ROANOKE, Va. (AP) - As a rising senior at Virginia Tech, Andrew Williams is “strongly encouraged” to test negative for COVID-19 before arriving on the Blacksburg campus next month.
But he probably won’t get that test. Not unless such an opportunity becomes more widely available around his home in the Hampton Roads area, where he works as a construction site inspector.
“It’s definitely ideal, but it’s definitely not as realistic,” Williams, 21, said of Tech’s testing plan, which includes asking students to quarantine for two weeks before returning. “People are doing different things, and some people can’t just have that time to isolate before they go back.”
Meanwhile, Williams’ sister, who attends the University of Virginia, will be sent a test kit in the mail, which she is required to return with a negative result before being allowed on Grounds. Radford University plans to test 1,700 on-campus students upon their arrival, while Virginia Commonwealth University in Richmond aims to mail tests to all residential students.
As Virginia colleges prepare to reopen next month, guided by a patchwork of plans, questions are arising from faculty, parents and students about whether universities, and the students themselves, can control the spread of COVID-19: Are college testing plans stringent enough? Will students take physical distancing seriously? Is it safe to hold classes on campus?
“If we continue on this trajectory in a month, there are no ways that any schools at any levels are going to be open,” Katie Carmichael, an associate professor of English at Tech, said July 14 about national trends, noting that increased travel, especially to small college towns, will increase spread of the virus. “I think that any amount of movement is tempting fate.”
Amid a spike in COVID-19 cases in the Hampton Roads area, mostly among the young, Hampton University reversed course on reopening campus and announced classes would be online only. Big-name schools, including Harvard and Yale universities, have said all of their classes will be remote for the fall.
But elsewhere in Virginia, 31 out of 33 colleges are planning for some type of in-person classes, according to a Chronicle of Higher Education tally as of July 16.
“I am concerned about the return of students to campus because they are in the classroom for only a few hours a day, and we can’t control what they do during the other hours of the day,” Linsey Marr, a Tech professor and expert on the airborne transmission of diseases, said in an email July 15.
Although Marr isn’t teaching this fall, she said she would be comfortable holding in-person classes - so long as students wear masks and the room has proper ventilation, which she would measure with a portable carbon dioxide sensor.
But outside the classroom is another matter.
“I am not confident that 20-year-olds will follow guidelines for distancing and avoiding crowds because I remember being that age and highly valuing socializing with friends and taking risks,” she said. “I expect to see a lot more cases in Montgomery County.”
ISSUES WITH TESTING
Anyone who wants a COVID-19 test can get tested, President Donald Trump said in March and again in May. That remains untrue today, according to the Virginia Department of Health.
“At this time, the New River Health District does not have the capacity to test every person returning to a college or university campus, and VDH does not recommend campus-wide testing of students or faculty/staff upon arrival or at certain set intervals,” Bobby Parker, a department spokesman, said in an email July 17.
So with the prospect of thousands of people on campuses, Virginia colleges must submit a plan to the state that includes a testing strategy. Local health departments help to guide those.
“Again, one size does not fit all, and these are complicated and difficult decisions to make,” Gov. Ralph Northam said July 14.
Testing by colleges only makes sense without certain restrictions, said Thomas Kerkering, a Virginia Tech professor in the field of infectious disease and a member of the Roanoke health district’s communicable disease team, as 40% to 80% of people who test positive have no symptoms.
“So it doesn’t really do any good to limit testing to only those who have symptoms,” Kerkering said July 14 on a health department conference call. “It would have to be a more generalized population that’s returning.”
Yet some college testing plans, such as those at Roanoke College and Hollins University, do not initially involve the testing of students who may be asymptomatic. Both colleges said the plans, which are subject to change, were made in consultation with VDH epidemiologists.
In its four-page “interim testing recommendations” for colleges, VDH recommends testing for asymptomatic persons who have had close contact with people who tested positive for COVID-19, only “as resources permit.”
If anything is to help Tech reopen in the fall, President Tim Sands said in May, “it’s going to be the ability to test significant numbers of individuals, not just on campus but in the community, with less than 24-hour turnaround.”
A Tech spokesman July 17 said the amount of testing supplies and the capacity to analyze them will become clearer closer to the start of the semester. Tech’s testing plan asks an estimated 9,000 on-campus students to get tested, which the university says would give a representative snapshot of 30% of the total student population.
The plan also encourages other students to get tested off-site and remain in quarantine, recommendations students and parents say will be hard to do.
“I’m just spinning in circles because I refuse to pay for a test that could be false negative, false positive,” Gail Asher, 59, of Newport News, said about trying to secure a test for her son, who does not have symptoms. “He could pick it up on the way down to Blacksburg.”
“Virginia Tech recognized that access to COVID tests is not consistent across the country,” Tech spokesman Mark Owczarski said in an email July 17. “That is why in the plan, testing prior to returning is a recommendation. The additional recommendation to quarantine for 14 days prior to return minimizes the opportunity to return to Blacksburg with the virus.”
Deborah Mayo, a professor emerita at Tech who studies the philosophy of statistics, said Tech’s testing plan’s “vague and not enforceable” rules risk causing an outbreak.
“I think it’s completely an ill-laid out plan,” Mayo said. “Something has to be done to fix it, to improve it, or we’re really going to have a serious problem in the fall.”
She said the university should consider pooled testing, which can test more people cost-effectively, but whose efficacy remains in its infancy when it comes to COVID-19.
“The university considered numerous options,” Owczarski said. “If or as guidance evolves or circumstances related to the pandemic change, Virginia Tech (as it has done) will consider or reconsider other options.”
CONTAINING THE SPREAD
Testing alone is not a panacea.
“A person can become infected after the test has been taken,” the health department’s guide to colleges notes. “The test results should not be seen as implying that someone who tested negative on the date of the test will continue to not pose a risk to the campus community.”
Wearing masks, physical distancing and frequent hand-washing will be critical.
Laura Hungerford, head of the Department of Population Health Sciences at Virginia-Maryland College of Veterinary Medicine, said that while the Centers for Disease Control and Prevention estimates 40% to 60% of spread is asymptomatic, that means 40% to 60% of spread is symptomatic.
“So, if one person infects two others, this would mean that one of them, on average, would show signs and we would find them after just one transmission cycle,” Hungerford said in an email.
“This is why health districts strongly emphasize contact tracing. When we find the case that shows signs, it should lead us to find and test others to determine who gave the infection to them and then trace where the disease may be spreading.”
Aris Spanos, a professor of economics at Tech, also expressed concern about the potential for COVID-19 to spread on campus by those without symptoms.
“I predicted that we’re going to rush the opening and get ourselves in trouble, and that’s exactly what happened,” Spanos said about recent nationwide case trends, noting that Virginia, and Tech itself, do not exist in a vacuum.
“I expect in a group of 15,000, we will have, let’s say, at least 100 (infected) who will show absolutely no symptoms,” he said. “And that is enough to start a real problem within a couple of weeks.”
Parker, the health department spokesman, did not respond to a direct question about how many contact tracers the New River Health District has or hopes to have by September. He said, “We are currently handling our caseload and have a plan for surge, as we do expect an increase in cases as the students return and our population increases.”
If one is worried about transmission, Hungerford said, “then the best thing we can do is to adopt practices that stop spread - wearing masks, physical distancing and practicing good hygiene - which have been shown to inhibit spread even when there are infected people among us.”
That’s why masks are required on campuses, faculty will teach behind shields and most classroom occupancy is reduced by about 75% and capped at 49 students.
Blacksburg Mayor Leslie Hager-Smith said the town works closely with Tech, and she doesn’t share her Charlottesville counterpart’s assessment that UVa’s opening will be “a recipe for disaster.” In her view, testing is the “least effective part of staying safe,” and that “none of that is as important as practices we can put into play,” such as physical distancing and wearing masks.
“The bugaboo, really the big concern, is that there are going to be out-of-control parties,” Hager-Smith said.
Dr. Noelle Bissell, director of the New River Health District, said that residents shouldn’t hold students to a higher standard.
“The students are not bringing in COVID. It’s here,” she said July 16 at an economic development conference. “It’s all over the New River Valley. … There’s no bad place. There’s bad behavior. It’s not where you go, it’s what you do.”
Williams, the rising Tech senior, expects he won’t travel over fall break or engage in as many activities as usual.
“We have this kind of imaginary vision of what college was like before the pandemic,” he said. “A lot of things that make college fun, I think, like concerts that we have, and social gatherings that would be organized at the beginning of the semester, and hanging out with friends, are just not going to happen.”
And he’s left with his own unanswered questions: Will football happen? Will he work his campus dining job? How will buses deal with physical distancing?
“I don’t think anybody knows what’s really going to happen,” he said. “Everything changes, every single day.”
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