By Melba Newsome

When the fall semester came to a close, Warren Wilson College had a particular reason to celebrate. The private liberal arts college in Swannanoa ended the term with no positive on-campus cases of COVID-19, a claim no other residential college in western North Carolina could make.

“The fact that we were able to have zero cases this semester is mind-blowing,” said Justin Gildner, Warren Wilson’s director of safety and risk management and leader of the Pandemic Response Team. “Every week I told the team to hold their breath and keep doing what they’re doing. We took it one day at a time.”

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What Warren Wilson was doing was following the guidelines and protocols established with five other western N.C. colleges and universities to control COVID on campus.

The effort began last spring when COVID-19 outbreaks first hit college campuses. COVID-19 Preparedness for Institutions of Higher Education, a program created by UNC Health Sciences at MAHEC, provided weekly support and live virtual training sessions for 200 administrators, faculty and staff on prevention, testing and tracing, health equity, outbreak, case management, and student wellness.

“It is remarkable to have public and private institutions from all over the region work together with public health professionals to keep their campuses and communities safe,” shares MAHEC CEO Jeffery Heck. “Their diligence has kept thousands of Western North Carolinians and students safe, employed, and able to learn during a very challenging time.”

In addition to Warren Wilson, leadership and faculty from Brevard College, Mars Hill University, Montreat College, Western Carolina University and the University of North Carolina Asheville worked to develop public health guidance. The group shared best practices and resources to implement containment strategies that would keep campuses open and safe. During weekly virtual support calls, chancellors, presidents and designated COVID team members worked with clinical and public health experts on containment strategies.

“Since April, our innovative collaboration with the presidents and chancellors has been focused on adopting best practices in virus mitigation and health protocols on our campus,” said UNC Asheville Chancellor Nancy J. Cable. “Through demonstrated leadership in the UNC System, we’ve been successful because of their good advice, our institutional cooperation, and our shared culture of care and respect for one another across our campuses.”

Peers in the lead

Early on, it became clear that students were best positioned to promote practices to prevent or slow the spread of COVID-19 on campus. The initiative began by recruiting, hiring and training trained students at all six partner institutions to provide COVID-19 education, prevention tips and support to their classmates.

Thanks to a $610,000 COVID-prevention grant from the N.C. Policy Collaboratory at UNC Chapel Hill, MAHEC trained 94 student health ambassadors (SHA) to promote a culture of health and safety by engaging and educating peers through a variety of activities. SHAs were required to complete 10 hours of training and receive ongoing support from fellow ambassadors and through cross-campus huddles.

“I applied to be an SHA to be part of a team that provided multiple levels of support to students,” said UNC Asheville senior biology major Albert Chow. “I accomplished that through work in peer education, tabling outreach across campus and policy work.”

Early in the semester, students were anxious about classes and on-campus housing due to regional cases of COVID. The SHAs quickly developed outreach initiatives to promote healthy behaviors.

“As the university’s positive case count remained low, students felt less anxious about attending in-person classes,” said Chow. “That allowed them to have access to campus resources like RAs, housing and dining, and the library.”

SHAs work in specialized teams, ranging from communication to wellness coaching. Each group is supported by a faculty or staff advisor and has the autonomy to design its own programs.

For example, at Western Carolina University and Brevard College, SHAs modeled mask-wearing, social distancing and healthy exercise through daily wellness walks. Warren Wilson SHAs hosted weekly virtual drop-in sessions. Mars Hill’s SHAs rewarded safe behaviors with Healthy Lion stamps that can be redeemed for swag.

Isolation and anxiety are common mental health struggles during the pandemic and became a particular focus of the SHA teams.

For example, SHAs developed an online pen pal program, created virtual game and movie nights, drop-in support sessions and meal and care package delivery for students who were quarantined or in isolation. At UNC Asheville, SHAs coordinated music and drama performances outside quarantine housing to lift students’ spirits.

Persuasion over enforcement

UNC Asheville SHA Alexis Baker explained that most of the information they shared with fellow classmates was a reiteration of the communications from professors and the administration.

“Having an answer come from a peer seems to resonate better with students,” said Baker.

NC Center for Health and Wellness executive director Amy Lanou said it was an intentional decision to avoid putting the SHAs in an enforcement role.

Peer education experience and higher education experts agree that shame and fear tactics aren’t an effective strategy. Punishing and scolding students for not following guidelines can make them less likely to cooperate with testing or contact tracing efforts later on.

Because SHAs are classmates, friends and peers, their messages tend to resonate more than directives from a stranger or higher-up who issues edicts or reprimands.

“The ambassadors’ role is largely in education and support,” said Lanou. “We really want them to use peer education and support strategies, which tend to be focused on cheering each other on when we are doing well, and then using things like bystander intervention strategies when there’s something happening of concern.”

That strategy appears to have paid off.

“I am exceedingly grateful that we made it without the outbreaks of COVID that have so seriously affected other campuses,” said Warren Wilson College president Lynn Morton. “In the end, we were able to ensure the health and safety of our campus because of the students, faculty and staff who took the virus seriously and followed our health and safety protocols.”

While UNC Asheville did not end the semester COVID-free, Chow says the university has a lot to be proud of.

“We have the lowest prevalence in the entire UNC system. Behind that has been the informed, dedicated response of the entire campus community, including staff, faculty, housekeeping and students,” he said.

The SHAs also developed strategies to keep students engaged and safe over the winter break. When they return to campus in January, these health and safety diplomats say they’ll be there to encourage safe behaviors and COVID-19 vaccination when it becomes available.

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Melba Newsome is an award-winning freelance writer with more than 20 years' experience reporting on news and features. Her feature credits in many prominent publications including the New York Times, Bloomberg Businessweek, Oprah, Playboy, Reader’s Digest, Time, Good Housekeeping and Wired. Melba also is a frequent contributor to such online sites as NBCNews and Healthline.

Thanks to a Crisis Reporting grant from the Pulitzer Center, she will be reporting extensively on the physiological, emotional, and societal impact of the novel coronavirus for NC Health News.