As a current undergraduate and volunteer first responder, I have been able to garner unique insight from my peers about the coming fall university term. Students share a diversity in viewpoints similar to that of the greater population: Some have little to no concern about COVID-19, while others will not engage with work or school until a vaccine is offered. Yet as so many work toward safe returns to campuses in the fall, the reality is that there will be college outbreaks of COVID-19 when students return, no matter how robust our testing and tracing efforts are.
We need to be ready to respond to public health situations at higher-education institutions. By planning for potential outcomes, the “breaking news” of a university outbreak will be blunted with appropriate, prompt countermeasures and decreased angst.
Why is this outbreak almost certain to occur? Simply put, our universities and colleges are almost universally designed to promote the exact opposite of what’s needed to contain the virus’ spread. The culture of communal interaction—in athletics, classrooms, dormitories, and group dining—is fundamental to the college experience. Trying to fully upend these practices will be almost impossible, and certainly a challenge to enforce. The widespread use of social media will further hinder efforts to control widespread fear: If a handful of cases are found, the nearly instant sharing of information will exacerbate fears in the community that could prove counterproductive to containment efforts.
Furthermore, the robust testing many of these schools are implementing will prove fatal to the intended goal of responsive containment of the virus. Testing is a vital component to containment; however, excessive testing can, in fact, be a deterrent. Some schools have already committed to nearly 30 COVID-19 tests per student from September until Thanksgiving. With testing of this magnitude, one might assume any spread can be adequately contained. This is not the case. Overtesting on a campus (especially larger colleges) will lead to widespread concerns and exaggerated views of the extent of the virus’ presence. This could be mitigated with less frequent testing and an increased commitment to student education on preventative measures.
Even with robust contact tracing, limiting classroom sizes, and stricter social distancing policies, outbreaks are still likely. The work so many institutions are carrying out should not be undermined as “not enough,” which is an easy criticism to foresee once communities begin to deal with campus outbreaks.
I do not feel it will be an administrative failure if we see outbreaks on campus—it will be the result of an insurmountable challenge our colleges inherently face with in-person operations. Recent models show inevitable transmission rates even with robust modifications and contact tracing.1 Schools that have pledged to test students more than 30 times before Thanksgiving break will find compliance very challenging—and my biggest concern is that the robust testing will unintentionally fuel heightened concern once the reality of a campuswide outbreak has begun. The inability to contain it will begin a domino effect: Students and community members will continue transmission silently for that week of the unknown outbreak, and compliance with quarantine will be impossible given the nature of how we interact inside and outside class.
Nonetheless, with this knowledge, we can encourage campus leaders, local providers, and community members to be aware of the possibility of campuswide outbreaks in their communities. If we can prepare one another as EMS responders by encouraging the adherence of our local colleges and, more important, not succumb to the potential communitywide panic and last-second scrambling if an outbreak occurs, future spikes in COVID-19 cases will be met with a more appropriately organized and calm response.
1. Burke L. Simulating COVID Spread in a College Setting. Inside Higher Ed, 2020 Jun 22; www.insidehighered.com/news/2020/06/22/working-paper-models-covid-spread-university.
Christopher Gaeta is a student at Swarthmore College. He has been published in several peer-reviewed journals in the field of emergency medicine and has garnered one of the largest LinkedIn networks among individuals his age, with approximately two million professionals following his posts and updates.