
2	Yes	Yes	Yes	No	No	No
3	No	Yes	Yes	No	No	No
4	No	No	Yes	Yes	Yes	No
5	No	No	Yes	Yes	Yes	Yes

Symptom/Exposure Assessment

Through the assessment of symptoms/exposures, reports are identified as a Potential Case based on the following criteria:

• Reported exposure
• Severity/type of symptom(s)
• Quantity of symptoms
• Frequency of symptom(s)

Reports that are not identified as a Potential Case are then closed for that day (NOTE: the criteria for frequency of symptoms does include prior closed reports).

For individuals who have previously tested positive (and who have completed isolation) within the last 90 days may test positive a second time when participating in asymptomatic/precautionary COVID-19 testing (either as part of the University’s requirements or requirements from other organizations). These individuals with a second positive result will be assessed differently than those who are testing positive for the first time. The assessment for repeat positive tests will be based on two factors: first, the elapsed time since the previous positive test result (specifically, whether the elapsed time is under/over 90 days) and second, both the presence and explanation of any symptoms.

• For individuals who test positive within 90 days and are asymptomatic:
  • No further action would be initially required by the University.
  • The results and known history will be reported to the Berrien County Health Department for any additional guidance/direction.
• For individuals who test positive within 90 days and are symptomatic:
  • Those individuals will initially be asked to stay home “sick”, just as if they were sick or ill for any cause (regardless of COVID-19).
  • The duration of “staying home sick” for that individual would then depend on any additional factors (additional testing, potential cause/explanation of symptoms, and medical/Health Dept. input).
  • The minimum duration would be 24hrs at home or residence without symptoms (the same protocol for any illness).
• Individuals who test positive outside of 90 days will follow standard isolation protocols, pending further input from the Berrien County Health Department.

Potential Case Review

The Case Manager will contact the individuals who are Potential Cases and determine whether the case should be closed or remain open.

Cases may be closed due to: accidental symptom selection, known non-illness related cause (e.g. fatigue due to staying up all night studying for an exam), or by not meeting close contact definition.

Open cases will be classified by the Case Manager as: Pending, Quarantine, Probable, or Isolation. Changes to a case status can only be determined by either a University Case Manager or the Health Department. If changes are communicated to the individual by the Health Department and prior to Case Manager contact, the individual should report those changes to the Case Management Team via email or call/text.

Communication with faculty/supervisors regarding their student/employee and Potential Case is dependent on the case type. Faculty/Supervisors should also contact the Case Management team if they:

• Faculty
  • Have a student out of class for more than two days due to illness and
  • Do not see a change in their iVUE class roster status (cleared/not-cleared)
• Supervisors
  • Have an employee out of work for more than two days due to illness with symptoms associated with COVID-19.

Pending

Pending Cases are divided into two sub-categories:

• Continued Monitoring — individuals should:
  • Remain at home.
  • Work with Case Managers to determine if symptoms escalate; persist, worsen, increase (number of symptoms), or if the symptoms are no longer explained. If symptoms do escalate, individuals would be referred for testing.
• Referred for Testing — individuals should:
  • Remain at home.
  • Pursue COVID-19 testing.

Pending Cases are then completed by being:

• Closed by the Case Manager as unrelated illness due to:
  • Symptoms remain explained and/or did not escalate.
  • Negative COVID-19 test result.
  • NOTE: Individuals must be symptom-free for 24hours before returning to regular campus access.
• Changed to Isolation by the Case Manager (due to positive COVID-19 test result)

Pending Case Communication:

• Individuals should provide screenshots of their Campus Clear results to relevant faculty/supervisors.
• Students work with Faculty on academic requirements during the quarantine period.
• Employees must notify their supervisor that they are unable to work in-person.

Quarantine

Quarantine cases are for individuals that have been in confirmed close contact with a COVID-19 Probable or Positive person. (NOTE: This determination is made either by a Case Manager or the Health Department). Following CDC guidance, the University responds to quarantine cases as follows.

The CDC's defintion of Close Contact* includes:

• Being within 6 feet of the individual for a cumulative total of 15 minutes over a 24 hour period
• Having direct physical contact (hug/kiss) with the individual
• Sharing eating utensils
• NOTE: The use of face masks is not a factor for determining close contact (aside from an N-95).

Contagious Period:The close contact would have had to occur within the contagious time period of the positive individual. The postiver individual's contagious time period starts 48hrs prior to either symptom onset or testing positive, whichever occurred first. Their contagious time period would end 10 days after the symptom onset or positive test (whichever occurs first) and could be lenghthened if fever symptoms continue past the 10 days.

Close Contact and Indirect Contact: Individuals who have had close contact would need to quarantine. Those with indirect contact would not. Please see diagram below:

Individuals can be identified as a close contact either by self-reporting or through Contact Trace methods that may include:

• Interviewing the positive individual.
• Review of classroom seating charts and attendance records.
• Review of other available information.

Individuals in quarantine are not allowed to physically access the campus for classes, work, or other in-person activities (on-campus residences excluded).

Depending on the type of exposure, Residence Hall students with roommates may be asked to temporarily relocate to a single occupancy room to complete their quarantine. This type of exposure may include close contact while eating or not wearing masks and space availability.

Quarantine Timeline:

• Day 0: Close Contact with COVID-19 Positive/Probable person - Begin Quarantine
• Day 5: First day eligible to be tested/retested for COVID-19
• Day 7: If negative test result & asymptomatic, last day of quarantine
• Day 10: Without testing & asymptomatic, last day of quarantine

Quarantine Cases are completed by the Case Manager when either:

• Individual meets Quarantine Timeline or
• Case changed to Probable (symptomatic) or Isolation (positive test result)

Quarantine Case Communication:

• Case Managers will notify Faculty through iVUE Class Roster that the student is not cleared for in-person classes (as well as when they are cleared).
• Students work with Faculty on academic requirements during the quarantine period.
• Employees must notify their supervisor that they are unable to work in-person.

Probable Cases

Probable Cases are for individuals who are either:

• Quarantined and symptomatic and/or
• Exhibiting specific COVID-19 symptoms (flu-like symptoms in addition to loss of taste/smell or headaches).

Probable individuals are directed to be tested for COVID-19 and are not allowed to physically access the campus for classes, work, or other in-person activities until a negative test result is received. Residence Hall students may be relocated to a single room occupancy and/or the campus isolation residence depending on the case details.

Probable Cases are considered complete by the Case Manager when they are:

• Changed back to Quarantine Case due to negative results.
• Closed due to negative test result and no current quarantine requirements
  • NOTE: Individuals must be symptom-free for 24 hours before returning to regular campus access.
• Changed to Isolation Case due to positive results.

Probable Case communication:

• As a probable case is either based on a pending or quarantine case, there are no additional communication steps beyond the steps described above for those two categories.

Isolation

Isolation cases are for individuals who have tested positive for COVID-19. Following CDC guidance, the University responds to isolation cases as follows.

Isolated individuals are not allowed to physically access the campus for classes, work, or other in-person activities. Residence Hall students will be relocated to an isolation residence.

Isolation Timeline:

• 2 Days Prior: Contagious period starts
• Day 0: Symptom Onset or Tested Positive, whichever occurred first
  • Note: Testing positive refers to the specific day the sample was collected, not when results were received).
• Day 10: Last day of Isolation (as long as no fever in the past 24 hours and symptoms improving)

Isolation cases are completed by the Case Manager when the isolation timeline has been completed.

The timeline of isolation refers to the potential contagious period of the individual. A COVID-19 positive person can continue to experience long-term symptoms and may not be fully recovered after isolation has ended. 

Individuals may also continue to test positive for up to 90 days after their initial positive. Due to this, Andrews University does not require a negative test result to end isolation.

Isolation Case Communication:

• Case Managers will notify Faculty through iVUE Class Roster that the student is not cleared for in-person classes (and then again when they are cleared for in-person classes).
• Students are to work with Faculty on academic requirements during the quarantine period.
• Employees must notify their supervisor that they are unable to work in-person.