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Does this letter put pressure on medical students to get jabbed?

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A WHISTLEBLOWER from Queen’s University Belfast has contacted us about a ‘guide’ sent out by the University’s Medical School to its students, with the stated purpose of giving them precautionary ‘Covid’ advice. His concern is that although the letter is technically and legally short of making vaccination mandatory for its students it is psychologically coercive, all but making it a requirement for students to vaccinate in order to continue their course. You can read the letter in full below and decide for yourself.

Our interpretation is that it puts the students under considerable pressure, and the associated specified testing regimen and isolation requirements the letter sets out are not communicated as an alternative. It states: ‘Any student who is not fully vaccinated and is in clinical placement MUST inform Prof N Kennedy if you have not already done so, to perform a risk assessment.’ 

Whether this means a one-to-one meeting or simply an email, it is still intimidating. And why, given the epidemic of Covid amongst the vaccinated, the unvaccinated student has to undergo a ‘risk assessment’ appears to us to be discriminatory. The letter also warns students that ‘some GP practices have said they will take only vaccinated students’.  


This may indicate that pressure to get the jab is coming from this quarter rather than the university. But if those GP practices can exercise a sanction against unvaccinated students – that is, they can bar them from attending their surgeries – that also is discriminatory. While the medical school might argue that it is only passing on to its students legitimate concerns from GPs and would not be doing its duty if it failed to do so, it does not offer further advice or help for those students who equally legitimately wish to retain their right not to be vaccinated, or to be exposed to unnecessary vaccination risk.

Anyone debarred from access to a GP practice to which he/she is allocated for their primary care secondments might find it hard to complete that vital element of the course and put them into a disadvantageous position. Few students would wish the Eye of Sauron to be upon them.

As yet there has been no comprehensive safety review undertaken ‘to reassure that the risks associated with genetic vaccines in the young population do not outweigh the desired benefits’. The latest government figures show there have been a total of 2,868 adverse reaction reports made for children under 18, an increase of 122 since the previous report on January 6. Table 9 shows there have been 4 additional reports of myocarditis in children under 18, bringing the total to 53. There have also been 22 additional fatalities. 

Here is the letter in full:

3rd January 2022

Dear medical student,

This guide covers most Covid related questions you may have as a QUB medical student.

**** Please read it all carefully. I hope it is useful. QUB have useful information online too, here:

https://www.qub.ac.uk/home/coronavirus-faqs/information-for-students/

**** Contact us if you have any other queries. We want to know about any issues as soon as they arise: email redacted anytime.

**** QUB have an excellent website on self isolation, highlighting sources of support:

https://www.qub.ac.uk/sites/my-queens/self-isolation/

The risk of your catching or transmitting Covid cannot be eliminated, but we can minimise the risk. Students’ behaviour is an important part of maintaining safety. We know that you do your best to be diligent in keeping patients, your peers, tutors, healthcare workers and all their relatives and contacts safe: thank you.

The basics still apply such as washing hands regularly and keeping rooms well ventilated where possible.

·         social distancing is not mandatory between students, but must be maintained between students and staff

·         face masks are mandatory whilst in face-to-face teaching sessions, including Case-based learning sessions, practical classes exams and while circulating around corridors and communal areas

Clinical Attachments: the premise is that you should follow the practices of the clinical team you are attached to.

We strongly urge all students to do the following:

·         If you have ANY SYMPTOMS that could relate to COVID – DO NOT ATTEND YOUR ATTACHMENT. GET a PCR test as soon as possible (DON’T USE A LATERAL FLOW TEST) 

·         Ensure you are fully vaccinated. Some General Practices have communicated that they will only take students who are fully vaccinated.

·         Any student who is not fully vaccinated and is in clinical placement MUST inform Prof N Kennedy if you have not already done so, to perform a risk assessment.

·         Download the Stop COVID NI app

·         Wear the correct PPE

·         Get a supply of Lateral Flow Tests and undergo asymptomatic testing regularly.

·         If you test positive on a lateral flow test you MUST book a PCR test as soon as possible

We want to highlight the particular responsibilities of students going to any General Practice attachments. The visible impact on service delivery if General Practice staff have to isolate due to contact with a student who has COVID is very high, i.e. many patients are affected. In the first week of 2021/22, two Practices had to have large proportions of their team isolate which has significant impact on a service already under great pressure. News of such events quickly spreads among the GP community, and potentially erodes GPs’ ongoing willingness to host students. Please help with the efforts to keep the clinical attachments going while keeping everyone safe.

Its important to remember that support is always available, from the CME pastoral support team, or from QUB at: redacted. Your mental wellbeing is important. Personally, I strongly believe that mental wellbeing is best served by striving for perspective, cultivating company, protecting regular exercise (like a long walk) and even remembering the basics like healthy eating and sleeping. None of this will happen without your planning. 

Please click and browse here: www.qub.ac.uk/directorates/sgc/wellbeing/Covid-19/

Best wishes,

Dr Michael Williams
CME COVID Coordinator

Professor Neil Kennedy
CME Director

With thanks to Prof Nigel Hart, Dr Ciaran O’Gorman and Mr David Norwood

Contents.

Q1. What do I do if I have symptoms of COVID?

Q2a. What do I do if I test positive for COVID on PCR?  (**UPDATED**)

Q2b.    What do I do if I need COVID secure transport?  (**NEW**)

Q2c. Where can I pick up lateral flow tests?  (**UPDATED**)

Q3.  What is contact?

Q4.  What do I do if I am a contact of someone who is COVID positive?

(**UPDATED**)

Q5.  What is the correct PPE?

Q6.       Who should I contact for pastoral support in relation to COVID? 

Q7. Who should I contact if I am still unsure what to do? 

Q1. What do I do if I have symptoms of COVID?

If you develop any symptoms of COVID (e.g. high temperature, a new continuous cough or loss or change to sense of taste or smell or other symptoms suggestive of COVID-19), then:

9.    self isolate right away. Put on a face covering, return to your accommodation immediately, avoiding public transport if possible. See 2b for info. on transport.

10.                       book a PCR test

If the result is negative, then you can return, if you haven’t had a fever for over 48 hours.

If you are on placement, you can arrange a test by phoning the appropriate COVID19 Helpline from the Health Trust in which you are placed:

Health Trust COVID19 Helpline
Belfast 028 96152828
Northern 028 94424401 
Southern 028 37562600 
South Eastern 028 92680803 
Western 028 71611281 

The Health Trust will then arrange for you to receive a COVID19 test at the Trust Testing Facility and will phone you with the result within 48 hours.

If you are not on clinical placement, arrange a test, via this link:

https://www.gov.uk/get-coronavirus-test

                       … or call 119

11.                       and as soon as possible:

l.       if you live in QUB accommodation, inform QUB, here: http://go.qub.ac.uk/covidupdate (previously every QUB student had to complete this online form, but this is not the case now)

m. If you are on clinical placement, you must inform your Clinical Supervisor AND the Trust’s Undergraduate Office / GP Practice that you are self isolating, and then with your PCR result when you get it

n.    Please complete an online “self-cert” to inform CME of your absence. 

o.    redacted

Q2a. What do I do if I test positive for COVID on PCR?

If required to self-isolate, who should I contact?

·         only if you live in QUB accommodation, inform QUB, here: http://go.qub.ac.uk/covidupdate (previously every QUB student had to complete this online form, but this is not the case now)

·         If you are on clinical placement, you must inform your Clinical Supervisor AND the Trust’s Undergraduate Office / GP Practice that you are self isolating, and then with your PCR result when you get it

·         Please complete an online “self-cert” to inform CME of your absence

·         redacted

·         All students are encouraged to download the COVIDCareNI and the STOPCOVID apps. If you test positive, please ‘inform’ the app

The Public Health Authority will contact you and conduct contact tracing: there is no need for you to do this. However you are encouraged to inform any possible close contacts: see later for how ‘contact’ is defined.

If I have to self isolate, what do I do?

·         If you must self isolate, and are on placement, we suggest you return to your Belfast accommodation / home if possible: see 2b for information on transport

·         QUB have a useful ‘FAQ for Students’ page, including advice on self-isolation: qub.ac.uk/sites/my-queens/self-isolation/

When can I return to normal?

·         after day 10 if you haven’t had a fever for over 48 hours (you do not need to keep self isolating if you have a cough, or loss of taste or smell, as these symptoms can last weeks)

·         the self isolation time period starts from the date your PCR was positive, or from the first date you had symptoms, whichever was sooner

·         if you have two consecutive negative lateral flow test results, from day six onwards. This means the earliest you can end self isolation is day 7.

Q2b. What do I do if I need COVID secure transport?

COVID- secure travel can be arranged for medical students in the specific circumstance of needing to self isolate, either as a contact or a case, and needing then to move from hospital or GP-placement related accommodation anywhere in Northern Ireland, back to your usual accommodation. You will not need to pay for the taxi yourself.

If you need this, please email all of:

redacted

We will respond as quickly as possible to arrange this.

If you need transport to get a PCR test, arrangements are different: the University can assist you in booking a special COVID-secure taxi to transport you to a PCR test if you need this: call: 90973550. There will be a cost to you for this taxi service.

Q2c. Where can I pick up lateral flow tests?

Order from the government site:

https://www.gov.uk/order-coronavirus-rapid-lateral-flow-tests

Or take home kits are available from QUB at:

§  Mondays: MBC Foyer, 10 00 – 15 00

§  Tuesdays: David Kier Building Hub, 10 00 – 13 00

§  Wednesdays: Main site Tower Building, beside Junction Cafe, 10 00 – 15 00

§  Thursdays:           Ashby Foyer, 10 00 – 13 00

§  Elms receptions, BT1, BT2 and BT9, McClay library reception

§  Security Control in the Administration Building (24/7)

Or kits can be obtained from Trusts at:

·         South Eastern Trust: contact redacted

·         Northern Trust: pick up kits from Education Offices in Causeway or Antrim Hospitals

·         Southern Trust: pick up from a “Cascade Trainer’ (there is one on each ward), or in Craigavon Hospital from the COVID Priority Screening Pod, or ‘Donning and Doffing’, or in Daisy Hill Hospital from domestic staff

·         Western Trust: contact Medical Education, for example here: redacted

Q3. What is ‘contact’?

The current PHA criteria defines close contact as:

·         anyone who lives in the same household as someone with COVID symptoms or who has tested positive for COVID

·         anyone who has had any of the following types of contact with someone who has tested positive for COVID with a PCR test:

§  face-to-face contact, including being coughed on, or having a face-to-face conversation within 1 metre

§  being within 1 metre for 1 minute or longer without face-to-face contact

§  being within 2 metres for more than 15 minutes (either as a one-off contact, or added up over 1 day)

§  skin to skin or any sexual contact

§  travelled in the same vehicle or plane

Closeness may be assessed on a case-by-case basis. Contact tracers may ask about who you have seen in the 48 hours before symptoms began. You may be asked about duration of contact, proximity of people and use of PPE such as facemasks.

Q4. What do I do if I am a contact of someone who is COVID positive?

Do I have to self isolate?

As a QUB medical student, if you are a contact, you have to self isolate (whatever a PCR test shows) for ten days after the last day of contact with the case if you are not fully vaccinated OR you have ongoing household contact with the case, or both.

·         ‘Fully vaccinated’ means you have had 2 doses of an approved COVID vaccine AND the booster, with the booster at least 14 days prior to the date of contact

·         If you haven’t had the booster because you had your second dose less than 3 months ago, then you are considered fully vaccinated if your second dose was at least 14 days prior to the date of contact. Arrange your booster when you can.

·         Transmission in household settings is more likely than in other settings

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Edited by Kathy Gyngell

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