The Tricky Business Of Coronavirus Testing On College Campuses
MADDIE SOFIA, HOST:
You're listening to SHORT WAVE from NPR. Hey, everybody. Maddie Sofia here with NPR education reporter Elissa Nadworny. Welcome, Elissa. First time on the show.
ELISSA NADWORNY, BYLINE: Hi. I can't. I like - seriously, I've been wanting to be on this show for so long. I'm really glad to be here.
SOFIA: Yes, our time has come, Elissa, finally. Here we are. All right. I know that you and your producer, Lauren Migaki, are in the middle of a kind of college coronavirus road trip, visiting campuses all over the country during the pandemic. What have you been seeing, Elissa?
NADWORNY: So we've been to more than a dozen colleges in nine different states. And one thing that we've seen everywhere is coronavirus. Every college we visited has had cases.
SOFIA: Makes sense. Yeah.
NADWORNY: And we started at the University of Georgia, watching students move in. And in that week, we had traveled north to the University of North Carolina, Chapel Hill, where they had had outbreaks on campus and were shutting everything down. So there we watched students move out of the dorm.
SOFIA: Yeah, OK. All right. So how are they approaching testing?
NADWORNY: Well, the biggest difference has been testing for coronavirus. So I'm speaking here for campuses that are in person. The majority of colleges are only testing students who feel sick or who think they've been exposed. And that's in line with what the CDC had recommended.
SOFIA: Right. Right.
NADWORNY: But there are a lot of issues with only testing students if they feel sick.
DAVID PALTIEL: We looked at thousands of scenarios. We didn't, in our mathematical model, find a single, plausible circumstance where that strategy would be sufficient to contain an outbreak. You can't play catch up with this virus.
NADWORNY: That's David Paltiel, a public health expert at Yale. He's one of the experts we've been checking in on as we've gone through this road trip. He did research that showed that colleges should be testing multiple times a week if they're going to reopen campuses. And when I told him what we were seeing, he was kind of frustrated and a bit baffled.
PALTIEL: A school that tests in response only when symptoms have been observed is a fire department that responds only to calls when the house is already burnt to the ground.
SOFIA: Yeah, I mean, that's a poignant and accurate and disturbing metaphor, Elissa.
NADWORNY: Yeah, it's apt and also very scary.
SOFIA: Yeah. I mean, it is true, right? Testing works better when there's a ton of it and it's random so you have a chance to catch some of those asymptomatic cases.
NADWORNY: Right. And every epidemiologist we spoke to and lots of folks at colleges said if you want to see how they're doing this, where they're testing the most, you've got to go to the University of Illinois at Urbana-Champaign.
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SOFIA: So, Elissa, you're taking us to Illinois today?
NADWORNY: That's right. You're coming on our road trip, Maddie.
SOFIA: So this episode, we look at how one university is trying to stop the spread of the coronavirus - what worked, what didn't and what we can learn from it.
NADWORNY: Buckle up.
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SOFIA: Today, we're looking at how one university is tackling the coronavirus, the University of Illinois at Urbana-Champaign.
UNIDENTIFIED PERSON #1: Pleased to meet you.
SOFIA: Elissa, this is a really big campus, right?
NADWORNY: Yeah, they have about 30,000 undergrads and it's massive and beautiful and green and kind of like exactly what you think college looks like from the movies. Except this year, of course, it's a little different. You know, everyone's wearing masks on campus when you're walking around.
NADWORNY: And there's all these signs to promote mask wearing and social distancing. There's the great one that says it's a great day to practice smizing. Do you know what that means?
SOFIA: Smile with your eyes, scream with your heart, am I right?
NADWORNY: (Laughter) Yeah. But the big thing that I noticed on campus is that there are all these big white tents everywhere. They're COVID testing centers.
UNIDENTIFIED PERSON #2: Have you had anything to eat, drink, smoke...
NADWORNY: The campus actually started with 17 places where you can get tested. So students go every few days to get tested.
UNIDENTIFIED PERSON #2: Can you confirm your name and date of birth?
NADWORNY: And they're using saliva tests.
UNIDENTIFIED PERSON #3: So what you'll do is you'll take your mask off, you'll open up the test tube and you will drool into the test tube. And you want to - the more the better.
EMILY GARTI: My mouth is dry but the hardest part always. I always think of lemons and it makes, like, me have more saliva in my mouth.
SOFIA: Well, now my mouth is full of saliva, Nadworny. Thank you.
NADWORNY: I mean, students told us that it was really hard to, like, muster up all the spit.
NADWORNY: That was Emily Garti. She and her classmates are part of this massive experiment. It's basically like become just a part of life. It's like so normal there.
GARTI: Right when I wake up, I put it in my schedule of things I need to do for the day, and COVID testing is the very first thing on that list.
SOFIA: So, Elissa, are they testing every student, like, whether or not you have symptoms - all of them?
NADWORNY: Yeah, that's right. They're testing undergrads, staff, grad students, everybody on campus.
NADWORNY: And students need a negative result from that test to get into buildings on campus and to go to class.
NADWORNY: So it's, like, baked into the fabric of daily life.
SOFIA: Wow. I mean, Elissa, that is - I have not heard of this before, the fact that you need to get a negative test to go to class. That is wild. Like how are they doing this? I'm, like, confused on, like, how you could do all of this.
NADWORNY: Yeah. So, I mean, they're doing so many tests a day and they're able to do it because they developed their test in-house. They process their tests at the vet lab. They've repurposed to focus on these tests.
SOFIA: Mmm hmm.
NADWORNY: They're working pretty much 24/7 to get the results back. So they're able to get them back so fast, like, because they're literally working at 3 a.m. in the lab. Like, they're cranking this stuff out.
NADWORNY: And when we were there, some days they actually did about 2% of all the testing in the U.S. done right on the campus.
SOFIA: Wow. That is wild. OK, OK.
NADWORNY: It's wild. Yeah.
SOFIA: So they're testing a lot like, you know, more than I think anywhere else it sounds like. What does that mean for controlling the virus? Are they able to have, like a relatively COVID-free semester their first semester?
NADWORNY: Well, that's what they were hoping. I mean, in just under two weeks of classes, there were more than 700 positive COVID-19 cases on campus.
SOFIA: Wow. That - I mean, that's a lot.
SOFIA: Probably more than they anticipated, I imagine.
NADWORNY: That's about what their original models had predicted for the entire semester.
SOFIA: I mean, I guess I'm not really surprised, though. It's a really big university.
NADWORNY: Yeah. And it didn't surprise the students we talked to. We happened to be on campus when this kind of big spike happened and the school announced a lockdown. So we went to the quad to kind of see what students thought. Here's a freshman that we talked to named Noelle Johnson.
NOELLE JOHNSON: Like, when I came to U of I, I knew it was, like, known as a party school. So I knew that just because we were going to be testing a lot didn't mean that they were going to stop partying. So they're doing their best to keep everyone safe. But it's just - the system can't work if the people aren't working with it.
SOFIA: So they put all of this money into testing. Did the university really not factor in that the students would be partying or what?
NADWORNY: So they did anticipate partying. Becky Smith, the epidemiologist leading the reopening plan, she explained that really, they just didn't anticipate something else.
REBECCA LEE SMITH: So it's not necessarily partying. We accounted for the fact that students will party. We just assumed that they wouldn't party knowing that they were infected and infectious.
SOFIA: Oh, OK. So kids found out they were sick. They were still partying.
NADWORNY: That's right. Yeah. And in one case that they actually publicized, they said a student hosted a party while positive. And this really worried Smith because, you know, she was afraid that if she didn't see improvements after they locked everything down, she'd have to recommend that they closed campus.
SMITH: Everybody was, this is an amazing test. This is wonderful. We want the test. We want the test. But testing is not enough.
NADWORNY: So the one thing that Smith said was if you have a test and it doesn't inform what you do, it doesn't change your behavior, then it's not a worthwhile test, which is really funny coming from Smith because the human choice part of infection control, it's actually a new issue for her. She normally works at the vet school. So much of her work has been controlling disease in cattle.
SMITH: So it can be mathematically similar. The only difference is that cattle generally don't make their own decisions about if they're going to follow guidelines or not.
NADWORNY: So big difference. You know, cows don't get invited to keggers.
NADWORNY: That's my favorite thing to say. But, you know, even with rogue student behavior, mass testing did allow them to catch the spread on campus before it became a crisis.
SMITH: Other places are seeing the tip of the iceberg. We're seeing the whole iceberg and it's big. But we know that it's not just the tip. We know we're finding all the cases.
NADWORNY: And what they found is that more than 95% were undergrads. And they also found that it's not really spreading in classrooms where everyone's masked and socially distanced. It's happening at parties and gatherings.
SOFIA: Yeah, I mean, that's the power of testing and contact tracing, right? It helps you find out not just, like, how many people but, like, truly the how.
SOFIA: So Elissa, what do they do with all of this information? Like, what did they do?
NADWORNY: So, you know, the lockdown is a pretty big strategy. And actually, a number of universities are using this two-week time to kind of shut down the campus and get this thing under control.
NADWORNY: They say don't hang out, don't go out, like, just sit tight. And at Illinois, they did beef up contact tracers, including hiring a bunch of students.
OLIVE: Hi, this is Olive (ph) calling from the Champaign-Urbana...
UNIDENTIFIED PERSON #4: Calling from Champaign-Urbana public health district with some important information. Please call us back at 217...
NADWORNY: They are now making sure that students are contacted within 30 minutes of those positive results so they know what to do next. We got to see the contact tracers make these calls at the local public health department.
UNIDENTIFIED PERSON #5: OK. So you've pretty much been keeping yourself in the quarantine on your own. Good.
SOFIA: Yeah, I mean, we've talked about contact tracing before on the pod. When it's done right, it's an extremely helpful tool.
NADWORNY: Yeah, exactly. But again, you can have all the testing and contact tracing you want, but you have to get people to change their behavior. They need to isolate and they need to quarantine, like we were talking about before.
SOFIA: Yeah, I mean, that sounds like it'll be their real challenge - right? - like, getting people to follow through.
SOFIA: But I am curious, did lockdown and increasing contact tracers help out at all?
NADWORNY: Yeah, the numbers went down. I called Becky Smith to get an update. She said the restrictions were really helpful. Before the lockdown, they were seeing about 100 or 200 positive cases a day. Now they're averaging about 25 cases a day. So it's still more than they'd like, but it's a big improvement.
SOFIA: Right, yeah. I mean, that's certainly better. And, you know, all of this is really intense. And I have to imagine there's some lessons here for other colleges, but it doesn't seem easy to pull off. Like I have to imagine this has been extremely expensive.
NADWORNY: Yeah, no, it's not cheap. And remember, they even developed their own test, right? So it's actually much cheaper than many other tests that campuses are using. It's only about $10 a test.
SOFIA: Right, right.
NADWORNY: But think about how many tests they're doing for the whole semester. It could end up being more than $10 million by the end of fall.
SOFIA: Oh, my God. OK. But here's the thing, Elissa, like why do this? Like, I would argue until our case numbers are under control, there's no safe way to open up in-person college campuses.
NADWORNY: Yeah, absolutely. I hear you. Public health officials have told me, if you can't open in a way that keeps the virus under control, you shouldn't be open, you should be online. But college administrators have told me that if they can't get the university going, we're not going to be able to get society going. And there's this attitude that in-person learning is better and that they really have to do kind of whatever they can, whatever it takes to figure out how to make this work. And, you know, there is a risk to not opening - mental health, student safety, development, especially for young people.
MARTIN BURKE: We can't miss a generation of young people, right? These are the future leaders of our world. So, you know, they're inheriting our future.
NADWORNY: We talked to Martin Burke about this. He's a chemistry professor and the person who led the efforts to do campus testing. I think regardless of whether or not you think it's a good idea, universities are opening.
NADWORNY: So now that we're about halfway through the fall semester, we are learning about what's working. And Dr. Burke and the University of Illinois say they want to make their experiment work and they want to be able to be a model for other campuses trying to do the same thing.
BURKE: Our mission, you know, we are a land grant institution, so our charge is do something good. You know, with fast frequent testing, it can make a difference. And, you know, I think that's the best thing that we could do as - beyond our own borders at UIUC. If we can be an example and show that it can work, that can be extremely powerful.
NADWORNY: You know, despite all the ups and downs and the lockdown at the university, folks around the country are taking note. You know, they're looking to the University of Illinois to learn how they can better implement testing programs.
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SOFIA: OK, Elissa Nadworny, thank you for taking us on the road with you. We appreciate you.
NADWORNY: I'm so glad to be here, really.
SOFIA: This episode was produced by Lauren Migaki and Rebecca Ramirez. Viet Le did the editing and Ariela Zebede checked the facts. I'm Maddie Sofia, the host of SHORT WAVE from NPR.
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