Impact of University Re-Opening on Total Community Covid-19 Burden

Abstract

Purpose: Post-secondary students have higher than average contacts than the general population due to congregate living, use of public transit, high-density academic and social activities, and employment in the services sector. We evaluated the impact of a large student population returning to a mid-sized city currently experiencing a low rate of COVID-19 on community health outcomes. We consider whether targeted routine or one-time screening in this population can mitigate community COVID-19 impacts. Methods: We developed a dynamic transmission model of COVID-19 subdivided into three interacting populations: general population, university students, and long-term care residents. We parameterized the model using the medical literature and expert opinion. We calibrated the model to the observed outcomes in a mid-sized Canadian city between March 1 and August 15, 2020 prior to the arrival of a relatively large post-secondary student population. We evaluated the impact of the student population (20,000 people arriving on September 1) on cumulative COVID-19 infections over the fall semester, the timing of peak infections, the timing and peak level of critical care occupancy, and the timing of re-engaged social and economic restrictions. We consider multiple scenarios with different student and general population COVID-19 prevention behaviours as well as different COVID-19 screening strategies in students. Results: In a city with low levels of COVID-19 activity, the return of a relatively large student population substantially increases the total number of COVID-19 infections in the community. In a scenario in which students immediately engage in a 24% contact reduction compared to pre-COVID levels, the total number of infections in the community increases by 87% (from 3,900 without the students to 7,299 infections with the students), with 71% of the incremental infections occurring in the general population, causing social and economic restrictions to be re-engaged 3 weeks earlier and an incremental 17 COVID-19 deaths. Scenarios in which students have an initial, short-term increase in contacts with other students before engaging in contact reduction behaviours can increase infections in the community by 150% or more. In such scenarios, screening asymptomatic students every 5 days reduces the number of infections attributable to the introduction of the university student population by 42% and delays the re-engagement of social and economic restrictions by 1 week. Compared to screening every 5 days, one-time mass screening of students prevents fewer infections, but is highly efficient in terms of infections prevented per screening test performed. Discussion: University students are highly inter-connected with the city communities in which they live and go to school, and they have a higher number of contacts than the general population. High density living environments, enthusiasm for the new school year, and relatively high rates of asymptomatic presentation may decrease their self-protective behaviours and contribute to increased community transmission of COVID-19 affecting at-risk members of the city community. Screening targeted at this population provides significant public health benefits to the community through averted infections, critical care admissions, and COVID-19 deaths.

COVID-19 anxiety and uncertainty of classes: Devastating effect on students’ academic behavior and performance

“…Due to COVID-19, students felt a high level of anxiety and underwent depression, insomnia, and stress, which was also proved in the study of Dangal and Bajracharya (2020). As a study result of Cipriano et al (2020) students hardly find themselves comfortable in an online class and it does not replace classroom teaching. This study also justified the findings of Snipes and Tran (2017) that online exams will increase anxiety.…”

“…Students opined that they missed classroom chit-chat due to class suspension and felt bored in an online class. Students were not able to concentrate on academic life, which causes a decrease in academic satisfaction which leads to lower academic performance (Cipriano et al, 2020;Akcil and Bastas, 2021).…”

“…There is a mixed opinion on the measurement of the academic performance of students. Some literature measured based on their exam score (grade point average or percentage) (Aristovnik et al, 2020;Cipriano et al, 2020;Faize and Husain, 2020;Sarah et al, 2021), and some literature considered other aspects such as extracurricular activities along with exam scores (Sarrot, 2020;Trammell, Ph.D. et al, 2021). Due to COVID-19, most of the extracurricular activities were suspended, and exams were cancelled in some universities.…”

MITIGATING THE 4th WAVE OF THE COVID-19 PANDEMIC IN ONTARIO

“…We extended a previously developed deterministic dynamic compartmental model of SARS-CoV-2 transmission that predicts health outcomes and resource use in a representative mid-sized city with a full-time population of 500,000 and an additional part-time academic year population of 50,000 post-secondary students [24]. We estimated model parameters, including the duration of time spent in each health state, the infectiousness of COVID-19, the probability of needing general and specialized hospital resources, COVID-19-associated mortality, the effectiveness of COVID-19 public health measures, and the effectiveness of vaccination using the peer-reviewed literature, pre-published reports, government reports, and expert opinion.…”

COVID-19 anxiety and uncertainty of classes: Devastating effect on students’ academic behavior and performance

“…Students' expressions of missing the informal classroom interactions, the camaraderie of classmates, and the dynamics of traditional in-person learning underscore the pandemic's impact. As illuminated by Cipriano et al (2020) and Akcil and Bastas (2021), the abrupt shift to online classes has been met with feelings of boredom and decreased concentration. These factors have collectively led to a decline in academic satisfaction, ultimately linked to reduced academic performance.…”