While dozens of colleges have announced they’re planning to reopen in the fall, few have said how they’ll do so while preventing the new coronavirus from spreading in their dorms, dining halls, and classrooms.
But this week, the University of California at San Diego released one of the most detailed and ambitious plans yet made public for bringing students back to campus. And starting on Monday, it will put part of the plan to the test, conducting a dry run of a monitoring regime that would offer a coronavirus test to every single one of the 5,000 students now on campus. Ultimately the university hopes to run tens of thousands of tests a month, and to allow the 65,000-person campus to achieve a loose semblance of normal operations come fall.
Test widely for novel coronavirus infections, isolate infected people, find infected people’s contacts, and quarantine the contacts for 14 days.
Also included in a fall-reopening plan would be increased cleaning, requirements in some cases that people wear masks, and even tests of the wastewater system for the virus, to try to detect outbreaks early, said Pradeep K. Khosla, the university’s chancellor.
Other universities may be considering similar plans, even if few are public now: The Miami Hurricane recently reported that the University of Miami was considering a reopening plan that would include weekly testing of everyone on its 35,000-person campus.
Public-health experts interviewed by The Chronicle offered cautious praise for UCSD’s testing proposal. Theoretically, it should help university leaders catch coronavirus infections early and keep outbreaks from spreading on campus. Where possible, it might be ideal for all campuses to take steps like it to monitor everyone for infections, some experts said.
And yet whether even aggressive measures like what the university is proposing could make the campus reasonably safe amid a pandemic remains unclear. Too much depends on unknowns about how exactly the virus would spread in different scenarios, and how well the program would work in real life.
Stress-Testing the Plan
Even as the university puts its ambitious plan into motion, it’s not committing to in-person operations in the fall. “There’s a lot that can happen between now and the fall,” Khosla said. “My view is, we’re going to keep our options open, and we are not going to make a decision until we absolutely have to.”
But the hope is that this approach will help return the university to something that looks more like normal operations, including housing students in two-person dorm rooms. (“Triple” dorm rooms have been ruled out.) “If we are able to find out who’s infected, while they’re asymptomatic, and manage the process of isolation, then we have a way to live reasonably, without panicking and without making everybody infected,” Khosla said.
“Putting all of these ideas together, you can actually find a way to contain the spread of this virus while leading a reasonably normal life,” he added.
Determining whether those ideas are workable takes stress-testing. On Monday the university will begin offering self-administered virus tests to the mostly graduate students for whom UCSD is the primary residence, plus some undergraduates who faced challenges in going home to another residence.
Students will be able to pick up test kits at designated stations around campus. They’ll use an app to scan the kit’s barcode, which will link the kit to the student’s phone number. If a kit shows a positive result, then health-care providers and public-health officials will be able to see the person’s identity and be able to notify him or her. Anyone else handling the kits or looking at the testing data will see only anonymized codes.
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.
To use the kits, students will swab their own noses, seal the swab up, and drop it into a collection box. If people test positive, program organizers plan to interview them to try to determine whom they’ve been in contact with. In accordance with state regulations, the county health department will be notified too. If the person isn’t already living in a single room with a separate bathroom, he or she will move into a designated isolation unit. The person’s contacts will be told they’ve been around a campus community member who tested positive for the new coronavirus, and will be advised to seek out a test too.
If all goes well, the university plans to expand the program to include the whole campus in the fall. Although some areas of the country have struggled with Covid-19 testing shortages, UCSD reports the ability to run about 1,200 tests a day, or enough to test about 55 percent of its entire campus monthly. Internal modeling, led by Natasha Martin, an associate professor in the university’s infectious-disease division, suggests that if it can test at least 60 percent of its full, 65,000-person campus monthly, researchers will be able to know even when very few people have caught the new virus — fewer than 10.
“They’ve got the right approach,” said Jean E. Chin, chair of the American College Health Association’s Covid-19 Task Force. She noted that San Diego’s proposal hews to the “Box It In” principles that many public-health experts are following, which posit that any community that wants to reopen for business needs to do four things to protect people’s health: test widely for novel-coronavirus infections, isolate infected people, find infected people’s contacts, and quarantine the contacts for 14 days.
It would be “a good idea” for any university considering reopening to be able to widely test even people who feel healthy, Chin said. That’s because evidence suggests people may be infected with, and spread, the virus that causes Covid-19 even when they don’t feel ill, and therefore wouldn’t otherwise have any reason to seek care and trigger important containment steps, such as having their contacts notified.
But Chin wouldn’t say whether San Diego’s plan would be enough to allow for a return to hallmarks of the residential-college experience, like having roommates. “I’ll tell you, most epidemiologists won’t give you that answer, because I’ve asked them,” she said.
The American College Health Association on Thursday published guidelines for college reopenings. While she was working on them, Chin tried to nail down specifics such as how big shared dorm rooms should be, or even if some bed arrangements are better than others. Ultimately, she couldn’t get concrete answers. The guidelines suggest students live in single rooms, and ideally have their own bathrooms.
As San Diego tests its own containment measures, it may face serious challenges. Administrators are expecting to find very few infections among asymptomatic community members, but what happens if their infection rate is actually quite high, requiring many more tests and isolation rooms than are available? What if testing 1,200 people a day isn’t enough to catch infections quickly? What if there are logistical hurdles to collecting the tests, processing them, and notifying students?
Everyone agreed that doing a dry run of the program, with the students on campus now, is a good way to work out those problems and determine if it’s feasible to apply the plan to the whole campus in the fall.
“I’m really happy to see them doing this,” said Eli P. Fenichel, an economics professor at Yale University who has recently turned to modeling the effects of social distancing for Covid-19. “There are some really hard problems, but everyone is grappling with those.”
If testing the whole campus turns out to be simply impossible, or not worth the money and effort, the university could always continue instruction remotely and keep students widely spaced in on-campus housing, as they are now, said Khosla, the chancellor.
“We are excited about this,” he said. “We cannot guarantee the outcome, but I can tell you, if the outcome is what we expect, it’s going to be really good for everybody.”
