S1E41 / Back to Campus / Allison Slater-Tate, Amy Gorin, Eleanor Daugherty, Rochelle Walensky

I'm Dr. Celine Gounder, and this is Epidemic. Today is Tuesday, August 4th. This is our second episode looking at education during the pandemic. In our last episode, I spoke with my friend Allison Slater Tate, who's about to send one of her sons off to college for the first time.

Things are changing by the day, and as a college counselor, I felt a little bit like a Debbie Downer for the past few months because I, I do not feel great about colleges bringing kids back to campus this fall, honestly, and I was very skeptical that it was going to be able to happen.

Universities and colleges are starting to announce their plans for the fall as we record this episode, and some may change their plans again in the coming weeks, but it's clear that many schools will welcome students back to campus this fall, at least in some form. Allison says she understands why people want to get back to campus.

We're paying a lot of money and our kids are really excited and they've worked really, really hard and they want to go to college where they have that campus experience, which is so much a part of the college experience.

But that experience, whatever it looks like, is going to sound pretty strange to anyone who's been a freshman living on campus. All of her son's classes will be online. All sports have been canceled. No clubs, no social events, but he will get to live in a dorm.

He will have the experience of a communal bathroom, which I'm not sure is a bonus. And he will get to meet some of the administrators and the, uh, staff of his residential college at his college. And that's about it.

And as a parent, Allison has another motivation to send her son away to college during a pandemic. His safety. Allison lives just north of Orlando, Florida, where cases of COVID have been spiking for weeks now. Her son is going to school in New Jersey, which, for now at least, is having a better experience with the virus.

The, the best thing I can say about it is he might be safer than he is here. And that's how I feel about that.

So—

There's a lot of ways different schools, from kindergartens through colleges, are approaching what the fall is going to look like. I just want to say, we're not endorsing any one plan here. Now, that being said, in this episode, we're going to take a deep dive into how one big state Division I school is approaching education this fall with a hybrid model of in-person and remote learning. The University of Connecticut.

UConn.

UConn. UConn. UConn. UConn. Eleanor Dougherty is the Associate Vice President for Student Affairs and Dean of Students at the University of Connecticut. UConn is one of the universities that is bringing students back to campus this fall.

If we want to bring students back to college, we have to redefine what college is for the short term. And so we need to think about it with more innovation and depth of thought. Than we would if we were just applying crisis management models.

Crisis management helped UConn salvage the spring semester. But as the administration considered what to do for the upcoming academic year, they went back to basics.

The purpose is education and connection.

But health and safety concerns in the time of COVID meant they had to ask a new question.

How do we completely recalibrate given the world we're living in right now, rather than flip a switch and go online and say we got it.

The University of Connecticut didn't have to look far to get some guidance on how to do this.

What we have is a grand challenge. COVID presents an unprecedented challenge to our colleges and our universities across the nation about, you know, how to minimize risks to our students, faculty, and staff, while at the same time doing all the things that a good university does: maximize learning, support research, prioritize prioritizing the physical and mental health of our student body.

This is Amy Gorin. Amy's a professor of psychological sciences at UConn and the director of the Institute for Collaboration on Health Intervention and Policy. As the pandemic took hold of the spring semester, her institute was suddenly in high demand.

My research focuses on behavioral management of obesity, and myself and several colleagues worked in fields such as weight management, HIV prevention, substance use treatment, and we we realized that we had a lot of insights to offer to the conversation about potentially reopening campus.

Amy and her colleagues surveyed thousands of students about their expectations and concerns for the fall.

And we heard lots of different questions and concerns. You know, there were certainly many safety concerns that students shared about the fall semester. There was a strong desire to return to campus among many of our students. A lot of our students wanted flexibility. That was incredibly important. They either felt felt strongly about coming back to campus or felt strongly about wanting to have quality online options available.

Students had emotional concerns, too.

We also heard that the pandemic has been hard on many of our students. It's taken them away from their college experience. There's a sense of loss over what they're missing out on, and there's a real desire to return to some sense of normalcy.

Students wanted to get back to campus. Amy and her colleagues asked themselves how they could do it safely. They conducted focus groups to try to understand the ways students would or would not adhere to new policies and safety regulations. Many students were worried that others would not wear masks at parties and other social gatherings, that they'd wear them in class, but once outside, all bets would be off.

They also express concerns about shame. You know, if they test positive, what will that mean for their social circle? Will they get their friends in trouble? Will they themselves get in trouble if they've been at a larger gathering? And so there's just a lot of questions. Even though they do want a sense of normalcy, which I think we all want, our students do express concerns about how that may actually happen.

So using Amy's research, they started mapping out what the university would look like this fall. The first step was to figure out classes. Eleanor Dougherty, the Dean of Students, says professors decided if they wanted to offer in-person or online courses.

And then students choose based on the normal online course registration process. It's just that those online courses now have designations when the student registers, so they know it's not an in-person class.

Any student who chose to take an entirely digital schedule got something like a 10% cut in tuition. But about 8,000 of the school's 20,000 students chose to come back to campus this fall. And so the next challenge was housing.

That's meant reducing our housing capacity by about 30%. That's meant putting new expectations in place for students, like wearing masks, maintaining distancing, reporting symptoms.

The changes will be obvious when students arrive on campus. They'll get tested as soon as they move in, and then they'll be expected to quarantine.

And the idea is not that they will come to campus and have to sit in their dorms in solitary confinement for 2 weeks, which would be completely unrealistic, but that we're creating these pods and sort of these family units that they can socialize with.

The university looked to students to offer ways to make the quarantine as painless as possible.

So they made suggestions about online trivia and scavenger hunts and other things that they could do that would still be relatively low risk, but allow them the opportunity to see some of their, their friends and in the case of incoming students, make new connections. Even some requests to offer some programming during that period. Could they start their classes online a little bit earlier? Are there any research experiences that they could engage in during those 2 weeks so that they just had a little bit more structure to their day?

At the end of the quarantine, the idea is to return to a campus life as close to normal as possible., but things will definitely be different.

For a Division I school to rethink community is a big ask, right? We're not all going to crowd into an athletic event now. We need to look at it differently.

The university's 600 student-led organizations will be permitted to hold their usual events and meetings so long as they stay within state-mandated guidelines for group gatherings.

And then the university hosts programming as well and will continue to do so. We're just reducing in terms of scale of the size of our programs and where they happen, more outside than inside.

But having a somewhat normal college experience comes with a price. Once you're in the campus bubble, you have to stay in the bubble. And there are consequences if students don't follow the rules.

The health and safety procedures are tied to the potential for conduct and potentially being removed from housing if you don't follow them. And students are aware that they are governed by the student code of conduct as well. And certainly if there was repeated and reckless behavior that was endangering the health of others, we would look to the code for enforcement. I wanna make sure as we bring students back to campus, we're not creating that false comfort of, I came with a negative test, so everything is fine, right? It's the extensive surveillance, it's following quarantine, that I think is going to be the only way for us to get through an academic term.

Testing is going to be a key part of that surveillance effort, but what testing looks like at different colleges and universities will vary. The resources available to small liberal arts colleges and public institutions aren't the same as what the nation's most elite universities will have at their disposal. This past week, a team from Harvard and Yale released a study modeling what testing would have to look like to keep students, faculty, and staff safe. Dr. Rochelle Walensky was one of the researchers.

The question became how frequently testing would have to happen and what kind of test you would need in order to keep the kids safe and in order to have a residential environment be a safe environment.

They found that if students practiced social distancing but didn't wear masks, you probably need to test every 2 or 3 days in order to keep people safe. If they wore masks all the time, including in their dorms, they might only need to test weekly. And if they acted as though the pandemic didn't exist, just went about life as though everything were normal, and if that were the case, then we really said daily testing would need to, to occur. The team analyzed various tests too, to determine what type of test would be needed to keep a college campus safe.

What we found in that piece of the analysis is actually if you're testing frequently, you'd much rather have a rather insensitive test, but something cheap that you could do, you know, every day, every other day. So I would rather have something that's only 70% sensitive sensitive that I might be able to do every other day than some gold standard that's going to take 9 days to return.

Even in a best-case scenario, Rochelle says, any on-campus testing program is going to be difficult.

There's an enormous logistical load to try and be able to do this, both in terms of getting kids tested, ensuring that they're accurately collecting sample, getting them their test results. And then sort of doing the appropriate contact tracing and rapid isolation that might be necessary.

Rochelle's model was based on a mid-sized college, institutions with roughly 5,000 students. She's quick to add, though, that at a college with a larger student body, say UConn, for example, the logistics will be an even greater challenge.

It really is this dance between ensuring that the behavior is is in place to make sure that whatever testing program you have in place is going to be enough to capture all the cases that are going to be out there.

Regardless of the size of the campus, there are no guarantees, especially when it comes to this coronavirus, which can spread rapidly between people with no visible symptoms.

We looked at many different scenarios where all you would do was testing based on symptoms. And in each of those scenarios, we were very worried that we could not create a situation that would control outbreaks if you were just simply testing on symptoms alone. And I think that that was actually a really important insight that we had from this model.

But Elinore says testing like that is not going to be realistic at a school as big as UConn.

When you are a large university, it is very difficult to routinely test every single one of your students and adopt that as a surveillance model.

So UConn plans to conduct symptomatic testing as well as random testing in 5 to 10% of the residential student population.

That's a manageable way for a large university with limited resources to fulfill, I think, an obligation to surveillance and awareness of the health of the broader community.

Inevitably, some students will get COVID. When this happens, the university will carry out contact tracing to see who else was exposed, and infected students will be isolated.

For students who test positive, they will be able to go home if they can convalesce comfortably at home. We have a large in-state population, so that could be something that is what they would prefer to do. If not, we've identified several beds on campus that will be used specifically for medical isolation for us to separate a positive student from the community until they recover. And they'll have meal delivery daily, telemedicine, symptom checking, all the medical care that will be necessary until they recover.

Eleanor says they'll be paying close attention to testing and any cases that appear.

The, the nice thing is we'll get these signals because we're also responsible for medical care for our students. So we'll, we'll see the tipping point and we'll see ourselves moving closer to it.

And if there's an outbreak, they'll change their plans for the semester.

When we start using up isolation beds rapidly and not being able to effectively contain infection on campus, then we need to start signaling to university leadership that we're not sure how much longer. We can stay open.

Plans are important, but in a few short weeks, UConn and other universities that have opted to bring students back to campus are about to find out if all their plans will work in real life. A survey by The New York Times found that more than 6,600 cases of COVID have been reported at universities and colleges across the United States since the beginning of the pandemic. That includes 112 cases in the University of Connecticut system. With a majority of states showing increasing numbers of cases as summer ends, it's going to be an uphill battle for any institution with students on campus to control the spread of coronavirus. But ultimately, it's up to students to follow the rules, and Eleanor thinks they have a good reason to do so.

Students care about going back to college. It's very important for them to come back. They don't want us to close again.

It's like what former U.S. Secretary of Education Arne Duncan said in our last episode: the goal isn't just to reopen school, the goal is to keep schools open.

And so if we make that choice to come back, we must in turn make a choice to care for each other by following the measures we put in place.

And the university is going to try to leverage that desire to keep students safe and in compliance with the rules.

If we're inspired to participate, you'll have a better outcome than if you're compelled.

Amy Gorin is looking for ways to make students and others on campus feel like their concerns are heard, and then working with them to find ways to bring them into compliance. But she's trying to take a pragmatic approach.

And so that may be figuring out what, you know, if it's they don't like to wear masks because they're uncomfortable, they can't breathe, you know, whatever the particular barrier is, working with them to eliminate those barriers or to understand how their behavior choice impacts those around them. So finding those sources of motivation that we can leverage so that they make healthy behavior change.

They're also trying to head off any issues with a student ambassador program.

So if they're out and they see someone not wearing a mask, we're training them to have some language around how to encourage people to adopt that behavior.

Shame may seem like an obvious tool, but research shows it can easily backfire. Instead, they're trying an approach that reminds students of the wider community.

The message of personal health may not be as motivating to young adults as it might be for other demographics, but what was really motivating was, was the message of keeping campus open and that we all need to be in this together.

So the administration created a new initiative called the UConn Promise.

So part of our UConn Promise is a promise of allyship and compassion. So recognizing the twin pandemics that we're facing right now with COVID and systemic racism, and we are encouraging our entire community to make a pledge to each other. To, as I said, be an ally for marginalized groups, and particularly those that have been disproportionately impacted by the pandemic.

Allison knows that her son is going to have a very different freshman year than the one she and I had, but she thinks the kind of collective experience students have everywhere this fall, regardless of how or where they attend school, will be a defining one.

This is going to be their story and their story as a class. And for every kid who does go to campus this year and doesn't take a gap year and doesn't decide to stay online at home, which is a completely valid choice, this will be a story that bonds them together and a narrative that will only, I think, make their shared experience a stronger one between them.

She thinks about when her father was in college in the late '60s and how that was another time of great unrest in this country. Her father also had health issues that limited his college experience.

And so I kind of tell my son, like, you're sort of having the same experience that your granddad did. And granddad always talks about those experiences with fondness, not with, like, just, you know, depression or discouragement or sadness, he says, you know, we had— our class had a really unconventional end to our college career, but it was ours, and it's our story, and that class is extremely bonded. So I'm trying to look at it and reframe it as this is not what we expected, it's not what we envisioned, it's not what we had, but it will be His. And whatever it is, that is valid and that is special too. So it doesn't have to be bad. It can be okay and it can be good. It's really about how we approach it.

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