Yale Spends, Tests More; Practices Vary

UNH is ramping up random testing. Albertus is focusing on student-athletes, who get swabbed every other week. Yale is screening all undergrads twice weekly. Most commuter students at Southern needn’t get tested at all.

Those four New Haven schools have tried different approaches to Covid-19 this semester — and preliminary results are in.

Among the takeaways: Frequent testing and a focus on sports teams seem to help colleges detect outbreaks sooner rather than later.

And testing is crucial, though campuses are split so far on how widespread or often.

Like other campuses across the country, Albertus Magnus College, Southern Connecticut State University, the University of New Haven, and Yale are effectively conducting live experiments in mandatory asymptomatic Covid testing policies.

In the New Haven area, universities and colleges are trying various combinations of Covid-19 testing protocols in an effort to locate and contain the virus, focusing different proportions of resources on residential students, commuters, athletes, undergraduates, and graduate students.

Midway through the fall semester, the consequences are beginning to play out as various schools have caught outbreaks, or the beginnings of outbreaks, at different stages. The University of New Haven recently moved all classes temporarily online and encouraged students to ​“study-in-place” after a Covid-19 outbreak on campus. In mid-October, Yale reported an uptick in cases after 18 members of its ice hockey team caught the virus. And that same week, Albertus Magnus announced its first couple of cases of the virus. 

A timeline of the cumulative numbers of Covid-positive students at UNH, Albertus, Yale, and Southern begins to tell a story of where various schools have converged and diverged.

The outbreak at UNH began to taper off when case numbers neared at least 150; the university tested every student when the outbreak first hit, and has since promised to increase its capacity to at least 20 percent weekly, in part by making use of saliva based tests.

Meanwhile, Yale appears so far to have controlled a Covid cluster of about 20 cases that affected its ice hockey team two weeks ago, identifying the group of cases before the outbreak worsened.

Within this small sample on a local level, the number of detected Covid cases doesn’t have a clear relationship with the extent to which students are tested. At Albertus, for instance, around 10 percent of non-athlete students are tested each week, a relatively low rate; but after discovering two cases of Covid among students, Albertus hasn’t reported further infections. (Update: Albertus reported that in the week of October 19, six residential students and three commuter students tested positive for the virus.)

The data, particularly for schools that test students less frequently, is likely an underestimate of the actual number of Covid cases on each campus, as these numbers can account only for Covid cases that were caught and officially reported by the universities.

The four institutions differ in size and in the insularity of their communities. They also vary somewhat in their social distancing enforcement, student culture, and the number of in-person classes this semester. But one of the most concrete policy differences in their approaches to the pandemic lie in their testing procedures.

All but Yale are testing weekly samples of up to a quarter of their student populations, rather than screening every student. Midway through the semester, the Connecticut Health Department requested that several schools increase their weekly testing capacities.

SCSU began the semester by testing 10 percent of residential students weekly, as well as periodic testing of nursing students and student athletes, through Griffin Health. After Sept. 5, it raised testing proportions to 25 percent of the student population.

Meanwhile, UNH began by testing 5 to 10 percent of its campus population. Now, in the aftermath of the outbreak, the university is testing 20 percent of campus, with a breakdown of on-campus students, off-campus students, staff, and faculty that changes from week to week, through Murphy Medical Associates.

And Albertus Magnus tests 10 percent of both residential and commuter students weekly. In addition, since sports teams began practicing, the school has been testing all athletes every other week, bringing weekly testing of its residential population up to about 20 percent, according to spokesperson Sarah Barr.

Going further than sampling the student population, Yale has been testing every enrolled undergraduate from the start of the semester two times per week, including both on-campus and off-campus students. Both Yale and Albertus are processing asymptomatic tests through the Broad Institute of MIT and Harvard.

All four schools use anterior nasal PCR tests for asymptomatic students. At SCSU, medical professionals administer the tests, while at the other schools, the tests are self-administered under supervision. UNH is beginning to provide saliva tests as well, according to spokesperson Doug Whiting.

Expert Supports Twice-Weekly Model

According to A. David Paltiel, a public health professor at Yale who published a widely-cited study in July simulating Covid-19 containment strategies on college campuses, ​“the role of screening is essential” in universities’ Covid-19 mitigation plans.

“We looked at thousands and thousands of different scenarios in this model, and over and over again, we found that screening was by far the most powerful factor” in allowing schools to contain outbreaks, Paltiel said.

Paltiel says it’s necessary to test all students two, if not three, times a week. Schools ranging from large public universities like the University of Illinois Urbana-Champaign to small private schools like Brandeis University are following this protocol.

Paltiel’s model did not account for contact tracing systems, which he argued may not even be necessary after a certain frequency of testing; all four of the above New Haven-area schools use contact tracing to determine whom Covid-positive community members have interacted with.

In an interview with the Independent, Paltiel said that the strategy of sampling a percentage of the campus population weekly can give schools a sense of how widespread the virus is, but it won’t necessarily be enough to contain the virus.

“If your objective is outbreak control, which I think is the objective on college campuses, then I don’t get what purpose it serves by randomly selecting a sample. I don’t get it,” he said.

Sampling can help university officials infer how prevalent the virus is on campus, Paltiel said, but that strategy won’t be sufficient to identify every asymptomatic spreader.

In order to control a potential outbreak, every asymptomatic carrier needs to be pinpointed and isolated, he said.

The resources required to test students two to three times per week are costly. But ​“because it’s too expensive doesn’t mean it isn’t important,” he said. ​“Any school that couldn’t see its way toward doing it … maybe ought to have been asking if [it] had any business opening in the first place.”

Positives, Negatives, Question Marks

Majesty Moore took her second Covid-19 test of the semester on Monday afternoon. A residential student at Southern, she had received an email that she had been randomly selected to take a test. So she showed up at the former student lounge in Engleman Hall, where a medical professional swabbed each nostril for ten seconds behind tall blue curtains.

Meanwhile, Jacob Payne has taken 17 tests since arriving for his senior year at Yale this August. He walks to a testing station in the dormitory across the street from his every Tuesday and Friday, where he self-administers a swab.

He said that at the start of the semester, he felt apprehensive about the frequent testing, expecting it to be uncomfortable. But he learned that the anterior nasal tests that Yale and other New Haven colleges use don’t go as deep up the nose as nasopharyngeal tests. ​“Since we’re doing the easier one, I don’t really hate it,” he said, adding that the twice-weekly testing schedule ​“makes me feel safer.”

Moore echoed this sentiment. ​“It’s uncomfortable, but it’s important,” she said.

While Southern and Yale have experienced similar trends in their respective numbers of Covid cases, the on-the-ground reality is more complicated. Students like Payne receive test results monitoring their viral status multiple times per week, while students like Moore get tested a handful of times per semester.

While Yale has reported a higher concentration of cases given the size of its undergraduate population, Southern’s numbers reflect only part of the story, as the university is testing a smaller proportion of its students each week. Schools that test more of their students confront less uncertainty about the infection rates in their populations.

The following charts provide a snapshot of test results at UNH, Albertus, Yale, and SCSU from each school’s most recent seven-day reporting period.

The red bars and their corresponding numbers represent the students who tested positive for the virus in the past week; the green bars represent students who tested negative, and the gray bars represent students who were not tested for Covid last week. (Note that the group of ​“untested” students at each school may include students who tested positive for the virus in previous weeks.)

SCSU wasn’t able to provide the total number of commuter or off-campus students living in or near New Haven, and mainly tracks self-reported cases among this subset of students. The school does randomly test athletes and nursing students, including those living off campus.

Moore said she hadn’t realized that non-athlete or nursing off campus students don’t need to be tested.

“They’re coming on campus interacting with the rest of us,” Moore said. ​“If they can get tested, they should.”

In general, though, Moore said she feels safe with the amount that Southern tests students. From her perspective, the school does a great job of enforcing mask-wearing, promoting hygiene, and shutting down social gatherings.

Reece Batwood, a senior at Southern who’s been selected for testing twice this semester, also said they feel comfortable with the amount that the school is testing students. ​“Southern is quite vigilant,” they said.

Nicholas Thompson, a sophomore at the University of New Haven living on campus, has been randomly selected for asymptomatic testing twice. But over the course of the semester, due to the outbreak, a job requirement, and a case of strep throat, he’s been tested about 9 times.

As at Yale, the tests at UNH are self-administered. Once, Thompson gave himself a nosebleed from sticking the swab up too far. ​“I didn’t know what the hell I was doing,” he laughed. ​“I followed the directions, but there’s a chance I was doing it wrong.”

$25M Pricetag

While experts say that universities should ideally be testing all students multiple times per week, such protocols are costly. According to an announcement from Provost Scott Strobel, Yale has shelled out more than $25 million on Covid testing, contact tracing, personal protective equipment, and isolation space. So in cases where asymptomatic testing of all students isn’t an option on the table, should some populations be prioritized over others?

Albertus, SCSU, and UNH are all testing greater proportions of residential students than off-campus or commuter students. Those three schools tend to have a more locally-based student population, and a more sizable commuter student culture, than Yale does.

The city’s health director, Maritza Bond, wrote over email that both on-campus and off-campus student populations are at a higher-than-average risk for Covid spreading, and that both groups should ideally be tested.

“The shared restrooms and doubles/triples rooming situations increase the risk of exposures for students [on campus], but also off-campus housing has encouraged exposures and due to the non-college addresses and limited supervision, have also complicated the contact tracing and information gathering process,” Bond wrote. ​“All should be tested, where feasible.”

Bond added that athletes could be at higher risk for outbreaks, pointing to a recent cluster of cases on Yale’s Ice Hockey team.

“Rigorous physical activities and sports have been aiding the spread of Covid-19,” she wrote. ​“Partially, this is the result of increased breathing and spread of droplets both large and small, but also what happens off the field/court/rink is just as important as what happens on it.”

SCSU and Albertus are both targeting testing resources towards student athletes; neither school has reported a significant Covid cluster or outbreak so far.

In general, Bond said that colleges could be doing a better job of communicating with her department.

“Overall, I am pleased that colleges have a consistent screening and tracing for their students, but there is room for improvement,” she wrote. ​“We need to ensure timely and comprehensive communications with public health authorities for situational awareness and decision-making. This helps us make decisions at a city level if we start seeing concerning trends/issues.”

“I think that insofar, we seem to be getting pretty lucky in the New Haven area,” said Paltiel. But he’s still uneasy about what might happen. ​“If things go awry, the adverse consequences are not likely to be borne by the students,” he said. ​“They’re more likely to be imposed on the non-student members of the community, the staff, the faculty, the most vulnerable members of the surrounding community.”

This story was produced with financial support from Solutions Journalism Network.

Previous stories:

• Students Play The Covid Heavy
• 2 Campuses, Week 1: Zoom vs. Zip
• Albertus Continues Convocation Tradition, With A Twist
• Yalies Begin 14-Day Dorm Quarantines
• ​“K.I.S.S.” Keeps Auto Cohort Humming After Covid Scare
• Future Mechanics Return To Class In Person
• In Car Lab, They’re Geared Up For Covid
• Prof, Students Forge ​“Hybrid” Routine
• Coronavirus Takes A Seat
• Despite An Outbreak, Colleges Stay Course
• Covid-Positive Chef: UNH ​“Bats Blind Eye”
• Classes Move Online As Outbreak Spreads
• Colleges Confront Climbing Covid Cases