As the fall semester draws near, schools, public health officials, and President Donald Trump are struggling to find a way to reopen academic institutions.
A new study by experts at Yale University suggests it’s possible after all, but only if every student is tested every two to three days.
To minimize infections and potential fatalities, other restrictions would also be needed, such as a shortened semester and moving students with coronavirus symptoms to an ‘isolating dormitory’.
By testing only students with symptoms, or even testing each student only once a week, the coronavirus could spread to almost every person on campus, the Yale model found.
Testing every one or two days over the course of a stunted 80-day semester would result in 60 to 160 infections at any time – a relatively acceptable number of sick students.
It’s doable – but barely cheap, costs between $ 120 and $ 910 per student – or at least $ 6.9 million for a three-month semester.
“We believe that students will be able to return to university safely in the fall of 2020,” the study authors wrote.
But this ‘sets a very high bar – logistically, financially and behaviorally – which may be beyond the reach of many university administrators and the students under their care.’
Testing based on symptoms alone would cause isolated dormitories to be overwhelmed by a coronavirus spreading across a full student population of 5,000 people (bottom left), but testing every two days (top right keeps infections relatively low – but costs millions of dollars)
Using a hypothetical class of 5,000 students, of which 0.2 percent – 10 students – are asymptomatic carriers of coronavirus, some of the scenarios that the scientists have put through their model can prevent any student – in addition to teachers, staff and other members of the community – contracts coronavirus.
They came up with their recommendations for reopening schools by considering how much loss of life Americans are willing to tolerate compared to how many universities and families are willing to spend.
In the study, published Friday in JAMA Network Open, the Yale team came up with three scenarios: best, worst, and base.
While there could be new forms of testing that could be faster, more accurate, cheaper, or all three, the scientists estimate that each test would cost between $ 10 and $ 50 each (for both the test kit and associated costs, such as the personnel to be managed) the tests).
Schools like Boston University are frantically trying to decide if and how to open again this fall. BU will test its students like others but with different strategies (file)
Assuming schools would opt for a cheaper test and move each student with symptoms or a positive test (whether false or positive) to an isolation home, they found that the best scenario would be tested every two days, with approximately 60 to 80 students would be isolated at any time, but most would be false positive.
If screening were only done weekly, things would take longer to identify, but they would only increase. That would mean that by the end of the semester, more than 300 students would be in the isolating dorm, and up to 200 of them would be real positives.
Just testing people with symptoms would hardly mean false positives, but by the 70th day of school, more than 400 truly covid-infected students would be in the isolation room.
Screening in this way would also cause the entire student body to become infected – consciously or unconsciously – before they even go to school for 80 days.
Daily screening would yield comparable results for isolation and limit the number of students who became infected to at least 60 infected students at any time.
In the worst case (center), even a perfect test, given only based on symptoms, would not prevent the coronavirus from spreading to every student on a campus
But the costs would almost certainly be prohibitive.
Even with the cheapest, most inaccurate daily student screening, it would cost $ 48 million – about half of the combined tuition income the school would earn from those 5,000 students.
Testing every two to three days was the most balanced outcome, resulting in approximately 106 infected students in the isolating dormitories at some point during the semester.
It would cost a little more modest $ 24 million (still enough to send nearly 200 students to a public university for a year).
And their findings only explain the risk that students run themselves.
Reopening university campuses involves risks that go beyond students to the faculty that teaches them, the many university staff (administrative and facility staff) who come in close contact with them on a daily basis, and the countless other members of the surrounding community with whom students come into contact, ‘the authors wrote.
“University presidents have a duty to reflect on the downstream effect of their reopening decisions on these constituencies.
“Their primary responsibility, however, lies with the safety of the students.”