As colleges re-open, students test positive for Covid—here's what Yale and UCLA experts say can be learned

A student walks through the campus of the University of North Carolina at Chapel Hill on August 18, 2020 in Chapel Hill, North Carolina. The school halted in-person classes and reverted back to online courses after a rise in the number of COVID-19 cases over the past week.
Melissa Sue Gerrits/Getty Images

When the coronavirus pandemic hit the United States in March, schools were relatively quick to send students home. On March 9th, The University of Washington was the first to move to remote learning, creating a domino effect of schools across the country and causing headaches for some students. Schools such as Harvard gave students only a handful of days to evacuate campus. 

But while the coronavirus has continued to surge in communities across the country, many schools and politicians have steadily insisted students should return for the new academic year.

Now, as the fall semester begins, some schools that have returned students to campus are experiencing troubling spikes in cases of coronavirus. 

The University of North Carolina, University of Notre Dame and Michigan State University are among the schools that have been forced to permanently or temporarily return to remote learning. 

Here's what these cases can teach us about what steps can be taken to stem the spread of the virus on college campuses: 

Students walk past Wilson Library on the campus of the University of North Carolina at Chapel Hill.
Jonathan Drake | Reuters

Consistent messaging is key

On August 17, UNC announced that the school's Chapel Hill campus would be canceling in-person undergraduate classes and shifting them entirely to remote learning — just one week after 5,800 students moved into the dorms and thousands more moved back to Chapel Hill to take in-person classes. 

At the time of the decision, school representatives said the rate of students positive for Covid-19 had jumped from 2.8% to 13.6% over the week students were on campus.

"As of this morning, we have tested 954 students and have 177 in isolation and 349 in quarantine, both on and off campus," UNC-Chapel Hill's chancellor, Kevin Guskiewicz, and provost, Robert Blouin, said in a statement. At the time, the school indicated it had just four remaining quarantine rooms.

According to the university's online coronavirus dashboard, these figures have improved slightly in the short time since the announcement. 

Just three days later, the student positivity rate is down to 10.6% and the number of available quarantine rooms is up to 26. 

According to student newspaper The Daily Tar Heel, at least four clusters of infections were traced back to residence halls and a fraternity.

The school has enacted community standards in which students are expected to wear masks, socially distance and avoid large groups, but these clusters indicate that such guidelines are not sufficient in stemming the spread. 

"We do have the expectations that students will maintain their compliance with our community standards whether they're on campus or off campus, particularly in the town of Chapel Hill," said Blouin. "But that is something that has been very difficult for us to enforce unless there is an actual citation, or a complaint, that is made with respect to that student."

Doctor and professor Howard P. Forman, who directs Yale's Health Care Management program, admits that it can be difficult for schools to enforce these kinds of community rules, especially when students may be getting mixed messages. 

"If you grew up in a family that believes that [coronavirus] is a hoax, these community rules may seem like an excessive use of force by your institution and you're going to violate them and you're going to go to those parties. If I'm 19 years old and I want to go out and socialize and somebody says to me, 'it's all a hoax.' Well, I'm going to think it's a hoax and I'm going to go out," he says. "This is the consequence of us having inconsistent messaging at the federal, state, local levels."

Coordinated, crystal-clear messaging from schools, state and federal officials could help reduce these flare-ups caused by students breaking rules against large groups, he argues. 

Dr. Russell Buhr, assistant professor at the David Geffen School of Medicine at UCLA says there are several additional lessons schools should learn. 

"First, unsanctioned socialization is going to happen no matter what. You can reduce it by enforcing with severe penalties, but even then it will happen," he says. "Second, we can't let perfect be the enemy of better. Harm reduction is a very well-established technique in public health promotion that could go a long way here. Third, without the appropriate testing and contact tracing, and without wide-scale adoption and availability of things like face coverings and masks, this will be a lot worse."

University of Notre Dame
ReDunnLev | Getty Images

Sharing data is vital

On August 18, Notre Dame announced that the school would temporarily shift to remote learning in order to curb a coronavirus outbreak on campus.

According to the university's dashboard of coronavirus statistics, the school has confirmed 222 cases of the virus since August 3 from 1,287 tests — a positivity rate of roughly 17.3%.

Forman stresses that these kinds of dashboards that provide the public with up-to-date information are "incredibly important."

"First of all, they can help other schools understand what to look out for and to learn from those experiences," he says. "But they also give people a much greater understanding of what the status is at their school and when you have to shut things down completely."

Buhr, similarly, stressed the importance of the public data that some schools are providing. 

"The only way other schools, universities, and even workplaces will know what they should be doing is to have data. From a public health standpoint, we think of every reopening as a kind of experiment, and obtaining feedback on which infection prevention methods are working and which are not really is key to broader reopening," he explains. "We can learn from each other and get closer to some sense of normalcy again faster by doing so."

Indeed, colleges do seem to be paying close attention to how other schools are faring. 

Less than an hour after the University of Notre Dame announcement, Michigan State University said it was pivoting to an online-only fall for undergrads before they arrive on campus, telling students who planned to live in dorms to stay home.

In a letter to students, Michigan State president Dr. Samuel Stanley wrote that "Given the current status of the virus in our country — particularly what we are seeing at other institutions as they re-populate their campus communities — it has become evident to me that, despite our best efforts and strong planning, it is unlikely we can prevent widespread transmission of Covid-19 between students if our undergraduates return to campus."

A Harvard University graduate wears a mask on campus.
Craig F. Walker/The Boston Globe via Getty Images

Money matters

Perhaps the most important lesson that can be learned from the past several weeks is that schools that have the resources to conduct extensive monitoring and testing of students will fare the best in the months ahead. 

For instance, Harvard University has said that the school will test on-campus students every three days. Yale plans to test on-campus students twice a week. 

These fast and regular tests will help the schools track and prevent the spread of infection, says Forman, but it's not cheap. 

"At the current prices, these tests are very expensive. In the case of Harvard, you're still talking about actual costs of testing that are at least $100 per student per week. And probably much more than that," he explains, noting that the tests, processing and labor all add to the total. "Not to mention all the other things that you have to put in place to protect students and to create the environment where you can continue to learn and be safe and so on. These costs are very, very large."

Without a robust and efficient public testing program, colleges without the significant financial means of schools such as Harvard and Yale will face serious difficulties, says Forman.

"Testing like that is completely unaffordable to most public institutions," he says. "Institutions that have large endowments, and can afford to take a loss for one year or one semester, are able to absorb it. Institutions that are reliant on state funds, to a great degree in an environment where states are cash strapped, are just not able to do it."

He continues, "and we're in the worst of all worlds in that way."

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