Like many campuses that welcomed students back this fall, the University of Wisconsin at La Crosse initially limited its Covid-19 testing to students living in dorms. Meanwhile, students who lived off campus frequented bars and stores, mingling with local townspeople. Some who were training for health-care careers honed their skills caring for residents of area nursing homes.
So it came as little surprise when an outbreak of Covid-19 last month, concentrated mainly among 18- to 24-year-olds, spilled over into some of the area’s most vulnerable residents. The possible links between the reopening of three La Crosse colleges and the deaths of at least nine area nursing-home residents are the subject of a study that has not yet been peer reviewed, but has been touted as a cautionary note on campus reopenings.
As the ties between infection rates among students and college towns become clear, campuses like Wisconsin-LaCrosse are extending frequent testing to more students, including those who live off campus. It’s a financial and logistical challenge, but one that could be vital to maintaining the community’s trust.
In the LaCrosse study, researchers found direct genetic links between cases in different age groups that provide “compelling evidence” that rapid spread of infection among college-age people poses “a direct threat to older persons in the surrounding community.” Testing students — both those living on and off campus — more frequently could play a small role in helping contain a pandemic that has threatened both lives and livelihoods, the researchers said.
“It’s easy to blame college students for these outbreaks, but we’ve known that students enjoy partying and they feel impervious” to the virus, said Paraic A. Kenny, director of the Kabara Cancer Research Institute at the Gundersen Medical Foundation, who led the study.
More responsibility, he said in an interview on Friday, rests with college administrators who decided to welcome students back “without adequately factoring in these community concerns.” While more testing could help, Kenny said, “you can’t test yourself out of a behavioral problem.”
Wisconsin is one of the states with the most rapidly rising infection rates, with nearly 200,000 cases and 1,730 deaths since the beginning of the pandemic, according to a New York Times database.
The state’s Democratic governor, Tony Evers, issued a statewide order last month extending a mandate to wear masks following a sharp increase in the number of 18- to 24-year-olds diagnosed with the virus since mid-August. The order has been largely ignored by conservative critics and rarely enforced, putting more pressure on the state’s universities to plead with students to follow public-health precautions and get tested.
More testing, of course, means more positive results that add to the perception, accurate or not, that college-age students are the primary drivers of community outbreaks.
Clusters of cases at several University of Wisconsin campuses prompted the system to temporarily shift to online classes this fall. Last month it joined forces with the La Crosse County Health Department to offer two mass testing sessions for the community. And this month, the university’s student-health center began offering 50 antigen tests a day to off-campus students. Student-government leaders sent an email encouraging students to sign up. The test, they said, uses a shallow nasal swab, and results come back the same day.
A county health-department video posted on the university’s Facebook page shows hypothetical students working in day-care centers and nursing homes a few days before testing positive. “Covid-19 can have ripple effects in our community,” it warns.
The university’s chancellor, Joe Gow, has said that most students have cooperated but that the university can’t require off-campus students to get tested and that it doesn’t have the capacity to test everyone. The capacity problem is one many colleges share, said Gerri Taylor, co-chair of the American College Health Association Covid-19 Task Force.
“Many of our colleges just don’t have the testing materials or staffing or labs that can turn around tests in less than a week or so,” so they’re restricting tests to students on campus or those who have symptoms, she said.
Resources aren’t the only problem. Some students don’t want to be tested because they fear a positive result will confine them to their homes for the next few weeks and cause them to miss in-person classes. Knowing that many young people experience few or no symptoms, some might try to ride out the illness without getting tested, a decision that puts others at risk, Taylor said.
When tests are required for students living in dorms — say, once a week — students who fail to show up at their appointments two or three times can be written up for student-conduct violations. When testing is extended for students living off campus, colleges are usually relying on voluntary cooperation.
At the University of Wisconsin at Oshkosh, about 500 of the approximately 2,000 tests the university runs each week are of off-campus students, according to Kimberly M. Langolf, director of risk and safety. Combing data from the county health department and from the university’s own testing site, the university identifies off-campus areas where clusters of student cases have emerged. Letters are sent to landlords with information about testing, and contact tracers knock on on doors, asking students to get tested.
Students, Langolf said, don’t usually respond to emailed invitations, “so the most effective way to reach them is literally going door to door.”
Expanding testing to more students living off campus is critical, she said, to maintaining the community’s trust that the university is doing its part to keep local residents safe. “Our campus, being in an urban setting, is integrated into the community,” she said. “Our kids live and work there. Our strategy has been to test as many as we can as quickly as we can, and as often as we can, and that reassures our community that we are taking the Covid pandemic seriously and are in it together.”
Similar efforts are happening around the country. Georgetown University provides free on-campus testing or weekly test-at-home kits to students living nearby.
Binghamton University has increased testing from around 200 students a day in early September to around 800 a day now. Testing is a combination of random and targeted toward groups like Greek life and club sports that administrators suspected might be more likely to flout public-health rules.
Getting students to agree to be tested is one challenge. But so is turning away students who turn up at the wrong centers wanting a quick assurance that it’s safe to go out. Off-campus students with no symptoms might occasionally show up at the surveillance-testing center “wanting to get a clean test before they go out for the weekend,” said Brian Rose, vice president for student affairs at Binghamton. “That’s not what surveillance is about.”
Testing has, in recent weeks, been expanded to include more off-campus students. With Binghamton planning to close dorms for the semester before Thanksgiving and resume in-person classes in early February, continued testing could help reassure local residents, he said. The pandemic and the town-gown response is further proof, he said, that “we’re deeply entwined in the fabric of our community.”