The Logistics of Testing and Contract Tracing on Campus

How would Universities actually take steps to prevent the spread of COVID-19?

California State University announced that classes at its twenty-three campuses would be cancelled for the fall. Instruction, with few exceptions would take place online. This decision affects nearly 500,000 students. The system announced that dealing with COVID-19 was simply not feasible. CalState would have had to spend $25 million a week on testing, and it was "enormously expensive" to contract-trace students.

Other institutions have announced plans to bring students back on campus. For example, the University of South Carolina is planning to "test every Student, Faculty and Staff member for COVID-19 upon return the campus." USC will also plan to "have the capacity to sustain a robust testing program throughout the entire semester." The University is now "reviewing several comprehensive tracing and tracking apps for early and thorough identification of at-risk contacts."

I've tried to visualize how these steps would work, logistically. Presumably, students and faculty would be required to undergo testing immediately upon their return to campus. The results may take some time to compile. Will those students be allowed to attend classes during that period? How often will students be re-tested?

Purdue University offers this plan:

We intend to know as much as possible about the viral health status of our community.  This could include pre-testing of students and staff before arrival in August, for both infection and post-infection immunity through antibodies.  It will include a robust testing system during the school year, using Purdue's own BSL-2 level laboratory for fast results.  Anyone showing symptoms will be tested promptly, and quarantined if positive, in space we will set aside for that purpose.

We expect to be able to trace proximate and/or frequent contacts of those who test positive.  Contacts in the vulnerable categories will be asked to self-quarantine for the recommended period, currently 14 days.  Those in the young, least vulnerable group will be tested, quarantined if positive, or checked regularly for symptoms if negative for both antibodies and the virus.

Keep in mind, these test kits are expensive, and the process is quite invasive. Will students actually report for regular testing? Will they actually stay quarantined. Students are not always responsible for these sorts of matters. Several of my students were studying together for final exams, social-distancing be damned.  And what if a student refuses to undergo regular testing? Or forgets?

And what about contact tracing? Imagine that you are a student, and some person calls you, and asks you to list everyone you've been in contact with the past two weeks. What if students refuse to talk to the tracers? What if students don't pick up their phones? (Students do not pick up their phones). What if they do not install the app on their phones? What if their answers are incomplete? For example, a student may have been engaging in illicit or embarrassing conduct. They may not want to disclose their contacts. There are so many reasons why students may be uncomfortable sharing that information. And I am not confident that structures can be put in place to maintain confidentiality. (Wait until those apps are hacked.)

What about contract tracers at state institutions? Students are taught not to talk to the police. Contract tracers are state officials. Washington has indicated that talking with contact tracers is voluntary. But could a University in Washington remove a student from campus who refuses to talk to a contact tracer?

And what happens if a professor learns that one of his students tested positive. At that point, the entire class goes virtual. I think professors--who tend to be older and more at risk--will fiercely resist starting and stopping a semester, based solely on the unpredictable behavior of students.

Universities usually make changes at a glacial pace. Committees meet and discuss issues for months and months. And invariably, any new policy only slightly deviate from former policies. I am not confident that educational institutions can create public health infrastructures in the span of months. I am confident that attempting to create this infrastructure will be extremely expensive, and divert much needed funds from educational missions. Any tuition increase to cover these sorts of unpopular measures will be very unpopular. I am also confident these efforts will distract professors from their primary mission: improving educational opportunities for students. I do not have answers about the correct way forward.

Comments

[santamonica811]

I would assume that any university or college would require a tracing phone app be installed and activated as a condition of being allowed on campus. I am not sure what to do about students who do not have a smartphone...maybe the university would have to provide them?? How to ensure that students and faculty/staff have the apps installed, and are using them, bringing the phones with them everywhere, etc? Only way I can think of is by randomly auditing this--and, of course, fully informing students and staff in advance that this will be done.

I am quite worried about the privacy implications. But that is a *different* question than, "Can this work effectively, and how?"

[Dr. Ed]

UMass Amherst already requires students to take an alcoholism evaluation before they can register for second semester classes.

[librarian]

Maybe students could return to campus while the high-risk facility continue to teach remotely? That way, the youngsters can develop herd immunity, while the professors are away.

[anorlunda]

Usually, I don't see University administrations as being at all sympathetic. But in this case, I can imagine the intense pressure they're under no matter which way they decide.

The survival of very many small businesses is questionable. Survival for many colleges and universities is likewise in jeopardy.

[Dr. Ed]

I say "good riddance" -- we would be better off if a lot of them (including a lot of public ones) never reopened.

[The Turtle Dove]

The old system of colleges within a university (or the Inns, for that matter) would make things considerably easier. Sleeping, dining, and studying within the same groups would more easily compartmentalize the plague, if plague there be. And events where a cross-section of the university attended would be more rare, and special precautions could be taken. The difficulty with the present arrangement is that it's essentially 30,000 university-wide random walks overlaid.

Mr. D.

[KHP54]

Bah. The right answer is for the universities to do nothing that they weren't doing previously. Like so many of our important, "elite" individuals and institutions, it sounds like they're acting as if COVID19 were as contagious as Measles, and as dangerous as Ebola, when in fact it's the other way around.

For the most part, college students are in the second-lowest risk group; and any elderly professors who have risk factors should have already been taking that into account; the seasonal flu can be fairly dangerous for those in that category.

[Hendo]

This would make a little bit of sense if you could put the campuses in a bubble, and require all of those students to stay on campus, and only interact with other students.

The problem is that most of these CSU campuses are commuter campuses, and a significant portion of the student population lives at home, with parents and also, in some cases, with grandparents. Many of them come from poor families with inadequate or no health insurance. You have to consider the fact that, even if the students themselves are in a low-risk group, cramming dozens or hundreds of them together in classrooms and labs and lecture theaters dramatically increases the risk of transmission, and the risk that they'll carry the virus home, to the store, and anywhere else they're likely to go.

I teach in the CSU, and to be quite frank, I'd much prefer to be in the classroom rather than teaching online. Face-to-face engagement with my students is one of the things I love about the job, and the announcement that we're teaching online next semester was quite disappointing to me. I'm also not especially concerned about myself, even though I'm pushing 50. But I understand why they're doing it this way. As Josh Blackman notes, these are difficult decisions, and the type of blase hand-waving that you're doing, completely discounting a whole range of important factors, doesn't do anything at all to advance the discussion.

[Armchair Lawyer]

Here's the real issue.

It's increasingly likely that a large proportion of the population (10% of higher) already has COVID and most of them are asymptomatic. The "curve has been flattened"...the stay at home orders were never really about "stopping the disease" (at least not initially), but about spreading out the peak number of cases.

By September, >70% of the population should have COVID antibodies through normal transmission (given typical conditions). Given that situation, social distancing doesn't really make sense.

[KHP54]

I thoroughly disagree. The hand-waving is all on the part of those who say this disease is unprecedented, when in fact its only our response that is.

Consider the fact that Prof. Ferguson and his colleagues have been shopping around a similarly-apocalyptic fatality scenarios for other diseases for quite a while (based on the same or earlier-version of the same model) and have generally overestimated the degree of fatality by a least an order of magnitude... in cases where we didn't do any kind of heavy-duty risk reduction.

[KHP54]

That's disagree with Hendo, not Armchair.

[librarian]

Would it be possible to teach a dual track online/campus class, and people return at their own risk?

[David Nieporent]

For the most part, college students are in the second-lowest risk group; and any elderly professors who have risk factors should have already been taking that into account; the seasonal flu can be fairly dangerous for those in that category.

You may not be aware, but we have a flu vaccine.

[Armchair Lawyer]

Wow.... The entire fall, gone to online teaching.

If I was a student in the California State system, I simply couldn't justify paying the full tuition for a program that could just as easily be handled (and probably better) by the University of Phoenix online, at a fraction of the cost.

Perhaps if a majority of Cal State students just "skip" fall semester there (as well as paying tuition, of course), Cal State might change its mind.

[Dr. Ed]

AL -- the real issue is going to be the loss of out-of-state tuition revenue. Why would you pay out-of-state tuition to have Junior sitting upstairs with his laptop?

Personally, I think the Governor bullied them into this -- and that they are banking on a *massive* revenue loss which the Feds will (they think) have to bail out. The larger issue, of course, is the unfunded state pensions and that's what these Governors really want bailouts for -- and the economic carnage be damned.

Cal State is making a high stakes gamble here -- that the Feds will bail them out -- and it will be interesting if they don't....

[Armchair Lawyer]

Also, the out of country revenue.

[TwelveInchPianist]

University administrators and faculty need to open wide and accept the fact that distance learning, provided by their technological betters, is the future of education.

[Armchair Lawyer]

Indeed. One more thing we can outsource to China. Education.

I foresee absolutely no long term problems with outsourcing college educational content to the great People's Republic of China.

[TwelveInchPianist]

Well then we better figure out how to educate people online. Because the days of people disrupting their calendars to travel to some lecture hall to hear a lecture, when they can hear the same material at their convenience, are over.

Especially when the material can be created for large scale distribution with better production and pedagogical values, and not just delivered by your average lecturer.

[David Nieporent]

Well, based on the posts of most Trumpkins, the American educational system is failing people, so maybe.

[jubulent]

The Logistics of Testing and Contract Tracing on Campus

What about the legal issues of testing students as a prerequisite for entering the University, either as a student, guest, or professor?

There are EEOC limits on employer mandated medical tests, are there similar limits for universities?

[Dr. Ed]

Respectfully, Professor Blackman, you need to understand that administrators (a) consider students to be a fungible resource and (b) could care less about things like students' rights.

They'll try a "sucks to be you" approach but what they don't realize is that they've already done that this spring, and parents won't be burnt twice. Parents (and students) are p*ssed about losing out on what they wrote checks for last January, and there are numerous lawsuits already filed, with more likely to follow.

But that's one thing -- writing *another* check in late August is something that parents don't have to do, and I'm suspecting won't. Think like a parent here -- Junior's inevitably going to do a keg stand, get quarantined, and flunk the classes he isn't allowed to attend because he is quarantined. So you're going to write a check for thousands upon thousands of dollars with this possibility? To an institution that already took a "sucks to be you" attitude this spring?

I don't think so....

And don't even get me going about the (quite fascist) "Behavioral Intervention Teams" that these institutions have formed over the past decade or so. That -- and not unrefunded money -- should be raising alarms, and somehow isn't.

[cmcc_aus]

Regular temperature checks are feasible. Frequent virus testing requiring lab results is simply an unreasonable expectation. My university expects to be open in the fall, although, unlike several other major universities in the state, it will not make an official announcement until it has recommendations back from a number of task forces.
One consideration is that there might not be large classes in giant lecture halls; those can be offered electronically, and supplemented by smaller breakout sessions, as they sometimes are now, but more so.
Granted that the Cal State system is mostly for commuters, and that raises somewhat different issues those at a Tier I school (and we are waiting to see what UC decides) -- but the typical students of commuter campus often need more face to face contacts and assistance, and are less well equipped to do everything electronically. Pretty much, the CSU system's decision might best be in parallel with whatever California does for public secondary education.

[Longtobefree]

No major logistical issues here.
Implant the chip, track everybody everywhere, require every contact be reported in person to a new campus bureaucracy hiring thousands of otherwise useless -ism studies graduates.
As a side benefit, require that all contact reports identify if consensual sex was involved. Those records will be important in the years to come. In the event the matching contact reports do not agree on consent, shoot them both (or how ever many were involved)

[Dr. Ed]

Don't encourage them....

[M L]

Nobody can or should "prevent" the spread of the virus.

Remember, the original justification for placing the citizenry under house arrest was to "flatten the curve." Slow the spread over time so that hospitals aren't overwhelmed. This was the justification given for drastic curtailments of liberty and putting 26 million out of jobs they depend on to fee their kids.

But now that this was already accomplished and the curve was flattened, and no hospitals were overwhelmed and many of them actually sat nearly empty, and the evidence suggests that the lockdowns were actually completely useless and didn't slow the spread anyway . . . now, a new bill of goods is being marketed, and it's far more ludicrous than the first.

[David Nieporent]

None of the words in that comment are true, which would be astonishing if it weren't for the fact that this is par for the course for you.

[M L]

Right back at ya.

Here's an example of advocacy for doing more than flattening the curve.
https://www.vox.com/2020/5/6/21241058/coronavirus-mitigation-suppression-flatten-the-curve

There's many more. Zeke Emanuel, brother of the man who famously said never let a good crisis go to waste, came on TV and said that the US must be locked down for years until there's a rushed vaccine, which I assume he would force on people. "Conferences, concerts, sporting events, religious services, dinner in a restaurant. None of that will resume until we find a vaccine," he proclaimed.

[Commenter_XY]

Any tuition increase to cover these sorts of unpopular measures will be very unpopular.

FTFY 🙂