Policies and procedures to minimise risk of Covid-19 for ...

Confidentiality Statement This Document is the property of Trinity College School of Medicine and must not be reproduced without permission.

Printed Copies of this document are for reference only

Title: Return to Business Manual- School of Medicine

Version Number: 6 Effective Date: 8th September 2020

Document Number: SOM-SOP-MAN-0040

Policies and procedures to minimise risk of Covid-19 for

students, staff and patients - 2021

Version 2

of 75 Confidentiality Statement

This Document is the property of Trinity College School of Medicine and must not be reproduced without permission.



Version Number: 2 Effective Date:


Table of Contents:

1.0 PURPOSE ................................................................................................................. 2

2.0 SCOPE ...................................................................................................................... 2 3.0 BASELINE PRINCIPLES .............................................................................................. 2 4.0 GOVERNANCE & RESPONSIBILITY ........................................................................... 3 5.0 REFERENCES ............................................................................................................ 4

6.0 DEFINITIONS & ABBREVIATIONS ............................................................................. 4 7.0 PROCEDURE ............................................................................................................. 4 8.0 APPENDICES .......................................................................................................... 11 9.0 SIGN OFF ................................................................................................................ 12 10.0 VERSION HISTORY ............................................................................................... 13







1.0 PURPOSE

1.1 This manual is intended to mitigate and reduce the risk of spread of COVID-19 as students return to their studies on campus and at associated clinical settings. All staff and students are expected to follow and model compliance with this manual and the published public health guidelines. This manual and associated appendices are subject to frequent review alongside with the introduction and review of additional public health guidelines from the Health Services Executive and the University. Any policy amendments or updates will be communicated immediately through the School of Medicine COVID-19 webpage and circulated to staff via email. Information from this manual will be provided to students by email, Blackboard and in posters. All communications with students should be based on the information within this document. All staff and students are advised to check their TCD emails regularly. All new policies and amendments will take effect as of the date and time of publication, and any communications that flow from this policy will need to be updated accordingly. This policy aligns with the allocated roles and responsibilities outlined to the School via the wider College’s phased resumption of activities project.

2.0 SCOPE

2.1 This manual seeks to outline the policies and procedures to be followed by students to minimize the risk of Covid-19 infections to students and toothers.

3.0 BASELINE PRINCIPLES

3.1 This manual is a live document applicable to all staff and students in the School of Medicine and will be continuously reviewed and amended as public health and College guidelines are updated and as phases pass.

• All policies and procedures being implemented are aligned with Government and the College roadmap as listed on the TCD COVID-19 website

• All policies and procedures will comply with social distancing protocols, health and safety recommendations and Health Services Executive requirements.

• Each discipline has devolved responsibilities at a local level and with their associated clinical sites, as outlined in the document. It is essential that all staff and students across the School of Medicine take individual responsibility for the implementation of this policy across all the SOM sites.

• Students are advised to follow public health guidance when traveling to, from and between SOM campuses and hospital sites.

• Should lockdown or increased levels of restrictions be re-established, School of Medicine staff and students will follow Government, College and updated School of Medicine advice.

https://www.tcd.ie/about/coronavirus/phased-reopening-plans/

https://www.tcd.ie/about/coronavirus/







4.0 GOVERNANCE & RESPONSIBILITY

4.1 The SOM COVID Return to Business Committee meets regularly and will continue to do so in order to review the mechanisms in place to ensure the health and safety of staff and students across the multiple campuses.

5.0 REFERENCES

• Resumption of Education Guidelines-Gov.ie

• Self-isolation and restricted movements

• Covid-19 symptoms and treatment

• Covid-19 vaccination guidelines

• Covid-19 Testing guidelines

• Close contacts and contact tracing guidelines

• Close contacts and contact tracing guidelines

• COVID-19 Plan for re-opening of third level from September

• College Campus Resumption plans 2021

6.0 DEFINITIONS & ABBREVIATIONS

6.1 The Head of School: Hereafter referred to as HOS, has overall responsibility for the management and running of the SOM.

6.2 The School Manager: Hereafter referred to as SM, provides support to the HOS in the management and co-ordination of all the School's activities.

6.3 The HSE defines a close contact as:

• Having a cumulative unprotected exposure during one work shift (i.e. any breach or omission of the appropriate PPE) for > 15 minutes face- to-face (< 1 meters distance) to a case

• Having any unprotected exposure of your eyes or mouth or mucus membranes, to the bodily fluids (mainly respiratory secretions e.g. coughing, but also includes blood, stools, vomit, and urine) of the case.

• Having any unprotected exposure (i.e. any breach in the appropriate PPE) while present in the same room when an aerosol generating procedure is undertaken on the case.

6.4 The HSE define a casual contact as:

• A cumulative protected exposure during one work shift for > 15 minutes face-to-face (< 1 meters distance) to a case

• Any protected exposure to the bodily fluids (mainly respiratory secretions e.g. coughing but also includes blood, stools, vomit, and urine) of the case.

https://www.gov.ie/en/publication/372c0-commitments-and-actions-for-a-safe-return/#careful-and-safe-opening-up-on-site

https://www.gov.ie/en/publication/372c0-commitments-and-actions-for-a-safe-return/#careful-and-safe-opening-up-on-site

https://www2.hse.ie/conditions/covid19/restricted-movements/restricted-movements/

https://www2.hse.ie/conditions/covid19/restricted-movements/restricted-movements/

https://www2.hse.ie/conditions/covid19/symptoms/

https://www2.hse.ie/conditions/covid19/symptoms/

https://www2.hse.ie/screening-and-vaccinations/covid-19-vaccine/


https://www2.hse.ie/conditions/covid19/testing/

https://www2.hse.ie/conditions/covid19/testing/

https://www2.hse.ie/conditions/covid19/contact-tracing/




https://hea.ie/2021/06/16/covid-19-plan-for-re-opening-of-third-level-from-september/

https://www.tcd.ie/provost/assets/pdf/2021/return-to-campus-document.pdf







• Any protected exposure while present in the same room when an aerosol generating procedure is undertaken on the case.

• Not wearing gloves but was wearing other appropriate PPE, performed hand hygiene immediately after hand skin contact with secretions / excretions of a case, would be considered low risk and therefore not a close contact.

• A cumulative unprotected exposure during one shift (i.e. any breach or omission of appropriate PPE) for less than 15 minutes face-to-face (less than 1 meters distance) to a case.

6.5 It is important to note that in clinical areas, all students and staff must abide by local Infection Control Guidance. If these differ from University/School Guidelines, local Infection Control decisions are paramount.

7.0 PROCEDURE

7.1 Logistics & Management

7.1.1 Travelling into Ireland:- Students are advised to monitor the conditions of entry into Ireland as outlined in the government website at https://www.dfa.ie/travel/travel-advice/

7.1.2 The SOM plans on return to work will be changed and updated as required in line with University and government guidelines and policy. It is important to note that the SOM management team and COVID-19 coordinators have discussed and agreed general safety, cleaning and ventilation with the Premises Managers for the relevant premises, this work is at different stages within the different buildings as the building plans are being prepared and finalised. the School needs to inform the Director of TBSI if any undergraduate/ post-graduate students and research staff based in TBSI have reported symptoms and/or are positive for Covid 19 with floor number/area.

7.1.3 Travel to Ireland and from airport to accommodation: The student will have provided Trinity with their travel arrangements two weeks in advance. The completed forms will be sent to the company organising the greet and transfer service After landing in Dublin, the student should present themself to a member of the International Higher Education Students – Greet and Transfer Service team who will be in both Terminal 1 and Terminal 2, Dublin Airport. They will be wearing bright yellow jackets and there will be signage in Arrivals and, from there, you will be directed to the dedicated transport service to bring you to your Trinity approved accommodation

7.1.4 Students must wear and bring a supply of face coverings. Face coverings should be worn at all times indoors as per HSE guidelines.

7.1.5 Derogation from the 1M social distancing rule: In certain circumstances it is permissible to hold teaching events with masks and no social distancing for classes that are fully vaccinated. This can be applied at the discretion of the Discipline with advice, if required from the RTB team

https://www.dfa.ie/travel/travel-advice/

https://www.dfa.ie/travel/travel-advice/

https://www.tcd.ie/study/international/trinity-life/arrival/

https://www.tcd.ie/study/international/trinity-life/arrival/







7.1.6 Before arriving to teaching locations or to the hospitals: In order to ensure the safe return of students to clinical placements, proof of vaccination status must be provided to the SOM. In addition, all relevant HSE guidelines should be followed.

7.1.7 Covid-19 Students Undertaking/Declaration – Resumption of Clinical Placements: The Covid-19 Student Undertaking/Declaration (Appendix 2) is accessed via BlackBoard under the relevant Year overview 2021/22. This is a once-off self-declaration that all students/staff must complete 3 days before resuming teaching/work. This includes a declaration regarding the completion of quarantine or self-isolation, where applicable, for those students travelling from outside Ireland.

7.1.8 Covid-19 Risk Assessment Form (includes self-declaration of completion of the Covid-19 Training Pack): The Covid-19 training pack is accessed via Blackboard under the relevant Year overview 2021/22. Students must ensure that they comprehensively review all the sections in this training pack before they complete and upload each of the 4 certificates and the Risk Assessment Form. Students are required to upload the completed form by Friday 3rd September 2021.

7.1.9 Covid-19 Daily Health Questionnaire: The Covid-19 Daily Health Questionnaire (Appendix 4) is accessed via the Trinity Live App and is required by the HSE. This is a daily self-declaration which must be completed each weekday by all SoM students in all years, regardless of whether they are on clinical placement, teaching, study or at home (see section 7.5 below). This exercise must be completed no later than 10 am each day. The completed forms will be regularly reviewed by a member of staff. The preclinical year student reports will be reviewed every two weeks and clinical year student declarations will be reviewed once a week. Repeated failure to submit this self-declaration may result in the student being removed from clinical placement with immediate effect. Students should follow the instructions on the form and the algorithm outlined in the Daily COVID- 19 Questionnaire Algorithm for TCD medical students on placement (see Appendix 7 ).

7.1.10 HSE Covid tracker app: Students are being asked to download the HSE Covid-tracker app and fill in the symptom Check-in daily. This app will support contact tracing by identifying other users within 2m. The app is available at https://covidtracker.gov.ie or via the app store. This

app uses Bluetooth to determine those in close contact with a known case of Covid-19 and is used by Public Health to assist in contact tracing. If the student is contacted by public health in relation to contact tracing, they should follow the advice but also notify the dedicated email address [email protected] for further instruction.

https://covidtracker.gov.ie/

mailto:[email protected]










7.1.11 Zoom etiquette: Do’s

Don’ts

• Find a clean, quiet space and dress appropriately.

• Let all household members know when and where you will be in class, and ask them not to disturb you.

• Make sure your full name as appears on your student ID card is displayed at all times.

• Be aware of your background, lighting, and noise.

• Mute until you are required to talk. Use the Zoom functions to communicate if needed (chat, raise your hand, answer yes/no, etc.).

• Use an appropriate zoom background.

• Be on time to class. Communicate with your lecturer (via their preferred communication method listed on the syllabus) if you will be late or if you lose your connection during class.

• Enter a zoom that you weren't invited to, share the zoom access information for your class with others, or enter under a different name.

• Take screenshots, or otherwise record the meeting.

• Change your name or change your zoom background during the meeting.

• Use the chat for side conversations / inappropriate chats with classmates

7.2 Use of Scrubs in clinical settings

7.2.1 All students on clinical placements must wear the SOM approved scrubs. The School has organized for students to order three sets of scrubs from the supplier on a dedicated website https://r1.dotdigital- pages.com/p/208K- PG1/trinity-college-Dublin-uniform-sign-up. These scrubs are embroidered with the School of Medicine, Trinity College Dublin logo and are dark blue. In extreme circumstances students can avail of a hardship fund to assist with the purchase of the scrubs and should contact School Manager Dr. Alex Mc Kee

7.2.2 Students must order three sets of scrubs - one to wear, one ready to wear for the next day, and one in the wash. Scrubs should be washed at 40 degrees or higher with detergent. Students may need to change into hospital-provided scrubs for certain areas (e.g. theatre, ICU). Students must not wear scrubs while travelling to or from hospital.

https://r1.dotdigital-pages.com/p/208K-PG1/trinity-college-dublin-uniform-sign-up










7.3 Student identification and use of lanyards 7.3.1 Students will not be allowed access to hospitals and clinical sites without

their student identification. Students have been advised not to let the lanyard fall loosely when examining patients and must abide by local Infection Control Guidance as to their use in clinical areas.

7.4 Face coverings for Students

7.4.1 Students are required to wear a face covering as follows:

• In all classroom and laboratory settings: Masks are to be supplied by students and worn in all classroom and laboratory settings and on entry/exit and when moving around the teaching space in all buildings. Cloth or surgical masks are acceptable unless instructed otherwise in relation to a specific activity.

• Mask wearing in the clinical setting: In most hospital settings, masks will be supplied by the Hospital where the student is on placement to ensure it is of the required grade. There may be exceptions to this. There will be no access to any clinical setting for students without masks. Local infection prevention and control team advice will take precedence over this advice. Higher grade (N95) masks may be required in certain settings, in these cases the hospital IPC will be responsible for ensuring appropriate mask use by students, in the same way that they ensure this for staff. Please ensure masks used in the hospital are disposed of in clinical waste.

7.5 Self-declaration of Covid-19 symptoms by students, or close contact with a person with Covid-19 symptoms, or a diagnosis ofCovid-19.

7.5.1 If a student experiences symptoms of possible COVID-19 at any time they must follow the advice in the Daily COVID-19 Questionnaire Algorithm for TCD medical students on placement (Appendix 7)

• Stay at accommodation or return to accommodation

• Contact Student Health (01 896 1591) or your personal GP and ask for advice regarding the need for a test.

7.5.2 Any students who are a casual/close contact (see definitions section 6.3 & 6.4) of someone with COVID-19 you should follow the Daily COVID- 19 Questionnaire Algorithm for TCD SoM students on placement. Household contact. If students on clinical placement (predominately 3rd , 4th & 5th year) are determined to be a household contact of a confirmed case they will need to isolate for 10 days and follow appendix 12.







If students not on clinical placement (predominantly 1st and 2nd year students) are determined to be a household contact of a confirmed case they should follow public health advice.

7.5.3 The SOM contact person monitoring [email protected] Will notify the Occupational Health (OH) Department and Infection Prevention and Control (IPC) Team in the hospital of any cases of confirmed COVID- 19 in students who have been on placement in the hospital within 48 hours of the onset of COVID-19 symptoms (or 24 hours prior to testing in the case of asymptomatic cases).

7.5.4 The SOM contact person will also notify OH and IPC (Appendix 6) at the placement site of any students who are close contacts of confirmed COVID-19.

7.5.5 Positive test results will be notified to Public Health according to the usual protocols. Public Health will carry out contact tracing and testing on social contacts. Hospitals and health partners are responsible for contact tracing and testing patients and staff who may have had contact with positive cases of COVID-19, and it is therefore of paramount importance that their Occupational Health departments (contact details in Appendix 6) be notified of these in a timely manner.

7.6 Students with underlying medical conditions

7.6.1 Students who self-declare health conditions that place them in a ‘high risk’ category should follow the HSE guidelines available on: https://www2.hse.ie/conditions/coronavirus/people-at-higher- risk.html and outlined in Appendix 5. Students may also consider discussing this with their General Practitioner, and/or personal Physician (if applicable), and/or College Student Health. For students in this category who are undertaking clinical placements, additional to following all local infection control policies with regard to wearing of PPE, social distancing, and hand hygiene, they should avoid visiting the following clinical areas/procedures:

7.6.2 Emergency Department, Intensive Care Unit, designated COVID-19 wards, Aerosol Generating Procedures (e.g. Bronchoscopy), and clerking patients with suspected or confirmed COVID-19 infection. Students may wish to additionally consider wearing an FFP2 mask rather than a surgical mask and a visor. During their induction training and as part of their pre- placement declaration (Appendix 2) students will be asked to declare if they have an underlying medical condition that places them in a ‘very high risk’ or ‘high risk’ category for severe COVID- 19 infection (see HSE risk categories in Appendix 5)and at People at higher risk - HSE.ie

7.6.3 Students who self-declare that they fall into the "very high risk" category must notify Student Health, their College tutor and the SoM via [email protected] and request for their case to be reviewed. In the meantime, students who self-declare that they belong to the ‘very high-

https://www2.hse.ie/conditions/covid19/testing/antigen-testing/

mailto:%[email protected]

https://www2.hse.ie/conditions/coronavirus/people-at-higher-risk.html




https://www2.hse.ie/conditions/covid19/people-at-higher-risk/



https://www2.hse.ie/conditions/covid19/people-at-higher-risk/overview/#very-high-risk-groups-(extremely-vulnerable)









risk category’ must not start their clinical attachments but should cocoon pending their case being reviewed and a decision being made.

7.6.4 Trinity College Covid-19 response plan. To comply with Trinity College Covid-19 response plan (Appendix 9), All School of Medicine students, if they are diagnosed as having Covid-19 must notify their Discipline EO/Administrator, [email protected] AND Course Director as required by the response plan. Having a detailed diary of contacts over the preceding 14 days will be important in assisting with contact tracing.

7.6.5 Trinity College resumption plan (2021) The College, in response to the Government guidelines has produced a two phase resumption plan (here) that provides guidance to the Schools in managing a return to face to face teaching. The first phase will include a social distance rule of 1M, and the use of facemasks in laboratories, lectures and tutorials. A 2M social distance rule will continue to apply in libraries and study spaces. It is anticipated that the second phase will commence after reading week.

7.6.6 Named individuals in the School in relation to the Trinity College Covid- 19 response plan: The names and contact details of staff with roles and responsibilities in relation to the Trinity College Covid-19 response plan are in Appendix 10

7.6.7 Covid-19 Vaccination Policy All students in the School of Medicine are expected to be fully vaccinated against Covid-19. The School of Medicine Vaccination policy is outlined in Appendix 11.

7.6.8 UniCov Ireland testing The SOM has a strong expectation that students participate in this programme as it will facilitate the safe, continual return to on-campus learning and teaching for SOM students and staff, UniCoV will explore effective rapid testing and surveillance systems within third-level institutes to assist with the early identification of asymptomatic SARS-CoV- 2. Findings will inform the development of early warning systems and expedite future outbreak prevention and control. All students participating in this programme are expected to declare results in a professional manner. https://www.tcd.ie/ttmi/unicov/




http://www.tcd.ie/ttmi/unicov/







8.0 APPENDICES

8.1 Appendix 1: HSE Guidance on Clinical Placements in HSE Facilities August 2021

8.2 Appendix 2: COVID-19 Supplemental Student Undertaking/Declaration

8.3 Appendix 3: COVID-19 Risk assessment Form for Students

8.4 Appendix 4: Daily Check in Form- App

8.5 Appendix 5: Classifications of high risk and very high- risk groups

8.6 Appendix 6: Contact details for Covid- 19 Coordinators

8.7 Appendix 7: Student symptom Response Flow chart

8.8 Appendix 8: Letter's from CCO to all HEIs regarding healthcare students placements

8.9 Appendix 9: Covid- 19 Response Plan- Trinity College 2021

8.10 Appendix 10: Names and contact details for those with roles and responsibilities under the Trinity College Dublin Covid-19 response plan

8.11 Appendix 11: School of Medicine Vaccination Policy 8.12 Appendix 12: St. James's Hospital Household Contact Policy 8.13 Appendix 13: School of Medicine Vaccination Policy 8.14 Appendix 14: Letter from Colm Henry re: students who decline vaccination and

clarification letter re: clinical placements







9.0 SIGN OFF

Prepared by Prof. Thomas Rogers

Signature:

Date:22.11.21

Reviewed by Prof. Kevin Conlon (Return to Business Committee Chair)

Signature:

Date:22.11.21

Reviewed by Prof. Joseph Harbison (Director of Undergraduate Teaching and Learning)

Signature:

Date:22.11.21 Reviewed by: Dr. Alex Mc Kee (School Manager)

Signature:

Date: 22.11.21

Approved by: Professor Michael Gill Head of School

Signature:

Date: 22.11.21







10.0 Version History

Version Description of Change Revised By

1.0 Original M.Gill

2.0 Update to section 7.5.2 to state if students are determined to be a household contact whilst on clinical placement in SJH they should refer to and follow appendix 12.

Algorithm updated to reflect household contact protocol

M.Gill


Version Number: 2 Effective Date: 2 September 2020

Document Number: Appendix 1: HSE Guidance on Clinical Placements in HSE Facilities August 2021

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HSE Guidance on Clinical Placements in HSE Facilities August 2021

The education and training of undergraduate students in healthcare disciplines within our model is based on a multi-stakeholder partnership involving patients, students, the Higher Education Institutes, the regulators of the professions and healthcare service providers including the HSE. Throughout the last academic year the HSE worked with the Higher Education Institute and other partners to ensure that clinical placements for students in the healthcare professions were facilitated through an exceptionally challenging year.

The HSE remains committed to working with key partners to support clinical placements for the coming academic year to the greatest practical degree subject to the priority of protecting the safety of patients, staff and students. In the context of an infectious disease that is now vaccine preventable, vaccination plays a key role in balancing the support for clinical placements with protection of the safety of all concerned. Given the importance of vaccination, the HSE will continue to promote vaccination and to provide vaccination free of charge to students intending to undertake clinical placements on the same basis as it provides vaccination to staff. The vast majority of students intending to go on clinical placement have accepted vaccination in the interest of protecting patients, their colleagues and themselves and we anticipate that this will continue. Vaccination against COVID-19 is voluntary in Ireland. The HSE is not seeking to impose vaccination on students.

There are a relatively small number of students that have not accepted vaccination. In a very limited number of cases this is because of a specific medical contraindication identified in the guidance published in the Immunisation Guidelines for Ireland. In a number of cases students have declined vaccination for other reasons.

In relation to staff who are not vaccinated because of a specific medical contraindication identified in the guidance published in the Immunisation Guidelines for Ireland or for other reasons the HSE applies a risk assessment process that is designed to protect both the staff member and the most vulnerable of patients from exposure to non-vaccinated staff to the greatest degree that is practical while maintaining services. The guidance on risk assessment is provided as an appendix to this document for information. The risk assessment indicates that redeployment of some non-vaccinated staff to areas where the risk to them and to patients/service users is lower may be necessary for a period of time. The HSE proposes to adopt a similar approach to Clinical Placements although the process presented in the appendix is for staff is not intended to prescribe how HEI approach this with individual students.

For the purpose of this document, Clinical Placements refers to unpaid clinical experience for healthcare students whose presence is not specifically required to sustain service delivery. Students (for example 4th year nursing students) who constitute part of the workforce that sustain service delivery are in the same category as other healthcare workers. Those students who are paid members of the workforce are considered as staff members at work rather than as students on clinical placement.

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For the purposes of this document fully vaccinated means: ▪ 7 days after the second dose of Comirnaty (Pfizer-BioNTech) ▪ 14 days after the second dose of Spikevax (Moderna) ▪ 15 days after the second dose of Vaxzevria (Astra-Zeneca) ▪ 14 days after the single dose of the Janssen vaccine

Although heterologous vaccine is only recommended in very exceptional circumstances (previous anaphylaxis) in the Immunisation Guidelines for Ireland (Chapter 5a) at present this is recognised as effective in that context. Therefore students who have had a heterologous booster administered in another country can be considered as vaccinated for the purposes of clinical placement in HSE facilities if both the first and second dose of vaccine was with vaccines licensed for use in the EU/EEA.

The HSE will continue to accept clinical placements for HEI students on the following basis:

Governance

A document should be agreed between the Higher Education Institute (HEI) and service/hospital that accommodates the clinical placement. The document should address issues of legal liability in the event of alleged harm to students arising from their clinical placement and specific measures to manage risks of infection for patients, healthcare workers and students related to the clinical placements. Where such a document is already in place the partners should consider if a review is required in the context of changes and experience since last reviewed.

There is a requirement for the HEIs to periodically review adherence to the agreed processes.

Infection Prevention and Control Requirements from Higher Education Institutes

1. The HEI will provide an assurance that students and teachers/educators have given a clear commitment that they will not present on clinical placement if they have any symptoms of acute infection such as symptoms of viral respiratory tract infection or gastroenteritis. This continues to apply to students and educators who are fully vaccinated. The format and the manner in which this commitment is given is at the discretion of the HEI.

2. The HEI will provide an assurance that a readily accessible record is retained of which clinical areas

/services students and teachers/educators have been assigned to and at when. Data for the previous 2 to 4 weeks may be required in the event of an IPC incident such as an outbreak. There is no requirement for long-term storage of this data. The HEI will determine the manner of recording and storing the information. Students who perform physical examination on patients should not record patient identifiers in their logbook or personal electronic devices but may record their own name and student number and date on which they examined the patient in the patient’s record.

3. The HEI will provide an assurance that there is a pathway by which students and teachers/educators can rapidly inform an appropriate person in the HEI in the event that they develop an infectious disease (COVID-19 or other communicable infectious disease) that may have implications for patients and staff who have recently been exposed to the students. The HEI will have a process for communicating this information appropriately to the relevant HSE service area.

4. The HEI will provide an assurance that clinical placements have been reviewed to ensure that

student(s) and teacher(s)/educator(s) presence in clinical areas is limited to events/time that ae essential for student education so that students are not present in clinical areas without a specific purpose.

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5. The HEI will provide an assurance that unsupervised presence of students in clinical areas is carefully controlled. If students to engage in self-directed and unsupervised learning in clinical areas they must do so alone or in small groups (usually 2 or 3), this should be limited to defined areas or services (for example the team to which they are assigned) and they should be present in the clinical area for the minimum time necessary for their learning. Students engaged in self- directed learning should move away from the clinical area for any extended group discussion of their learning.

6. The HEI will provide an assurance that students and teachers/educators will be “bare below the

elbows/bare above the wrist” when in clinical areas.

7. The HEI will provide an assurance that all students have had appropriate infection prevention and control training in advance of clinical placement, to include Standard and Transmission-based Precautions.

8. The HEI will provide an assurance that all students have been assessed and certified as competent

in performance of hand hygiene in advance of clinical placement and have competence re- assessed at least once in each academic year. Competence may be assessed by visual observation of performance of hand hygiene by an assessor with appropriate training.

9. The HEI will provide an assurance that all students and teachers/educators will comply with IPC direction given by HSE staff when they are in HSE clinical areas.

10. The HEI will provide an assurance that there is a process in place to ensure that students have been assessed to ensure that they have been offered immunisation, have been immunised and where appropriate (for example Hepatitis B virus) have been tested to ensure immunity to relevant infectious disease in line with relevant national guidance.

11. Students who are not confirmed as immune to Hepatitis B virus may not engage in exposure prone

procedures (Note 1).

12. Students who are not fully vaccinated against COVID-19 (see definition above) must not be assigned to clinical placement in readily identifiable areas where they are likely to have frequent contact with people who are at high risk of severe disease if they the acquire COVID-19. This includes in particular haematology & oncology in-patient areas, haemodialysis services, intensive care units including neonatal intensive care units. Unvaccinated students should also give an undertaking to excuse themselves in the event that they become aware that they are in close contact with a person who is at high risk of severe disease on any clinical placement. Students who are not vaccinated should be instructed not to attend clinical placements in clinical areas where they are aware that there is evidence of an outbreak of COVID-19 and to avoid any situation in which they are knowingly in contact with a patient or staff member who has suspected or confirmed infectious COVID-19. (Note 2).

13. The HEI will provide an assurance that students undertake to co-operate with requirements for

management of outbreaks or other incidents of infection including providing samples for testing where required.

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14. The HEI will provide an assurance that where relevant PPE training has been completed to ensure correct donning and doffing including training on www.hseland.ie and videos on www.hpsc.ie and that

15. The HEI will provide an assurance that IPC Guidance including IPC COVID-19 Guidance and

educational videos on www.HPSC.ie/infection control/ have been reviewed.

16. The HEI will provide an assurance that a process is in place for students to make a declaration that they are free of key symptom of COVID-19 each day immediately before or when they present for placement. The format of the declaration may be any means that is practical in the context. Students must understand that if they are not in a position to make such a declaration they may not attend for placement. There is no requirement that the declaration is reviewed by the HEI before the student attends on a given day. The HEI should have a process in place to monitor students’ adherence to the requirement in a reasonably timely manner.

17. The HEI should provide an assurance that clinical placements have been reviewed to minimise the

extent to which students move between multiple different healthcare or social care sites over a short period of time. It is accepted that in some cases attendance at different sites is required on consecutive days.

18. The HEI should ensure there is an agreed maximum number of students present in a clinical space for any teaching activity. Generally, the number of people present at a bedside teaching session should be no more than six excluding the patient and any accompanying person (five students with one teacher/educator). In certain settings where there is a requirement for a relatively large number of clinical staff (for example a surgical team, some procedures in the intensive care unit, delivery of a baby, ward round) the number of students should be limited to one or at most two.

19. Moving from one placement site to another:

Students can move from a placement in one institution to a placement in another without an interval of time subject to the following: ▪ They have adhered to recommended Infection Prevention and Control Practice at all times with

all individuals during clinical placement. ▪ They do not have fever, cough, shortness of breath or other symptoms of COVID-19 or other

communicable infectious disease. Routine testing of asymptomatic vaccinated students for COVID-19 before moving from one clinical placement to another is not required. Students who are not vaccinated must complete a COVID-19 Healthcare Worker Relocation Self Risk Assessment where the student is reassigned from one institution/service to another on completion of the placement in one institution/service. (For example if the student is moving their base from one hospital to another or from a primary care service to a hospital, they should complete the Self Risk Assessment). Testing should be performed, if required, based on the outcome of that Self Risk Assessment. The Self Risk Assessment form is available at the link below.

https://www.hse.ie/eng/staff/workplace-health-and-wellbeing-unit/covid-19-guidance/covid-19- testing-protocol-for-healthcare-workers-moving-to-a-different-service.pdf

Similarly, if the student works in a healthcare setting during the same period as attending clinical placements, they should complete this self-assessment on an ongoing basis to identify the need for testing.

http://www.hseland.ie/

http://www.hpsc.ie/

http://www.hpsc.ie/infection

https://www.hse.ie/eng/staff/workplace-health-and-wellbeing-unit/covid-19-guidance/covid-19-

5

Notes:

1. Where the student has fully cooperated with the required immunisation process but immunity to a specific infection cannot be confirmed (for example non-response to Hepatitis B vaccine) there should be an assurance that there is a process to manage the risk to patients and the student. Where a student has a chronic viral infection (for example HIV) there should be an assurance that there is a process in place to manage the risk to patients.

2. The HSE understands that it may be very difficult for some students in some disciplines to meet all the current requirements for training as specified in the curriculum within the limits set out. The HSE facilitates and supports clinical training in the partnership model as set out and will seek to support the HEIs and Professional Regulators in any adaptation that they can make to facilitate students in completing their education within these limits.

6

Appendix 1

Appendix

Risk Assessment for COVID-19 Vaccination

Guidelines for Healthcare Workers

12th July 2021

Changes from Version of 28th May

- This document replaces the previous version issued 28thMay. - The key change is the insertion of section 8 on assessing risk-benefit associated with

deployment of non-vaccinated healthcare workers to direct patient/service user care roles. - There are some editorial changes and clearer indication that risk of exposure is lower for

patients/service users who are vaccinated.

- Rephrasing of questions in Appendix 5.

1. Introduction

In March 2020, the WHO declared a SARS-CoV-2 (COVID-19) pandemic. Since its emergence,

COVID-19has spread rapidly on a global scale.

Frontline Healthcare Workers (HCWs) have a higher exposure to COVID-19 virus due to the nature

of their work. In comparison to other workers, healthcare workers appear to have a higher risk of

COVID-19 infection (1). This is likely to be related to the fact that frontline healthcare work

requires close personal exposure to patients/service users with SARS-CoV-2 (2).

Since the pandemic commenced in Ireland from 01/03/2020 until 01/05/2021 the total number

of COVID-19 confirmed Healthcare worker cases has been 28,719 cases (11.4% of total cases in

Ireland). Of these 786 cases were hospitalised and 101 admitted to ICU (3). However the

proportion of all cases accounted for by healthcare workers is much lower since vaccination of

healthcare workers was implemented.

During outbreaks of vaccine preventable disease, for which there is a safe and effective vaccine,

institutions have a responsibility to provide and promote immunisation to staff to protect them

from infection and disease. Healthcare institutions have a further responsibility to limit

patient/service user exposure and the exposure of other staff to risk of infection from individuals

who are not immunised (4).

Vaccination of Healthcare Workers (HCWs) for infectious diseases is recommended in the Safety,

Health and Welfare at Work (Biological Agents) Regulations 2013 and 2020 (S.I. No. 572 of 2013)

(5). The primary aim of the COVID-19 vaccination programme is to protect those who are most at

risk of illness or death from COVID-19. The organisation is providing the vaccine to staff free of

charge together with full information and support. The HSE is also committed to make the process

of receiving the vaccine as convenient as possible. The COVID-19 vaccination is recommended for

all Healthcare Workers except for those with a specific medical contraindication (9).

7

To enhance the safety, health & wellbeing of staff and patients/service users, the organisation

introduced a process of risk assessment in May of this year, to support staff working in roles where

COVID-19 vaccination is particularly recommended and who may not have availed of vaccination. This

is an update on that process. While the HSE is committed to respecting the privacy of staff

members it is necessary in this context to collect and manage data on vaccination status of staff

members. The HSE is committed to protect the security and confidentiality of data collected.

Please see relevant DPC guidelines issued in July 2021, http://www.dataprotection.ie/en/dpc-

guidance/processing-covid-19-vaccination-data-context-employment which acknowledges the

need for healthcare organizations to include vaccination status as an essential mitigation in

certain circumstances.

2. Risk of COVID-19 Infection in Healthcare Workers

During the ongoing COVID-19 pandemic, healthcare workers are at substantially increased risk of

becoming infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and

infection is associated with a significant risk of serious disease, in particular in those who are

unvaccinated. Healthcare workers may be exposed to both infectious patients/service users and

colleagues in the workplace and may be exposed outside of the workplace. (6). According to a

study relating to UK experience between March and July 2020 (prior to availability of vaccine) Healthcare

workers had a more than seven-fold higher risk of severe COVID-19 compared with the general

population(1).

3. Impact of Vaccination on Transmission of SARS-CoV-2

European Centre for Disease Prevention and Control have stated that ‘COVID-19 vaccines licensed

in the EU/EEA have been shown during clinical trials to be highly effective in providing protection

against symptomatic and severe COVID-19. Evidence from real-life usage of COVID-19 vaccines has

confirmed these clinical trial findings and showed high vaccine effectiveness against PCR-

confirmed SARS-CoV-2 infection.

The ECDC Interim Guidance on benefits of full vaccination against COVID-19 for transmission risks

and implications for non- pharmaceutical interventions concludes that ‘’based on the limited

evidence available the likelihood of an infected vaccinated person transmitting the disease is

currently assessed to be very low to low”. They further state that the likelihood of severe disease

for unvaccinated individuals is low for younger adults and adolescents and high for unvaccinated

older adults or people with underlying comorbidities. (11).

Many patients/service users are older adults or people with underlying comorbidities and some

of them may be unvaccinated or may have conditions that impair their response to vaccine. There

is a significant concern regarding the risk to them of severe disease and it is essential that the

healthcare service do all that is practical to minimise risk to them associated with accessing

healthcare services.

4. Healthcare Workers and Risk Categorisation for prioritisation of COVID-19 vaccination

4.1. The COVID-19 Vaccine Allocation Strategy sets out a provisional priority list of groups for vaccination. The Strategy was based on recommendations from the National Immunisation

http://www.dataprotection.ie/en/dpc-guidance/processing-covid-19-vaccination-data-context-employment

http://www.dataprotection.ie/en/dpc-guidance/processing-covid-19-vaccination-data-context-employment

https://www.ecdc.europa.eu/en/publications-data/interim-guidance-benefits-full-vaccination-against-covid-19-transmission




8

Advisory Committee (NIAC) and initially approved by government on 8th December 2020. The allocation groups have been updated more recently taking account of new recommendations from NIAC.

4.2. Currently frontline Healthcare workers are in allocation group 2 for vaccination. This group is divided into further subgroups as outlined at the following link https://www.gov.ie/en/publication/39038-provisional-vaccine-allocation-groups/ (7).

5. Risk Categorisation

5.1. HCW positions must first be categorised as Category A – Frontline HCW or Category B -Other Workers

5.2. Those in Category A must be further categorised using the ‘Healthcare Worker Categorisation Risk Assessment - COVID-19 Vaccine’ (See appendix 3), to determine if they are in a ‘Category A High Risk position’.

5.3. The classification is given to a position depending on the requirements of the role and as specified in Appendix 1 Risk Categorisation Guidelines.

6. COVID-19 Vaccination Programme and Risk Assessment

6.1. The Safety, Health and Welfare at Work Act 2005 provides that employers have a duty of care towards employees in relation to safety, health and welfare at work. In that context it is appropriate to manage the risk to any employee of contracting the virus and/or potentially passing on the virus to other employees (8).

6.2. For the purpose of managing this risk, COVID -19 vaccination is recommended for all Healthcare Workers other than those who have a specific medical contraindication. Where people have a specific medical contraindication it is important that this is appropriately assessed and documented. Where there is a contraindication to one type of vaccine another type of vaccine may be appropriate.

6.3. The HSE provides information on COVID-19 vaccination and provides vaccination as above. Vaccination is based on the consent of the staff member to accept vaccination.

6.4. Healthcare workers, students, contractors and other people exposed in Category A High Risk Area positions should confirm their status with respect to vaccination against COVID-19 to their line manager when requested to do so.

6.5. Healthcare workers, students, contractors and other people exposed in Category A High Risk Area positions who can confirm that they have had COVID-19 in the previous 9 months may be regarded as equivalent to vaccinated healthcare workers, students, contractors and other people for purposes of this risk assessment.

6.6. Healthcare workers, students, contractors who decline vaccination should be asked to confirm that they have been offered vaccination and that they understand that vaccination remains available to them if they change their mind or if their circumstances change. The manager should complete the ‘COVID-19 Vaccination Status Form’ in appendix 5 with the HCW.

7. Individual Risk Assessment

7.1. All Category A positions must be assessed according to the level of risk of exposure to COVID- 19 in the context of work location and client group.

https://www.gov.ie/en/publication/39038-provisional-vaccine-allocation-groups/


9

7.2. This should be carried out by the individual’s Line Manager in accordance with existing HSE policy and in consultation with the individual employee. See Appendix 3 – Healthcare Worker Categorisation Risk Assessment - COVID-19 Vaccine

7.3. The conduct of the risk assessment should be planned and scheduled with the staff member.

7.4. The highest priority of assessment, screening and vaccination must be assigned to workers employed in Category A - High Risk Area positions (refer to Appendix 1).

8. Risk Mitigation Options for Category A High Risk HCWs who decline vaccination.

8.1. Good infection prevention and control practice including appropriate use of PPE is recommended for all healthcare workers but are particularly important for those who are not vaccinated.

8.2. Reassignment to areas with lower exposure risk is an important option for managing risk of exposure for people who are not vaccinated. This is a temporary reassignment and is subject to review as the situation changes.

8.3. Monitoring for evidence of infection is important for all healthcare workers to protect others from exposure to infection. This is particularly important for those who are not vaccinated but staff members who are vaccinated can have infection and should also be monitored. Monitoring for evidence can be based on reporting of symptoms and on testing. Testing of healthcare workers who are not vaccinated for SARS-CoV-2 infection at intervals based on risk assessment may be an option for mitigation of the additional risk they may pose to others, but it is not equivalent to vaccination in terms of risk reduction.

8.4. Risk management options should reflect a point in time and be reviewed as appropriate to take account of the current level of transmission of COVID-19 in the community and the specific healthcare setting.

8.5. HCWs should be advised as to who they can contact for vaccination if they change their mind or if they have further questions. Please see NIAC (National Immunisation Advisory Committee) for contraindications to COVID-19 vaccination. https://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/covid19.pdf(9)

9. Risk Benefit Assessment and Mitigation Options for Category A High Risk HCWs who decline vaccination.

9.1. Decision on the deployment of non-vaccinated staff to roles that involve direct contact with

patient/service users must take account of the risks to patients/service users associated with contact with non-vaccinated staff and the benefits to patient/services users associated with contact with non-vaccinated staff

9.2. All healthcare facilities are required to implement good IPC practices and all healthcare workers (vaccinated and un-vaccinated) are required to adhere to good IPC practices including:

• processes to assess staff for symptoms on arrival at work and exclusion of staff who have symptoms

• processes to ensure that staff who become symptomatic while at work report those symptoms and leave work promptly

• monitoring of compliance with appropriate IPC measures (PPE, social distancing, etc.)

https://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/covid19.pdf



10

• appropriate processes for testing of staff as appropriate based on national guidance and local risk assessment

9.3. All of the above measures lower the risk to patients/service users associated with exposure to

non-vaccinated staff.

9.4. In that context other elements relevant to assessing the risk to patient/service users are

• The level of virus circulation in the community where the healthcare worker or other person concerned lives

• The vaccination status of potentially exposed patients/service users; the risk is much lower for fully vaccinated patients and service users

• The age, medical condition and medication of potentially exposed patients/service users; for example those who are immunocompromised by virtue of their condition or treatment are likely to be a greater risk even if vaccinated

9.5. Elements relevant to assessing the benefit to patient/service users are

• The importance of the role of the healthcare worker or other person concerned to supporting service delivery.

• The availability of others to fulfil that role if the healthcare worker or other person concerned is not available.

9.6. The risk to benefit ratio

• Unfavourable risk-benefit The risk with respect of exposure of a patient/service user to a non-vaccinated health care worker is likely to be high if there is a high incidence of infection in the community and if the patient/service user is at high risk of severe disease because of their vaccination status (non-vaccinated) and or age or medical condition. The benefit to the patient/service user is less if alternative appropriately skilled and vaccinated people are available to provide the service and greater if alternative appropriately skilled and vaccinated people are NOT available to provide the service.

For example, a non-vaccinated healthcare worker should not work on a transplant service during a period of high community transmission unless their role is essential, and no other appropriately skilled and vaccinated person is available to provide the service

• Favourable risk-benefit The risk with respect of exposure of a patient/service user to a non-vaccinated health care worker is likely to be low if there is a low incidence of infection in the community and if the patient/service user is at low risk of severe disease because of their vaccination status (non-vaccinated) and or age or medical condition. The benefit to the patient/service user is less if alternative appropriately skilled and vaccinated people are available to provide the service and greater if alternative appropriately skilled and vaccinated people are NOT available to provide the service.

11

For example a non-vaccinated healthcare worker on a community nursing unit or day care service where most service users are vaccinated would represent a low-risk in proportion to the benefit during a period of low community transmission if their role is essential and no other appropriate skilled person is available to provide the service

The examples given represent extremes. Many situations will be intermediate between these extremes. Each situation must be assessed individually.

10. Audit

Service management is responsible for auditing compliance with the process. An audit

tool is available in appendix 6.

11. References

1. Mutambudzi M, Niedwiedz C, Macdonald EB, Leyland A, Mair F, Anderson J, Celis- Morales C, Cleland J, Forbes J, Gill J, Hastie C, Ho F, Jani B, Mackay DF, Nicholl B, O'Donnell C, Sattar N, Welsh P,Pell JP, Katikireddi SV, Demou E. Occupation and risk of severe COVID-19: prospective cohort study of 120 075 UK Biobank participants. Occup Environ Med. 2020 Dec 9:oemed-2020-106731. doi: 10.1136/oemed-2020-106731.

2. Bailey JRM, Przewrocka C, Dijkstra KK ,Swanton C. COVID-19:the case for health-care-worker screening to prevent hospital transmission. The Lancet, 2020 ISSN:0140- 6736,Vol:395,Issue 10234,page:1418-1420.

3. HSPC (2021) Report of the profile of COVID-19 cases in healthcare workers in Ireland. Report prepared by HPSC on 04/05/2021. https://www.hpsc.ie/a- z/respiratory/coronavirus/novelcoronavirus/surveillance/covid- 19casesinhealthcareworkers/COVID- 19_HCW_weekly_report_04%2005%202021_v1.0%20website%20version.pdf

4. AMA (2021). Code of medical ethics: physicians and the Health of the community, Opinion 8.7. https://www.ama-assn.org/delivering-care/ethics/routine-universal- immunization-physicians

5. Safety, Health and Welfare at Work. (Biological Agents) Regulations 2013 and 2020

(S.I. No. 572 of2013). http://www.irishstatutebook.ie/eli/2020/si/539/made/en/print#

6. Bielicki JA, Duval X, Gobat N.et al. Monitoring approaches for health-care workers during theCOVID-19 pandemic. Lancet InfectDis2020:20:e261-67.

7. Department of Health (2021). Provisional Vaccine Allocation

Groups. https://www.gov.ie/en/publication/39038-provisional-

vaccine-allocation-groups/

8. The Safety, Health and Welfare at Work Act. 2005.

http://www.irishstatutebook.ie/eli/2005/act/10/enacte

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/surveillance/covid-19casesinhealthcareworkers/COVID-19_HCW_weekly_report_04%2005%202021_v1.0%20website%20version.pdf









https://www.ama-assn.org/delivering-care/ethics/routine-universal-immunization-physicians



http://www.irishstatutebook.ie/eli/2020/si/539/made/en/print



http://www.irishstatutebook.ie/eli/2005/act/10/enacted/en/print

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d/en/print

9. NIAC - National Immunisation Advisory Committee. www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/c ovid19.pdf

10. Health Protection Surveillance Centre - Infection Prevention and control guidance for COVID-19- personal protective equipment. https://www.hpsc.ie/a- z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolg uidance/ppe /

11. ECDC Technical Report ‘Interim guidance on the benefits of full vaccination against

COVID-19 for transmission and implications for non-pharmaceutical interventions’, 21st

April 2021. Available at: https://www.ecdc.europa.eu/en/publications-data/interim-

guidance-benefits-full-vaccination- against-covid-19-transmission

http://www.irishstatutebook.ie/eli/2005/act/10/enacted/en/print

http://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/covid19.pdf





https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/ppe/










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12. Appendix 1 - Risk Categorisation Guidelines Category A All positions must be categorised as Category A that involve either:

1. Direct Physical contact with:

A) patients/clients

B) deceased persons, body parts

C) blood, body substances, infectious material or surfaces or equipment that might

contain these(e.g. soiled linen, surgical equipment, syringes)

OR

2. Contact that would allow the acquisition or transmission of diseases that are spread by

respiratory means:

A) Workers with frequent/ prolonged face to face contact with patients or clients e.g.

interviewing or counselling individual clients or small groups; performing reception duties

in an emergency /outpatient department.

B) Normal work location is a clinical area such as a ward, outpatient clinic (including, for

example ward clerks and patient transport officers);or who frequently throughout their

working week are required to attend clinical areas, e.g. persons employed in food services

who deliver meals and maintenance workers.

Category A - HIGH RISK AREA WORKERS

1. This applies to workers:

• In associated community settings whose usual clients are pregnant women,

transplant, or oncology/haematology patients

• Who are required to work in a variety of areas or change location on a rotating

basis or who may be required to work in Category A High Risk areas

• who are posted to or frequently work in Category A High Risk clinical areas

Workers employed in positions in the following high-risk clinical areas are particularly

recommended to receive the COVID-19 vaccine.

High Risk clinical areas include but not be limited to the following

1. Residential aged care facilities and other facilities caring for older people (especially if non- vaccinated)

2. Emergency Departments

3. Intensive Care Units

4. Transplant and Oncology/Haematology wards and units

5. Pre-natal maternity units and clinics

14

Category B – OTHER WORKERS

1. Do not work with high-risk client groups or in the high-risk clinical areas listed above

2. Work predominantly with vaccinated groups in whom the vaccine is likely to be effective (that is non-immunocompromised)

3. No direct physical contact with patients/clients, deceased persons, blood, body

substances or infectious material or surfaces/equipment that might contain these.

4. Normal work location is not in a clinical area, e.g. persons employed in administrative

positions not working in a ward environment, food services personnel in kitchens

5. Only attends clinical areas infrequently and for short periods e.g. visits a ward occasionally

on administrative duties; is a maintenance contractor undertaking work in a clinical area.

6. Incidental contact with patients no different to other visitors to a facility (e.g. in elevators,

cafeteria etc.)

15

13. Appendix 2 - Frequently Asked Questions for Managers on Risk assessment for COVID-19Vaccination

i. Why must a HCW undergo a risk assessment for COVID-19 vaccination this year?

COVID-19 has caused a worldwide pandemic and has placed significant demands on the health

service.

Due to the current COVID-19 pandemic, it is important to support and encourage all HCWs to

accept vaccination but particularly those HCWs working in high-risk areas. It is likely that the

introduction of a Risk Assessment will help improve the uptake of COVID-19 vaccination among

Healthcare workers (HCW) and those in frontline positions and where vaccination is declined, to

consider how the risks to staff and patients can be mitigated.

ii. Who should carry out the risk assessment?

As a manager you should use this risk assessment for all Category A HCWs to identify if the HCW

is in a ‘Category A High Risk Area’ position.

iii. What if a person I manage indicates that they have not been vaccinated?

In the first instance it is important to explore why the person does not wish to be vaccinated and

to provide them with access to Occupational Health or other appropriate expertise so that they

may discuss their concerns.

In addition it is important to assess the risk to the person of acquiring COVID-19 and the risk

that they may represent to others if they become infected and consider which, if any, risk

management options are appropriate.

It is also necessary to consider how critical the role of the staff member is to maintaining service

in the context of availability of others with relevant skills to maintain the service

iv. Why are there so few high risk clinical areas? What about other areas?

The current list of Category A High Risk clinical areas represents identified key areas however a

service may identify other areas based on their knowledge and experience of their service.

v. Do Category A High Risk Area Workers involve community workers?

Yes. The assessment must consider the extent of exposure not the service area. (Refer to appendix 1 - Risk Categorisation Guidelines).

vi. How are workers that are involved in rotating positions/on-call managed in relation to the

Category A High Risk Area requirements?

Workers that are required to work in a variety of areas or change locations on a rotating basis

may be required to work in Category A High Risk clinical areas and will therefore be categorised

as Category A High Risk.

16

vii. Does the Category A High Risk Area requirement apply to workers who work in the specified

unit/s for part of their shift?

The requirements for Category A High Risk workers applies if the worker is posted to or

frequently works in a Category A high risk unit/s

viii. What if a HCW gets vaccinated by their local GP/ Nurse/Pharmacist/Mass Vaccination Clinic?

The Healthcare worker should ensure that their vaccinator provides them with evidence of

COVID-19 vaccination. They can then inform their manager.

17

14. Appendix 3 -Healthcare Worker Categorisation Risk Assessment - COVID-19 Vaccine Healthcare Workers

Name:

Work location:

Assessment Date:

Job title:

Manager:

Healthcare Worker Category:

1. Category A Worker – If any boxes ticked in i OR ii , Go to Part 2 for further categorisation

i- Direct Physical contact with:

☐ patients/clients

☐ deceased persons, body parts

☐ blood, body substances, infectious material or surfaces or equipment that might contain these (e.g. soiled linen, surgical equipment, syringes)

ii - Contact that would allow the acquisition or transmission of diseases that are spread by respiratory means:

☐ Frequent/ prolonged face to face contact with patients or clients e.g. interviewing or counselling individual clients or small groups; performing reception duties in an emergency /outpatient department.

☐ Normal work location is a clinical area such as a ward, outpatient clinic(including, for example ward clerks and patient transport officers);or who frequently throughout their working week are required to attend clinical areas where they may have significant exposure to patients/service users.

2. Category A - HIGH RISK AREA WORKERS – If any in i AND ii applies – COVID-19 Vaccination requirements apply and evidence of vaccination to be provided to manager.

i - Applies to Workers in

☐ associated community settings whose usual clients include transplant, or oncology/haematology patients or other high risk groups

☐ required to work in a variety of areas or change location on a rotating basis or who may be required to work in Category A High Risk areas

☐ posted to or predominately work in Category A High Risk clinical areas

ii - High Risk clinical areas

☐ Residential aged care facilities and other facilities caring for older people (particularly if non- vaccinated or immunocompromised).

☐ Emergency Departments

☐ Intensive Care Units

☐ Transplant and Oncology/Haematology wards and units ☐ Pre-natal maternity units and clinics ☐ Other -

3. Category B Workers - COVID-19 Vaccination is recommended.

18

Applies to workers who:

☐ Do not work with high risk client groups or in the high-risk clinical areas listed above

☐ Work almost exclusively with vaccinated people who are not immunocompromised

☐ Have no direct physical contact with patients/clients, deceased persons, blood, body substances or infectious material or surfaces/equipment that might contain these.

☐ Normal work location is not in a clinical area, e.g. persons employed in administrative positions not working in a ward environment, food services personnel in kitchens

☐ Only attends clinical areas infrequently and for short periods of time e.g. visits a ward occasionally on administrative duties; is a maintenance contractor undertaking work in a clinical area.

☐ Incidental contact with patients no different to other visitors to a facility (e.g. in elevators, cafeteria etc.

18

15. Appendix 4 – Sample Risk Assessments

Sample 1 - Clerical Officer. Office based. Attends 2 half day Outpatient clinics weekly where there is significant interaction with patients/service users

1. Category A Worker – If any boxes ticked in i OR ii , Go to Part 2 for further categorisation

i - Direct Physical contact with:

☒ patients/clients

☐ deceased persons, body parts ☐ blood, body substances, infectious material or surfaces or equipment that might contain these

(e.g. soiled linen, surgical equipment, syringes)


☐ Frequent/ prolonged face to face contact with patients or clients e.g. interviewing or counselling individual clients or small groups; performing reception duties in an emergency /outpatient department.

☒ Normal work location is a clinical area such as a ward, outpatient clinic (including, for example

ward clerks and patient transport officers); or who frequently throughout their working week are

required to attend clinical areas where they may have significant exposure to patients/service users.

2. Category A - HIGH RISK AREA WORKERS – If any in i AND ii applies – COVID-19 Vaccination requirements apply and evidence of vaccination to be provided to manager.


☐ associated community settings whose usual clients include transplant, or oncology/haematology patients or other high risk groups

☐ required to work in a variety of areas or change location on a rotating basis or who may be required to work in Category A High Risk areas

☐ posted to or predominately work in Category A High Risk clinical areas


☐ Residential aged care facilities and other facilities caring for older people (particularly if non-vaccinated

or immunocompromised).



☐ Transplant and Oncology/Haematology wards and units and home based services ☐ Pre-natal maternity units and clinics ☐ Other -

3. Category B Workers - –COVID-19 Vaccination is recommended.



☐ Work almost exclusively with vaccinated non-immunocompromised people

☐ Have no direct physical contact with patients/clients, deceased persons, blood, body substances or infectious material or surfaces/equipment that might contain these.

☐ Normal work location is not in a clinical area, e.g. persons employed in administrative positions not working in a ward environment, food services personnel in kitchens

☐ Only attends clinical areas infrequently and for short periods of time e.g. visits a ward occasionally on administrative duties; is a maintenance contractor undertaking work in a clinical area.

☐ Incidental contact with patients no different to other visitors to a facility (e.g. in elevators, cafeteria etc.

Outcome – Category A worker. COVID-19 Vaccination is of importance. If vaccination is not

accepted all other risk mitigation options must be considered including redeployment. This must

take into consideration the feasibility of maintaining service if the person is redeployed.

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Sample 2 - Staff Nurse on an Oncology ward

1. Category A Worker – If any boxes are ticked in i OR ii, Go to Part 2 for further

Categorization

i - Direct Physical contact with:

☒ patients/clients

☒ deceased persons, body parts

☒ blood, body substances, infectious material or surfaces or equipment that might contain these(e.g.

soiled linen, surgical equipment, syringes)


☒ Frequent/ prolonged face to face contact with patients or clients e.g. interviewing or counselling individual

clients or small groups; performing reception duties in an emergency /outpatient department.

☒ Normal work location is a clinical area such as a ward, outpatient clinic (including, for example ward

clerks and patient transport officers); or who frequently throughout their working week are required to attend clinical areas where they may have significant exposure to patients/service users.

2. Category A - HIGH RISK AREA WORKERS – If any in i AND ii applies- COVID-19 Vaccination requirements apply and evidence of vaccination to be provided to manager.


☒ associated community settings whose usual clients include infants, pregnant women, transplant, or

oncology/haematology patients

☐ required to work in a variety of areas or change location on a rotating basis or who may be

required to work in Category A High Risk areas

☒ posted to or predominately work in Category A High Risk clinical areas


☐ Residential aged care facilities and other facilities caring for older people.



☒Transplant and Oncology/Haematology wards and units and home based services

☐ Pre-natal maternity units and clinics ☐ Other -

3. Category B Workers - COVID-19 Vaccination is recommended.



☐ Have no direct physical contact with patients/clients, deceased persons, blood, body substances or

infectious material or surfaces/equipment that might contain these.

☐ Normal work location is not in a clinical area, e.g. persons employed in administrative positions not

working in a ward environment, food services personnel in kitchens

☐ Only attends clinical areas infrequently and for short periods of time e.g. visits a ward occasionally on

administrative duties; is a maintenance contractor undertaking work in a clinical area.

☐ Incidental contact with patients no different to other visitors to a facility (e.g. in elevators,

cafeteria etc.

Outcome – Category A High Risk Area worker. COVID-19 vaccine is very

important. If vaccination is not accepted redeployment is likely to be necessary

unless the service cannot be maintained without that person. If redeployment

is not possible all other risk assessment options should be considered.

20

16. Appendix 5 - COVID-19 Vaccination Status Form

Healthcare Workers Name: Job title: _

Work location: Manager:

Assessment Date: Healthcare Worker Category:

1. I have read and understood the vaccine patient information available at https://www2.hse.ie/screening-and-vaccinations/covid-19-vaccine/ and the guidelines regarding Risk Assessment for COVID-19 Vaccination Guidelines for Healthcare Workers YES NO

2. I have been fully vaccinated against COVID-19 YES NO

3. I have been partially vaccinated against COVID-19 and waiting to complete YES NO

4. I have not been vaccinated against COVID-19 YES NO

Questions 5 to 8 do not apply to people who have answered yes to Question 2 or 3 above

5. I have been advised of the risks to myself, patients and/or others associated with my vaccination status. YES NO

6. I am aware that my non-vaccinated status may result in my being reassigned to a non-high risk area or other requirements to protect me and others with whom I may come in contact as per the ‘Risk Assessment for COVID-19 Vaccination, Guidelines for Healthcare Workers’ YES NO

7. I understand that vaccination remains available to me if I change their mind or if my circumstances change YES NO

8. The reason why I am not vaccinated is :

Perceived risk

Beliefs

Medical condition

Anaphylaxis

Medication

Concern re possible serious side effects

Other

Do not wish to say

Healthcare Worker Signature: Date:

Manager Signature: Date:

Refusal to sign: In circumstances where the Healthcare worker prefers not to sign this form, all details on this form should be discussed with the Healthcare Worker and it should be noted on the form by the line manager.

Healthcare Worker declined to sign form:


21

17. Appendix 6 – Audit tool

Name of Department/Service:

Department Managers name:

Date of Audit:

Audit on the Implementation of the Risk Assessment for COVID-19 Vaccination in Healthcare Workers

Yes No N/A Comment/Actions

1. Have Healthcare Workers been categorised as either Category A, Category A High Risk Area or Category B using the Risk Assessment Healthcare Worker Risk Assessment For COVID-19 Vaccine Form?

2. Have all Healthcare Workers in Category A High Risk Area positions informed the line manager of their vaccination status?

4. Where a possible medical contraindication has been identified have Healthcare Workers in Category A High Risk Area positions been referred to Occupational Health?

5. Where a HCW has a medical contraindication or has declined vaccination for any reason have risk mitigation options been considered and applied for Healthcare Workers in Category A High Risk Area positions?

6. Have Healthcare Workers in Category A –High Risk Area positions confirmed that they have been offered vaccination, been offered an opportunity to discuss their concerns and advised as to who to contact if they change their mind. ?

Auditor Name:

Auditor Signature:






Document Number: Appendix 2: COVID-19 Supplemental Student Undertaking/Declaration

COVID-19 Supplemental Student Undertaking/Declaration

RESUMPTION OF CLINICAL PLACEMENTS

Infection Prevention and Control (IPC)

In advance of resumption of clinical placement as part of studies at Trinity College Dublin, the University of

Dublin (“University”), I acknowledge I have a personal responsibility to protect myself, patients and the general

public from the potential of Covid-19 virus transmission, and to comply with Public Health Advice.

Accordingly, I will ensure:

1. I am aware of COVID-19 symptoms or other related pandemic symptoms. Please

see: https://www2.hse.ie/coronavirus/

2. I will not present myself to clinical placement (or to the University) if I have symptoms of COVID-19

or acute infections such as symptoms of viral respiratory tract infection or gastroenteritis.

3. I commit to declaring to the School daily that I am free of symptoms of COVID-19 each day before I

present myself to clinical placement

4. In event I develop an infectious disease (COVID-19 or other communicable infectious disease), I will

immediately notify the University through my supervising Lecturer Registrar so the University can

communicate with the relevant HSE service in case it has implications for patients and staff.

5. I will keep myself up-to-date and comply with current Public Health Advice regarding COVID- 19

or other related pandemics.

6. I am aware that if I have had close contact with someone with COVID-19 that I am not to present to

clinical placement (or to the University) and should avoid public places for 14 days after the last day of

close contact with the COVID-19 case.

7. I commit in advance of returning to clinical placement, to comply with regulations regarding Personal

Protective Equipment (PPE) training/requirements in addition to all related policies, guidelines and

directives available locally and on www.hseland.ie and www.hpsc.ie to ensure, amongst other things,

correct donning and doffing.

8. I will ensure that I abide by, and comply with, the rule of ‘bare below the elbows/bare above the wrist’

while on clinical placement.

9. I commit to reviewing, in advance of clinical placement, the guidance and educational videos on

Infection Prevention and Control COVID-19 on www.HPSC.ie/infection control/ which include

Standard and Transmission-based Precautions.

10. I acknowledge I have been provided with training in performance of hand hygiene in advance of

clinical placement and will undertake competence re-training at least once in each academic year.

11. I will comply with Infection Prevention and Control directions given by HSE and other Clinical staff at

all times when I am in clinical areas, and any other measures the HSE has in place to prevent the

emergence of COVID-19 in while I am on clinical placement.

https://www2.hse.ie/coronavirus/

http://www.hseland.ie/

http://www.hpsc.ie/

http://www.hpsc.ie/infection%20control/






Document Number: Appendix 2: COVID-19 Supplemental Student Undertaking/Declaration

12. I undertake to cooperate with requirements for management of outbreaks or other incidents of infection

including providing samples for testing where required.

13. Students can move from a clinical placement in one institution to a clinical placement in another

without an interval of time as part of their programme. In such circumstances, I acknowledge I must

adhere to Infection Prevention and Control Practice at all times with all individuals.

14. I acknowledge that my Clinical Placement is subject to Public Health Advice which may be in place from

time to time and that public health advice may result in changes to arrangements during the course of my

Clinical Placement.

15. I commit to meet the full, statutory 14-dayisolation and restricted movement commitments if I return to

Ireland from and non-Green Zone country before or during the university semesters.

Data Protection

Any information disclosed to the University pursuant to this declaration will be treated with the highest standards

of security and confidentiality and processed in accordance with the University’s Data Protection Notice. The

University is collecting this personal data in light of the COVID-19 pandemic and to implement the requirements

of the HSE in relation to the resumption of clinical placements. The legal basis for processing this data is for

compliance with a legal obligation to which Trinity College is subject (the provision of education under the

Universities Act 1997) and for the reasons of public interest in the area of public health. The data collected in this

form will only be kept for 4 weeks after which time it will be deleted

Signed:

Print student name:

Student number:

Date:

I confirm that I do not have an underlying medical condition or other risk factor which makes

me a person who may be at higher risk from COVID-19 (as identified by the Health Service

Executive here):

Signed:

Print student name:

Student number:

Date:







Document Number: Appendix 3 : COVID-19 Risk assessment Form for Students

COVID-19 Risk assessment Form for Students

Student

Information

Name:

Student Number:

Course/Module of Study:

E-mail:

Instructions:

• Please complete the following questions and upload the completed form and any

additional documentation (if required) to Blackboard prior to commencement of

placement.

• Retain a copy of this form and any relevant documentation to take with you if any further

assessment is required.

• If you do not understand the questions, please complete this form with your doctor’s help.

• Further testing and/or health assessment may be required, depending on

your personal circumstances.

Part A: Possible signs and symptoms of active COVID-19 – Do you currently have any

of the following? Please Circle

1. Fever (high temperature – 38 degree Celsius or above) Yes No

2. Cough Yes No 3. Shortness of breath Yes No

4. Sudden onset loss of sense of smell and/or taste disturbance Yes No

If you have answered Yes to any questions from Part A:

1) Make an urgent appointment with College Health Services for assessment of your

symptom/s. They will refer you for COVID testing if needed. Self-isolation may be

recommended by your doctor.

2 Notify [email protected] who will follow up with your clinical placement site.








Part B: COVID-19 Training Pack

Have you completed mandatory COVID-19 Training Pack on the following sections on

Blackboard? Please Circle

Hand Hygiene Yes No Introduction to coronavirus Yes No How Covid-19 spreads Yes No

Basic personal protective equipment Yes No

What to do if you are asked to self-isolate Yes No

Please complete the training pack if you have answered No to any questions from Part B.

Part C: Identification of students who have an underlying or chronic illness, or who are

in at risk/vulnerable group

https://www2.hse.ie/conditions/coronavirus/people-at-higher-risk.html, updated 21st August 2020

The following are very high risk:

• Solid organ transplant recipients

• People with specific cancers

o People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer.

o People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment.

o People having immunotherapy or other continuing antibody treatments for cancer. o People having other targeted cancer treatments which can affect

the immune system, such as protein kinase inhibitors or PARP inhibitors

• People who have had bone marrow or stem cell transplants in the last 6 months, or who

are still taking immunosuppression drugs

• People with severe respiratory conditions including cystic fibrosis, severe

asthma and severe COPD as confirmed by their specialist.

• People with rare diseases and in born errors of metabolism that significantly increase

the risk of infections (such as SCID, homozygous sickle cell)

• People on immunosuppression therapies, sufficient to significantly increase risk

of infection.(please refer to the ‘HSE COVID-19: Interim Clinical Guidance–








Immunosuppressant Therapy

(https://hse.drsteevenslibrary.ie/ld.php?content_id=32936271))

• Are pregnant with significant heart disease, congenital or acquired Please circle if.

Any of the above applies to you Yes No

If any of the above apply to you, please contact Student Health and [email protected]

People are high risk if they:

• have a lung condition that's not severe (such as moderate or severe asthma,

COPD, emphysema or bronchitis)

• have a heart condition

• have high blood pressure

• have diabetes

• have chronic kidney disease

• have liver disease (such as hepatitis)

• have a medical condition that can affect your breathing

• have cancer

• have a weak immune system/are immunosuppressed

• have cerebrovascular disease

• have a condition affecting your brain or nerves (such as Parkinson's disease, motor neuron disease, multiple sclerosis, or cerebral palsy)

• have a problem with your spleen or have had your spleen removed

• have a condition that means you have a high risk of getting infections (such as HIV, lupus or scleroderma)

• have obesity

Please circle if

If any of the above apply to you, please follow HSE advice, and notify the school via

[email protected] .

Any of the above applies to you Yes No










People with Other Pre-Existing Disease or are Pregnant:

(Source: Pregnant Healthcare Workers (HCWs), Vulnerable HCWs and HCW with Other

Pre-Existing Disease Version 5, 15/04/2020)

• People with other medically managed pre-existing disease are unlikely to be at greater risk of

acquiring COVID-19 virus infection compared with other HCW’s if the appropriate personal

protective equipment is worn.

• These people can continue to work UNLESS there is a specific recommendation from their

treating specialist.

• Pregnant women should be allocated to patients, and duties, that have reduced exposure to

patients with, or suspected to have, COVID-19 infection. It is specifically recommended to

avoid rostering pregnant staff to COVID-specific units or wards, and redeployment to lower

risk duties should be considered

Please circle if.

You have another medically managed pre-existing disease not mentioned above Yes No You live with someone who has either an underlying illness or chronic condition Yes No You are pregnant Yes No

Referral to Student Cases Committee required

No Yes

Clearance letter attached N/A Yes

Acknowledgement and Consent:

I certify that I have read and understand the Trinity College Dublin: Student’s Guide for the

control of Covid-19; medical students in health care facilities risk assessment on the

Blackboard, in preparation for my placement. I agree to comply with the guidelines and all

procedures in place at hospital and Health Service facility at which I am placed, in respect of

HSE infection control of health care workers.

I understand that this risk assessment and any required follow-up action is one of the

requirements of eligibility for a placement at hospital and Health Service facility, and I agree

to act as required.

I consent to TCD School of Medicine giving personal information in this form to affiliated

hospitals for placement and infection management planning and response. This may include

infection disease services.







I certify that the information I have provided in this risk assessment is true

and correct.

Full name:

Signed:

Date:



Document Number: Appendix 4: Daily Check in Form- App

Yes/No answers

Q1 I am feeling well today and do not have any issues concerning COVID-19 or other symptoms (If you answer NO, then don’t come to

placement, “self-isolate” and contact your GP/College Health/Occ Health. Inform your Discipline EO)

Q2 I have symptoms, am “self-isolating” and contacting my GP/awaiting a test result. (If you answer YES, then don’t come to placement. Inform

your Discipline EO and “self-isolate” until you get your result)

Q3 I am a household contact of a suspected case and am “restricting my movements” until their test result is available (If you answer

YES, then don’t come to placement. Inform your Discipline EO)

Q4 I am a close contact of a confirmed case and am “restricting my movements” for at least 14 days. (If you answer YES, then don’t come to

placement. Inform your Discipline EO AND [email protected])

Q5 I have tested positive for COVID-19 and am “self-isolating”. (If you answer YES, then don’t come to placement. Inform your Discipline EO

AND [email protected])

Q6 Did you answer 'Yes' to any of the questions: 2, 3, 4 or 5?






Step 1. Download the Trinity Live app and login with your student username and password.

Step 2. Click on the Yellow virus symbol at the top of the screen.




Step 3. Complete the declaration form accordingly, you will need to select the edit button the bottom of the screen. Once your submission is complete click submit response. If you make a mistake you can resubmit by clicking edit response. The app will only register you last submission.


This Document is the property of Trinity College School of Medicine and must not be reproduced without

permission. Printed Copies of this document are for reference only



Document Number: Appendix 5 Classifications of high risk and very high- risk groups.

Very high-risk groups (extremely vulnerable) The list of people in very high-risk groups include people who:

• are over 70 years of age - even if you're fit and well • have had an organ transplant

• are undergoing active chemotherapy for cancer • are having radical radiotherapy for lung cancer • have cancers of the blood or bone marrow such as leukaemia, lymphoma

or myeloma who are at any stage of treatment • are having immunotherapy or other continuing antibody treatments for cancer • are having other targeted cancer treatments which can affect the immune system,

such as protein kinase inhibitors or PARP inhibitors • have had bone marrow or stem cell transplants in the last 6 months, or who are still

taking immunosuppression drugs • severe respiratory conditions including cystic fibrosis, Alpha-1 antitrypsin

deficiency, severe asthma, pulmonary fibrosis, lung fibrosis, interstitial lung disease and severe COPD

• have a condition that means you have a very high risk of getting infections (such as SCID, homozygous sickle cell)

• are taking medicine that makes you much more likely to get infections(such as high doses of steroids or immunosuppression therapies)

• have a serious heart condition and you’re pregnant?

What to do if you're at very high risk (extremely vulnerable)

If you are in a very high-risk group, you need to cocoon.

Read our guide on how to cocoon.

High risk groups

The list of people in high-risk groups includes people who:

• are over 60 years of age

• have a learning disability • have a lung condition that's not severe (such as asthma, COPD, emphysema or bronchitis) • have heart disease (such as heart failure) • have high blood pressure(hypertension)

https://www2.hse.ie/conditions/coronavirus/cancer-patients.html

https://www.alpha1.ie/news-events/latest-news/367-coronavirus-update



https://www2.hse.ie/conditions/coronavirus/asthma.html

https://www2.hse.ie/conditions/coronavirus/copd.html



https://www2.hse.ie/conditions/coronavirus/weak-immune-system.html

https://www2.hse.ie/conditions/coronavirus/cocooning.html

https://www2.hse.ie/conditions/coronavirus/asthma.html


https://www2.hse.ie/conditions/coronavirus/heart-conditions.html

https://www2.hse.ie/conditions/coronavirus/high-blood-pressure.html







• have diabetes

• have chronic kidney disease • have liver disease (such as hepatitis) • have a medical condition that can affect your breathing • have cancer • have a weak immune system(immunosuppressed) • have cerebrovascular disease • have a condition affecting your brain or nerves(such as Parkinson's disease, motor

neuron disease, multiple sclerosis, or cerebral palsy) • have a problem with your spleen or have had your spleen removed • have a condition that means you have a high risk of getting infections (such as HIV, lupus or

scleroderma)

• are taking medicine that can affect your immune system (such as low doses of steroids) • have obesity • are residents of nursing homes and other long-stay settings • are in specialist disability care and are over 50 years of age or have an underlying health

problem

What to do if you're at high risk

Take extra care to follow the advice on how to protect yourself from coronavirus.

This means:

• staying at home as much as possible • social distancing • limiting your social interactions to a very small network for short periods of time • washing your hands regularly and properly

You do not need to self-isolate unless you have symptoms of coronavirus.

You should work from home if you are at high risk from coronavirus. If you cannot work

from home and you must go to your workplace, take extra care to:

• practice social distancing where possible • wash your hands regularly and properly

Ask the people in your life to take extra care to protect you from coronavirus

Contact details

School of Medicine Contact Persons for Suspected or Confirmed COVID-19:[email protected] The School

of Medicine designated contact persons monitoring the

[email protected] will be responsible for notifying the designated Infection

https://www2.hse.ie/conditions/coronavirus/diabetes-and-coronavirus.html



https://www2.hse.ie/conditions/coronavirus/obesity-and-coronavirus.html

https://www2.hse.ie/conditions/coronavirus/protect-yourself-and-others.html#social-distancing

https://www2.hse.ie/conditions/coronavirus/protect-yourself-and-others.html#hand-washing

https://www2.hse.ie/conditions/coronavirus/managing-coronavirus-at-home/self-isolation.html

https://www2.hse.ie/conditions/coronavirus/symptoms.html

https://www2.hse.ie/conditions/coronavirus/symptoms.html

https://www2.hse.ie/conditions/coronavirus/protect-yourself-and-others.html









Prevention and Control (IPC) and Occupational Health (OH) teams of suspected or confirmed

cases of COVID-19 that have been on placement in their hospital within 48 hours of the onset of

symptoms or within 24 hours of sampling in the case of asymptomatic infection. They will also

be responsible for notifying the IPC and OH teams of the results of SARS-CoV-2 tests in relevant

cases

.


Version Number: 2

Effective Date: 2 September 2020

Document Number: Appendix 6 : Contact details for Covid- 19 Coordinators

Hospital Contacts for Notification of Suspected or Confirmed COVID-19

Hospital Infection Prevention and Control Contact

Occupational Health Contact

St James’s Hospital [email protected] [email protected] [email protected]

Tallaght University Hospital

01 4143938 [email protected]

Coombe 01 4085200 – Geraldine Chawke [email protected]


Crumlin #321/#323 through switch [email protected]

Ailish Ferris/Elizabeth Lawless Through switch

Temple St 01 8784389 [email protected]

01 8784398

St Patrick’s [email protected] [email protected]

Naas 045 849935 [email protected] Dr. Grant Jeffrey 01 6352789

Brid Ryan O’Malley [email protected] 045 843114 (Mon & Thurs) Otherwise, 01 6352789

Our Lady’s Hospice 01 4986289 [email protected]


Peamount Fiona Conway [email protected] Phone number through switch

Health & Safety Risk Phone number through switch

Hermitage [email protected], [email protected],

[email protected] [email protected].

National Rehab Hospital [email protected] X5300

[email protected] X5424

Blackrock Clinic 01 283 2222 (Ext 8053).

Royal Victoria Eye and Ear

Dr Susan Knowles 01 664 4661 Sinead Fitzgerald/ Margie McCarthy 8am-5pm Mon-Fri 087 3927847 via switch Bleep 48 Medmark 01 676 1493

Occupational Health – Medmark Dublin office 01 6761493 Medmark 01 676 1493

Beacon 01 2938640 - Lenora Leonard [email protected]

01 6504381 – Caroline Casey [email protected] [email protected]

Isle of Man +44 1624 650177 +44 1624 642150

St Luke’s Hospital Susan McGovern [email protected]

Occupational Health Bernie Barry 01 4065340

Page 40 of 75 Confidentiality Statement


































Document Number: Appendix 7 : Student symptom Response Flow chart

Have you been diagnosed with COVID-19 in the last 10 days?

Yes

No

• Don’t come to placement • Email your Discipline EO AND [email protected] • Self-isolate (stay in your room) for at least 10 days from symptom onset (or from

date of positive test if asymptomatic) • Only return to placement when advised by your GP/Occ/College/Public Health

*START HERE*

Have you travelled outside of the island of Ireland in the last 14 days?

No

• You MUST adhere to government guidelines for quarantine following travel specific to that country https://www.gov.ie/en/publication/77952-government-advice-on-international-travel/

• Self monitor for symptoms – Contact GP/Occ/College Health if concerned

Yes

Do you have any of the following: • cough, • fever, • shortness of breath, • change/loss in sense of smell, • change/loss in sense of taste, • headache • sore throat • runny nose/nasal congestion • Any other flu-like symptoms

(fatigue/aches & pains etc.)

now or in the last 10-14 days?

Yes

• Don’t come to placement • Self-isolate (stay in your room) • Contact GP/Occ/College Health

to see if a COVID test is required • Continue to self isolate until test

result known • Email your Discipline EO

• Inform your Discipline EO • Return to placement 48 hours after your

symptoms resolve unless advised otherwise

COVID test required and COVID detected

Are you a casual contact of a confirmed case?

No

Are you a close contact of a confirmed case?

ACTIVE Follow up (Active follow up required - see

appendix 12 ) You must leave placement

Contact Occ Health & discipline EO

PASSIVE follow up (see box) Can stay on placement if symptom free.

If you become symptomatic, leave placement immediately & contact Occ health to organise testing

Are you a household contact of a suspected case?

Are you fully vaccinated OR have had COVID in last 9 months, AND don’t have conditions

associated with a suboptimal vaccine response (see box)?

If COVID DETECTED ACTIVE Follow up (see box) You must leave placement Contact Occ Health & EO

You can attend placement

pending result if symptom free

If COVID NOT DETECTED You can attend

placement

Restrict movements (stay at home) until household contact’s result is known. Inform your Discipline EO

No

No Are you fully vaccinated OR have had COVID in

last 9 months, AND don’t have conditions associated with a suboptimal vaccine response

(see box)?

No You can attend placement

Yes Yes

Yes

Yes

No

No

COVID test NOT required, OR COVID NOT detected

Yes

Are you a household contact of a confirmed case?

Isolate for 10 days & contact MedDailyCheck

Yes

Isolate for 5 days with testing as per public health advice

Are you on clinical

placement?

Yes

No


https://www2.hse.ie/conditions/covid19/restricted-movements/self-isolating-restricted-movements-differences/

https://www.gov.ie/en/publication/77952-government-advice-on-international-travel/

https://www.gov.ie/en/publication/77952-government-advice-on-international-travel/




Daily COVID-19 Questionnaire Algorithm for TCD medical students on placement (Update 19/8/21) – Subject to Revision

Close contact definition: have a cumulative unprotected exposure during one work shift (i.e. any breach or omission of the appropriate PPE) for > 15 minutes face-to-face (< 1 meters distance) to a case OR have any unprotected exposure of your eyes or mouth or mucus membranes, to the bodily fluids (mainly respiratory secretions e.g. coughing, but also includes blood, stools, vomit, and urine) of the case. OR have any unprotected exposure (i.e. any breach in the appropriate PPE) while present in the same room when an aerosol generating procedure is undertaken on the case.

Casual contact definition: A cumulative protected exposure during one work shift for > 15 minutes face-to-face (< 1 meters distance) to a case OR Any protected exposure to the bodily fluids (mainly respiratory secretions e.g. coughing but also includes blood, stools, vomit, and urine) of the case OR Any protected exposure while present in the same room when an aerosol generating procedure is undertaken on the case OR Not wearing gloves but was wearing other appropriate PPE, performed hand hygiene immediately after hand skin contact with secretions / excretions of a case, would be considered low risk and therefore not a close contact. OR A cumulative unprotected exposure during one shift (i.e. any breach or omission of appropriate PPE) for less than 15 minutes face-to-face (less than 1 meters distance) to a case.

This algorithm is intended as a guide only. Please obey local Occ Health advice if specific advice is given. TCD College Health COVID-19 queries phone 01 896 1556 (https://www.tcd.ie/collegehealth/) For more COVID-19 information, visit the following sites: https://www2.hse.ie/coronavirus/ & https://www.hse.ie/eng/staff/workplace-health-and-wellbeing-unit/covid-19-guidance/

Passive Follow up:

• Can remain at placement IF asymptomatic • Symptomatic Casual Contacts Must not remain atwork • Casual Contact specific advice provided • Self-monitor for symptoms for 14 days after the last potential exposure • Contact Occ/Student Health/GP if you develop relevantsymptoms

Active Follow up: • Must not come to placement • Must restrict movement (Stay at home) • Inform Occ Health if not already done • Inform Discipline EO • Receive Close Contact specific advice • Contact Occ health daily • Self-monitor for symptoms for 14 days after the exposure incident (or 17 days if you are sharing accommodation with a positive household contact who cannot self isolate) • Contact Occupational Health/GP if you develop relevantsymptoms

Conditions associated with suboptimal vaccine response: Persons; with advanced cancer, undergoing cancer treatment (in the last 6 weeks, or 1 year for haematological malignancy), eGFR <30ml/min, history of solid organ transplant, HSC transplant in last year, listed for solid organ/HSC transplant, HIV, APECED, Inborn errors in the interferon pathway, receiving immunosuppressants including high dose steroids, cyclophosphamide, rituximab, alemtuzumab, cladribine, ocrelizumab etc. https://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/covid19.pdf - Table 5a.2

Household contact definition: Sexual partners, or people living or sleeping in the same home, individuals in shared accommodation sharing kitchen or bathroom facilities.

https://www.tcd.ie/collegehealth/

https://www2.hse.ie/coronavirus/

https://www.hse.ie/eng/staff/workplace-health-and-wellbeing-unit/covid-19-guidance/occupational-health-interim-guidance.pdf





Document Number: Appendix 8: Letter's from CCO to all HEIs regarding healthcare students placements




Office of the Chief Clinical Officer Dr Steevens’ Hospital|Steevens’ Lane|D08 W2A8

email: [email protected]

Oifig an Phríomhoifigigh Cliniciúil Ospidéal Dr. Steevens|Baile Átha Cliath 8|D08 W2A8

By Email Only

Date 26th March 2021

Re: Student who decline vaccinations

Dear colleagues,

Last year following engagement with your institutes, we were able to agree a process that facilitated essential clinical placements for healthcare students in HSE facilities through the past year. The process agreed was consistent with the need to ensure patient and student safety to the greatest degree practical at that time. We are all agreed that the safety of patients, staff and students remains a shared key priority. I wish to advise you of some updated decisions in relation to clinical placements in the context of the COVID1-19 Vaccination Programme, which provided and added opportunity to ensure the safety of all concerned.

For this purpose, Clinical Placements refers to unpaid clinical experience for healthcare students whose presence is not specifically required to sustain service delivery. Students (for example 4th year nursing students) who constitute part of the workforce that sustain service delivery are in the same category as other healthcare workers. The following does not apply to them.

Following consideration the HSE COVID-19 Vaccination Working Group has taken the following decision and I ask that your institutes now apply this to all student placements in HSE facilities with effect from April 1st 2021.

Students that are eligible for vaccination, that have been offered vaccination and decline vaccination should not be assigned to clinical placements in HSE facilities. This may be reviewed as the epidemiological situation evolves.

Please note that for those very exceptional circumstances where there is specific and documented medical contraindication to vaccination for a healthcare student an individual risk assessment should be performed by the higher education institute to determine if a suitable placement can be designed that minimizes risk to patients and to the student.

Kind regards,

Dr. Colm Henry, Chief Clinical Officer


Office of the Chief Clinical Officer Dr Steevens’ Hospital|Steevens’ Lane Dublin 8|D08 W2A8

email: [email protected]

Oifig an Phríomhoifigigh Cliniciúil Ospidéal Dr Steevens|Lána Steevens|Baile Átha Cliath 8|D08W2A8

By Email Only

To: Each Higher Education Institute

From: Dr Colm Henry, HSE Chief Clinical Officer

Regarding: Clinical Placements and vaccination.

Date: 12th April 2021

Dear colleagues,

I wish to advise that clinical placements for all healthcare students (those who have and have

not received/taken a vaccine) may continue in HSE facilities subject to students continuing

compliance with public health recommendations and infection prevention and control

practice. This is subject to the pending opinion of the National Immunisation Advisory

Committee regarding the use of AstraZeneca.

The above now supersedes correspondence dated 26th March (attached) advising that

students eligible for vaccination, had been offered and declined vaccination, should not be

assigned to clinical placements in HSE facilities.

I will provide you with an update as soon as further information is available.

Yours,

Dr Colm Henry,

Chief Clinical Officer




Document Number: Appendix 9: Covid- 19 Response Plan- Trinity College




1

RETURN TO CAMPUS A TWO PHASED APPROACH Trinity will open on September 6th. We will be taking a two-phased approach to our return.

In the first part of semester 1 up to and including Reading Week starting Oct 25th, we will follow the regulations laid out in this document.

For the second part of the semester and beyond, from Nov 1st onwards, we intend to relax regulations further to allow for many more in-person campus experiences. The details of any changes in rules will be collaboratively worked out and distributed in a timely fashion. These statements of course come with the caveat that constraints can be relaxed provided trends in infection rates, vaccine up-take and public health guidelines are all pointing in the right direction.

WHY TAKE A TWO PHASED APROACH? As a sector, we signed a pact with Government about the return to campus1. The spirit of that pact asks we do as much as we can to give in-person campus experiences, while keeping students and staff safe. The pact also recognises that no one size fits all and that we each should carry out a risk assessment as to how we can best proceed.

Given that our main campus is compact and contained within the city centre, that other Trinity locations have similar space constraints and are also in urban settings, that many of our buildings are older and our rooms and lecture theatres in the main campus are not very large, that on the main campus residences are distributed across the campus and that we have more enclosed entrances and exit points, we believe indoor social-distancing must, for now, continue to be a part of our planned return, so we can ensure that our staff and students are safe.

In coming to this conclusion, we have drawn on the expertise in the University and our public health, clinical, science, and safety experts support this approach. I believe they have stood us well thus far and their expertise is the kind of expertise that allowed us to have safe and rewarding in-person graduations, when no other institution was doing so.

We understand that we are not yet at the peak of the current wave of infections. While predictions are not always accurate, a peak is expected over the next month. This means the more cautious approach would coincide with the peak of infections and allow us to adjust after Reading Week to provide more in-person experiences.

The following pages sets out high-level regulations that will be in place from September 13th

under the headings Lectures, Labs & Tutorials, The Library & Study Spaces, Dedicated

1 A safe return to on-site further and higher education and research (Safe Return Plan) published by D/FHERIS on 15 June 2021

2

Research Space, Shared Offices, Accommodation, General Campus Access and Social Activity.

Lectures, Labs & Tutorials The overall approach here is that we will adopt 1m social distancing with mandatory mask- wearing in lectures, labs and tutorials, with lecturers distanced by 2m from students. This means that any lecture, lab or tutorial that can conform to these criteria in its allocated space, should go ahead. There will be no time limit for labs.

In line with Government expectations, and the pact the sector signed, we must ensure that every student has some kind of regular in-person learning experience. There is no hard and fast definition of what this means. Different disciplines will be best placed to understand what this should look like in the context of that discipline. This does mean that there may be cases where additional measures need to be taken to ensure that every student has some kind of regular in-person learning experience. For example, it may be necessary to support rotated attendance of students in classes, and if this is the case, this should be taken into account during the time-tabling process. This is just an example of one approach, and it is up to the School to decide how best to respond. It is hugely important we maximise the in- person experience in every way we can, especially as a number of other institutions will start the academic year with no social distancing in lectures.

The safe working practices we have adopted to date will continue, and this will help further ensure the safety of staff and students. Staff when delivering content at a 2m distance from students do not need to wear a mask. In fact, we do need to ensure from an accessibility point of view that material can be clearly heard. Staff should wear masks if moving around the laboratory or teaching space. Time-tabled in-person events should finish at 15 minutes to the hour to allow for changeover.

The Federation of European Heating, Ventilation and Air Conditioning (RHEVA) ventilation guidance is 10 litres/second per person, and this is in the process of being measured in 400 teaching spaces. By September 6th a notice will be posted outside each of these rooms confirming that this guidance has been met.

It is worth mentioning UniCoV. UniCoV will explore effective rapid testing and surveillance systems within third-level institutes to assist with the early identification of asymptomatic SARS-CoV-2. We encourage people to join the UniCoV study - https://www.tcd.ie/ttmi/unicov/

Lectures, Labs & Tutorials in summary:

http://www.tcd.ie/ttmi/unicov/

The Library & Study Spaces

3

The Library & Study Spaces will continue to operate at 2m social distancing with mandatory mask-wearing. The 1 hr 45 minute limit and booking system will remain in place. There are two main reasons for this. Firstly, we do not have the same leeway under public health guidelines for libraries as we have with teaching and learning spaces, and secondly the time limit will help maximise the number of students who can be accommodated.

The Library & Study Spaces in summary:

Dedicated Research Space The term dedicated research space is used here as a catchall for space that is typically dedicated to research activities for postgraduate researchers and staff. These can be labs or other spaces that are solely for the purposes of research and are dedicated to such (i.e. not shared with other activities). We understand that undergraduate students do research projects, and that research can take place in many locations, but are not referring to this broader definition under this heading, although undergraduate students may undertake short-term lab based research projects within dedicated research spaces under the guidelines set out. Dedicated research spaces tend to be controlled environments to which defined cohorts of postgrads and staff have access. These spaces also have extensive safe working practice protocols in place, which have been in action for over a year now.

Dedicated research space will operate at 1m social distancing with masks. However, in a number of dedicated research spaces all occupants are vaccinated, due to for example mandatory vaccination stipulated by the HSE for those needing access to clinical settings. Advantage can be taken of this and no social distancing will be required.

We cannot ask or put pressure on an individual to self-declare that they are vaccinated but if it can be determined that all the occupants are vaccinated through voluntary self- declaration, then any dedicated research space can remove the need for social distancing.

Dedicated Research Space in summary:

Shared Offices

4

Shared office space will operate at 2m social distancing with mandatory mask-wearing. We encourage those who can, and where it makes sense, to continue working from home. People should continue to wear masks while moving around indoors.

We cannot ask or put pressure on an individual to self-declare that they are vaccinated but if it can be determined that all the occupants are vaccinated through voluntary self- declaration, then the need for wearing masks in shared offices can be removed.

Shared Offices in summary:

Accommodation Residents should comply with normal indoor rules, as per national guidelines, when in rooms. Residents must wear masks when outside their apartments when circulating in residential buildings/blocks. The agreed protocols for isolation (for example for incoming international students) and protocols for any outbreak must of course be followed.

There is an additional requirement for residents who are sharing a room. Residents who are sharing a room must have a valid EU Digital Covid Certificate or evidence of full vaccination with a Covid Vaccine approved in Ireland.

General Campus Access The main message here is that campus will be open to all staff and students. Students will not need to have proof of a Library or study space booking to come on campus. We will not be insisting students leave campus once lectures/labs/tutorials are finished. We do encourage staff to continue to work from home were agreed or required and where appropriate. Staff and students will need to swipe in and out of college.

Visitors to campus for work–related purposes will be allowed and will have to comply with visiting rules. Visitors include visitors for research purposes.

We will continue to allow visitors to the Book of Kells and will monitor that to ensure smooth functioning.

The campus however will not be open to the general public for the moment.

We do intend to open Front Gate on September 6th.

5

Social Activity It is very important that the social life of the College continues.

We look forward to Freshers week. There will be orientation for 2nd year students in the week beginning September 6th as well as a full programme of social events run by the SU, which will act as a Freshers week for 2nd years as they missed out on their own week last year. Freshers Week for 1st years will take place on September 20th, alongside classes for 2nd, 3rd, and 4th years, during Freshers Orientation Week. Freshers Fair will take place, in- person, over 3 days, Monday, Wednesday, and Friday during Freshers Week.

The Students Union will have an outdoor covered event area near the Pavilion operational from September 6th to October 1st. A time limit will apply to this specific event area for both safety reasons and to ensure as many students as possible get access.

Currently indoor events are not allowed. Hence, we are working on creating more outdoor covered spaces that can be used by Clubs & Societies and students more generally. Sports events will follow public health guidelines.

Masks are not mandatory outdoors, as per public health guidelines, but we recommend the use of masks where groups are gathered.

Any changes in Government guidelines that have an impact on these activities can be put into action immediately.

Social Activity in summary:

We will of course work to find solutions for staff and students that are in the very high-risk

categories on a case-by-case basis.




COVID-19 RESPONSE PLAN Trinity College Dublin

September 2020




Executive Summary

COVID-19 is within the community and will become part of the college community throughout the

coming year. It is important to remember that:

• Outbreaks in Trinity are very likely. Two confirmed cases in the same area constitute an outbreak.

• Asymptomatic transmission is a key risk in the university setting

• Increased cases and outbreaks in Trinity could increase local prevalence

• All staff and students must take all preventative measures to prevent the spread of the virus

– as if everyone has the disease and thus is a suspected case.

• Trinity should plan for an increase in cases, or an outbreak associated with our buildings

• Effective systems to record and respond to cases, particularly those within accommodation

or academic departments, are required to be able to understand where transmission is

occurring within the college

• There should be clear plans for communication and encouraging adherence if an

outbreak occurs.

In such circumstances, the COVID-19 Response Plan includes the following:

• TCD’s system to facilitate rapid testing of suspected cases. This is being managed by the setting-up of an on-site testing facility managed by College Health in consultation with HSE Public Health Department

• TCD’s systems to ensure confirmed cases of COVID-19 are urgently followed up in collaboration with HSE Public Health Department.

• TCD’s systems to support the public health risk assessment by HSE Public Health Department which will guide outbreak control measures.

• TCD’s systems and procedures for taking and retaining contact information1 on campus to support the public health risk assessment

• TCD’s communications and instructions developed to encourage students and staff to download the COVID-19 Tracker App and record2 their close contacts3 on a daily basis

• TCD’s dedicated spaces provided to isolate confirmed cases and facilities to support students or staff members in self-isolation

• TCD’s systems to facilitate public health communications on site. This can be augmented using the SafeZone App.

The COVID-19 Response Plan described below elaborates on the Implementation Guidelines should cases of COVID-19 be confirmed on campus. Specifically, it focuses on:

1. Prevention and Protection 2. Outbreak Response Team 3. Detection of potential cases of COVID-19 - Testing pathway 4. Confirmation of COVID-19 and Contact Tracing 5. Public Health Risk Assessment 6. Outbreak Control Measures and Public Health Principles

7. Appendix 1: COVID-19 Roles and Responsibilities 8. Appendix 2: COVID-19 forms for Student s and Staff 9. Appendix 3: Legislative role of the HSE Medical Officer of Health

https://www.iua.ie/wp-content/uploads/2020/08/Public-Health-Implementation-Guidelines-for-HEIs_05.08.20_Final.pdf




10.

11.

What to do if there is a confirmed case of COVID-19 on Campus is included here

What to do if there is a confirmed case of COVID-19 on Campus

If there is a suspected case of COVID -19, the staff member or student must be sent for testing, await the result and not attend College. No further action is required at this point.

If your Result is Negative, you may return to College after 48 hours*

Head of School/Unit/TRI must contact their COVID Coordinator by phone or email

If your Result is

Positive

If a staff member, you must notify your line Manager or Head of School

Head of School/Unit/TRI must contact College Health at [email protected]

COVID Coordinator must contact the E&F Duty Team at [email protected]

College Health and E&F Duty Team will ensure COVID-19

*Dependent on HSE Guidelines i.e. a close contact of a confirmed case (0- & 7- day tests) or you are still

If a student, you must notify your Course Director. The Course Director must notify the Head of School






1. Prevention and Protection

Robust advice on prevention and awareness measures are necessary and recommended for the safety of staff and students in relation to Covid-19. The need for a clear communication plan for staff and students is of paramount importance.

Clear Communication Plan for staff and students

TCD has a comprehensive and ongoing communication plan that covers the following:

1. Raising and maintaining awareness amongst all members of its community about how COVID-19 spreads and how spread can be prevented on-campus and off-campus.

2. Clear communication with all staff and students on what they should do if they develop symptoms of COVID-19 on-campus, in residences or elsewhere i.e., self-isolate and contact their GP or College Health.

3. Clear communication with all staff and students that they should not attend campus if they are showing COVID-19 symptoms and re-affirming this messaging on an ongoing basis

4. Guidance for staff and students on testing pathways, including where the College Test Centre is located.

5. Guidance for staff and students on what to do if they receive a positive result, importance of informing 24/7 COVID contact person in Trinity (Dr David McGrath, Director of College Health Services), and on what supports are available to students and staff, and where the isolation facilities are located on campus.

2. COVID-19 Outbreak Response Team

• 24-hour Rapid Response System

The COVID-19 Outbreak Response team for responding to outbreaks on campus in liaison with

HSE Public Health Department will have the following features:

1. A COVID Contact Person (Dr David McGrath, Director, College Health Service) to lead

the Outbreak Response Team on campus

2. A COVID Outbreak Response team composed of Provost, Vice-Provost/CAO, College

Secretary, Head of Facilities and Services (Brendan Leahy), Head of Safety (Katharine

Murray), Dr David McGrath, Communications (Tom Molloy or representative) 3. A dedicated TCD contact who is available 24/7 (College Health: [email protected])

COVID Contact Person – responsibilities (Dr David McGrath) o Designated contact person for local HSE Public Health Department in each

HSE Community Healthcare Organisation to ensure ongoing and timely communications

o To act as on-going liaison with the HSE

o To liaise as appropriate with the TCD COVID Response Team

o To co-ordinate with the National Outbreaks in HEIs Oversight Group

Internal COVID-19 Response Team responsibilities – o To ensure early detection of suspected cases and testing in support of local HSE Public

Health Department o To oversee ongoing liaisons with the HSE Public Health





o To approve any closure of any buildings or unit, whether partial orfully

o To oversee communications to students and staff and wider public

3. Detection of potential cases of COVID-19 on campus – testing pathway

If unwell prior to coming on campus -please stay at home & don’t come on campus.

If a student/staff member develops symptoms of COVID-19 whilst on campus, as outlined in HSPC Guidance :

• The student/staff member should proceed to the pre-identified COVID-19 isolation spaces within the campus, with good ventilation and preferable an outside window opened and contact the College Health Centre by phone on the following number: 01-896 1556 and see if a COVID consultation can be arranged with a GP with a view to prompt testing if indicated.

• Students and staff members presenting with symptoms suggestive of COVID-19 infection

e.g. fever OR a new cough, shortness of breath, deterioration of existing respiratory

condition OR symptoms of change in sense of taste or smell should contact College Health

Centre by phone on the following number: 01-896 1556 or their GP by phone.

• College Health or their GP will assess and advise as per normal clinical practice and refer

for testing as required and outlined in HSE adult testing guidance. Testing is advised for

any adult who meets the testing criteria unless there is a strong clinical reason to do

otherwise.

• Covid-19 test results remain confidential as per doctor - patient relationship. However,

students and staff members should be advised at the point of testing that their test result

if Covid-19 is detected may need to be shared with the university, if this is deemed

necessary by the HSE Public Health doctor, for the safe management of any potential

outbreak. Only details as necessary for safe onward management are shared with an

agreed senior person in the college, such that appropriate public health actions can be

undertaken.

• Information shall be widely available on the location of test centre on campus, which is located adjacent to the College Health Centre.

• Clear messages on cost for students, test by HSE is free, option of taxis paid for by the university to transport an individual home who has been tested to self-isolate. (Taxi will be organized by College Health Centre if required, to avoid public transport)

Test Results - COVID-19 “not detected” result

If a symptomatic individual has a Covid-19 ‘not detected’ result, they should remain at home

or in student accommodation for at least 48 hours and until he/she is clinically well enough to

return to campus, unless they are specifically asked by HSE Public Health to remain

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/primarycareguidance/adviceriskassessmentandmanagementofpatients/

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/primarycareguidance/adviceriskassessmentandmanagementofpatients/COVID-19%20Assessment%20and%20testing%20pathway%20for%20children.pdf




excluded because of other investigations e.g. if the individual is a known close contact of a

now confirmed case.

As there will be a number of suspected cases who will be referred for testing, it is important to await official confirmation of a positive case before activating the College’s COVID-19 Response team. This is necessary to prevent any misunderstanding and imposition of unnecessary restrictions of movement.

4. Confirmation of Cases and Contact Tracing

In the event a student or staff member tests positive for COVID-19, the HSE informs the individual of the positive result by text/phone. It is important that students and staff are aware of the need to inform the University of the result as soon as possible. A 24 hr. COVID helpline is in place for staff and students to send an email to contact out of hours so prompt action can be taken when College opens the following morning. The email [email protected]

The HSE contact tracing team follow up with the case to identify household and close

contacts. Confirmed cases will be contacted directly by the contact tracing centres and case

information and contact identification will be initiated. The case will be referred to the HSE

Medical Officer of Health within the regional Public Health Department to conduct a Public

Health Risk Assessment (PHRA).

If the college is informed of a confirmed case on campus, the COVID Contact Person (Dr McGrath) should contact the designated person for HEIs in local HSE Public Health Department. The university will have a crucial role to collect initial information on potential household and close contacts and forward to local Public Health Dept for the public health risk assessment.

COVID-19 Types of Contact Between Persons

Different types of contact between people gives rise to different levels of risk from COVID19.

The Health Protection Surveillance Centre (HPSC) considers the following types of contact to be ‘close’ from the point of view of contact tracing. If you have had contact with an infected person when they are deemed to be infectious, and you fall into one of the following categories then you will be contacted by the HSE and may be advised to isolate and / or undergo testing:

• If you had greater than 15 minutes face-to-face (<2 meters) contact with a confirmed case of

COVID-19 in any setting

• If you are a household contact of a confirmed case of COVID-19 (i.e. living or sleeping in the same home, individuals in shared accommodation sharing kitchen or bathroom facilities and sexual partners.)

• If you have shared a closed space, including a workspace, with a person infected with COVID- 19 for longer than two hours then you MAY be considered a close contact. A risk assessment will be undertaken by HSE (Public Health) to determine whether you are a close contact – the risk assessment will consider multiple factors, including the occupancy of the room, size of the room, ventilation and the distance of each individual from the confirmed case. If you are considered to be a close contact after risk assessment, you will be contacted by HSE and advised of appropriate action (i.e. restricted movements, COVID-19 testing).





5. Public Health Risk Assessment (PHRA)

The HSE Medical Officer of Health (Consultant in Public Health Medicine, MOH), and teams

will liaise directly with the college’s designated COVID Contact person and inform them of

the confirmed case as necessary. The Public Health team will undertake a Public Health

Risk Assessment to inform any further actions and recommendations by the HSE Medical

Officer of Health.

ACTION FOR COLLEGE FOR PHRA

The College will need to prepare a summary (outlined below) to give to the HSE Medical Officer

of Health as part of the statutory investigation and management of COVID-19:

a) A brief description of the University (numbers of staff and students and special features)

b) A list of relevant staff with appropriate contact telephone numbers

c) Prepare a broad description of teaching spaces or other locations affected in the outbreak

d) A list of activities attended by confirmed case(s) around the campus, i.e.

lectures/laboratory practical’s/sports and entertainment facilities (This can be

compiled using form attached for students or from staff contact logs and sent to

[email protected] )

e) List of initial household and close contact 48 hours prior to symptom onset (this

information will be provided by the individual student or staff member involved, and

hence should be collected and retained by them).

Each course, to the greatest extent possible, should record attendance by students and staff at all scheduled classes/lectures/laboratory practical’s and retain records for 4 weeks in case required

for contact tracing purposes.

To assist with this, and broader off campus contact tracing, every member of the college community is strongly advised to download and use the Government’s COVID-19 Tracker App.

The college also requires a daily questionnaire to be used for a self-assessment before anyone comes on campus – but this will have no impact on the PHRA.

All staff and students must keep their own COVID-19 Contact Log to record details of the owner’s

activities when on campus, including what locations, (including bathrooms accessed) they accessed, who they have had contact with and for how long in each case.

Staff are required to log their attendance and location on campus daily (keep their contact logs and make them available to HSE on request for control tracing purposes.

Any information held centrally by the college e.g. records of attendance at lectures can then be made available to the HSE for contact tracing purposes in the event of a positive COVID- 19 case on campus.






6. Outbreak Control Measures and Public Health Principles

• Public Health will discuss with the College’s COVID Contact and COVID Coordinators to direct any appropriate exclusions i.e. advice to isolate for identified staff or students and to remove from the college setting based on an informed Public Health Risk Assessment (PHRA).

• Core to the PHRA will be assessing the likelihood of onward transmission from

the case identified. This will inform their further actions.

• HSE Public Health will assess whether the index case is also likely to be the primary

case within the college setting or a secondary case. They will assess the likelihood of

onward transmission from the case identified. This will inform their further actions.

• Onward testing strategy will be determined by information from the initial risk

assessment. The strategy will be determined after risk assessment of the

confirmed case, considering the likely source of infection and the likely potential for

onward transmission of infection within college.

• The risk assessment may be dynamic and change as new information becomes available.

• Close contacts will be identified following PHRA and engagement with the College. They

will be tested as per national contact guidelines (Day 0 and 7) and they will be advised to

restrict their movements and remain alert for symptoms, as per national guidelines.

• The testing strategy may evolve as information unfolds.

• There may be other community close contacts who will also be excluded from the

University but because of their community exposure NOT their college exposure.

family members if a student is living at home etc.

• Depending on results from testing, or following initial PHRA, the HSE MOH may

recommend widespread testing within a class or a facility under HSE mass

testing processes.

• Whether all students from a class/discipline/year are removed whilst undergoing testing,

or whether they remain in the university, will be determined by the risk assessment.

• An Outbreak Control Team may be called as appropriate, and to assist the HSE Medical

Officer of Health in the investigation and control of Covid-19 cases and outbreaks.

• A general outbreak plan for Covid-19 outbreaks can be found here

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/outbreakmanagementguidance/




The PHRA will have collected information on the following to inform control measures:

• unique information and factors relevant to College and its infrastructure, with

regard to infection transmission

• interactions of the community of students and staff members both within the

university and how they interlink within the wider community

• patterns of infection within the wider local community and

• consider general community infection rates in the regions serviced by the University.

This information will inform the decisions regarding the need for full, or partial, closure of the

University, or any control measures to be immediately implemented short of actual closure. A

range of issues (e.g. multiple cases in different departments/schools) may lead the HSE

Medical Officer of Health , in conjunction with any relevant Outbreak Control Team (OCT), to

decide that maintaining an open facility will present ongoing risk to students, staff and the wider

community above which that is acceptable. Also keeping the University open may not allow for

the adequate control of the spread of infection or adequate removal of the conditions

favourable to infection.

Notwithstanding the results of the public health risk assessment, the University may also opt to close the campus, whether partially or completely, in advance of any instruction from public health to safeguard the college community.

Consideration of the need for full, or partial, building or facility closure

If there are concerns regarding the need for closure, or partial closure, these will be discussed

by the HSE MOH in conjunction with the educational facility, and as part of local outbreak

control teams within the HSE Departments of Public Health. Any decision to close, or partially

close the University will be based on the best approach to control the spread of Covid-19 and

allow opportunity to remove the conditions favourable to such infection, as deemed necessary

and appropriate by the HSE MOH. In the evaluation of the need for closure of the university

affected by any outbreak of infectious disease, the standard Public Health approach is to utilize

a Risk Assessment model. This enables the most accurate and effective determination of the

likely health impacts of a range of possible interventions, ranging from exclusion and testing of

a small group of students and/or staff, up to and including closure of an affected discipline or

building. The actual criteria used by an HSE MOH, may be modified in the light of local

conditions or specific local information, which informs the Public Health Risk Assessment

(PHRA) required to provide for sensible and safe decisions regarding closure and, by

extension, the reopening of the University too.

Criteria for closure (Full or partial)

Decisions on the need to, close, or partially close the University will be undertaken by HSE

Medical Officer of Health, informed by a robust Public Health Risk Assessment. The criteria

to be ordinarily considered with regard to any potential outbreak and closure, or partial

university closure, include but are not limited to:




1. Evidence or clear concern that spread within the university is the primary driver of cases, or

suspect cases, notified. This is as opposed to spread of infection externally within the community setting (e.g. within households where students / staff members live etc.

2. The numbers of, or rate of increase of, Covid-19 detected cases amongst students/staff members is concerning

3. Physical structure or layout of the university which limits the range or adequacy for any

increased recommended prevention measures e.g. further social distancing implementation within pods or groups, more specific recommendations relating to hygiene or cleaning measure.

4. Any evidence that significant spread in wider local community can be shown, or be

highly suspected of being linked or intertwined with the Trinity setting

4. Results from any swabbing recommendations identified a large number/high proportion

of asymptomatic cases, particularly amongst groupings or pods not previously

considered to be at high risk of infection transmission

In all Public Health investigations, in which the closure or partial closure of the university

affected by any infectious disease outbreak is being considered, the criteria guiding closure

will broadly provide the criteria for reopening. However, outbreaks are dynamic, and in the

course of the investigation new risks may be identified and therefore new parameters required

to be included for criteria to re-open or allow for full student/staff member return. A list of the

agreed criteria for closure (involving for example, high levels of disease, the requirement of

decontamination to a level that meets with the approval of the HSE MOH, (OCT), the

compliance of management and staff etc.), will form the basis for the criteria to guide

reopening. It would only be when all these criteria, and any additional identified in the process

of investigation have been satisfied, that a decision on reopening, or full return of students

/staff would be made by the HSE MOH.

As a result, each Covid-19 outbreak will be assessed on an individual basis and a unique

decision made as to whether it is safe for the facility to remain fully or partially open, or

whether closure is necessary.




Appendix 1. COVID-19 Roles and Responsibilities

Persons / Role Responsibilities Issues Arising

Student 1. Student has a responsibility to keep a record of their “close contacts”

2. Download and have active the HSE COVID 19 Tracker App

3. Keep a record of on campus classes attended

4. Keep a record of what seat was used for each class. (It may be helpful for individuals to use their phones to take a photo trail of spaces / seating areas that they access during the course of each day - these will provide a helpful reminder when it comes to contact tracing)

5. Keep a record of social contacts and activities

6. Contact [email protected] and their Course Director as soon as they become aware that they are a positive case

Failure by a student to use the App or to keep proper records of the classes they attended and where they sat will result in poor quality data being passed to the Contact Tracing Centre. Consequently, any follow up by the HSE to a known positive involving such a student could lead to entire classes (max 49 others) being advised to isolate and needing to be tested.

Staff Members 1. Download and have active the HSE COVID 19 Tracker App

2. Ensure that they know their ‘work pod’ if applicable

3. Keep a record of on campus activities, e.g. meetings attended, social activities, etc.

4. Contact their Line Manager as soon as they become aware that they are a positive case

If a staff member does not use the App or keep adequate records again the HSE could apply a precautionary approach to a positive case in such a staff member and advise that a wide range of their colleagues self-isolate and be tested. Whilst the numbers involved here may be less than with a student who does not keep adequate records, there is always the potential for business continuity issues for the College if a large group for staff from the same area have to isolate.





Estates and Facilities Duty Team

1. Act as a central coordination point for the university’s response to a positive COVID 19 case on campus.

2. Ensure that key persons are kept informed as to the progression / status of any response

3. Liaise with College Health regarding information flow to the CTC, messaging to affected




students, management of testing, other medical / risk assessment issues.

4. Ensure all data required for contact tracing is made available in relation to building and spaces

5. Arrange rapid decontamination of affected rooms following a confirmed case on campus (based on HSE and College Health advice)

6. Provide details of campus and spaces

7. Provide room seat mapping to identify potential seats associated with the case.

Local COVID Coordinators

1. Coordinate the collection of data in the early stages of the university’s response for forwarding on to the Contact Tracing Centre. (CTC)

2. Liaise with the Head of School’s Nominated Persons regarding class lists and messaging to students

3. Liaise with E&F Team in relation to classroom mapping of suspect case

The role of the local COVID coordinators is key. The early collection of information is important for the best possible outcome. The more data that the COVID Coordinator can collect and pass on to the CTC the more targeted the response of all parties can be.




Head of School/Unit/TRI

1. Ensure that within their School there exists a set of class lists for each module detailing which students were assigned to which face to face session

2. Ensure attendance records and taken and kept for all teaching events.

3. Ensure that this information is readily available for consultation by at least two nominated persons (COVID Coordinators)

4. Provide details of nominated persons to the E&F Duty Team

5. Ensure that they have a communication process in place for contacting lists of students as and when required / advised by the E&F Duty Team and / or College Health

6. Ensure that where necessary staff / researchers have been assigned to work pods so as to limit their close contacts amongst their colleagues, and ensure it is maintained.

This is a critical point in the management of on campus cases. A lack of access to this information will slow down and stunt any response to same. If this information is not easily accessible then there will be considerable challenges in identifying who needs to send targeted communications, who may need to isolate and who may need to be tested.




College Health Service

1. Act as the University’s central point of contact for the HSE / Public Health

2. Advise the E&F Duty Team about the management of on campus cases

3. Review information with the E&F Duty Team as it comes in to vary out a risk assessment and decide on the next steps re. communications, close contacts, what the CTC needs to know, etc.

4. Provide a rapid testing response on campus for staff and students deemed to be close contacts of an affected person, either as identified by the HSE / CTC or as part of any initial risk assessment.

5. Advise the COVID-19 Response Team on the messaging content and distribution to affected students following a positive case on campus.

Course Administrators

1. Ensure that they are familiar with how to access the information on what student has been assigned to what face to face class

2. Be familiar with the communication process for contacting designated students

3. Ensure accurate records are maintained for classes, and any teaching groups and these are kept up to date

4. Ensure the lists are provided to School and College

5. Assist in the completing of Student contact tracing form and provide to the Schools COVID Coordinator

This is a critical point of management to ensure that relevant cohorts of students can be identified and alerted appropriately.

Lack of accurate information will cause a delay in response and enlarge the potential population of individuals who may be regarded as close contacts.




Title: Student Covid-19 Contact Tracing Form

Version Number: 1

Effective Date: September 2020

Document Number: TCD-

Short Description: This document is completed by students themselves, or on their behalf by course coordinator, tutor or other designated staff member (referred herein as “representative”) and Course Administrator or Coordinator, to facilitate contact tracing and minimise the spread of Covid-19.

Appendix 2

COVID-19 CONTACT TRACING FORM Students (Taught Courses)

STUDENT COVID-19 CONTACT TRACING FORM This form should be completed by confirmed COVID-19 cases (or their representative) and Course

Coordinator or Administrator, and please email this form to: [email protected] with their Student number

in the subject of the email and “Covid-19 contact tracing”

Note: If required this form might be shared with the HSE to enable contact tracing and minimise the spread of COVID-19.

PART A: GENERAL INFORMATION Name of Student

Student Number

Student Email

Student Phone Number

Faculty

School

Course

Year

Sub-Grouping within year, if any:





Version Number: 1



Short Description: This document is completed by students themselves, or on their behalf by course coordinator, tutor or other designated staff member (referred herein as “representative”) and Course Administrator or Coordinator, to facilitate contact tracing and minimise the spread of Covid-19.

PART B: COVID-19 DIAGNOSIS

How was Student diagnosed with COVID-19?

☐ HSE testing

☐ On-site testing facility in TCD

☐ I don’t know

☐ other – please specify:

Date Student was diagnosed with COVID-19 Please provide date of a positive test.

Date Student first noticed symptoms. Please provide a date when your symptoms started, including cough, fever or feeling generally unwell.

Date Student started Self-Isolating. Please provide a date.

Date Student was last on campus. Please provide a date of last time student was physically present on campus.

Does Student live in TCD residences? ☐ Yes

☐ No

If YES, please provide address.

PART C: INFECTIOUS DISEASE REGULATIONS The Infectious Diseases Regulations (S.I. No. 390 of 1981) confer a general power on the Medical Officer for Health (MOH) to “take steps…for preventing the spread of [an]infection” where the MOH is aware of a suspected case of infection or a probable source of infection. The 1981 Regulations were amended by S.I. No 53 of 2020, to include COVID-19. Article 11 of S.I. No. 390 provides that:

“On becoming aware, whether from a notification or intimation under these Regulations or otherwise, of a case or a suspected case of an infectious disease or of a probable source of infection with such disease, a medical officer of health, or a health officer on the advice of a medical officer of health, shall make such enquiries and take such steps as are necessary or desirable for investigating the nature and source of such infection, for preventing the spread of such infection and for removing conditions favourable to such infection.”

This power may be enforceable by the risk of criminal liability under Article 19: “19. A person who refuses to comply with a requirement or direction given or a request for information made in pursuance of any of the provisions of these Regulations shall be guilty of a contravention of these Regulations.”

After investigating the outbreak and having put in place the necessary prevention measures, the MOH may assess the risk to staff, pupils or the wider community continues. In that case the use of Infectious Diseases regulations may need to be exercised. If a recommendation to close, or partially close an educational facility based on criteria and powers in S.I. No. 390 of 1981, the reasons for closure should be explained and the actions required or conditions to re-open.

In practice, actions by the MOH are usually considered in the context of an Outbreak Control Team. Experience from other settings shows that closures usually result when implementation of a set of preventive actions is not sufficient to control an outbreak and consensus is reached on the need for closure.

Page 62 of 75




Version Number: 1



Short Description:

This document is completed by students themselves, or on their behalf by course coordinator, tutor or other designated staff member (referred herein as “representative”) and Course Administrator or Coordinator, to facilitate contact tracing and minimise the spread of Covid-19.

PART C1: ATTENDANCE INFORMATION - to be completed By the Student Or their Representative Does Student have COVID-19 Tracker app installed? ☐ Yes, ☐ for >14 days

☐ for <14 days

☐ No

☐ I don’t know Has Student been keeping a daily record of Close Contacts?

☐ Yes

☐ No

☐ Partial

☐ I don’t know

If you have had contact with an infected person when they are deemed to be infectious, the Health Protection Surveillance Centre (HPSC) considers the following types of contact to be ‘close’ from the point of view of contact tracing: 1. If you had greater than 15 minutes face-to-face (<2 meters) contact with

confirmed case of COVID-19 in any setting. 2. If you are a household contact of a confirmed case of COVID-19 (i.e. living or

sleeping in the same home, individuals in shared accommodation sharing kitchen or bathroom facilities and sexual partners.)

3. If you have shared a closed space, including a workspace, with a person

infected with COVID-19 for longer than two hours then you MAY be considered

a close contact.

If YES or PARTIAL, please provide the following information for Close Contacts student had in the past 14 days: 1. Date of contact 2. Name of Close Contact 3. Phone Number of Close Contact 4. Type of close contact and setting (e.g. 22nd Sept, Joe Bloggs, 085 555 5555, housemate-apartment)

For repeated Close Contacts, include only the most recent one.

You may instead attach a file.

☐ File attached

Has Student kept a record of on campus classes they attended in person?

☐ Yes

☐ No

☐ Partially available

☐ I don’t know

Page 63 of 75





Version Number: 1



Short Description:


If YES or PARTIAL, please provide: 1. Date and Time of the class 2. Venue (Building and Room) 3. Seat Number (e.g. 22nd Sept, 10-12am, TTMI McNevin, seat: 2)


☐ File attached

PART C2: ATTENDANCE INFORMATION - to be completed by Course Coordinator or Administrator Your Name and Role

Please cross-checked the information provided in Part C1 with your own records.

Is information provided in Part C1 complete and accurate?

☐ Yes

☐ No

☐ Partially complete/ accurate

☐ I don’t know

If you answered YES, please skip next three question and continue to sign and date this section.

Are attendance lists available for this course? ☐ Yes

☐ No


☐ I don’t know

If YES, please list all on campus classes Student attended in person in the past 14 days. 1. Date and time of the class 2. Venue 3. Seat Number (if available)

(e.g. 22nd Sept, 10-12am, TTMI McNevin, seat: 2)


☐ File attached

If NO, please list all on campus classes Student was scheduled to attend in person in the past 14 days. 1. Date and time of the class 2. Venue 3. Seat Number (if available)



☐ This information is not available

☐ File attached

If information on schedule on campus activities is not available, please provide a class list pertinent for this case.


☐ File attached

Were there any other events or activities that this student attended in the past 14 days? Please provide relevant information.

Course Coordinator or Administrator Signature Electronic Signatures are permitted

Date





Version Number: 1



Short Description:


PART D: FOR COMPLETION BY THE STUDENT or THEIR REPRESENTATIVE Privacy Statement: This form together with all supporting documentation are submitted on the understanding that the data contained therein are used solely for the purposes of contact tracing and reducing the spread of COVID-19 on TCD campus and beyond. This information may be processed by designated staff in TCD to prevent further spread of disease and may be shared with the Health Services Executive (HSE) for the same purpose.

Student Signature Electronic Signatures are permitted

Date

If completed by Representative:

Name of Student’s Representative

Relationship to Student (e.g. course director, tutor, lecturer,)

Representative Signature Electronic Signatures are permitted

Date

FOR OFFICE USE ONLY: DOCUMENT CONTROL Prepared by: Prof Lina Zgaga (Associate Professor of Epidemiology, School of Medicine) Reviewed by Dr Katharine Murray (Head of Safety)

Approved by: TCD MEMT Next Review Date March 2021

VERSION Version 1 – Sept 2020

HISTORY

Confidentiality Statement This Document is the property of Trinity College Dublin and must not be reproduced without permission.


Appendix 2.1

COVID-19 CONTACT TRACING FORM Staff & Postgraduate Research Students



Title: Staff Covid-19 Contact Tracing Form

Version Number: 1



Short Description: This document is completed by the staff member themselves, or on their behalf by their line manager other designated staff member (referred herein as “representative”) to facilitate contact tracing and minimise the spread of Covid-19.

STAFF COVID 19 CONTACT TRACING FORM Postgraduate Research Students should also use this form.

This form should be completed by confirmed COVID-19 cases among staff and postgraduate research students (or their representative) and their Manager or Course Coordinator, and return this form to: [email protected] with the Staff/Student number in the subject of the email and “Covid-19 contact

tracing”

Note: If required this form might be shared with the HSE to enable contact tracing and minimise the spread of COVID-19.

PART A: GENERAL INFORMATION Name of Staff

Staff Number

Staff Email

Staff Mobile Phone Number

School/TRI/Unit

PART B: COVID-19 DIAGNOSIS How was Staff member diagnosed with COVID-19?

☐ HSE testing

☐ On-site testing facility in TCD

☐ I don’t know

☐ other – please specify:

Date Staff member was diagnosed with COVID-19 Please provide date of a positive test.

Date Staff member was last on campus. Please provide a date of last time student was physically present on campus.

Date Staff member first noticed symptoms. Please provide a date when your symptoms first

started, including cough, fever or feeling generally unwell.

Date Staff member started Self- Isolating. Please provide a date.





Version Number: 1




PART C: INFECTIOUS DISEASE REGULATIONS The Infectious Diseases Regulations (S.I. No. 390 of 1981) confer a general power on the Medical Officer for Health (MOH) to “take steps…for preventing the spread of [an]infection” where the MOH is aware of a suspected case of infection or a probable source of infection. The 1981 Regulations were amended by S.I. No 53 of 2020, to include COVID-19. Article 11 of S.I. No. 390 provides that:

“On becoming aware, whether from a notification or intimation under these Regulations or otherwise, of a case or a suspected case of an infectious disease or of a probable source of infection with such disease, a medical officer of health, or a health officer on the advice of a medical officer of health, shall make such enquiries and take such steps as are necessary or desirable for investigating the nature and source of such infection, for preventing the spread of such infection and for removing conditions favourable to such infection.”

This power may be enforceable by the risk of criminal liability under Article 19: “19. A person who refuses to comply with a requirement or direction given or a request for information made in pursuance of any of the provisions of these Regulations shall be guilty of a contravention of these Regulations.”

After investigating the outbreak and having put in place the necessary prevention measures, the MOH may assess the risk to staff, pupils or the wider community continues. In that case the use of Infectious Diseases regulations may need to be exercised. If a recommendation to close, or partially close an educational facility based on criteria and powers in S.I. No. 390 of 1981, the reasons for closure should be explained and the actions required or conditions to re-open.

In practice, actions by the MOH are usually considered in the context of an Outbreak Control Team. Experience from other settings shows that closures usually result when implementation of a set of preventive actions is not sufficient to control an outbreak and consensus is reached on the need for closure.

PART C1: ATTENDANCE INFORMATION - to be completed by the Staff member or their Representative Does Staff member have COVID-19 Tracker app installed? ☐ Yes, ☐ for >14 days

☐ for <14 days

☐ No

☐ I don’t know

Has the Staff member been keeping a daily record of Close ☐ Yes

☐ No

☐ Partial

☐ I don’t know

Contacts?

If you have had contact with an infected person when they are deemed to be infectious, the Health Protection Surveillance Centre (HPSC) considers the following types of contact to be ‘close’ from the point of view of contact tracing: 4. If you had greater than 15 minutes face-to-face (<2 meters) contact with a

confirmed case of COVID-19 in any setting. 5. If you are a household contact of a confirmed case of COVID-19 (i.e. living or

sleeping in the same home, individuals in shared accommodation sharing kitchen or bathroom facilities and sexual partners.)

6. If you have shared a closed space, including a workspace, with a person

infected with COVID-19 for longer than two hours then you MAY be considered

a close contact.

If YES or PARTIAL, please provide the following information for Close Contacts the staff have had in the past 14 days: 1. Date of contact 2. Name of Close Contact 3. Phone Number of Close Contact 4. Type of close contact and setting (e.g. 22nd Sept, Joe Bloggs, 085 555 5555, housemate-apartment)

For repeated Close Contacts, include only the most recent one.


☐ File attached

Has the Staff member kept a record of on campus classes, meetings

and other activities they have attended in person?

☐ Yes

☐ No





Version Number: 1




☐ I don’t know

If YES or PARTIAL, please provide: 1. Date and Time of the class/meeting/event 2. Venue (Building or location) 3. Seat Number (if applicable) (e.g. 22nd Sept, 10-12am, TTMI McNevin, seat: 2)


☐ File attached

PART C2: ATTENDANCE INFORMATION - to be completed by Staff Manager or PG Student’s Supervisor Your Name and Role

Please cross-checked the information provided in Part C1 with your own records.

Is information provided in Part C1 complete and accurate?

☐ Yes

☐ No

☐ Partially complete/ accurate

☐ I don’t know

If you answered YES, please skip next three question and continue to sign and date this section.

Are attendance lists available for this department? ☐ Yes

☐ No


☐ I don’t know

If YES, please list all on campus classes/activities Staff member attended in person in the past 14 days. 1. Date and time of the class/activity 2. Venue

3. Seat Number (if available and applicable)



☐ File attached

If NO, please provide a list of other staff members or students this person might have been in contact with in the past 14 days.


☐ File attached

Manager or Supervisor Signature

Date

PART D: FOR COMPLETION BY THE STAFF MEMBER OR THEIR REPRESENTATIVE Privacy Statement: This form together with all supporting documentation are submitted on the understanding that the data contained therein are used solely for the purposes of contact tracing and reducing the spread of COVID-19 on TCD campus and beyond. This information may be processed by designated staff in TCD to prevent further spread of disease and may be shared with the Health Services Executive (HSE) for the same purpose.

Staff Signature




Version Number: 1




Electronic Signatures are permitted

Date

If completed by Representative:

Name of Staff Member’s Representative

Relationship to Staff Member (e.g. line manager, colleague,)

Representative Signature Electronic Signatures are permitted

Date

FOR OFFICE USE ONLY: DOCUMENT CONTROL Prepared by: Prof Lina Zgaga (Associate Professor of Epidemiology, School of Medicine) Reviewed by: Dr Katharine Murray (Head of Safety) Approved by: TCD MEMT Next Review Date March 2021

VERSION HISTORY

Version 1 – Sept 2020

Appendix 3 – Legislative role of the HSE Medical Officer of Health

Infectious Disease regulations

The Infectious Diseases Regulations (S.I. No. 390 of 1981) confer a general power on the

Medical Officer for Health (MOH) to “take steps…for preventing the spread of [an]infection”

where the MOH is aware of a suspected case of infection or a probable source of infection.

The 1981 Regulations were amended by S.I. No 53 of 2020, to include COVID-19. Article

11 of S.I. No. 390 provides that:

“On becoming aware, whether from a notification or intimation under these Regulations or

otherwise, of a case or a suspected case of an infectious disease or of a probable source of

infection with such disease, a Medical Officer of Health , or a health officer on the advice of

a Medical Officer of Health , shall make such enquiries and take such steps as are

necessary or desirable for investigating the nature and source of such infection, for

preventing the spread of such infection and for removing conditions favourable to such

infection.”

This power may be enforceable by the risk of criminal liability under Article 19: “19. A

person who refuses to comply with a requirement or direction given or a request for

information made in pursuance of any of the provisions of these Regulations shall be

guilty of a contravention of these Regulations.”

After investigating the outbreak and having put in place the necessary prevention

measures, the MOH may assess the risk to staff, pupils or the wider community continues.

In that case the use of Infectious Diseases regulations may need to be exercised. If a

recommendation to close, or partially close an educational facility based on criteria and

powers in S.I. No. 390 of 1981, the reasons for closure should be explained and the actions

required or conditions to re-open.

In practice, actions by the MOH are usually considered in the context of an OCT. Experience

from other settings shows that closures usually result when implementation of a set of

preventive actions is not sufficient to control an outbreak and consensus is reached on the

need for closure.



Trinity College Dublin



Document Number: Appendix 10 Names and contact details for those with roles and responsibilities under the Trinity College Dublin Covid-19 response plan

Course Course Director Phone and email Covid Coordinator Phone and email Course Administrator

Phone and email

Medicine Y1

Joe Harbison 0862171571

[email protected]


[email protected]

Aine Wade/ Orla Mulligan

[email protected]/ [email protected] 896 1378

Medicine Y2

Joe Harbison

0862171571 [email protected]

Joe Harbison


Aine Wade/ Orla Mulligan

[email protected]/ [email protected] 896 1379

Medicine Y3

Joe Harbison


Colm Kerr

[email protected]

Aine Wade/ Sharon Thompson

[email protected] [email protected]

Medicine Y4

Joe Harbison 0862171571 [email protected]

Colm Kerr 0857899114

[email protected] Aine Wade/ Sharon Thompson


Medicine Y5


[email protected]

Colm Kerr

[email protected] Aine Wade/ Sharon Thompson


Occupational Therapy Tadhg Stapleton

[email protected] ext. 3214

Tadhg Stapleton 0874162593

[email protected] ext. 3214

Kate Brennan ouccupationtherap@tcd .ie ext. 3210

Physiotherapy Fiona Wilson [email protected] 0874174807

Fiona Wilson [email protected] 0874174807

Airna Nascimento [email protected]

Radiation Therapy

Michelle Leech 3252 [email protected] Michelle Leech 0868120995

3253 [email protected] Daléne Dougall 3234, [email protected]

Human Health and Disease

Eric Downer

[email protected]; 086 3685544/

Jean Fletcher [email protected]; 085 127 0599

Heather Hackett

[email protected]
































Staff Alex McKee [email protected] 086 1701469

Alex McKee [email protected] 086 1701469

Shannon Keegan [email protected]

Postgraduate courses

Individua l Course Directors

Kumlesh Dev/ Catherine Darker

Kumlesh Dev/ Catherine Darker

Kumlesh 0864117717 CD 0879377437

Ailbhe Mealy

[email protected]

Molecular Medicine

Prof. Ross McMan us

[email protected] Prof. Ross McManus

[email protected]/ 2139

Ana Llavori [email protected]

MSc Genomic Medicine

Shigeki Nakagome

[email protected] Shigeki Nakagome [email protected] 2241

Ana Llavori [email protected]

Neuroscience Prof. Kumlesh K. Dev

[email protected] Prof. Kumlesh K. Dev

[email protected] 4180 Silvia Cortes- Manzanedo

[email protected] 1418

Translational Oncology

Prof. Jacintha O’Sullivan

[email protected] Prof. Jacintha O’Sullivan

[email protected] 2149 Patricia Vila [email protected] 2189

Cancer Survivorship

Dr Deirdre Connolly, Julie Broderick

[email protected], [email protected]

Dr Deirdre Connolly, Julie Broderick

[email protected], [email protected] 3216/

Clinical Chemistry

Gerard Boran, Ann Leonard

[email protected]; [email protected]; [email protected]; [email protected]

Gerard Boran, Ann Leonard

[email protected]; [email protected]; [email protected]; [email protected] 3721

Allison Collie


Pharmaceutical Medicine

Joanne Ramsey

[email protected]

Joanne Ramsey

[email protected]

Biomedical Sciences (Intercalated)

Prof. Henry Windle (MSc Nsci, Trans Onc, Mol Med, H.Infect)

[email protected]

Prof. Henry Windle (MSc Nsci, Trans Onc, Mol Med, H.Infect)


Patricia Vila

[email protected]

Global Health Dr. Ann Nolan [email protected] Dr. Ann Nolan [email protected] 2764 Fiona Clarke [email protected] 4394

Health Services Management

Dr. Sarah Barry (Mandy Lee)

[email protected]

Dr. Sarah Barry (Mandy Lee)

[email protected]

[email protected]
















































Healthcare Infection

Julie Renwick, Stephen Smith

[email protected]; [email protected]

Julie Renwick, Stephen Smith

[email protected]; [email protected] 3791/8590

Healthcare Innovation

Seamas Donnelly, Michelle Armstrong

[email protected]; [email protected] e

Seamas Donnelly, Michelle Armstrong

[email protected]

; michelle.armstrong@tc d.ie

Dr. Nina Holmes

[email protected]

MSc Cognitive Behavioural Psychotherapy

Dr. Craig Chigwedere

[email protected]; cchigwedere@stpatsmail. com;

Dr. Craig Chigwedere

[email protected]; cchigwedere@stpatsma il il.com;

Majella Moloney


Dip Cognitive Behavioural Psychotherapy

Dr. Brian Fitzmaurice

[email protected]

Dr. Brian Fitzmaurice


Majella Moloney


Psychoanalytic Psychotherapy

Dr Paul Moore [email protected] Dr Paul Moore [email protected] Majella Moloney [email protected] 2493561

Addiction Recovery

Jo-Hanna Ivers [email protected] Jo-Hanna Ivers [email protected] 8507/086 031 7027

Ailbhe Mealy [email protected] 1087

Medical Imaging

Dr. Suzanne Dennan

[email protected] Dr. Suzanne Dennan


Michelle Hendrick [email protected]

Diagnostic Radiography

Dr. Suzanne Dennan

[email protected] Dr. Suzanne Dennan


Sports & Exercise Medicine

Dr Nick Mahony, Dr. Neil Fleming


Dr Nick Mahony, Dr. Neil Fleming

[email protected]; [email protected] 1413

Christine Monagha n

[email protected] 1182/2723

Sports & Exercise Medicine

Dr. Cuisle Forde

[email protected]

Dr. Cuisle Forde


Advanced Radiotherapy Practice

Laura Mullaney, Laure Marignol, Michelle Leech, Sarah Barrett

[email protected]; [email protected]; [email protected]; [email protected]

Laura Mullaney, Laure Marignol, Michelle Leech, Sarah Barrett

[email protected]; [email protected]; [email protected]; [email protected] 3254/3255/3252/3248

Magdalena Dougall












































Frailty in Ageing Adults

Roman Romero- Ortuno

[email protected] Roman Romero- Ortuno

[email protected] 8551/4103095

Dementia and AD: Foundational

Prof. Brian Lawlor, Dr Eoin Cotter


Prof. Brian Lawlor, Dr Eoin Cotter

[email protected]; [email protected] 2493200/

Confidentiality Statement







Confidentiality Statement This Document is the property of Trinity College School of Medicine and must not be reproduced

without permission. Printed Copies of this document are for reference only



Document Number: Appendix 11: School of Medicine Vaccination Policy

Table of Contents

1.0 PURPOSE .............................................................................................................................. 2

2.0 SCOPE ................................................................................................................................... 2

3.0 GOVERNANCE & RESPONSIBILITY ........................................................................................ 3

4.0 REFERENCES ......................................................................................................................... 4

5.0 DEFINITIONS & ABBREVIATIONS .......................................................................................... 4

6.0 PROCEDURE ......................................................................................................................... 5

7.0 APPENDIX ........................................................................................................................... 13

8.0 SIGN OFF ............................................................................................................................ 14

9.0 VERSION HISTORY .............................................................................................................. 14

of 11



Title: Vaccination Policy


Document Number: SOM-SOP-POL-002

Short Description: This policy outlines the process for School of Medicine students to avail of the Covid- 19 Vaccination.

1.0 PURPOSE

1.1 The purpose of this policy is to protect the health and safety of the School of Medicine (Hereinafter referred to as SoM) faculty, students, patients and others who work or train in the SoM’s healthcare locations – including all of the academic teaching hospitals and medical centres. The policy requires all SoM personnel, students and trainees working on-site in these locations to participate in education about the SARS- CoV-2 vaccines that will be available and either consent to administration of the vaccine or affirmatively opt out of Covid-19 vaccination. This policy provides interim guidance pending a national approach from the HSE and a College policy and this policy will be adapted, if necessary, once the HSE and College policies have been published.

2.0 SCOPE

2.1 This manual seeks to outline the policies and procedures to be followed by students to minimize the risk of Covid-19 infections to students, patients and to others through vaccination.

3.0 GOVERNANCE & RESPONSIBILITY

3.1 The SoM COVID Return to Business Committee meets regularly every month and will continue to do so in order to review the mechanisms in place to ensure the health and safety of staff and students across the multiple campuses.

4.0 REFERENCES

4.1 Resumption of Education Guidelines- HEA

4.2 https://www2.hse.ie/conditions/coronavirus/managing-coronavirus- at- home/if-you-live-with-someone-who-has-coronavirus.html

4.3 (https://www.hpsc.ie/a- z/respiratory/coronavirus/novelcoronavirus/guidance/contacttracingg uidance/National%20Interim%20Guidance%20for%20contact%20traci

4.4 https://www.hpsc.ie/a- z/respiratory/coronavirus/novel coronavirus/algorithms/COVID-19%20Telephone%20Assessm0for%20

https://www2.hse.ie/conditions/coronavirus/managing-coronavirus-at-




https://www2.hse.ie/conditions/coronavirus/managing-coronavirus-at-home/if-you-live-with-someone-who-has-coronavirus.html

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/contacttracingguidance/National%20Interim%20Guidance%20for%20contact%20tracing.pdf







https://www.hpsc.ie/a-

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/algorithms/COVID-19%20Telephone%20Assessment%20and%20testing%20pathway%20for%20patients%20(aged%2013%20and%20over)%20who%20phone%20GP.pdf

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/algorithms/COVID-19%20Telephone%20Assessment%20and%20testing%20pathway%20for%20patients%20(aged%2013%20and%20over)%20who%20phone%20GP.pdf

of 11







5.0 DEFINITIONS & ABBREVIATIONS

5.1 The Head of School: Hereafter referred to as HOS, has overall responsibility for the management and running of the SOM.

5.2 The School Manager: Hereafter referred to as SM, provides support to the HOS in the management and co-ordination of all the School's activities. The SM is responsible for the implementation of the quality manual and other SOM policies applicable.

5.3 Approval: For purposes of this policy, a Covid-19 vaccine is considered “approved” after the following conditions are met: (i) That the European Medicines Authority or HPRA have approved its administration(ii) That the Department of Health and the HSE has recommended its administration; and (iii) the relevant clinical location (e.g., Academic teaching hospital, Trinity Student Health Service) has authorized the vaccine for distribution to SoM students, as applicable.

5.4 Participation: Receipt of education about Covid-19 vaccine and either: (i) receipt of an approved Covid-19 vaccine, (ii) obtaining vaccination at an alternative location (e.g., GP student health or healthcare placement provider), or (iii) submission of a signed vaccination declination statement. Participation compliance under this policy for those receiving vaccine may require recurrent vaccinations or boosters on an annual or recurring basis consistent with Irish public health authorities labelling and CDC recommendations. In the event of supply shortages, programme participation may be delayed for some or all personnel and students .

5.5 SoM Vaccination programme: A vaccination programme intended to reduce the incidence of Covid-19 infection and resultant COVID-19 disease among SoM staff, students and patients. The Vaccination programme includes education about vaccinations and receiving or declining the vaccination.

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5.6 Vaccine Information Statement (“VIS”): An information sheet produced by the SoM or vaccine administrating authority including

information derived from the Centres for Disease Control and

Prevention, the HPRA, the EMA, the Health Service Executive (HSE)

,National Public Health Emergency Team (NPHET) or Trinity Health, explaining in plain language the benefits and risks of a vaccine to vaccine recipients. A VIS generally must be provided to an individual being vaccinated prior to each dose of the vaccine.

5.7 Vaccine Authority: the agency/clinical site that is providing the vaccination to the individual

6.0 PROCEDURE

6.1 This policy refers specifically to covid-19 vaccination and does not replace existing policies on vaccinations in the Trinity Calendar (Appendix 2) or other policies requiring SoM staff, students, patients, and visitors to observe non-pharmaceutical interventions including appropriate use of personal protective equipment (or, for patients and visitors, face coverings or facemasks), social and physical distancing, and frequent handwashing.

6.2 All SoM students on clinical placement in connection with their programme must participate in the SoM Vaccination programme by receiving education(6.2.1) concerning the vaccine; and consenting to or declining vaccination (6.2.2), as further describedbelow:

6.2.1 Education: Completing education on HSE.ie at the time of entry into Medical School, at the time of each required vaccination activity, as part of ongoing training and education, or any combination thereof concerning:

• The potential benefits of Covid-19 vaccination;

• The potential health consequences of COVID-19 illness for themselves, family members and other contacts, co-workers, patients, and the community;

• Occupational exposure to Covid-19;

• The epidemiology and modes of transmission, diagnosis, and nonvaccine infection control strategies (such as the use of appropriate

https://www.hse.ie/eng/health/immunisation/

https://www2.hse.ie/covid-19-vaccine/

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precautions, personal protective equipment, and respiratory hygiene/cough etiquette), in

accordance with their level of responsibility in

preventing healthcare associated COVID-

19infections;

• The safety profile and potential risks of any Covid- 19 vaccine.

• Requirements for participation in the SARS-CoV-2 Vaccination programme and consequences of failing to participate.

Education may be conveyed through any combination of written information statements, verbal communications, or online or in-person training programmes, consistent with applicable law and location policies and practices. Students with disabilities who require accommodations to access or complete any educational materials or programmes should contact the TCD disability services office.

6.2.2 Participation: Either: (i) receiving a recommended vaccine for Covid-19 at the required intervals, or (ii) submitting a signed vaccination declination statement by completing any of the following steps.

• On-Site Vaccination: Receiving vaccination on-site at any SoM clinical placement provider location such as an affiliated teaching hospital.

• Off-Site Vaccination: Providing written documentation to the location vaccine authority of vaccination through an alternative clinical site such as GP placement or any other placement provider site.

• Declination: Formally declining the vaccine by completing and signing (on paper or electronically) a Vaccine Declination Statement and complying with the additional control measures described below (“Vaccine Declination”).

•

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6.3 Vaccine Declination: The School of Medicine recognises the right to decline to take the vaccine at this time. It will do everything it can to ensure that those who decline are able to meet their programme learning outcomes and acquire the required clinical skills. Remedies could include deferral of, for example, clinical placement and/or off- books extensions as appropriate. However students have to recognise that remedial action may not be possible in all cases, and progression, including the award of the Degree, may be jeopardised in some cases. It is notable that a number of placement providers will not accept unvaccinated students. Therefore the School of Medicine requests that you discuss carefully the academic implications of a declination decision with your tutor, mentor, Director of Undergraduate Teaching and Learning or Head of School as appropriate.

6.4 Students who choose to decline the vaccination must complete a Vaccine Declination Statement and submit it to the Head of School, Director of Undergraduate Teaching and Learning (DUTL) and Head of Discipline. A sample Vaccination Declination Statement is attached to this policy document that may be utilised. A list of individuals who decline vaccination (or subsequent doses, where those are required) may be provided to clinical placement providers/ department managers, including division and department heads where necessary to facilitate implementation of compensating safety measures, programme evaluation, or related activities.

6.5 Whether vaccinated or not, students must continue to wear personal protective equipment as directed by the location vaccine authority to mitigate risk to patients and other health care workers whenever they are on clinical placement in any clinical placement provider facility.

6.6 A student who initially declines the Covid-19 vaccine but later decides to become vaccinated should discuss their plans with occupational health, college health and the students GP, the Head of Discipline, Head of School and DUTL, and may receive the vaccine through any available vaccine provider and provide documentation of the administration to the School of Medicine, Therapy Discipline or associated Clinical Service

6.7 Initial Vaccine Allocation. During the period of initial allocation, locations may not mandate full programme participation, however, healthcare locations are expected to comply with applicable legal and policy

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requirements for providing information to individuals voluntarily receiving vaccine.

6.8 Superseding Public Health Guidelines. In the event that the Irish government or the HSE imposes a mandate restricting or eliminating participation options, the applicable public health mandate will be implemented at all SoM clinical locations.

6.9 Tracking and Reporting: The following information must be recorded and tracked by the location vaccine authority in the applicable confidential personnel health record or student health record:

• Date of administration

• Vaccine type

• Vaccine manufacturer

• Vaccine lot number

• Expiration date

• Site of administration

• Name and title of person administering vaccine

• VIS provided to the student Any adverse events associated with Covid-19 vaccine administration should be reported to medcheckdaily and should be tracked and logged by the location vaccine authority and reported as appropriate to the HPRA. Each clinical placement site may establish local procedures to facilitate administration of the Covid-19 vaccine and will be considered in conjunction to this policy.

6.10 Registry and programme Evaluation: Appropriate information about all vaccinations may be submitted to the HSE as required by applicable public health agencies or University policy. Individual clinical sites shall evaluate initial allocation and, thereafter, programme participation, on an annual and ongoing basis, including evaluation of equity and disparities in initial allocation and programme implementation; as well as reasons identified for non-participation or untimely participation, the number and characteristics of personnel and students not vaccinated, and the reasons given (if any) for declination.

6.11 Programme participation: programme participation in education is

mandatory, but each participant may, after receiving appropriate

information about the vaccine, consent to vaccination or decline.

Declination may require additional compensating safety measures, as

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determined by the clinical placement provider and consistent with applicable public health directives. In addition if a student’s decision or change of mind regarding the vaccination is not within a timely manner, the School or the discipline may not be in a position to secure a placement for them automatically or immediately. Therefore the student may be required to go off-books. It is important to note that that some placement providers may require vaccination and that the SoM cannot guarantee that an appropriate placement will be available, and completion of the course may be delayed or at risk.

7.0 Appendix

7.1 Vaccination Declination Statement 7.2 TCD Calendar Statement on Vaccinations






8.0 SIGN OFF

Prepared by:

Michael Gill Head of School of Medicine

Signature:

Date: 03. 03.21

Reviewed by:

Kevin Conlon Chair Return to Business Committee

Signature: Date: 03.03.21

Approved by:

Michael Gill Head of School of Medicine

Signature: Date: 03.03.21

8.0 VERSION HISTORY

Version Description of Change Revised By

1.0 Original M.Gill

Page 9 of 11







Document Number: SOM-SOP-POL-002 Appendix 1

Short Description: Vaccination Declination Statement

In signing this form I. [ insert your name] make explicit my decision to decline the offer of Covid-19 vaccination at this time. I have read the School of Medicine Covid-19 vaccination policy and documents cited therein, I have participated in the education part of the School of Medicine vaccination programme and have informed myself of the risks and benefits of Covid-19 vaccination. I have discussed the academic implications of my decision with my tutor, the Director of Undergraduate Teaching and Learning or Head of School.

Name of Person: First Name:

Last Name:

Consent: I am the above-named person signing this form. I am at least 18-years of age with full knowledge to the consequences of declining to receive the COVID-19 vaccine at this time.

Signature and Date:

is permitted. All costs associated with tests for health screening and vaccination must be met by the student.





Document Number: SOM-SOP-POL-002 Appendix 2

Short Description: TCD Calendar Statement on Vaccinations

Health screening and vaccination

3 All health care professionals have a duty of care to the public. In the interests of reducing the risk of the transmission of infectious disease from patients to students, or students to patients, all new entrants to the Faculty of Health Sciences in dental science must attend a registered general practitioner or the College Health Service and submit the completed required health screening and vaccination documents to the school prior to the first Friday in October to certify their vaccination status or immunity to tuberculosis, measles, mumps, rubella and chickenpox.

Students must produce evidence of their hepatitis B and C status and where appropriate confirmation that they do not have active disease. Students who are hepatitis B negative but not already deemed to be immune to hepatitis B will be required to undergo a course of vaccination. Students will not receive hepatitis B vaccination until they show evidence that they are negative for hepatitis B virus antigens. Students will not be permitted to commence practical clinical experience until they have received at least two doses of the hepatitis B vaccine. Complete details of the vaccination programmes and the blood borne viruses (BBV) policy must be adhered to and are communicated to applicants as part of the admissions process and are available from the school offices and websites. Students will also be advised to seek vaccination against influenza each year for the duration of their course of studies. Students who fail to complete the above requirements will be made withdrawn from their course of study and a re-admission fee may apply.

Advice for applicants who test positive for a BBV can be arranged through the College Health Service. Applicants who are chronic viral carriers and who successfully undergo treatment, which renders them no longer an infectious risk to patients, may reapply for admission to their chosen course. All efforts will be made to reserve a place on the forthcoming student intake for such individuals, however this cannot be guaranteed.

In the rare circumstances where during their studies a student acquires a BBV infection, their school will consider reasonable accommodations in accordance with statutory requirements. Details of the management of students who become infected with a BBV during their course are outlined in the BBV policy. In the event that a student has, or during the course of study becomes aware of, any life threatening infectious condition that could be transmitted to a patient or fellow health worker, such as HIV, hepatitis B, hepatitis C, tuberculosis, chickenpox, influenza, measles or rubella they should advise their school office and consult a registered general practitioner or the College Health Service to confirm they are not contagious. If they are contagious, they should obtain a medical certificate confirming the diagnosis and should refrain from patient contact until cleared medically.

If Irish law, or official guidance, changes between the date of publication of this documentation and the date of registration of new applicants to this course, the Faculty of Health Sciences reserves the right to require that the criteria adopted in relation to the ability to practise clinically in Ireland be satisfied before registration



Document Number: Appendix 14: Letter from Colm Henry re: students who decline vaccination and clarification letter re: clinical placements

Confidentiality Statement



Office of the Chief Clinical Officer Dr Steevens’ Hospital|Steevens’Lane|D08W2A8

email:[email protected]

Oifig an Phríomhoifigigh Cliniciúil Ospidéal Dr. Steevens|Baile Átha Cliath 8|D08W2A8

By Email Only

Date 26th March 2021

Re: Student who decline vaccinations

Dear colleagues,

Last year following engagement with your institutes, we were able to agree a process that facilitated essential clinical placements for healthcare students in HSE facilities through the past year. The process agreed was consistent with the need to ensure patient and student safety to the greatest degree practical at that time. We are all agreed that the safety of patients, staff and students remains a shared key priority. I wish to advise you of some updated decisions in relation to clinical placements in the context of the COVID1-19 Vaccination Programme, which provided and added opportunity to ensure the safety of all concerned.

For this purpose, Clinical Placements refers to unpaid clinical experience for healthcare students whose presence is not specifically required to sustain service delivery. Students (for example 4th year nursing students) who constitute part of the workforce that sustain service delivery are in the same category as other healthcare workers. The following does not apply to them.

Following consideration the HSE COVID-19 Vaccination Working Group has taken the following decision and I ask that your institutes now apply this to all student placements in HSE facilities with effect from April 1st 2021.

Students that are eligible for vaccination, that have been offered vaccination and decline vaccination should not be assigned to clinical placements in HSE facilities. This may be reviewed as the epidemiological situation evolves.

Please note that for those very exceptional circumstances where there is specific and documented medical contraindication to vaccination for a healthcare student an individual risk assessment should be performed by the higher education institute to determine if a suitable placement can be designed that minimizes risk to patients and to the student.

Kind regards,

Dr. Colm Henry, Chief Clinical Office


Office of HSE Clinical Lead - Healthcare Associated Infection and Antimicrobial Resistance.

1 | P a g e

Merlin Park Regional Hospital, Galway.

Oifig Treoir Chliniciúil FnaSS – Ionfhabtú a bhaineann le curam

sláinte agus frithsheasmhacht in aghaidh antaibheathaigh

Ospidéal Réigiúnach Pháirc Mheirlinne,Gaillimh

April 2 2021

TO: PRESIDENTS/PROVOST/HEADS OF SCHOOLS HEI’s

RE: Clinical placements and students who are eligible for vaccination, who have been offered vaccination and

who have declined vaccinations. Clarification on correspondence issued on 26/03/2021 from Dr Henry

Dear Colleagues

The HSE remains strongly committed to supporting clinical placements in partnership with the Higher Education

Institutes but must fulfil its obligation to reduce risk to patients and staff associated with hosting these clinical

placements.

Patients support education and training of healthcare students on clinical placement by accepting those students

in their room or in their bed space and granting those students the privilege of access to the details of their lives,

their clinical history and to their body. Patients are entitled to refuse to accept visits from students on clinical

placement but few do so. In recognising the generosity of patients in supporting healthcare students and the

systems for education and training there is an obligation on everyone including students to do all that is

reasonably practical to protect those patients who support them from avoidable risk.

The COVID vaccines protect those who receive them from severe disease and death. They also reduce the risk

of infection, including asymptomatic infection, and they reduce the amount of virus shed by an infected person.

Vaccines are therefore a readily available option to reduce the risk to patients associated with the patient’s

voluntary participation in the education and training of students on clinical placement.

In this context the letter from the CCO of 26/03/2021 stated that “Students that are eligible for vaccination, that

have been offered vaccination and decline vaccination should not be assigned to clinical placements in HSE

facilities. This may be reviewed as the epidemiological situation evolves.”

The direction is quite clear. It does not apply to students who are not eligible for the vaccine. Students who

have” a specific and documented medical contraindication to vaccination” are not eligible for vaccination. As

per Dr Henrys letter Higher Education Institutes, are invited to determine if a suitable placement can be designed

for these students that minimises risk to patients and to the student through the local mechanisms & structures

in place. Where requested to do so the HSE will seek to support the HEIs to the greatest extent practical.

Queries in relation to pregnant students, those under 18 years of age and contraindications are addressed in

the HSE National Immunisation Office Clinical Guidance for COVID – 19 Vaccination Version 10.3, dated

26/03/2021 (attached on e-mail). As above if the student is not eligible for vaccination or has not been offered

vaccination they are not encompassed by Dr Henry’s direction.

Students that have not been offered vaccination are not encompassed in the direction from Dr Henry. Students who have been offered vaccine and accepted the offer but who have not yet vaccinated are not

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encompassed by the direction from Dr Henry.

Those students who have not yet registered for the vaccine but now wish to do so are not refusing to accept

vaccination and are not encompassed by Dr Henry’s direction. The HSE is working on a process whereby all

healthcare workers and students will be able to registrar in approx. 2 weeks’ time. In due course it is expected

also that healthcare workers and students will be able to access the vaccine through their local Occupational

Health Service.

There is no scope to offer anyone, students or staff a choice of vaccine. Vaccine supplies are so limited that this

is not possible. All the vaccines are used in accordance with their licensed use and are effective.

In summary the intention of the direction is to do everything possible to support students and to support clinical

placements in manner that protects patients from avoidable risk related to their voluntary participation in

education of students. The HSE will continue to do everything practical to support access to vaccination as

quickly as is practical for students who now chose to be vaccinated and will try to accommodate proposals from

the Higher Education Institutes to accommodate students in exceptional circumstances who have a well-

documented contraindication to vaccination.

Thanking you for your ongoing assistance in this matter.

Professor Martin Cormican Clinical Advisor to the COVID-19 Vaccination Programme

Saint James’s and Tallaght Hospital Current Household Contact Policy



Document Number: Appendix 12: St. James's Hospital Household Contact Policy

Close contact is a household contact

Self-isolate at home (do not attend placement)

*Note if household contact is awaiting swab result then also self-isolate until result known +

then take appropriate action

Contact both MedCheckDaily + SJH/TUH Occupational Health

Day 0 and Day 5 swab required (Occ Health to arrange same once contacted by student)

A derogation form will be considered by Occ Health at day 5 if swab negative. The return to placement at this point is at the discretion of Occupational Health in SJH/TUH on a case-by-case basis. The responsibility lies with the student to contact them regarding further action after day 5. Keep MedCheckDaily informed

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