The CDC links in-person university operations with COVID spread
What does the coronavirus mean for colleges and universities? How did campuses handle this public safety emergency?
I’ve been researching how the pandemic impacts higher education since COVID first appeared in Hubei province. Part of my work reverses that equation, asking the question: how do campuses impact their communities through their handling of the virus?
This month the United States Centers for Disease Control (CDC) published a devastating answer. They found strong links between large universities conducting in-person operations and massive COVID-19 spikes in surrounding communities.
Let’s take a look at the report, then discuss what it could mean for higher education’s future.
First, for context: the novel coronavirus continues to gnaw at the human race. There are now 96,877,399 cases worldwide, according to the World Health Organization (WHO); 98,424,940, as per Johns Hopkins. The virus has killed 2,098,879 (WHO) or 2,113,938 (JHU). (Did we really pass that two million dead milestone without notice?) In the United States, the subject of today’s post, 24,512,618 people have been infected to date, or about 7.5% of the total population. 408,697 have died. These numbers are from the CDC, which has several times admitted they are conservative undercounts.
The numbers seem to be building to some degree. The University of Washington’s IHME project estimates a worldwide total of 3,349,426 deaths by May 1, 2021. Several nations have seen nightmarish winter outbreaks controlled, or at least dropping to plateaus, according to 91-DIVOC:
In that context, what have American universities been doing, and with what impact?
The CDC team looked at a group of very large universities (those with more than 20,000 students), then checked their operational strategy (in-person versus online) against COVID infections in their host counties during the start of classes. Their findings are stark:
U.S. counties with large colleges or universities with remote instruction (n = 22) experienced a 17.9% decrease in incidence and university counties with in-person instruction (n = 79) experienced a 56% increase in incidence, comparing the 21-day periods before and after classes started…
COVID-19 incidence, hotspot occurrence, COVID-19-related testing, and test positivity increased in university counties with in-person instruction. [emphases added]
In other words, if a large university shifted education online last fall, its county saw a drop in COVID cases. If, in contrast, the university opened its doors and hosted face to face activities, infections spiked upwards.
Here’s a visualization of the data from the Chronicle of Higher Ed:
How do we interpret this research?
On the one hand, we can react to the report with a great deal of caution. The CDC held back from casting blame directing, preferring to show correlation rather than causation, although the case for causation looks pretty clear. The closest they get to casting aspersions is this line: “the concurrent increases in percentage positivity and in incidence in these counties suggest that higher levels of transmission, in addition to increased case discovery, occurred in these communities.”
We can also bear in mind that this research describes only one segment of American academia, the very large campuses with the capacity for on-site, in-person education. That’s just 101 institutions, albeit huge ones, out of circa 4,400. And we can recall that the report addresses only the start of the semester (“these results might not be generalizable to counties with smaller colleges and universities”). It looks like a learning curve was — appropriately — involved. We can also add that the mechanism of infection does not seem to be classrooms, but housing, both on- and off-campus (“Congregate living settings at colleges and universities were linked to transmissions”).
On the other hand, it looks like the decision to hold in-person education led straight to spreading COVID in these universities’ communities. That means the face-to-face experience yielded stress, illness, and likely some deaths in surrounding populations. The choice to do so furthered the pandemic’s spread and flew in the face of public health. Put that way, the findings are damning, at least for those 79 campuses and their decision-makers.
What do we do with this report?
The CDC offers some advice for higher ed. Lisa Barrios, one of the researchers told the Chronicle of Higher Ed that “Colleges and universities with in-person classes should be considering ways that they can increase their mitigation efforts.” The report goes into more detail:
Testing students for COVID-19 when they return to campus and throughout the semester might be an effective strategy to rapidly identify and isolate new cases to interrupt and reduce further transmissions… Colleges and universities should work to achieve greater adherence to the recommended use of masks, hand hygiene, social distancing, and COVID-19 surveillance among students… including those who are exposed, symptomatic, and asymptomatic…
College and university administrators should work with local decision-makers and public health officials to strengthen community mitigation…
They also add this point about inequalities:
Increasing testing capacity and engaging in other COVID-19 mitigation strategies might be especially important for colleges and universities in areas where transmission from students into the broader community could exacerbate existing disparities, including access to and utilization of health care, as well as the disproportionate morbidity and mortality of COVID-19 among populations with prevalent underlying conditions associated with more severe outcomes following infection.
Curiously, the CDC does not advocate for online instruction. Which is strange, since this report makes that strategy abundantly appealing from a, well, disease control perspective.
We may also have to do some reputational damage control. If Americans think some universities — and these tend to be ones that make impressions — have knowingly caused illness, injury, and even death among their neighbors, it won’t just be hard right Republicans who look upon academia with dismay. I’ve written about this reputation crisis previously.
In self-defense, we may have to point to the work some research universities did to speed the vaccine, the development of which is surely a triumph. We can also bet that this story doesn’t get much traction. It’s dry stuff, statistics and science, things which most media outlets struggle to convey. The CDC report also competes with many other stories, including the demise of the Trump administration and the rise of the Biden. In other words, we can hope that word of academia’s role in worsening the pandemic doesn’t spread — unlike the virus did, in 79 American counties.
