(Bloomberg) — Many universities see Covid-19 testing as the only way to safely bring students back to campuses this fall, but their approaches vary as widely as their mascots.
Some are requiring test results before a student gets to school, others are offering screenings upon arrival. Still others are relying on symptom screening and random surveillance testing. And the lucky ones with their own labs are putting them to work, regularly testing swabs or saliva from those on campus for the novel coronavirus.
The costs of not testing were starkly illustrated by the University of North Carolina at Chapel Hill this week. The school didn’t require a test before returning and the rate at which results for on-campus tests were coming back positive shot to 13.6% from 2.8% just a week after classes began, bringing the total infected to 135 Tuesday. It canceled in-person classes Monday and is moving most students off campus.
The University of Notre Dame, like UNC, invited students back early in August but required them to be tested before arrival. Still, it saw results surge, hitting 147 on Tuesday, less than two weeks after the first case was diagnosed. Contact tracing efforts found that most cases traced to seniors living off-campus.
That prompted President John Jenkins to move all undergraduate classes online for at least two weeks and clamp down on activity, restricting students in off-campus housing from coming to campus. Public spaces on campus were closed and residence halls were restricted to those who live there, and gathering limits were cut in half to 10 people.
The school had partnered with Laboratory Corp. of America Holdings and administers tests at its football stadium where those with symptoms can be tested. Jenkins said in an on-line address on Tuesday evening that “we will in coming weeks both enhance our testing of those experiencing symptoms and our surveillance testing of those without symptoms.”
If those measures contain the spread, in-person learning could resume, Jenkins said. If not, students would be sent home as they were in the spring semester.
Schools across the U.S. are finding no easy answers for how to institute and police the new regimen of masks, distancing and screening for students who yearn to resume not only their educations but also their social lives, with parties and gatherings with friends.
“Many schools are handing out a mask and a bottle of hand sanitizer and saying, ‘OK, go behave yourselves,’” said A. David Paltiel, a Yale University professor of public health who co-authored a study that concluded schools should test every few days with rapid, inexpensive tests. “And I think that’s just setting students up to fail. And not only that, but be blamed for the failure.”
The U.S. Centers for Disease Control and Prevention doesn’t recommend testing all returning students, faculty and staff upon their return to campus. It does, however, recommend broad screenings of individuals who don’t have symptoms in some settings, like residence halls, lab facilities and lecture rooms where the novel coronavirus could spread rapidly.
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Many students who return to campuses will experience some form of testing, but the frequency of the tests has become a major differentiator between colleges.
Ruby Davis, an incoming freshman at Binghamton University in New York, will take a nasal swab test when she arrives on campus on Aug. 21 for her 11 a.m. appointment. She should get her results within 30 minutes. With a negative test, she said, she’ll be allowed to join freshman orientation.
Binghamton spokesman Ryan Yarosh said researchers are developing 3-D simulations to study indoor and outdoor movements and behaviors of students during high-traffic times at the school’s busiest locations to help develop guidelines. It also plans to randomly test a percentage of on-campus students each week.
Davis said she feels “a bit safer” knowing the school is trying to be vigilant. Still, the 18-year-old said, “I’m nervous for many reasons but Covid’s just adding a lot to that.”
Northeastern University in Boston will require three negative tests before a student can begin in-person classes. They’ll test every two to three days with medical professionals observing them as they self-swab in either a central sports facility or a separate facility intended for those who had close contact with someone who tested positive. The university aims to test students every five days thereafter for the rest of the semester.
The university built a new lab at a campus in Burlington, Massachusetts, where it aims to process up to 5,000 tests a day and partners with the Broad Institute in nearby Cambridge for added resources.
“Truly if any of us didn’t think we could do this safely, we wouldn’t do it,” provost David Madigan said. “This is not a commitment to reopen come hell and high water. This is a commitment to reopen so long as we can do it safely.”
Colleges that embrace testing are likely to face the same challenges that laboratories across the country have faced: Having enough supplies and getting timely results. Even so, experts say, it’s better than waiting until students, faculty and staff report symptoms to start testing.
“A school that tests and responds only when symptoms have been observed is like a fire department that responds only when a house has been burnt to the ground,” Yale’s Paltiel said. “Any school that can’t work its way through some of these minimum screening standards we have suggested should be asking themselves, Do we have any business reopening?”
The University of Illinois at Urbana-Champaign is preparing to screen about 60,000 students, faculty and staff twice a week.
When it began developing its testing strategy in May, the need for frequent screenings with quick turnaround times quickly became clear. But even state-of-the-art testing “was never going to get us there,” said Marty Burke, associate dean of research for the Carle Illinois College of Medicine who led the school’s testing and tracing program.
So Illinois developed a new test for which it’s seeking emergency authorization from the U.S. Food and Drug Administration. Similar to one developed by Yale researchers and funded by the National Basketball Association that won emergency authorization on Aug. 15, Illinois’s test uses saliva, allowing for easier collection at about 20 tents scattered across campus. The school is setting up a company to make the technology more broadly available.
Tests will be conducted at a converted veterinary lab, where they’re usually looking at illnesses in cows and pigs, Burke said. The shorter process streamlines logistics and requires less machinery and supplies. It also brings down costs to about $10 per test and aims to have capacity to process 20,000 tests a day, according to Burke.
“We are humbled by the challenge but we are really very hopeful that we can succeed,” Burke said.
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