The University of Arizona is, like many other colleges across the country, telling families that it’s doing everything possible to safely welcome students back to campus in the fall. But one aspect of Arizona’s reopening plan is — for now — unusual. The plan depends in part on offering to test the blood of all 60,000 students and faculty and staff members for antibodies against the new coronavirus.
The university’s president, Robert C. Robbins, announced the testing plan in a news conference last week, alongside the state’s governor. The university will even make its own test. Although testing positive for Covid-19 antibodies doesn’t guarantee immunity, Robbins said, “We need to get the data because knowledge is power. We feel that empowering our students, our faculty, and staff is really important.”
Arizona isn’t the only university to reference antibody testing for students. On Tuesday, Purdue University’s president, Mitchell E. Daniels Jr., announced the university “intends to accept students on campus in typical numbers this fall” — and broached antibody testing as one way to monitor the student body’s health.
As colleges and universities have struggled to devise policies to respond to the quickly evolving situation, here are links to The Chronicle’s key coverage of how this worldwide health crisis is affecting campuses.
Antibody testing will be “very, very important” to Purdue’s re-opening strategy, said David Broecker, chief innovation officer for the Purdue Research Foundation. The university has discussed testing everybody on campus, he said, but is still deciding how it will use the tests. And it’s waiting to see how accurate commercial tests, newly available on the market, turn out to be, he added.
The presence of antibodies in someone’s bloodstream suggests they’ve been infected with the virus in the past, whether they know it or not. The antibodies are part of the body’s natural immune response, and they should protect people against the virus, although Covid-19 is so new that scientists don’t yet know how fully antibodies shield against reinfection. Even so, tests for Covid-19 antibodies have gained attention nationwide as a possible tool for gauging who can return to work without fear of getting ill or sickening others.
At Arizona, leaders are considering telling students who get positive antibody results that they may gather in ways that their antibody-negative peers can’t: attend pep rallies, for example, or take classes in person.
“There’s a potential that, with this information, we can inform students’ activities,” said Michael D. Dake, senior vice president for University of Arizona Health Sciences.
Getting a positive test, or even taking the test at all, won’t be a requirement for returning to campus, Dake said. But leaders are thinking about either requiring a positive result for participating in specific activities, or giving students voluntary guidance about what might be safe for them, based on their antibody status. Dake was wary of setting ironclad requirements. “It’s not meant so much to be exclusionary,” he said. “You get into a lot of thorny issues if you try to make things other than voluntary.”
Some experts warn against making positive antibody results a bar for admission into work, school, and other everyday activities. “Have they thought about the perverse incentives that they’re creating here?” said Gigi K. Gronvall, an immunologist who studies biosecurity at the Johns Hopkins University. “You’re going to have people trying to get infected to be able to be released from restrictions.” Infected students are a danger to others, she said: “A campus is generally young, and young people have been faring well, but that’s not going to be true of everybody they come in contact with.”
Gronvall was part of a team of Johns Hopkins experts that published recommendations on Wednesday about how the country should — and should not — use antibody testing to combat the coronavirus pandemic and make decisions about public life.
There are a few major problems with using antibody tests as a “go/no-go” signal right now. One is the question of any test’s accuracy. The University of Arizona is testing its test and preparing paperwork to submit to the Food and Drug Administration for approval next week, said Janko Nikolich, a professor of immunology at the university who is developing the test. He said that until the FDA submission, he couldn’t share documents showing results from the university’s internal testing.
As of April 24, however, he emailed The Chronicle to say the university had run the test in 64 samples. There were no false negatives, and a 3-percent false positive rate. It’s critical to reduce false positives, which would make people think they are immune when they are not, so Nikolich’s team is working on adding a step to the test they hope will cut the false-positive rate by up to 100-fold. The team is also conducting more rigorous experiments to ensure the test doesn’t come up falsely positive if a person has antibodies for coronaviruses closely related to Covid-19, like SARS or MERS.
The second big problem is that scientists don’t yet know if having antibodies in your blood actually means you’re immune from another Covid-19 infection. It’s thought that it does because that’s what happens after people get sick from other coronaviruses, including MERS and SARS. Plus, those who have recovered from Covid-19 don’t seem to get seriously sick again, although there have been reports of some re-testing positive for the virus. It remains an open question whether people who now have antibodies against the new coronavirus, but never got gravely ill, are immune against Covid-19, Gronvall said.
Science may well prove that antibodies mean immunity by the time residential colleges want to reopen in the fall, Nikolich and Gronvall said. Until then, Gronvall’s team at Johns Hopkins doesn’t recommend universities or any other groups offer antibody testing as a personal decision-making tool. Gronvall instead suggested using antibody testing to calculate the prevalence of Covid-19 exposure on a campus, and then leaning on more classic public-health strategies, including isolating infected people and tracking down everybody the infected person came in contact with so they can self-isolate, too.
The University of Arizona plans to use these strategies as well, Dake said. It will set aside dorms where students can be quarantined, if necessary.
“The antibody testing is just a tool, one tool that can be valuable, we think, along with other tools to really ensure that if the students are going to come back in the fall — and that’s what we’re preparing for and what we highly expect to happen — that we can do this in a way that’s organized and coordinated,” he said.
So how do you organize and coordinate 60,000 people to get antibody tests in the first place, without crowding people and creating an infection hazard? Dake hopes Nikolich and his team will be able to make a test that requires only a few drops of blood, pricked from the finger, which could be more easily distributed to safely socially distant students. For now, however, the test requires a phlebotomist to draw a sample of blood, which means people would have to come to testing stations. One idea is to encourage as many students as possible to make appointments with their family doctors to get their blood drawn and send the sample to the university — all before returning to campus for the fall.
The university will soon get a serious preview of what antibody testing thousands of people looks like. It’s partnering with the state government to give antibody tests to 250,000 health-care workers and other front-line responders to the coronavirus pandemic in Arizona, starting next week. There will be testing stations around the state, which the university could later tell in-state students to use for their own tests, come August.
