Guidance for post-secondary institutions during the COVID-19 pandemic

July 24, 2020

Table of contents

• Preamble
• Introduction
• A risk-based approach to planning
• Personal measures to prevent and limit the spread of COVID-19
• Domestic and international travel
• Measures to prevent and limit the spread of COVID-19 within the context of post-secondary institutions
  • On-campus risk assessment and mitigation strategies
  • Academic instruction, experiential learning and research activities
  • On-campus housing
  • Provision of supports and services
  • Supporting community gatherings and student life
  • Off-campus activities
• Planning for COVID-19: Case management and outbreak response
  • Monitoring, screening and testing for COVID-19
  • Case management of a student, faculty or staff member
  • Contact tracing
  • Quarantine and isolation policies
• Responding to a COVID-19 outbreak
• Recovery from a COVID-19 outbreak
• Psychosocial and mental health needs of students and staff
• Additional resources
• References

Preamble

The Public Health Agency of Canada (PHAC), in collaboration with Canadian public health experts, has developed this guidance for post-secondary institutions administrators and local public health authorities (PHAs) in jurisdictions where these institutions exist in the context of the coronavirus pandemic. The guidance is based on the Canadian context and the currently available scientific evidence and expert opinion. It is also founded upon the core personal and community-based public health measures outlined in the guidance entitled: Community-based measures to mitigate the spread of coronavirus disease (COVID-19) in Canada^{Footnote 1}. These public health measures (PHMs) are recommended to mitigate the spread of coronavirus disease (COVID-19) that is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), taking into consideration the diverse needs of population groups based on vulnerability, ethnicity/culture, ability status, and other socioeconomic and demographic factors. For additional up-to-date and evolving information regarding COVID-19, that can be shared with students, staff, faculty and parents, visit the Canada.ca COVID-19 website.

This guidance is subject to change as new information on transmissibility and epidemiology becomes available. It should be read alongside relevant federal, provincial/territorial and local legislation, regulations and policies. Guidance from provincial/territorial health authorities will consider local epidemiology, which varies widely across the country. Therefore, implementation of guidance is not expected to be uniform throughout Canada, as outlined in the Guidance for a Strategic Approach to lifting Public Health Measures in Canada.

In interpreting and applying this guidance, it is im-portant to recognize that some individuals and vulnerable groups coping with systemic inequality and barriers to wellness (by virtue of their gender, race, Indigeneity, geographic location, rurality, ability, age, socioeconomic status and other intersecting identities), may face challenges/limitations in following recommended measures. This may necessitate adapted responses (e.g., not requiring physical distancing between a personal support worker and their client/student) and recommendations in some situations.

Introduction

This guidance provides information for the following settings:

Post-secondary/vocational schools: For the purpose of this guidance document, these settings include public and private colleges, universities, vocational/technical schools, and CEGEPs. Boarding schools (i.e., elementary or secondary settings where students reside at the school and may return to the family on holidays and vacations) may use some of this guidance, in addition to PHAC guidance for K-12 schools (updates in progress). School populations are typically comprised of young adults who live in on-campus or other local housing (e.g., dormitories, residences), private accommodations on or off-campus (e.g., shared rental apartments/houses), or in a family home. They may also comprise of adult learners, have families or children of their own, or may be working while studying. Faculty and staff also constitute part of the population, including potentially older adults who may be at risk of more severe disease or outcomes from COVID-19.

Post-secondary institutions are complex environments, and vary in geographic location, size (both in terms of infrastructure and student population), provision of services, and structure. They also comprise individuals who can vary widely in age, gender, ability, race, ethnicity/culture, and other factors, and may have underlying medical conditions and barriers to wellness. In addition to student instruction, they may also be engaged in activities such as housing staff and students, providing services to faculty, staff and students and the community, research, and hosting academic/social/cultural events and gatherings. Emphasis is placed on the public health considerations and public health measures that can be incorporated into the planning and operations by administrators and course providers. This guidance does not include advice for on-campus infrastructure projects and facilities such as pubs/bars, restaurants and shops as these settings would be subject to relevant provincial/territorial guidance.

A risk-based approach to planning

Public health measures implemented by local/provincial/territorial health authorities and federal/provincial/territorial (FPT) governments have been adjusted over time in response to COVID-19 activity. Institutions should collaborate with the local PHAs to consider applying a similar risk-based approach to planning their mitigation strategies and determining indicators (see Table 1) and thresholds for restricting, suspending or reinstituting in-person activities. Risk assessments should be integrated into decisions about opening or closing settings and how to function as safely as possible for those that are open. Further guidance for public health to apply a risk assessment is located in the Community-Based Measures guidance Appendix C: A framework for risk assessment and mitigation in community settings during the COVID-19 pandemic^{Footnote 1}.

Table 1. Examples of indicators to consider in post-secondary setting Risk Assessments (adapted from OpenSmartEDU)^{Footnote 3}

Potential indicators to guide increasing restrictions	Potential indicators to guide lifting of restrictions
Significant increases in on-campus COVID-19 transmission, particularly when occurring at a greater rate than surrounding community.	Significant decreases in on-campus COVID-19 transmission.
Significant increase in COVID-19 transmission in surrounding community (particularly when campus buildings/student housing are highly integrated/spread throughout the local community).	Significant decreases in COVID-19 transmission in surrounding community, particularly if transmission was higher than on campus.
Evidence that the students/faculty/staff or the surrounding community are not adhering to public health mitigation strategies related to physical distancing and/or other measures (e.g., use of non-medical masks where recommended).	Evidence of good adherence to public health mitigation strategies within the institution or surrounding community (through monitoring violations/complaints).
Insufficient healthcare or other service capacity on campus or at local healthcare facilities.	Sufficient healthcare or other service capacity on campus or at local healthcare facilities (given that incidence of cases are kept to a manageable level).
Insufficient space to manage students (individually or in cohorts) who need to quarantine or self-isolate.	Sufficient space to manage students (individually or in cohorts) who need to quarantine or self-isolate.

The Strategic approach to lifting restrictive public health measures^{Footnote 2} emphasizes the importance of core personal protective measures (outlined in the following section) as a means to maximize the ability as a society to control the spread of COVID-19. The Risk Assessment framework provides consideration for assessing characteristics of the setting and characteristics of individuals in these settings, and provides advice for PHAs to assess the risk level, the mitigation potential based on a hierarchy of controls, and to consider next steps for operating with risk mitigation measures.

Additional guidance on assessing risk for gathering and events operating during the COVID-19 pandemic is available^{Footnote 4}, and may assist decision-makers in evaluating risk and mitigation potential for on-campus gatherings and events such as orientation or sporting events, student affairs activities, group lectures/exams, etc.

Personal measures to prevent and limit the spread of COVID-19

With no targeted therapies or vaccine currently available, core personal public health practices will need to become the "new normal" to maximize the ability as a society and in the post-secondary community to limit the spread of the virus for the long-term. The following core personal protective practices that every individual should be observing are fundamental, and should continue throughout the COVID-19 response:

• Staying informed, being prepared and following public health advice;
• Practicing good hygiene (hand hygiene, avoid touching face, respiratory etiquette);
• Staying at home or in a designated space (i.e., in residence, hotel, off-campus housing) and away from others if symptomatic/feeling ill - not going to school/social events/academic placements/work;
• Maintaining physical distancing as much as possible when outside of the home (i.e., from non-household/co-living setting members);
• Cleaning and disinfecting surfaces and objects, as appropriate;
• Staying away from others (e.g., remote learning) as much as possible if at risk of more severe disease or outcomes, which includes, older adults (increasing risk with each decade, especially over age 60); people of any age who have chronic medical conditions, including: lung disease, heart disease, high blood pressure, diabetes, kidney disease, liver disease, stroke, or dementia; people of any age who are immunocompromised, including those with an underlying medical condition (e.g., cancer) or taking medications which lower the immune system (e.g., chemotherapy); and people living with obesity (BMI of 40 or higher);
• Based on jurisdictional requirements and/or when the local epidemiology and rate of community transmission warrant/require it, wearing of non-medical masks (NMMs) or cloth face coverings is recommended for periods of time when it is not possible to consistently maintain a two-metre physical distance from others, particularly in crowded public settings on or off-campus (e.g., lecture halls, public transit);
• Wearing a medical mask, or if not available, a NMM or cloth face covering, if experiencing symptoms, and if in close contact with others or when seeking medical care;
• Reducing personal non-essential travel. For students, faculty and staff, this may mean restricting travel in/out of province, and not traveling outside of Canada while travel restrictions are in place.

Domestic and international travel

Special consideration needs to be given to access to campus by individuals coming from outside the community, such as those travelling between provinces/territories within Canada, as well as international students and faculty. Local, provincial/territorial and/or federal requirements for domestic and international travellers will necessitate a period of self-isolation prior to integration into campus activity. As of March 25, 2020, all travellers incoming to Canada are subject to mandatory 14-day quarantine (self-isolation) enforceable through an Emergency Order under the Quarantine Act.

The quarantine plan of any student arriving from outside of Canada must respect the requirements for a quarantine plan as described in the Emergency Order in effect at the time of their entry into Canada. As with any other non-exempt traveller, these students must be able to self-quarantine or self-isolate for 14 days; they must not be in contact with a vulnerable person (as defined in the Order); and, they must have access to the necessities of life (e.g., food, their medication). The border screening officer or quarantine officer has the final say on what is considered a suitable quarantine plan upon entry into Canada.

Further information on the role and responsibilities of the federal, provincial and territorial governments and designated learning institutions on international students will be available soon.

Measures to prevent and limit spread of COVID-19 within the context of post-secondary institutions

The following sections outline specific considerations for a post-secondary institution. It is not an exhaustive list of considerations, but offers a public health lens to this setting for consideration by the academic sector.

On-campus risk assessment and mitigation strategies

Some people within post-secondary settings may be more likely to be exposed to the COVID-19 virus because: their jobs or occupations require them to be in contact with large numbers of people, which increases their chances of being exposed to someone who has COVID-19; they live in group settings (e.g., dormitories) where the COVID-19 virus may transmit more easily; or they face barriers that limit their ability to access or implement effective public health measures (e.g., individuals with disabilities who encounter non-accessible information, services, and/or facilities). Modifications that can be implemented on campus are key to managing the transmission of COVID-19. The extent to which a campus will be able to operate with reduced in-person capacity and to limit transiting of individuals through the campus will depend on many factors, including location, integration with the local community, and key priority services and institutional functions that must be maintained on-campus. There may be numerous campus access points due to provision of services to the local community. Many post-secondary institutions will remain accessible to some degree.

If activity is to take place on campus, school administrators should consider:

• To what extent does the local epidemiology of COVID-19, access to testing and access to healthcare services, as assessed by your local PHA, allow for students, faculty, staff and visitors to be on campus?
• To what extent can the campus accommodate students, faculty, staff, and visitors on campus grounds and/or buildings while implementing measures that promote the health and safety of these individuals including:
  • Preventing sick people from entering the campus (provide information beforehand, culturally safe screening, accessible signage at entrances, temperature checks, training, etc.);
  • Implementing additional physical distancing measures while also considering individuals' accessibility needs: widening outdoor pathways and ramps; marking areas of resting or movement (e.g., sitting, standing, and walking/wheeling); single use staircases, doors and pathways for high traffic areas; stanchions and/or accessible visual cues for lines of traffic direction; use of plexiglass, plastic or other transparent barriers for environments with high risk of transmission and physical distancing is not possible;
  • Ensuring proper air ventilation in all on-campus buildings;
  • Facilitating good hygiene practices: Installing accessible hand hygiene stations throughout the campus, particularly in high traffic areas, entrances and exits, places with high touch surfaces; installing touchless motion sensing appliances where possible;
  • Enhancing environmental cleaning and disinfection practices in all settings, with emphasis on high-touch surfaces.
  • Establishing policies regarding the use of NMM/cloth face coverings on campus, including student, faculty, staff, and visitor access to these materials and education around proper use;
  • Being able to identify and/or notify individuals in the event that they are exposed to COVID-19 (e.g., tracking apps, sign-in systems for classes/events);
  • Being aware of students/faculty/staff/visitors who may be more likely to be exposed to the COVID-19 virus or are at risk of more severe disease or outcomes, while avoiding stigma and discrimination, and implement measures to ensure their safety, including providing information to all these individuals on additional protective measures, offering online/remote learning, designating specific times to provide services/support, and making available appropriate services/resources as individuals may not self-identify.
• To what extent do students, faculty, staff, and visitors use public transportation to/from campus or through campus?
• How will students, faculty, staff, and visitors be informed about COVID-related protocols and activities, including expectations for behaviour (e.g., staying home/in-residence and away from others if symptomatic/feeling ill, physical distancing, use of NMM or cloth face coverings), and notification in the event of an outbreak or exposure? Could a contact tracing mobile application be used?
• In consultation with public health authorities, understanding how individuals who are in violation of protocols will be managed?

Because of the significant resources and effort involved in preparing for and maintaining these spaces, post-secondary institutions may choose to restrict access to or close areas where safety precautions cannot be adequately supported.

Post-secondary institutions should assess the feasibility of implementing "cohorting" on campus. This involves establishing or promoting the establishment of small groups, formally or informally, including keeping the same individuals in the groups to minimize the number of contacts in various settings. Settings where cohorting is a viable mitigation strategy are identified in the subsequent sections.

Academic instruction, experiential learning and research activities

Recognizing that there are different learning needs and requirements for students based on their program of study as well as their individual learning needs, institutional administrators must determine the level of transmission risk posed by the setting in which their courses or components of courses are conducted. Physical distancing is proven to be one of the most effective ways to reduce the spread of illness during an outbreak. To preserve academic integrity, online/remote access to course materials and instructors should be considered (while addressing accessibility requirements and potential need for alternate formats) when local public health recommends against on-campus activity, or if certain types of placement programs (e.g., early childhood educators, nursing, apprenticeship training) are suspended due to local outbreaks.

Whenever available, online/remote access to instruction can also be an important consideration for equitable access. Some individuals will be unable to attend in-person sessions due to measures imposed by COVID-19, such as those with health conditions or disabilities that prevent them from being able to physically distance or use NMM or face coverings, as well as students affected by travel restrictions. Additionally, some students who are at risk of more severe disease or outcomes from COVID-19 (e.g., older adults, people of any age with chronic medical conditions, people of any age who are immunocompromised, and people living with obesity) may choose not to attend in-person sessions in an effort to protect their own health. Students living with individuals at risk of more severe disease or outcomes may also choose not to attend in-person sessions. Post-secondary institutions should also consider and offer support for individuals, particularly those who are experiencing financial burden, students with disabilities, or those who may have difficulty accessing online learning tools. Refer to PHAC's guidance for COVID-19 and people with disabilities in Canada^{Footnote 5} for additional information.

Research activities are another key component in some post-secondary institutions. Institutions should consider implementing various physical distancing measures, engineering and administrative controls (see examples below) in these settings to minimize risk, if not addressed by occupational health requirements. It may be necessary to restrict access to or to close laboratories and/or temporarily halt research activities where safety precautions cannot be adequately supported. Therefore, investigators should review their research activities to determine which activities critically require in-person attendance (e.g., care of animals, plants, cultures; preservation of materials requiring special storage; maintenance of essential equipment) and whether staff can be cross-trained to perform multiple functions or similar functions across multiple research projects to reduce potential contacts.

Institutions should communicate and collaborate with organizations offering student internships, co-op placements, work-terms, or apprenticeship training about the importance of adopting proper safety protocols and risk mitigation strategies to offer enrichment learning or work opportunities. Institutions should be accommodating, where possible, for students who may need to complete these work placements online or remotely, whose placements have been cancelled, and/or are unable to find a placement opportunity. Depending on the setting (e.g., a trades apprenticeship, clinical placements in a hospital or long-term care setting), post-secondary institutions may need to conduct a risk assessment for allowing certain student work placements to occur. Refer to the risk mitigation tool for workplaces/businesses operating during the COVID-19 pandemic for further detail^{Footnote 6}. The extent to which in-person activities can take place will depend on factors such as the local epidemiology of COVID-19, the importation risks posed to the institution by allowing students on campus and into classrooms/lecture halls/labs/hands-on technical education, and any large group restrictions issued by local guidance. Additional mitigation strategies, particularly for high-risk settings, must be implemented to ensure that these activities (e.g., instructional labs, clinical placements, applied technology instruction) can take place safely.

Examples of mitigation strategies for academic and experiential/applied instruction

Hierarchy of control category	Examples of mitigation strategies (in addition to promotion of personal practices and environmental cleaning/disinfection)
Physical distancing	Seating students at least 2 meters apart when in-person (e.g., taping off every other seat in a lecture hall, placing markers on the floor in a lab, spacing desks appropriately during in-person exams). Offering virtual lectures simultaneously or asynchronously to limit the number of individuals in classrooms. Offering online exams and using remote proctoring as necessary or other alternative testing formats. Offering activities in outdoor environments to further increase distancing and reduce the likelihood of transmission (weather permitting).
Engineering	Increasing ventilation in learning environment by adjusting HVAC system or opening windows (weather permitting). Moving activities outdoors where feasible and weather permitting. Increasing access to hand hygiene facilities (e.g., hand sanitizer stations) throughout campus buildings/lecture halls/labs/workshops/studios etc.).
Administrative controls	Condensing the academic calendar to minimize time on campus, if in-person attendance is required, and academic standards are not compromised Enhancing environmental cleaning and disinfection practices in all settings (e.g., lecture halls, classrooms, bathrooms), with emphasis on high-touch surfaces (e.g., door handles, hand railings, chairs, tables, elevator buttons, shared equipment etc.). Limiting the number of individuals on campus and in classrooms/lecture halls at any given time by staggering classes, alternating in-class days for students. Establishing a schedule for access to lab facilities, including keeping the same individual timeslots to minimize number of potential contacts. Prioritizing presence on campus for small classes and experiential/applied learning opportunities. Restricting in-person instruction only for programs where it is required to fulfill industry or field-specific accreditation or licensing requirements. Developing virtual labs, simulations, and multimedia resources for experiential learning (e.g., laboratory-based learning, tutorials, and seminars) that may not be able to take place in-person. Considering other strategies, such as postal delivery or partnering with local businesses so that students are able to receive the necessary supplies to participate in the learning activity (e.g., ingredients for culinary programs). Cohorting/use of small groups, including keeping the same individuals in the groups to minimize number of contacts. Ensuring that strict exclusion policies are in place for students/faculty/staff/visitors who are ill, while taking care to support students, faculty and staff in isolation and avoid stigma or discrimination. Implementing policy and technology that allow students, faculty, and staff who are at risk of more severe disease or outcomes (i.e., older adults, people of any age with chronic medical conditions, people of any age who are immunocompromised, and people living with obesity) or cannot attend in-person learning activities classes, to participate online/remotely. Having a procedure for isolating students/faculty/staff/visitors who become sick while on campus. Keeping a safe, secure record/sign-in system of students/faculty/staff/visitors who access a campus building for learning and research activities, to facilitate public health investigation of cases and contacts in the event of an exposure at a campus building.
PPE and NMMs	Using PPE in clinical student learning settings or NMM or cloth face coverings in non-clinical settings when physical distancing may not be possible to maintain.

On-campus housing

Depending on individual circumstances, administrators may open no, some or all available residences. For those that will open residences, some styles of residences can be higher-risk settings than others (e.g., dormitory style vs. single rooms) and there are a number of strategies that can be implemented to mitigate the transmission of COVID-19. Institutions should also consider designating certain residences or other off-campus housing, particularly those with single rooms, for isolation and quarantine purposes. Refer to the Quarantine and Isolation policies section for further detail.

In cases where there is more than one individual sharing a room, or in suite-style housing, institutions (and with the advice of public health) may consider treating them as a family unit, with the corresponding terms for scheduling activities and physical distancing expectations. For guidance on how to respond to a suspected or confirmed case of COVID-19 in an individual living in a residence, please see sections on Case Management and Outbreak Response.

Post-secondary institutions should ensure that anyone providing additional support to someone living in a residence, such as personal support workers, is aware of guidance for infection prevention and control for home care workers (available on Canada.ca), and has taken appropriate mitigation measures.

If opening residences, post-secondary institutions will also need to consider and to plan for the possibility that restrictions to movement and travel could be imposed during the academic term, preventing some individuals from arriving/returning home. These individuals may need supports and services during periods when the institution traditionally closes or operates at reduced levels (e.g., winter break, Reading Week).

Examples of mitigation strategies for on-campus housing

Hierarchy of control category	Examples of mitigation strategies (in addition to promotion of personal practices and environmental cleaning/disinfection)
Physical distancing	Offering residences at a reduced capacity and/or make additional arrangements for off campus housing (e.g., hotels). Avoiding the use of residences that have a traditional dormitory style with shared washroom facilities. Instead, offer single occupancy in rooms with private washrooms or use suite-style apartments (with private sleeping quarters) to limit contacts. Increasing accessible signage and floor markings in residences to remind students/staff to practice physical distancing and have unidirectional flow of foot traffic in narrow hallways/stairways where feasible. Increasing spacing between furniture in communal areas (e.g., lounges, kitchens, other common areas) to maintain a 2-metre distance and to reduce crowding.
Engineering	Increasing ventilation in residences by adjusting HVAC system or opening windows (weather permitting). Implementing physical barriers (i.e., plexiglass/transparent barriers) at reception desk. Installing low-contact options for entry/exit points (e.g., pressure sensitive bars or touchless entry instead of doorknobs). Installing physical barriers or removing/fixing movable furniture to maintain appropriate physical distancing, while also considering individuals' accessibility needs. Increasing availability of accessible hand sanitizer stations throughout residence buildings and increase accessible signage to remind students about hand hygiene practices.
Administrative controls	Limiting the number of students living in residences by offering online/remote course delivery. Offering virtual information sessions/programming/social activities for students living in residences (and also those studying remotely) to reduce the need for in-person gatherings while maintaining social connectedness and student-life experiences. Introducing protocols to limit the number of students that are able to use communal spaces in residences (i.e., lounges, kitchens, laundry facilities, and other common areas) at any given time (e.g., sign-up times, restricted keyed access). Prohibiting the sharing of certain items in communal residence kitchens (e.g., food, glasses, dishes, utensils) and requiring students to use their own labeled, personal items. Establishing or reviewing protocols for environmental cleaning in communal spaces and increase frequency of commonly touched surfaces and objects. Implementing culturally safe security measures (e.g., hall monitors) to monitor and/or deter students from congregating in common areas, while being mindful to avoid stigma and discrimination of certain groups. Introducing protocols to limit the number of students/staff that can be inside an elevator at any given time and encourage unidirectional flow of foot traffic on campus. Limiting or prohibiting the entry of day- and overnight guests in residence at any time.
PPE and NMMs	Encouraging use of NMM or face-coverings in residence settings when physical distancing is not easy to maintain (e.g., elevators, stairwells, hallways, common areas).

Provision of supports and services

There is a wide range of supports and services on campus that are provided by the institution or through third party providers, including but not limited to, academic services, student services, athletics, health and wellness, and food services. Supports and services that can be offered online or by telephone will reduce the number of individuals making contact, and address accessibility for individuals unable to attend in-person. Supports and services that cannot implement the necessary protective measures may need to be temporarily closed.

It is well-recognized that athletics and sports, including varsity and intermural sports as well as individual use of fitness facilities/recreation areas, play a meaningful role in a post-secondary institution's sense of community; help facilitate individuals' physical and mental health; as well as promote social connectedness. Post-secondary institutions are encouraged to use a risk-based approach when considering if and how these types of activities will proceed on- and off-campus. Some sports and athletic activities, especially those that are high-contact or team sports, can pose a greater risk for COVID-19 transmission. Post-secondary institutions may consider a variety of approaches and mitigation strategies to limit the risk associated with sports and athletics, including postponing sports events/activities and limiting/prohibiting spectators at sports/athletic events. For further details about offering gatherings/events during the pandemic, refer to the risk mitigation tool for gatherings/events^{Footnote 4}.

Post-secondary institutions should also collaborate with their local PHA to ensure their gym facilities and other recreational areas align with jurisdictional guidelines, particularly around physical distancing efforts and cleaning and disinfection of gym/sports equipment.

For more information about specific athletic and sports guidance, refer to the following resources: COVID-19 Return to High Performance Sport Framework^{Footnote 7}, CCOHS Athletics/Sports tip sheets, and national level sporting organizations and clubs for sport-specific advice.

Examples of mitigation strategies for provision of supports and services (excluding food)

Hierarchy of control category	Examples of mitigation strategies (in addition to promotion of personal practices and environmental cleaning/disinfection)
Physical distancing	Limiting the number of students/faculty/staff/visitors that can be within a building offering support/services at any given time. Reducing/blocking off the number of seats available in waiting areas, libraries and other study areas; ensuring at least 2-metre distances between seats. In office spaces where students receive academic/health counselling, arranging furniture so that there is at least 2 metres separation between students and advisors/counsellors. In athletic facilities, placing equipment so that there is at least 2 metres separation between individuals. Increasing accessible signage and floor markings in service/support areas to remind students/faculty/staff/visitors to practice physical distancing and to have unidirectional flow of foot traffic in narrow hallways/stairways. Introducing protocols to limit the number students/faculty/staff/visitors that can be inside an elevator at any given time, with consideration of diverse needs (e.g., space for mobility devices or diverse body types). Conducting activities outdoors (weather permitting) where feasible
Engineering	Implementing physical barriers (i.e., plexiglass/transparent barriers): to separate students/staff/faculty/visitors between service desks or check-out/payment counters; between desks in libraries and in other study areas, or increase availability of high-wall cubicles; between fitness machines in indoor athletic facilities. Providing barriers to assist with distancing at entrances and exits, while ensuring appropriate and safe accessibility for those with different mobility needs. Increasing ventilation in service/support areas by adjusting HVAC system or opening windows (weather permitting). Increasing the number of accessible hand sanitizer stations within the service/support area Reducing the number of common surfaces that need to be touched and eliminate any shared objects that are not essential for safety (e.g., prop doors open, use no-touch plastic-lined waste containers).
Administrative controls	Continuing offering support and services for students/staff/faculty online or via telephone wherever possible and feasible, especially for those at risk of more severe disease or outcomes (e.g., older adults, people of any age with chronic medical conditions, people of any age who are immunocompromised, and people living with obesity). When providing in-person service/support, provide students and visitors with electronic resources when possible, to reduce touching of papers. In retail settings, remind students/faculty/staff/visitors to limit touching of merchandise, or adopt "curbside" pick up options. Adopting contactless payment models, when possible (with exceptions for persons who can only pay by cash). Assigning specific study spaces/desks/computers to students, when possible. Establishing or reviewing protocols for environmental cleaning in public spaces and increase frequency of commonly touched surfaces and objects. Ensuring that strict exclusion policies for entering a service/support area are in place for students/faculty/staff/visitors who are ill, while taking care to avoid stigma or discrimination. Having a procedure for isolating students/faculty/staff/visitors who become sick while in a support/service area, while taking care to avoid stigma or discrimination. Keeping a safe, secure record/sign-in system of students/faculty/staff/visitors who access a service/support area, to facilitate public health investigation of cases and contacts in the event of an exposure at a service/support area.
PPE and NMMs	Encouraging use of NMM or face-coverings in service/support areas when physical distancing is not easy to maintain. Using appropriate PPE for staff in clinical settings (i.e., health services and walk-in-clinics) and require patients to wear NMM or face coverings.

Examples of mitigation strategies for in-residence food/dining services

Hierarchy of control category	Examples of mitigation strategies (in addition to promotion of personal practices and environmental cleaning/disinfection)
Physical distancing	Limiting the number of individuals permitted in dining halls/food service areas at any given time. Ensuring at least 2-metres distance between any seating areas that are present in dining halls/food service areas. Increasing accessible signage and floor markings in dining halls/food services areas to remind students/staff to practice physical distancing and have unidirectional flow of foot traffic in narrow aisles/stairways.
Engineering	Increasing ventilation in dining halls by adjusting HVAC system or opening windows (weather permitting). Implementing physical barriers (i.e., plexiglass) at checkout/payment counters or behind food display counters to separate food service staff and students. Considering increasing the use of vending machines with touchless payment options for delivery of pre-packaged/grab-and-go food options. Increasing the number of accessible hand sanitizer stations within dining hall/food services areas.
Administrative controls	Limiting or prohibiting seating/gathering areas in dining halls and food service areas (e.g., cordoning off spaces, removing seating). Assigning individuals to a certain dining hall/facility to limit contacts. Considering the use of cohorts for using dining halls/food services during designated times (e.g., all students within the same residence using dining or all students in the same courses/program). Offering staggered meal times and/or increase times of availability to limit the number of individuals seeking dining hall/food services at the same time. Discontinuing self-serve models (e.g., avoid buffet-style options, remove shared food/condiments/utensil stations) and increasing staff-serving options. Enhancing telephone/online/mobile-app ordering to increase take-out food options and increase grab-and-go food options Reducing touching of food by increasing pre-packaged food options. Adopting touchless payment options when possible (with exceptions for persons who can only pay by cash). Establishing or reviewing protocols for environmental cleaning in dining halls and increase frequency of commonly touched surfaces and objects.
PPE and NMMs	Encouraging the use of NMM or cloth face-coverings in while individuals are ordering/picking-up food (i.e., not when eating) when physical distancing is not easy to maintain. Ensuring that appropriate use of PPE (such as gloves suitable for the cleaning agents) is continued for staff handling/preparing/serving food and beverages (see CCOHS restaurant and food service tip sheetFootnote 8 for further detail).

Supporting community gatherings and student life (gatherings/events/activities sanctioned by the institution)

The mitigation measures applied to lower the risk of COVID-19 transmission will greatly impact the social activities available to staff and students. This will pose a challenge particularly for those on-campus and/or new to the institution and without a local social support network. Therefore, it is important to identify areas proactively where constructive social bonds and a sense of wellness can be built. While there are many online/virtual options that can be conducted (e.g., text and/or video chat, mobile applications for socially matching individuals) there will inevitably be in-person gatherings, likely informal and spontaneous.

To mitigate covert behaviours that may result in gathering in larger numbers than prudent and/or interference with case management and contact tracing efforts, the institution will have to determine how to best communicate and to normalize the expectations for in-person gatherings/events, including any consequences for not adhering to personal preventive measures. Facilitating the ability for small in-person gatherings to take place may be more effective in controlling the transmission of COVID-19 than banning them outright, provided the appropriate outbreak protocols are in place.

Campus administration and leadership of student and faculty associations should also anticipate that individuals may consume substances that could impair their judgement before or during a gathering/event, and thus they may be less able/likely to comply with personal preventive practices. The institution should prepare appropriate communications to highlight the increased risk posed by substance use during in-person gatherings and to promote strategies for the safe consumption of these substances, where permitted.

Examples of mitigation strategies for offering community gatherings and supporting student life

Hierarchy of control category	Examples of mitigation strategies (in addition to promotion of personal practices and environmental cleaning/disinfection)
Physical distancing	Offering in-person gatherings in areas with adequate space that will allow for physical distancing, and use accessible visual cues to remind individuals of 2-metre separation (e.g., tape off every other seat in indoor spaces, floor markings). Reinforcing general personal practices to maintain physical distancing, such as avoiding greetings like handshakes, high fives, fist bumps, and hugs.
Engineering	Increasing ventilation in indoor spaces by adjusting HVAC system or opening windows (weather permitting). Offering gatherings/events in outdoor spaces when possible and consider how to accommodate if inclement weather suddenly arises (e.g., plan for an alternative safe indoor space, or cancelling the gathering/event if it cannot be safely moved indoors while ensuring physical distancing). Providing barriers to assist with distancing at entrances and exits, while ensuring appropriate and safe accessibility for those with different mobility needs. Reducing the number of common surfaces that need to be touched and eliminate any shared objects that are not essential for safety (e.g., prop doors open, use no-touch plastic-lined waste containers). Increasing availability of accessible hand sanitizer stations and accessible signage to promote hand hygiene.
Administrative controls	Increasing availability of online/virtual options for gatherings/social activities to limit in-person attendance while maintaining social connectedness and student life (e.g., virtual meetings, online fitness classes, live streaming the gathering/event, recording a podcast or video). Offering more gatherings/events at a reduced capacity rather than hosting a single large/gathering event, while being careful to allow sufficient time between gatherings/events to implement proper mitigation strategies such as environmental cleaning. Requiring in-person social gatherings sponsored by clubs, programs/faculties, student bodies, etc. be registered (e.g., with the student association, faculty office, residence advisors) Keeping the duration of the gathering/event to a minimum to limit contact among attendees. Establishing or reviewing protocols for environmental cleaning in dining halls and increase frequency of commonly touched surfaces and objects. Keeping a safe, secure record/sign-in system of students/faculty/staff/guests who attend an in-person event/gathering, to facilitate public health investigation of cases and contacts in the event of an exposure at the event/gathering.
PPE and NMMs	Encouraging use of NMM or cloth face-coverings for gatherings when it may not be possible to maintain physical distancing.

Off-campus activities (non-sanctioned gatherings/events/activities)

While Administrators and faculty cannot control the interactions and events that students engage in while off-campus, a rigorous communications strategy on the risk of COVID-19 transmission should be in place. Consider a mandatory learning program at the start of each semester for all students and faculty to undertake (such as a podcast or public health information session) on the proper use of masks, hand hygiene, social distancing, etc. For more information, refer to the Government of Canada's COVID-19 website.

Planning for COVID-19: Case management and outbreak response

A robust plan for case management and outbreak response can limit the transmission of COVID-19 in the institution if individuals who are infected can be rapidly detected and isolated and contacts traced and quarantined. Administrators of post-secondary institutions should collaborate, share information, and review emergency plans with their local PHAs in advance of the academic year to ensure measures are in place to help protect their faculty, staff, students and guests. Post-secondary institutions should work with their local PHA to:

• Establish a strong working relationship and effective communication plan (i.e., consider appointing a liaison for the post-secondary institution and the PHA).
• Access information about COVID-19 activity in your community.
• Collaborate on emergency planning and develop the institution's notification and reporting protocol for the local PHA and primary care hospitals in the event of a symptomatic student, faculty, or staff.
• Plan for access to COVID-19 assessment centers, or provide medical care (e.g., testing) on-site, as feasible.
• Discuss specialist services that may be required (e.g., pharmacy services, mental health services, support/programming while in isolation/quarantine, access to essential supplies, food delivery, and childcare) for individuals living in residence, in off-campus housing, and those studying/working remotely.
• Develop a plan to have appropriate supplies on hand, such as personal protective equipment (PPE) for any staff who are providing direct care for students/faculty/staff (within 2 metres) or who cannot maintain a physical distance of 2 metres (e.g., in campus walk-in-clinics or health services).
• Developing a response team for any outbreak or other significant COVID-19-related event.
• To support contact tracing efforts, explore options for students/faculty/staff to track their activities/contact/movement (e.g., contact tracing apps, journaling, calendar, buddy-system) in the event they become extremely sick and unable to report this information themselves.
• Provide information for people who are isolating to take care of their mental health.

Anticipate an increase in absenteeism among students/faculty/staff and collaborate with occupational health and safety groups to develop an appropriate plan. Demonstrate flexibility for personal circumstances, including flexible attendance and sick-leave policies. Support and encourage students/faculty/staff to take care of their mental health and wellbeing by informing individuals that support services and resources are available, such as the Wellness Together Canada: Mental Health and Substance Use Support portal. Individuals may need to stay home when they are ill, caring for a household member who is ill, or caring for their children in the context of school closures. Identify critical job functions and positions, and plan for alternative coverage by cross-training staff members.

Ensure that students/faculty/staff are aware of financial and other support programs available to those with financial instability related to COVID-19 (e.g., for those who are not able to work due to illness/exposure, isolation/self-isolation, or loss of job/income), that may be offered through the institution, as well as those offered by federal, provincial/territorial/ and local governments. Information on Government of Canada assistance is available at Canada's COVID-19 Economic Response Plan.
The on-campus health promotion services should also work with the local PHA to promote reliable, accurate messages about COVID-19. This should include plans to communicate messaging around COVID-19 related stigma towards individuals or groups and speaking out against negative behaviours toward those who may experience stigma. Stigma can facilitate the increased transmission of the virus, as individuals may hide illness, be prevented from seeking care, or forego the adoption of core personal preventive measures. It also may undermine the sense of belonging for some students, and may exacerbate mental health challenges and feelings of "othering" by vulnerable groups (e.g., racial minorities, newcomers, etc.).

Monitoring, screening and testing for COVID-19

It is recommended that:

• Basic information on how to recognize symptoms of COVID-19 is made available to parents/guardians, students, faculty, staff and visitors, before arrival and while engaged in activities at the institution.
• Students/faculty/staff are encouraged to monitor their health daily for symptoms of COVID-19 and get tested if they develop symptoms compatible with COVID-19.
• Faculty and staff observe students for any signs of COVID-19 and isolate any students who are ill away from others, as quickly as possible, in a way that is mindful to avoid stigma and discrimination and follow established protocol for accessing medical attention and notifying the local public health authority.
• Students are encouraged to monitor their own health and self-isolate themselves if experiencing illness.
• Students, staff and faculty should be provided appropriate instructions on seeking medical care and notifying their local PHA as appropriate.

Post secondary institutions should determine the capacity of the institution to develop and to implement active and passive screening efforts and testing activities for COVID-19. Efforts should be made to ensure that the institution has reviewed plans with the local public health authority and local healthcare facilities.

Administrators of post-secondary institutions should refer to their local PHA for testing protocols and guidance, and collaborate to ensure that students/faculty/staff can be connected with testing facilities and medical care appropriately.

Case management of a student, faculty or staff member

In an effort to prevent or to reduce the spread of COVID-19, the entire Canadian population has been asked to self-monitor for symptoms of COVID-19 and to isolate themselves should symptoms develop and to follow instructions provided by their PHA. This principle also applies to a post-secondary setting. If a student, faculty, or staff member develops symptoms compatible with COVID-19, the PHA and healthcare provider will determine whether the ill person requires further assessment and/or hospitalization. If the ill person has mild symptoms and no underlying health conditions, it may be determined that they can convalesce at their place of residence if located off campus, or according to protocol if residing on-campus. See guidance for isolating a case in the home or co-living setting.

Post-secondary institutions should have a plan in place to rapidly notify affected students, faculty, and staff members to take the necessary actions. Persons who are ill with COVID-19 or who may have been exposed but do not have symptoms, must isolate/quarantine themselves from others. Special considerations are needed when the ill person lives in a campus residence, or shared house or apartment. PHAs and any campus-based health and social care services should work together to ensure that individuals isolating themselves in their place of residence (in both on- and off-campus housing) while ill with COVID-19 will have access to needed food and provisions, without having to leave, and will reduce the risk of exposure to others in the co-living setting.

Contact tracing

An individual risk assessment conducted by the PHA will identify each contact's exposure risk level and determine the required level and parameters of quarantine. Post-secondary institutions should ensure appropriate policies and procedures are developed, including the maintenance of up-to-date records of contact information of students/faculty/staff/visitors, to support local public health authority's contact tracing activities. If cohorting has been implemented in certain settings, identifying members of the cohort can facilitate contact tracing.

Administrations may play a role in facilitating contact tracing by public health, within the confines of privacy policies, such as using existing access control technologies (e.g., on-campus video cameras, electronic lock records) to complement traditional contact tracing methods. Post-secondary institutions should also assess the implementation of a contact tracing mobile application for individuals who will be on campus, which can also be used to provide individuals with COVID-19 related information.

Quarantine and isolation policies

It is important that post-secondary institutions work with PHAs to establish comprehensive quarantine and isolation policies and procedures to reduce the transmission of COVID-19 at their institution. Post-secondary institutions should ensure that there is/are^{Footnote 3}:

• A plan developed to manage cases and outbreaks in consultation with local public health authorities in advance of the academic year.
• Detailed policy that outlines how to identify an individual or group who may be exposed to the virus and must be quarantined.
• Support available to students/faculty/staff for relocating to appropriate accommodations for isolating/quarantine, while being mindful to avoid stigma and discrimination. This may include:
  • Allowing students who already live in campus residences to isolate/quarantine in their dorm rooms (only for rooms with single occupancy and access to a private washroom);
  • Designating specific on-campus rooms/residences/housing for individuals suspected or confirmed to have COVID-19 as well as separate accommodation for quarantine of exposed individuals;
  • Developing contracts with local facilities (e.g., hotels) to secure off-campus accommodations for quarantining/isolation purposes;
  • Cohorting individuals who have laboratory confirmed COVID-19 in a double occupancy room, floor or wing if many individuals are ill.
• Appropriate procedures for moving individuals to isolation/quarantine units without additional spread to others on campus.
• Plans to ensure appropriate care and support for students/faculty/staff needing to isolate/quarantine. This may include:
  • Delivery for meals and medications;
  • Mental and physical health support;
  • Services for laundry, cleaning, and garbage pick-up;
  • Flexible remote work or leave policies;
  • Access to academic/work materials, aids and technologies;
  • Entertainment and access to other supplies.
• Monitoring of health status in compliance/cooperation with the local PHA, and monitoring of violations of campus isolation/quarantine protocols.
  • Note that signage, education, access to technology, access to classes and coursework, counseling, healthcare, ability to communication with friends and family, and exercise can increase likelihood of adherence to requirement.

If an ill person cannot isolated in a single room with a private bathroom and may interact with others in the co-living setting, additional guidance can be found in Appendix 1: Instructions for isolating a case in the home or co-living setting^{Footnote 9} of the and How to care for a person with COVID-19 at home: Advice for caregivers.

Responding to a COVID-19 outbreak

If COVID-19 transmission is ongoing in the local community or COVID-19 has been identified among students/faculty/staff or guests who had access to the institution, work with the local PHA to establish plans to reduce the risk of further transmission at the institution. Collaborate with the local PHA to determine the number of cases that meet the threshold for declaring an outbreak at the institution. In the event of an outbreak, ensure the institution has developed internal and external communication strategies to alert students/families/faculty/staff/guests, the local public health authority, primary care, and other relevant community stakeholders. If students/faculty/staff/guests have exposures or develop symptoms, ensure alignment with local or jurisdictional protocols for diagnostic testing, quarantine (self-isolation), isolation, and clinical management.

Post-secondary institutions should establish an outbreak response team, including a liaison or members of the local PHA. When responding to a COVID-19 outbreak at a post-secondary institution, administrators should put their emergency operations and communication plans into action. This may include:

• Working with the local PHA to determine whether an outbreak should be declared, how to implement mitigation measures, and how the outbreak will be monitored by the PHA.
• Staying informed about the local COVID-19 situation. Get up-to-date information from the PHA. Regularly provide accessible and actionable information to people who are accessing your campus in accessible ways relevant to the population (e.g., email/text notification, social media, website updates, and signage in classrooms or residences).
• Enhancing education for students/faculty/staff/guests about ways to prevent the spread of COVID-19 including physical distancing and other personal practices, as well as instructions of what to do if symptoms occur and where to access testing.
• Prohibiting non-essential visitors from accessing campus spaces, including student residences, gym facilities, food courts, etc.
• Enhancing active (asking culturally safe questions about health status) and passive (accessible signage, voluntary reporting) screening activities of students/faculty/staff.
• Increasing access to hand hygiene stations/hand sanitizer dispensers and reminders about cough etiquette for all individuals accessing campus.
• Increasing cleaning frequency of highly used spaces, high-touch surfaces and objects (lounges/common areas, dining halls/food service areas, desks, doorknobs, electronics, elevator buttons, and faucets).
• Monitoring or connecting with students/faculty/staff who may be more likely to be exposed to the COVID-19 virus and those at risk of more severe disease or outcomes (e.g., older adults, people of any age with chronic medical conditions, people of any age who are immunocompromised, and people living with obesity), and reach out to them regularly. Ensure that they are informed about the symptoms of COVID-19 and how they may protect themselves through physical distancing and hand hygiene. When possible consider single rooms for those living in residences who are high risk due to chronic medical conditions.

Recovery from a COVID-19 outbreak

A COVID-19 outbreak could last a long time, and the impact on the institution and the local community may be considerable. The PHA will work with your organization to determine when the outbreak has ended in the community or institution. Take time to discuss your experiences with your staff, faculty, and students. As PHAs continue to plan for COVID-19 and other disease outbreaks, your organization has an important role to play in ongoing planning efforts.

Evaluate the effectiveness of your organization's plan of action

• Discuss and note best practices and lessons learned. How effective were your organization's COVID-19 preparedness actions?
• Talk about problems found in your plan and effective solutions. Identify additional resources needed for you and your organization.
• Participate in community discussions about emergency planning. Let others know about what readiness actions worked. Maintain communication lines with your community.

Maintain and expand your emergency planning. Look for ways to expand community partnerships. Identify agencies or partners needed to help you prepare for an infectious disease outbreak in the future.

Psychosocial and mental health needs of students, faculty, and staff

It will be important to promote and provide mental health support services and resources throughout this period as the physical, social, mental and emotional health and wellbeing of students/faculty/staff may be impacted by COVID-19. Mental health and wellness supports may contribute to the resiliency of students and faculty/staff in this setting. Institutions should take appropriate actions to ensure mental health supports and resources are available to those who will be accessing campus in-person, as well as those who are working/studying online/remotely. This may include augmenting existing mental health services available through your institution. Mental health and wellbeing supports need to be made accessible for diverse groups (e.g., considerations based on factors such as gender, race, Indigeneity, geographic location, rurality, ability, age, socioeconomic status and other intersecting identities. Resources on taking care of physical and mental health during COVID-19 are available, including the Wellness Together Canada: Mental Health and Substance Use Support portal.

Additional resources

For preventing stigma in the workplace: Preventing stigma

For on-campus child-care facilities: Risk mitigation tool for child and youth settings operating during the COVID-19 pandemic

For occupational health advice on work settings, including student placements: Pandemic (COVID-19) tip sheets