Management of Infectious and Communicable Disease

Scope

This policy applies to all employees at Indiana University including faculty and staff, all students, all IU units, and all visitors to IU properties and facilities.

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Policy Statement

Indiana University will take reasonable measures to ensure the safety of members of the university community during local, regional, and global infectious disease events. These may include implementing infection control guidelines and other non-pharmaceutical interventions. These may include programs or guidance for immunization, points of dispensing, personal protective equipment, behavioral guidance, testing, isolation and quarantine procedures, waste disposal, and cleaning and disinfection guidance.

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Reason for Policy

The purpose of this document is to provide guidance and establish authority for the assessment and coordination of any necessary response when an infectious disease impacts university operations. Each infectious disease event is unique, and this policy is not meant to be an exhaustive compendium of all diseases or situations, but rather a general guide for assessing the corresponding necessary steps for the university to consider.

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Procedures

Roles and Responsibilities:

1. Office of the Chief Health Officer (OCHO) and Environmental Health and Safety’s (IUEHS) Public Health Group:
   
   1. Provide policy level decision making and determination when to initiate an internal communicable disease response, when to activate any related Emergency Operations Center (EOC) or Incident Management Team (IMT), and when to conclude a response. IMT membership should include at a minimum, representatives from: OCHO, IUEHS, Public Safety, University Communications and Marketing, and Information Technology.
   2. Serve as university liaison with health agencies such as campus healthcare facilities, Local Health Departments (LHDs), Indiana Department of Health (IDOH), and the Center for Disease Control and Prevention (CDC), as necessary.
   3. Alert executive leadership of developing infectious disease situations that may impact Indiana University.
   4. Provide public health guidance and recommendations to university administration on strategies for managing infectious disease events including various non-pharmaceutical interventions and medical countermeasures.
   5. Assist and help coordinate local and state health officials and student health centers with the management and response to infectious disease events when resources allow.
   6. Coordinate with other IUEHS functional groups, facility operations, human resources, residential housing, event services and others as needed to develop workplace infection control guidelines (including technical support for waste management, shipping of biological materials, etc.) in accordance with local, state, and federal regulations and recommendations.
   7. Develop and maintain this policy.
2. Local Health Departments (LHDs)
   1. Serve as the official public health authority for infectious disease events within their jurisdiction, including the ability to take actions to control infectious diseases.
   2. Responsible for establishing recommended and mandated isolation and quarantine methods, including requesting court orders for compliance as necessary.
   3. Assess infectious disease situations and develop strategies for the distribution of medical countermeasures; LHDs may be able to provide staff and resources to assist with these measures on individual campuses.
   4. Provide information and guidance to Indiana University (OCHO/IUEHS) on developing infectious disease situations that may impact the university.
   5. Issue any local health orders, as appropriate, for the management of infectious disease.
3. Indiana Department of Health (IDOH)
   1. Manage the Indiana Health Alert Network (IHAN), which distributes health alerts to healthcare providers and public health professionals in the state of Indiana.
   2. Provide state-level resources, such as therapeutics, medicines, vaccines, staff, laboratory support, and epidemiological support, during infectious disease events.
   3. Provide information and guidance to Indiana University (OCHO/IUEHS) on developing infectious disease situations that may impact the university.
4. University Communications and Marketing
   1. Provide university public information, including developing communication strategies, preparing messages, and coordinating media requests during infectious disease events.
   2. Participation in any activated Emergency Operations Center (EOC) and/or Incident Management Team (IMT) due to an infectious disease event.
   3. Review any related guidance documents prior to publication or dissemination.
5. Indiana University Emergency Management and Continuity
   1. Provide operational support and coordination, including the activation and management of the EOC and/or an IMT, as needed.
   2. Coordinate and facilitate (with the assistance of OCHO and IUEHS) related training and exercises.
   3. Facilitate the development and/or execution of mass care and other potentially related operations, such as points of distribution plans (PODs).
   4. Procurement, management, and maintenance of a stock of potentially needed supplies during a large-scale disease event.
6. University Healthcare Facilities
   1. Report infectious disease and conditions, as detailed and defined in 410 IAC 1, notify IU (OCHO/IUEHS) of potentially developing infectious disease situations on their assigned campus.
   2. Provide medical expertise and guidance in the development of strategies to manage infectious disease events at their assigned campus.
   3. Provide information and guidance to Indiana University (OCHO/IUEHS) on developing infectious disease situations that may impact the university.
   4. Liaise with local hospitals and other medical support networks, as needed.
7. On-campus, residential housing
   1. Select and provide, where possible, any necessary quarantine, isolation, or holding space for residents that live in on-campus housing, based on IUEHS/OCHO guidance.
   2. Assist with arrangements, where possible, for any necessary support services (food, medications, transportation, etc.) for residents in campus provided quarantine or isolation housing.
8. Facility Operations
   1. Provide cleaning and disinfection services when directed by IUEHS/OCHO in non-residential buildings.
   2. Supply related items, such as masks or disinfectants in buildings, as directed by IUEHS/OCHO during disease events.
   3. Post related signage as directed by IUEHS/OCHO during disease events.
9. Human Resources
   1. Implement policies and services for employees under the guidance of IUEHS/OCHO, which may include remote work options, as well as supporting employees whose in-person presence is essential to university operations.
   2. Review any related guidance documents prior to publication or dissemination.
10. Office of Procurement Services
    1. Assist IUEHS/OCHO as well as any other university entity with purchasing and travel related needs during infectious disease events. 
    2. Tasks include but are not limited to sourcing, contracting, inventory management support, reporting, and metrics.
11. Event Services
    1. Assist during large scale operations and events related to infectious disease response, when requested by IUEHS/OCHO.
    2. Ensure the ability to restrict, cancel, and/or pivot events to virtual at the advisement of IUEHS/OCHO.
    3. Consider prioritizing outdoor events during high levels of infectious disease transmission.
12. Student Affairs
    1. Ensure that students are supported during infectious disease events.
    2. Collaborate with health services and other relevant departments to create and implement health education initiatives. This might include workshops, seminars, digital content, or informational materials about disease prevention and personal health.
    3. Ensure that students adhere to all necessary safety guidelines, policies, and protocols established by the university and public health authorities.
    4. Help identify and support vulnerable student populations who might be at higher risk or have specific needs during an infectious disease event.
13. Academic Affairs
    1. Help support faculty to ensure academic continuity on our respective campuses, when possible, during large scale disease events, including working with respective campus entities to facilitate the pivot from in-person instruction to virtual. 
    2. Propose academic policy adjustments to the respective faculty governance bodies as needed to accommodate changes due to the infectious disease event, including instructional modes, grading policies, attendance requirements, and examination procedures. Ensure these changes are communicated regularly and effectively to all relevant parties.
14. Athletics
    1. Follow guidance from any related city or county health department, IUEHS/OCHO, as well as any governing athletic conference (NCAA, NAIA, etc.) during disease events.
    2. Implement and enforce appropriate safety protocols for student-athletes, coaches, and staff.
    3. Keep all student-athletes, coaches, staff, and relevant stakeholders informed about any changes to athletic policies, schedules, and safety procedures, while also providing necessary health education related to the infectious disease event.
15. University Information Technology Services (UITS)
    1. Assist IUEHS/OCHO with information technology needs during infectious disease events, which may include systems for: scheduling, reporting, case investigation, data management, metrics, and data visualization.
16. Office of International Services
    1. Provide specific guidance and support to international students, who may face additional challenges such as travel restrictions, visa issues, housing access, or access to healthcare.
    2. Ensure compliance with immigration regulations, which may need to be adjusted for international students who switch to online learning, leave the country, or otherwise change their status due to an infectious disease event.
17. Office of Overseas Study
    1. Monitor international travel advisories and adjust education study abroad programs accordingly, which might involve repatriation of students, postponing or canceling programs, or transitioning to virtual international experiences.
18. Research
    1. Develop and implement strategies to maintain critical research operations. This may involve supporting remote work, rearranging lab schedules to allow for physical distancing, or prioritizing certain types of research.
    2. Ensure that all research activities continue to comply with necessary regulations and ethical standards during the disease event, even if methods or procedures need to be adapted.
19. Office of the General Counsel
    1. Provide legal counsel on the university's actions, guidance, and policies, ensuring they comply with all relevant local, state, federal, and international laws and regulations.

Operations:

1. Immunizations
   1. Per state statute and to enable the university to provide a safer and healthier environment for the university community, all students who attend Indiana University Bloomington and Indiana University Indianapolis must provide certain immunization information to the Office of the Chief Health Officer by completing the online Immunization Compliance Form before or during the semester in which they first matriculate. Students will provide the information and upload the associated medical documentation identified below on the form, which can be accessed at One.IU.edu. Submitting medical documentation of immunization assists IU, local, and state health officials during outbreaks of these diseases. If a student does not have, or is unable to obtain, medical documentation, self-reported dates of immunization are an acceptable form of documentation, so long as the student submits a record maintained by the student or a parent of the student showing the month and year during which each dose of vaccine was administered or provides information from such a record and an attestation as to the accuracy of the information.
      1. Students must provide dates of immunizations for the following diseases:
         • measles (requires two immunizations)
         • rubella (German measles, requires two immunizations)
         • mumps (requires two immunizations)
         • tetanus-diphtheria-acellular pertussis (Tdap)
         • varicella (requires two immunizations) if born after 1980
         • meningitis (one dose of MenACWY (MCV4)) on or after the student’s 16th birthday if aged 21 years old or younger
      2. Immunization for meningitis B (two doses of MenB for students aged 23 years old or younger) is strongly recommended. Students can provide medical documentation or self-reported dates related to their MenB immunization through the Immunization Compliance Form identified in paragraph (a) above.
      3. Before the semester in which they matriculate, all international students must provide documentation of a negative tuberculosis (“TB”) blood test result or a chest x-ray indicating that they are not infected with TB. The test must be administered in the United States.
   2. Students who do not provide the required immunization data will be prevented from matriculating for the semester following the commencement of their first academic term.
   3. Students are excused from providing medical documentation or self-reported information described in section (a) above for one or more of the required vaccinations only upon provision of or one or more of the following:
      1. physician's written statement of immunity due to having had the infection
      2. A medical exemption that includes a statement of contraindication to a vaccine (accompanied by a physician's statement)
      3. a lab titer documenting immunity
      4. a statement of religious exemption
   4. The immunization requirements in this policy are not meant to supersede more restrictive immunization requirements associated with on-campus housing, childcare facilities, clinical, academic, research, or other university programs, or as required by specific university units as a condition of employment.

Infection Control Guidelines:

1. General
   1. As an organization, Indiana University reserves the right to restrict access to university properties and activities during an infectious disease event. Restrictions may include, but are not limited to classrooms, events, workplaces, and on-campus housing.
   2. OCHO/IUEHS will develop workplace infectious disease controls and guidance in accordance with local, state, and federal regulations and recommendations. Controls will depend on the infectious disease.
2. Quarantine and isolation
   1. Under IC 16-41-9, only the local public health authority may petition a court to issue an order of involuntary isolation or quarantine for a person who may have been infected or exposed to a dangerous communicable disease. Isolation and quarantine directives from Indiana University will be requests for individuals to self-isolate and self-quarantine. IU will work with local authorities in cases involving campus residents to ensure that the campus community is maximally protected.
   2. Indiana University will coordinate with local authorities on cases involving residential students and staff to ensure proper methods are applied to minimize risk to the campus community. The university will also ensure strategies are established to provide support services for those who live in on campus housing and may be impacted by such restrictions.
   3. Each residential campus will identify area(s) within existing campus facilities that could be used as quarantine and/or isolation space during larger infectious disease events. Additionally, they shall have the capacity to isolate rarer cases of infectious disease amongst their residents (tuberculosis, measles, mumps, etc.), if the residents are unable to safely return home for isolation. These locations and capacities should be communicated to OCHO/IUEHS for retention. If there is no area that exists that can be utilized for this purpose, that should also be communicated to OCHO/IUEHS. Note that the operation of quarantine and isolation facilities will necessitate the identification of staffing and support services and supplies such as beds, food, basic supplies, custodial services, security, etc.
3. Non-pharmaceutical interventions
   1. Additional non-pharmaceutical interventions that may be implemented during a larger infectious disease event could include distributing related supplies and protective equipment, universal masking, physical distancing, closures or restrictions of events or in-person gatherings, travel restrictions, cleaning and disinfection, hand hygiene, respiratory etiquette, air filtration and ventilation, education, and quarantine and isolation.
   2. Travel guidelines and restrictions
      1. Indiana University is responsible for maintaining a safe and healthy environment for faculty, staff, and students. Therefore, it reserves the ability to implement travel restrictions or reporting regulations during an infectious disease event. Travel guidelines may apply to official university business as well as personal travel. OCHO/IUEHS will work with various departments as needed relating to travel and infectious disease, including the Office of International Services and the Office of Overseas Study.
         1. The university will consider travel advisories established by the United States State Department and the CDC; however, it does reserve the right to implement restrictions above those established by either of these agencies.
         2. Humanitarian exemptions will be considered on a case-by-case basis by OCHO/IUEHS.
4. Distribution of Medical Countermeasures
   1. A point of distribution (POD) may be necessary for medical countermeasures including immunizations, medications, and/or medical supplies.
      1. OHCO/IUEHS is responsible for coordinating any necessary formal memorandum of understanding (MOU) with Local Health Departments (LHDs) on formal POD agreements, should it be determined a campus has the resources and capabilities to support an open or closed POD.
      2. A POD plan shall be required for each campus in which an MOU has been signed with the LHD, OCHO/IUEHS and IUEMC shall facilitate the development, evaluation, management, and maintenance of such plans.
      3. Areas designated for PODs should be large enough to allow large groups of people to easily flow through the operation. An ideal location allows for drive-through access to minimize interpersonal interactions.

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Definitions

Definitions and Acronyms

CDC – The Center for Disease Control and Prevention.

Closed POD – A closed POD is a point of dispensing location for medical countermeasures for a specific or defined group or population.

EOC – Emergency Operations Center.

IDOH – Indiana Department of Health.

Isolation – isolation separates sick people with a contagious disease from people who are not sick.

IMT – Incident Management Team.

IUEHS – Indiana University’s Environmental Health and Safety.

LHDs – Local Health Department.

MOU – Memorandum of Understanding, a memorandum of understanding is an agreement between two or more parties outlined in a formal document.

OCHO – Office of the Chief Health Officer.

Open POD – An open POD is a point of dispensing location for medical countermeasures that are available and open to anyone in the general community.

POD – a Point of Dispensing or Point of Distribution, is a location where agencies distribute medical countermeasures to the public or a specific group of individuals.

Quarantine – Quarantine separates and restricts the movement of people who were exposed to a contagious disease, to see if they become sick.

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Sanctions

Penalties or sanctions related to this policy and infectious disease will be managed on a case-by-case basis. In some emergent cases, the university may prescribe more specific actions, penalties, or sanctions based on the current disease situation.

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Additional Contacts

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History

This policy was established in 2015

Policy updated January 2016 to make a few minor clarifications to the policy consisting of allowing for electronic signature and clarifying that students that aren’t physically coming to campus aren’t covered.

Policy was updated in July 2018 due to changes in state law regarding immunization requirements.

Policy was updated in 2022 to clarify immunization reporting requirements.

Policy was substantively reviewed and updated in 2023 and transitioned to the Office of the Chief Health Officer (OCHO). The policy number was updated to reflect the transition to OCHO.

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