Duke University was one of higher education’s coronavirus success stories in the fall. Less than 1 percent of its students tested positive during the semester, and just before Thanksgiving, the Centers for Disease Control and Prevention published a report on how the university minimized spread, written by Duke scientists.
Now, three weeks into the spring term, the university has had more students test positive than it did all fall — 182, as of Tuesday, compared to 126 in the fall.
“We’re definitely hotter now,” said Thomas N. Denny, chief operating officer for the Duke Human Vaccine Institute. The university is partnering with the institute to handle coronavirus testing. Over the past few weeks, he said, “we were watching it closely and clearly uncomfortable with the numbers.”
Other colleges that were relatively successful in the fall have seen an overwhelming number of coronavirus cases in recent weeks. Wake Forest University had 608 students test positive in the fall of 2020. Just two weeks into the spring semester, an additional 585 have already caught the virus, representing 5 percent of the total student body. Villanova University, which has about 11,000 students, saw 399 get the coronavirus in the fall. So far, it’s tallied 689 cases in the new semester.
Wake Forest and Villanova, as well as other colleges suffering early-spring outbreaks — the University of California at Berkeley, the University of Dallas, Michigan State University, the University of Massachusetts at Amherst, the University of Miami, and the University of Michigan at Ann Arbor — have put their students under lockdowns of varying lengths.
Officials say the surge in some places can be attributed to higher rates of viral transmission nationwide, compared with the late summer, as well as pandemic fatigue. Students are tired of following the rules. Meanwhile, with new, more contagious variants of the virus appearing in ever more colleges — and healthy, traditional college-age adults far back in line for vaccines — it’s a critical time for campuses to do more to prevent coronavirus transmission, not less.
“Where we are right now is that we need to reinforce with everyone the need to be very vigilant in wearing masks and social distancing and all of the hygiene issues that we discussed in the fall,” said Anita Barkin, co-chair of the American College Health Association’s Covid-19 Task Force. “We can’t really let up.”
As was true for many colleges that saw big outbreaks in the fall, small social gatherings are driving these spring cases, according to interviews with administrators and public messages from the affected universities. The difference is that now, students may be feeling more complacent, colder weather is driving hangouts indoors, and, as the spring term started, the country was coming out of a peak in travel and infection rates.
Although entry-testing all students when they arrived on campus helped some colleges identify the ones who caught the virus over winter break, students are still getting infected afterward. Duke’s and Villanova’s numbers reported here reflect positive test results caught after entry testing. (Wake Forest’s media-relations office didn’t respond to a request for comment.)
More-transmissible variants of the virus have been found at several campuses, and may be present at others.
At the same time, more-transmissible variants of the coronavirus have been found in most U.S. states and at several college campuses. Variants may be present at other colleges without their leaders realizing it, because detecting variants requires an extra genomic-sequencing step that most testing programs don’t take. “Even though they’ve only identified, like, two cases here or a few cases there, it’s the tip of the iceberg,” Barkin said, “because we’re not sequencing enough to really know how much the variant strains are affecting our population.”
Duke and Villanova have not yet tested to see if coronavirus variants are circulating on their campuses. Duke plans to begin such testing soon, Denny said.
Even with the changed landscape, the basic advice for how colleges can keep coronavirus infections to a minimum remains mostly unchanged: requiring that people wear masks on campus, enforcing social distancing, limiting gatherings, and testing to find positive cases and quarantine them and their contacts. “We’ve been saying the same thing for a long time, but it works,” said Erin Sauber-Schatz, lead of the Community Interventions and Critical Populations Task Force within CDC’s Covid-19 response.
“I wish we had additional strategies that would prove to be the answer to all of this, but we clearly don’t,” Barkin said. “We have encouraged schools to continue to use those same strategies going forward and to by all means beef up your testing.”
Asked whether Duke’s numbers mean the university’s vaunted testing protocol failed, Denny said that wasn’t quite the way to look at it. “Testing is not the critical component to what we do,” he said. “Adhering to the public-health guidance and risk reduction are the key. Testing is a marker of how well or how not-well we’re doing that.”
For now, Duke plans to stay the course with its testing and level of in-person instruction. Denny is “cautiously optimistic” that administrators may already be bringing the outbreak under control, as positive test numbers fell last week, compared with the week before.
Experts suggested colleges need to be prepared to quickly shift their extent of in-person activity to deal with high cases. In the fall, some colleges successfully used two-week pauses to reduce infections without having to flip online and send everybody home.
Barkin and Sauber-Schatz did have a few new recommendations, based on improved science around Covid-19 prevention and the fresh presence of contagious variants in the United States. The CDC released new guidance on Wednesday urging people to mask more effectively, including wearing a disposable and a cloth mask together, as one option.
If a campus sees a sudden spike in coronavirus cases, or if students who get the virus seem to get sicker than they did in the fall, Barkin suggested that colleges call their public-health department to ask whether they should conduct the additional tests needed to determine whether any new variants are circulating on campus.
