To safely reopen college campuses this fall, students need to be screened for SARS-CoV-2 infection every two or three days, finds a new study led by the Yale School of Public Health.
The research, published today inJAMA Open Network,comes asuniversities across the United States are grappling with whether and how to reopen for the fall 2020 semester. Residential campuses with their communal living and dining spaces, crowded classrooms, and populations of young adults eager to socialize pose a particular challenge. For many U.S. colleges, COVID-19 represents an existential dilemma: Either they open their doors to students in September or they face severe financial consequences.
Investigators led by Professor A. David Paltiel used epidemic modeling and cost-effectiveness analysis to assemble data on SARS-CoV-2 screening performance including frequency, diagnostic accuracy, turnaround time, and cost to design a monitoring program that would minimize cumulative infections and reduce strain on colleges isolation and quarantine capacities at a justifiable cost. With this new testing program, researchers found, most colleges would be able to prevent significant outbreaks of the disease.
It is possible to reopen U.S. residential colleges safely in the fall, said Paltiel, but it will require high-cadence screening in addition to strict adherence to masking, social distancing, and other preventive practices.
Researchers from Massachusetts General Hospital and the Harvard Medical School co-authored the study.
Two findings surprised the investigators. First, it is possible to screen too frequently. Too much screening overwhelms isolation facilities with false positive results, generating unnecessary expenditures, fueling anxiety, and undermining confidence in the ability of the university to keep its students safe, said senior study author Rochelle P. Walensky, chief of the Massachusetts General Hospitals Division of Infectious Diseases and professor at Harvard Medical School.
Second, the frequency of screening is much more important than the accuracy of the test. Testing every two days, even with a low-quality test (e.g., one the has a 70% chance of correctly detecting the presence of infection and a 98% chance of correctly detecting the absence of infection) will avert more infections than weekly testing with a higher-quality alternative (e.g., one that has a 90% chance of correctly detecting the presence of infection and a 99.8% chance of correctly detecting the absence of infection).
Due to the limitations on regulating student behavior on campus, it will not be sufficient for colleges to simply monitor students for the symptoms of COVID-19 and use signs of illness to trigger isolation and contact tracing, the researchers said.
You cannot move swiftly enough to contain an outbreak if you wait until you see symptoms before you respond, said co-author Amy Zheng of Harvard Medical School. This virus is too readily transmitted by highly infectious, asymptomatic, silent spreaders, especially if there might be sporadic parties that lead to outbreaks.
The researchers acknowledge thatthe findings of their study set a high bar logistically, financially, and behaviorally that may be beyond the capacity of many universities and the students in their care. Paltiel concedes that the analysis recommended protocolsmay not, in fact, befeasible. But, he adds, the adverse consequences of an outbreak will be disproportionately visited upon the non-student members of a college community its staff, faculty, and the more vulnerable members of the surrounding community.
Any school that cannot meet these minimum screening standards or maintain uncompromising control over good prevention practices has to ask itself if it has any business reopening, Paltiel said.
The study was supported by grants from the National Institutes of Health and the Steve and Deborah Gorlin MGH Research Scholars Award.
More here:
Students need to be tested every 2-3 days for colleges to safely reopen - Yale News
- "Shift Happens" - November 8th, 2009 [November 8th, 2009]
- Getting Started With Your Personal Statement - November 8th, 2009 [November 8th, 2009]
- I started this blog 1 year ago. I'm ready to become a medical doctor. - November 8th, 2009 [November 8th, 2009]
- Poll Results: "What is your GPA?" - November 8th, 2009 [November 8th, 2009]
- Why Ross University School of Medicine? - November 8th, 2009 [November 8th, 2009]
- Why Ross University? (Continued) - November 8th, 2009 [November 8th, 2009]
- Filling out applications with the last 4 years in mind. - November 8th, 2009 [November 8th, 2009]
- "Active and Passive Euthanasia" - November 8th, 2009 [November 8th, 2009]
- 300 Word Personal Statement - First Draft - November 8th, 2009 [November 8th, 2009]
- 300 Word Personal Statement - 2nd Draft - November 8th, 2009 [November 8th, 2009]
- "Where did you do EMT training at?" - November 8th, 2009 [November 8th, 2009]
- "is this jonathan that went to brazil in the summer of 2006?" - November 8th, 2009 [November 8th, 2009]
- First Application is Away - Ross University - November 8th, 2009 [November 8th, 2009]
- AMCAS—The American Medical College Application Service - November 8th, 2009 [November 8th, 2009]
- The Student Doctor Network - November 8th, 2009 [November 8th, 2009]
- Crime Incident - Public Safety Announcement: STUDENTS - November 8th, 2009 [November 8th, 2009]
- AMCAS Deadlines & Delays - Answered - November 8th, 2009 [November 8th, 2009]
- Headstart on Secondary Applications - The Student Doctor Network - November 8th, 2009 [November 8th, 2009]
- The Complete Medical School & Admissions Guide - Revisited - November 8th, 2009 [November 8th, 2009]
- Interview Status - Ross University - November 8th, 2009 [November 8th, 2009]
- Finished my first interview. - November 8th, 2009 [November 8th, 2009]
- "You have a 95% chance of acceptance..." - November 8th, 2009 [November 8th, 2009]
- "I was just wondering if I have to go to medical school i will have to start college allover again." - November 8th, 2009 [November 8th, 2009]
- Interview Feedback - Allopathic Medical Schools - Ross University School of Medicine (Dominica Caribbean) - November 8th, 2009 [November 8th, 2009]
- ACCEPTED! - November 8th, 2009 [November 8th, 2009]
- Step 1 Revisited - November 8th, 2009 [November 8th, 2009]
- A Few More Thoughts On Moving - November 8th, 2009 [November 8th, 2009]
- Update - November 8th, 2009 [November 8th, 2009]
- Closing In - November 8th, 2009 [November 8th, 2009]
- Internet/Computer Hell - November 8th, 2009 [November 8th, 2009]
- Back On The Net - November 8th, 2009 [November 8th, 2009]
- 1 More Day - November 8th, 2009 [November 8th, 2009]
- Loan Deferment Blog - November 8th, 2009 [November 8th, 2009]
- Graduated! - November 8th, 2009 [November 8th, 2009]
- What Happened? - November 8th, 2009 [November 8th, 2009]
- Interesting Case - November 8th, 2009 [November 8th, 2009]
- What Made Me Stupid? - November 8th, 2009 [November 8th, 2009]
- Blah. - November 8th, 2009 [November 8th, 2009]
- Call - November 8th, 2009 [November 8th, 2009]
- Medicine in the Media - November 8th, 2009 [November 8th, 2009]
- Was Medical School Worth It? - November 8th, 2009 [November 8th, 2009]
- Off I Go... - November 8th, 2009 [November 8th, 2009]
- Is It Worth It, Part 2 - November 8th, 2009 [November 8th, 2009]
- Oriented - November 8th, 2009 [November 8th, 2009]
- GLBT in Medical School - November 8th, 2009 [November 8th, 2009]
- GLBT in Residency Applications - November 8th, 2009 [November 8th, 2009]
- I Survived - November 8th, 2009 [November 8th, 2009]
- Reflections on the First Week - November 8th, 2009 [November 8th, 2009]
- All Good Things Must End - November 8th, 2009 [November 8th, 2009]
- The Lone Coyote is Back - November 8th, 2009 [November 8th, 2009]
- Pre-med student switches gears to teach in Chicago school - Chicago Tribune - March 8th, 2010 [March 8th, 2010]
- Old-school barbecue coming to spot near Fort Worth medical district - Fort Worth Star Telegram - March 8th, 2010 [March 8th, 2010]
- Nursing home drug use puts many at risk - Boston Globe - March 8th, 2010 [March 8th, 2010]
- Dr. Anita Figueredo, first female surgeon in San Diego, dies at 93 - Los Angeles Times - March 8th, 2010 [March 8th, 2010]
- Stimulus funds pay for monkey research in NC - MiamiHerald.com - March 8th, 2010 [March 8th, 2010]
- Medicine as an economic engine - Buffalo News - March 8th, 2010 [March 8th, 2010]
- UM medical school feels the squeeze - MiamiHerald.com - March 8th, 2010 [March 8th, 2010]
- HARVARD MEDICAL SCHOOL ADVISER Bell's palsy not as serious as it appears - Detroit Free Press - March 8th, 2010 [March 8th, 2010]
- Baylor medical school works to get back on track - Houston Chronicle - March 8th, 2010 [March 8th, 2010]
- From community college to Amherst College and Yale Medical School - WalletPop (blog) - March 8th, 2010 [March 8th, 2010]
- Man questions merit of coke monkey study - UPI.com - March 8th, 2010 [March 8th, 2010]
- School Board has questions it wants answered about onsite medical clinic - Terre Haute Tribune Star - March 9th, 2010 [March 9th, 2010]
- Stimulus Funds Pay for Monkey Research - NewsMax.com - March 9th, 2010 [March 9th, 2010]
- Babylon schools head: Teen's collapse unrelated to athletics - Newsday (subscription) - March 9th, 2010 [March 9th, 2010]
- Cost Of Medical School Rises In Recession - NPR - March 9th, 2010 [March 9th, 2010]
- Flu Shots in Children Help People of All Ages - New York Times - March 9th, 2010 [March 9th, 2010]
- A prescription for improving science education - Scope (blog) - March 9th, 2010 [March 9th, 2010]
- Live kidney donors do not die sooner: study - Reuters - March 9th, 2010 [March 9th, 2010]
- UW football player suspended after alleged assault - Seattle Post Intelligencer - March 10th, 2010 [March 10th, 2010]
- More Comparative Studies Needed to Guide Physicians Study finds less than a ... - ModernMedicine - March 10th, 2010 [March 10th, 2010]
- Conservationists worry about Mo. med school plan - KOAM-TV - March 10th, 2010 [March 10th, 2010]
- Dr. William D. Lynn - Baltimore Sun - March 10th, 2010 [March 10th, 2010]
- Suspect in North Dallas shootings became reclusive after parents died, family says - Dallas Morning News - March 10th, 2010 [March 10th, 2010]
- Drinkers Gain Less Weight - Harvard Crimson - March 10th, 2010 [March 10th, 2010]
- Long-Term Health Risks Low for Kidney Donors - WebMD - March 10th, 2010 [March 10th, 2010]
- School resource officer remains in critical condition - Middletown Journal - March 10th, 2010 [March 10th, 2010]
- New Lucian Leape Institute Report Finds That U.S. Medical Schools Are Falling ... - PR Newswire (press release) - March 10th, 2010 [March 10th, 2010]
- Dual degrees program expands for Mayo Medical School students - Post-Bulletin - March 10th, 2010 [March 10th, 2010]
- Comparative Effectiveness Research is a Must - TopNews United States - March 10th, 2010 [March 10th, 2010]
- Long Beach OKs medical pot ordinance - Contra Costa Times - March 10th, 2010 [March 10th, 2010]