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Monday, September 7, 2020

Health Experts Warn Colleges Not to Send Students Home. But What if Quarantine Spaces Run Out? - The Chronicle of Higher Education

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During the first week of classes, officials at James Madison University watched warily as the numbers of Covid-19 cases on campus ticked up and the number of beds set aside to isolate infected or exposed students dwindled.

Knowing that each infected student could potentially spread the virus that causes Covid-19 to dozens more, the university decided on September 1, after consulting with the Virginia Department of Health, that the safest bet would be to send students home for at least four weeks. That would give JMU time to work with local health officials to build up its capacity to contain the spread.

The following day, Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, declared that sending students home amid Covid-19 outbreaks is “the worst thing you could do.”

Colleges might have made different decisions if Fauci’s advice had come earlier.

“When you send them home, particularly when you’re dealing with a university where people come from multiple different locations, you could be seeding the different places with infection,” he said in an interview on NBC‘s Today show.

James Madison wasn’t alone in feeling whiplash from advice coming from all corners. After summer months spent weighing conflicting views about whether to open their campuses to in-person learning, many colleges that decided they could do so have been overwhelmed with Covid-19 cases. Now comes the next important decision: Hunker down, or send students home? Colleges are hearing arguments in favor of both.

Fauci’s advice is probably correct, Holden Thorp, editor in chief of the Science family of journalsand a former chancellor of the University of North Carolina at Chapel Hill, wrote in an email to The Chronicle, “but it is a major miss that it wasn’t given to the universities as they were making their decisions to come back. I’m sure that was tough because the president was tweeting and talking about how colleges needed to come back.”

Many were unprepared for the consequences. “The schools that didn’t have resources to test everyone when they came in certainly don’t have the resources to test everyone again before they go home,” Thorp wrote, so their decisions to invite students back might have been different if Fauci’s advice had come earlier.

At the University of Alabama at Tuscaloosa last month, some freshmen who had just moved in to their residence halls were told to relocate to another dorm so that the building — which was only half occupied — could be converted to more space for isolation rooms. University officials apologized for the disruption, but said they were doing everything they could to control outbreaks on campus so they wouldn’t have to send students home.

University officials facing intense pressure to move online justified the decision to remain open in terms similar to Fauci’s; that staying put was the best way to contain the virus. “The risk in closing a college campus and forcing thousands of students home at once is that the virus then has the opportunity to spread more widely to other geographic locations and possibly more vulnerable populations,” Michael S. Saag, a professor of medicine in and director of the University of Alabama at Birmingham Division of Infectious Diseases wrote in written statement endorsed by the university.

Selwyn M. Vickers, dean of the UAB School of Medicine, concurred. “From a public-health perspective, you want to contain and mitigate the spread of the virus,” Vickers said. “If resources are available on campus to manage an outbreak and keep it from spreading to other locations and people that may not be experiencing spread, that should be the goal.”

But for some colleges that started the semester feeling confident they could manage the pandemic, the numbers told otherwise.

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Last week, James Madison’s president, Jonathan R. Alger, told students that the university had decided to transition to mostly online classes through the end of September. After monitoring health trends, it will decide whether to resume in-person classes in early October.

Students were given until September 7 to pack up and move out but were told exemptions would be considered for anyone with vulnerable relatives at home or other compelling reasons to remain on campus.

The decision was described as a way to protect the health of the university’s students and employees, as well as the surrounding community. But what about the university’s responsibilities to the families and communities of students who live farther away, possibly in areas that have escaped widespread outbreaks until now?

Alger wrote that the university is taking steps to minimize those risks. “To protect the health and safety of the communities to which students might be returning, students who have been advised to isolate or quarantine should finish out their prescribed time before leaving Harrisonburg,” his message said. “Additionally, as a precaution, students should plan to quarantine for two weeks upon arriving at their destination.”

One of the challenges, though, is that unless everyone is tested before they leave the campus, there is no way to know how many asymptomatic people might be unknowingly taking Covid-19 home with them. There was no mass testing before students pulled out; James Madison officials said they followed Centers for Disease Control and Prevention guidelines, which recommend against testing asymptomatic people who don’t have strong reasons to think they’ve been exposed.

The University of North Carolina at Chapel Hill reversed plans for an in-person semester last month after an outbreak of cases in the first week of classes. “As much as we believe we have worked diligently to help create a healthy and safe campus living and learning environment, we believe the current data presents an untenable situation,” Kevin M. Guskiewicz, the chancellor, and Robert A. Blouin, provost, wrote in a campus email.

The university also encouraged students to complete a 14-day, self-imposed quarantine after leaving campus, even if they didn’t have symptoms of Covid-19. It has been sending out regular emails to remind students of their responsibilities to observe public-health requirements wherever they land in the coming weeks, and warning them that the Chapel Hill police will report them to the university for disciplinary action if they’re cited for holding unsafe gatherings. But for UNC and other flagships that draw students from around the country, monitoring compliance once students leave the campus could be all but impossible.

To our knowledge, no one in the country is able to test at the scale we have implemented.

Many colleges instituted robust testing capacities to keep the virus under control, but they, too, are finding it hard to keep up with the growing numbers of cases. The University of Illinois at Urbana-Champaign developed its own rapid-response, saliva-based test that it administers to students twice a week.

But its ability to keep in-person classes viable has been threatened by a recent surge of cases traced to large student gatherings and students ignoring directives to isolate if they’ve tested positive, or quarantine if they’ve been exposed, Robert J. Jones, the university’s chancellor, warned students last week.

“Over these past few days, the irresponsible actions of a small number of students have created the very real possibility of ending an in-person semester for all of us,” he wrote. The university has responded by doubling down on restrictions and punishments: Students were told in the September 2 message to avoid all nonessential in-person activities for two weeks.

In an email to The Chronicle, Jones suggested that students are safer remaining on campus, where they can be frequently tested and monitored. While Fauci’s warnings focused on the risks college students could pose to their families and communities if they’re sent home, Jones said the risks go both ways.

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“We believe travel out of our community to areas without the ability to test everyone frequently creates a much higher risk of exposure to our students and makes it more likely that they will bring back new infections when they return,” Jones wrote in an email to The Chronicle.

“Until we have an effective and widely distributed vaccine, the best tools to maximize safety are social distancing, careful hygiene, face coverings, and adequate testing. And to our knowledge, no one in the country is able to test at the scale we have implemented.”

Among those arguing that staying put is the safest bet for students, even when Covid-19 cases are surging, is the Interfraternity Council at Indiana University at Bloomington. The university recommended that all of the university’s 40 Greek houses close their chapters because of “alarming” positivity rates, but the governing council responded that forcing students to go home or find other housing in Bloomington could endanger their families and result in the kind of community spread that Fauci had warned about.

At least three fraternities told the student newspaper they had no intention of closing.

Containing students on campus as Covid-19 counts rage may make sense from a broader public-health perspective, but it makes some faculty and staff members on the affected campuses uncomfortable. As one staff member wrote to The Chronicle’s Higher Ed and the Coronavirus Facebook group: “My thoughts are, that would mean that the rest of us are then trapped in an environment where the virus is spreading. Neatly bottled up inside.”

The Link Lonk


September 08, 2020 at 01:09AM
https://www.chronicle.com/article/health-experts-warn-colleges-not-to-send-students-home-but-what-if-they-run-out-of-quarantine-space

Health Experts Warn Colleges Not to Send Students Home. But What if Quarantine Spaces Run Out? - The Chronicle of Higher Education

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