COVID-19 won’t respond to wishful thinking. Why Cal Poly’s reopening plan is risky

Cal Poly recently reported that over 5,000 students will return to its dorms starting next week — 60% capacity.

University-based COVID-19 outbreaks demonstrate the challenges of students returning to campus. Within one week, UNC Chapel Hill’s positivity rate jumped from 2.8% to 13.6%, while Notre Dame’s reached 16% (5% is considered acceptable); both are now exclusively online and UNC Chapel Hill sent all students home. University of Alabama added 560 new COVID-19 cases its first week and Notre Dame 403.

What is Cal Poly doing to ensure that its outcome will be different?

Sadly, in my opinion as a Ph.D. in public health, I don’t believe it’s doing enough. The reopening strategy on its website appears haphazard and ill-defined. Only symptomatic students or those concerned about exposure can access testing at the on-campus health center, without acknowledgment that youth have the highest levels of asymptomatic transmission.

As of Aug. 25, Cal Poly requires residential students to provide a negative COVID-19 result from no more than 72 hours before arrival, placing the onus on students in a state where obtaining rapid testing is a challenge. Students exposed to COVID-19 are directed to self-quarantine, but there is no explanation of how meals will be provided; the university is “in the process” of developing an Isolation and Quarantine Support Team, but offers no additional detail.

Students should wear personal protective equipment when leaving their dorm room, but there is no mention of who will supply this, especially given existing shortages among some medical professionals, or details about logistics (e.g., using the bathroom). There is no mention of on-campus visitor policies or how the university will increase ventilation within its buildings.

While Cal Poly will provide information at an upcoming town hall, students begin returning next week. In order to open safely, Cal Poly must present an in-depth plan with metrics and details that will ensure the safety of students, staff, faculty and SLO County residents. Based on public health models and research, Cal Poly needs to:

Accept the fact that these are students

Cal Poly’s plan is overly reliant on students to self-control. Research shows students will not stay isolated in their rooms, eat and study by themselves, give up partying and shun the attraction of sex. Young people face a different risk calculation than adults: They are at lower risk of COVID-19-related complications but higher risk of poor mental health outcomes, which social isolation exacerbates.

Even so, dozens of universities have reopened, and then suspended hundreds of students for socializing — on and off-campus. While university honor codes may help, they can also force a potentially lonely student to choose between meeting new friends or ‘snitching’ on an off-campus gathering.

My work in HIV/AIDS demonstrates the need for a harm-reduction approach that meets youth where they are. When youth are shamed for a risky behavior, that behavior is driven underground and they become reluctant to share relevant information. Cal Poly must create an environment in which students feel safe to test and engage in contact tracing without fear of repercussions.

Test early and often

Actual COVID cases are likely 10 times higher than reported; based on California’s weekly case rate, approximately 70 arriving students will be COVID-positive.

Like UC Berkeley, every residential student should be tested upon arrival, quarantined for one week, and then retested. This process must reoccur every time a student leaves the county (e.g., for a family event). Cal Poly plans to test only exposed and symptomatic students, but 50-80% of youth cases are asymptomatic.

To mitigate coronavirus outbreaks that would shut down in-person classes, modeling studies from Harvard show that universities should test all students, staff and faculty every three days, return tests within 24 hours, and include daily symptom checks, an approach used by the University of Illinois.

Cal Poly should also follow UC San Diego’s approach and conduct weekly sewage tests, which can identify asymptomatic cases. In sum: Cal Poly must commit the logistical and financial capacity to rapidly conduct thousands of daily tests.

Quarantine and isolation

To avoid spread, all exposed and infected students must quarantine for two weeks with meal delivered to their dorm rooms, a logistical challenge — in numerous institutions, demand for isolation beds quickly outstripped supply. Cal Poly’s reopening plan fails to clarify whether the on-campus clinic is able to treat COVID-positive students and, if so, in a way that does not expose others. Students who require local care and hospitalization may impact SLO County’s capacity to treat its own residents, and slow the county’s phased reopening — slowing the return of local businesses.

Transparency

Like other universities, Cal Poly must provide publicly available daily updates on the number of tests conducted (overall and per day), positive cases, exposed cases, positivity rates and where the infections occurred (e.g., which dorm or fraternity) as this affects the safety of everyone on campus and in our community. Cal Poly must also clarify ahead of time which metrics would require dorms to shut down and how students would return home.

Wishful thinking will not make Cal Poly safe to reopen.

UNC Chapel Hill and Notre Dame moved on-line within one week of opening, while Columbia, Harvard and Penn State are not letting students return to campus. Cal Poly faculty have written an open letter asking students not to return. Much like SLO County, in order to safely reopen, Cal Poly must achieve certain benchmarks.

Unfortunately, however, Cal Poly’s current reopening plan fails to outline how it will create an environment that will promote students’ emotional and physical safety, along with the well-being of staff, faculty and community members.

Morgan Philbin was born and raised in San Luis Obispo and comes from a family with over 10 Cal Poly graduates and faculty. She is an Assistant Professor of Sociomedical Sciences at the Columbia University Mailman School of Public Health in New York City where her research focuses on individual behaviors and infectious disease transmission in communities.

This story was originally published August 26, 2020 at 12:53 PM.