Student Experience Working in Covid EAS Dr Joe Wilson

Medical Student Working in the COVID early Alert Service

Mr Joseph Wilson

(Oriel College, 2016) Newly Qualified Doctor

From August 2020 to March 2022, the University ran its own in-house COVID-19 test and trace system – the Early Alert Service (EAS). A collaboration between the University and Oxford University Hospitals NHS Foundation Trust (OUHFT) involving everyone from retired public health officials to medical students in their first year of clinical training, more than 12,000 PCR tests were performed, approximately half a million lateral flow devices issued, and y people vaccinated on University sites.

However, despite best efforts, our ability to limit the spread of infection within the University and the wider Oxford community was repeatedly hampered by the Government’s inability to enact suitable, proportionate, yet impactful policies when necessary.

The clearest example of this is Trinity Term 2021: the relaxing of restrictions and removal of government support coincided with the emergence and swift dominance of the Delta variant within the UK. Compounded by the relative paucity of vaccinated students due to the nature of the vaccine rollout, plus the increased socialising characteristic of Trinity and the want to make up for lost socialising, our community was at particular risk. The government’s lack of practical policy and guidance for higher education institutions and verbose insistence that it would all blow over left the University in a precarious position: continue to align with the Government as it had done throughout the pandemic or go further than Ministers presented as necessary and de facto announce that Oxford University believed that the Government was getting this wrong. Ultimately, the University toed the government line, but quite quickly we saw cases surge with multiple sources of infection with transmission occurring at events deemed to be COVID safe. Arguably, we learnt our lesson for when the Omicron variant took hold in the run up to Christmas 2021. Through EAS testing, we detected one of the first Omicron infections in the UK. The forensic work of our results liaison team swiftly identified the source of infection and isolated the index case; overnight we quadrupled our testing capacity in which our dedicated team of more than eighty medical students were instrumental. Although cases began to rise, and they rose quickly, we were confident of where in our community transmission was occurring. Subsequently, and in direct contravention of Government guidance, the Vice Chancellor cancelled all Christmas parties and encouraged working from home where possible. Were it not for the diligence of EAS, and the University’s willingness to act on its findings, I believe there would have been a swifter Omicron wave in Oxford with a real potential to further squeeze local NHS services already under immense strain.

Following the Government’s abolition of isolation requirements and testing availability earlier this Spring, the University chose to dissolve EAS. This action, however, must not be conflated with the University taking the position that the pandemic is over. Moreover, it signifies that there was no longer the foundation of Government support on which EAS required to be a successful infection control tool. How can staff and students possibly know that they are close contacts if widescale testing is no longer available? What good is there in us continuing to test in-house if there if the requirement for isolation and support has been removed?

Having reflected on this almighty near two-year ordeal, a few thoughts come to mind. Firstly, if we end up in a position once again requiring EAS, we now have a solid framework that we would implement. Many lessons were learnt en-route, but our willingness to act on our mistakes was fundamental to the success of EAS in which I take a lot of pride. Secondly, gratitude to those who stepped up, thinking their public health and clinical days were firmly behind them, and taking the time to guide those such as myself for whom this was very much their first rodeo.

EAS was a real success in limiting infection within and maintaining the productivity of the University in response to one of its greatest adversities throughout its long history. Whilst hoping our doors never have to reopen, if they do it can only be as an adjunct to sensible, effective, nationwide policies.