Ombudsman Shares RSU's Stance on Vaccination Procedures; Similar Regulations at PSCUH

Rīga Stradiņš University (RSU) is an institution that trains prospective medical and healthcare professionals. Practical training at "patients' bedside" is considered an essential part of medical studies. To this end, it is crucial to protect the patients that medical students come into contact with from COVID-19. Ombudsman Juris Jansons has assessed the decree released by the RSU Rector and comes out in favour of it.

Jansons emphasises that creating a safe environment is not only in the interests of employees, students and society, but is crucial to the implementation of several study programmes. In addition, doctors working in the same hospitals where the prospective doctors train already adhere to similar rules for creating an infection-free environment. 

At the end of May, RSU published information about the conditions that will have to be observed in the new study year (in autumn 2021). The conditions stipulate that only people vaccinated against COVID-19 and those who have recovered from the infection will be able to attend their studies in person. Under certain conditions, people who have neither had the vaccine, nor the infection will also be able to study at the university in person.

Students who are going to study at RSU have several options: they can receive the COVID-19 vaccine, or take a COVID-19 test regularly. Unless a student can confirm that they have had an anaphylactic reaction after receiving the first vaccine, they will have to pay for the COVID-19 test themselves.

Additionally, students who can provide documentation of having contracted and recovered from COVID-19 can participate in studies in person. These students need documentation to show that they are within a very specific period: between the date that a doctor has ended their isolation, until day 180 after the date that the specimen that tested positive for COVID-19 was taken in a laboratory.

Following a request from several people to provide an assessment of the Rector's order, the ombudsman stresses that RSU has not made vaccination against COVID-19 compulsory, but rather has provided several options for participating in the study process. ‘Since the only means available in the world today to achieving a safe environment are either vaccination or testing, the options outlined by RSU are limited to these to be able to ensure a safe study process,’ the ombudsman's assessment reads.

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In addition, Jansons says that if a student is dissatisfied with the current procedures and has chosen not to get vaccinated, but also does not want to take regular COVID-19 tests, the student has the opportunity to take academic leave so that ‘as the overall epidemiological situation in the country stabilises, it might be possible in the future be possible for unvaccinated persons to continue their studies’.

The procedure for practicing doctors is similar to RSU guidelines

Oskars Šneiders, a representative of the Ministry of Health, points out that there is no mandatory vaccination policy for practicing doctors, but if a doctor has not received their vaccine, they, just like RSU students, must undergo regular COVID-19 testing. Šneiders also explains that medical institutions try to organise their work in a way so that staff in particularly critical departments, such as intensive care units, are vaccinated.

Organising staff is far from easy, since Pauls Stradiņš Clinical University Hospital (PSCUH), for example, is currently understaffed. ‘[...] Unfortunately we lack staff now and cannot transfer doctors from one station to another etc. Accordingly, people have to work where they are. We are taking all possible measures to limit the spread of COVID-19,’ said Rinalds Muciņš, President of the PSCUH Executive Board.

In general, the majority of staff at both PSUCH and RSU have already received the COVID-19 vaccine. ‘Now only about 25% of employees are unvaccinated, which is a quarter of our team. We reached the goal of 70% easily, but for every next percentage point we have had to put in a lot of work with our employees,’ explains Muciņš.

According to the hospital's representative Janita Veinberga, currently 75% of the entire hospital team has completed the vaccination course and have received both doses of a vaccine. 78% have received the first dose of the COVID-19 vaccine, while 22% have not received any. However, the data is for the period up until the end of May, so these figures may since have increased, according to Veinberga.

Edijs Šauers, the Director of the RSU Communications Department, points out that the majority of RSU students (or 80% out of total 1,200 graduates of medical and healthcare studies) have already been fully vaccinated or have recovered from COVID-19.

Why current and prospective doctors need to be vaccinated

After evaluating the RSU Rector’s decree, Jansons agrees with the arguments expressed therein. Namely, that RSU reports that vaccination is the only effective way in which to significantly reduce the risk of spreading the infection and to be able to ensure full-time in person studies and research at the university. The ombudsman goes on to say that ‘creating a safe environment is not only in the interests of employees, students and society, but crucial to the further implementation of several study programmes in general.’ But ‘the reserves of deferral time for practical training are almost exhausted’.

It is important to emphasise that RSU trains prospective medical and healthcare specialists for whom it is crucial that they meet patients in person. When a student goes to a hospital, they may often encounter severely ill patients for whom contacting COVID-19 could lead to serious health disorders and even death.

RSU has contracts with medical institutions in order to be able to provide practical training for students. It is already clear that some of these hospitals are on the list of institutions with the highest risk for COVID-19 spreading and will therefore refuse to admit students who are not safe for patients. As indicated in the ombudsman's public report, the legal framework for such restrictions is laid down in the Regulations of the Cabinet of Ministers: “Epidemiological Safety Measures for the Containment of the Spread of COVID-19 Infection”.

As RSU works in close cooperation with PSCUH, the procedures the university has outlined for vaccination, testing or confirmation of having contracted COVID-19 are appropriate. ‘Our approach to vaccination and testing is similar because students cannot study medicine without practical training. If you cannot receive practical training for a long period time, the quality of your education decreases,’ explains Muciņš. ‘It is therefore also in the interests of the state to prevent the risk of studies at institutions of higher education to deviate in an excessive and uncontrolled manner from the contents, scope and implementation rules that have been established within the accreditation framework,’ the ombudsman's report states.

RSU representative Šauers emphasises that that RSU ‘is an institution of higher education of life sciences that provides practical training in medical institutions. Such training is only possible in person.’ He explains that each student has the free choice to either get vaccinated, or to perform appropriate diagnostic tests until the university resumes on-site studies. There are similar requirements in many universities in the European Union and the USA.

There have also been a number of questions as to why both medical students and social science students have the same requirements for vaccination, testing or certification. '[..] since contact between both healthcare and social science students and academic staff is unavoidable throughout RSU premises (common areas, the library, canteen, student hostels, etc.), it is necessary that social science students also observe all measures for creating a safe environment,’ the ombudsman explains in the report. 

Therefore, Jansons shares RSU’s overall stance that ‘[...] the state cannot allow the subjective interests of individuals to prevail over the interests of the state and the majority of society’.

Higher education institutions are waiting for unified state regulations

A number of institutions of higher education are currently waiting for the government and the relevant ministries to provide guidelines on how to organise their studies in the upcoming academic year. Šauers points out that the responsible ministries are now working on regulations for on-site studies for the next study year. ‘The Cabinet of Ministers will soon adopt these regulations. If necessary, RSU will make amendments to the Rector's decree in accordance with state regulations’.

It has already been reported that Prime Minister Krišjānis Kariņš called on the responsible ministries to "seriously consider" imposing mandatory vaccination against COVID-19 for certain service providers at a government meeting on 15 June. The day after, in an interview with Latvijas Radio, Kariņš explained that it is important to increase vaccination in areas where employees have close and long-term contact indoors. These people include doctors, teachers and social workers, as practice shows that the focus of infections occurs precisely at the workplaces of these professionals.

This article was basing on an article in Delfi "Tiesībsargs pievienojas RSU paustajam par vakcinācijas kārtību; arī PSKUS noteikumi ir līdzīgi" (writer: Liene Fedotova).