Response to a COVID-19 Outbreak on a University Campus — Indiana, August 2020

Abstract

Institutions of higher education adopted different approaches for the fall semester 2020 in response to the coronavirus disease 2019 pandemic. Approximately 45% of colleges and universities implemented online instruction, more than one fourth (27%) provided in-person instruction, and 21% used a hybrid model (1). Although CDC has published COVID-19 guidance for institutions of higher education (2-4), little has been published regarding the response to COVID-19 outbreaks on college and university campuses (5). In August 2020, an Indiana university with approximately 12,000 students (including 8,000 undergraduate students, 85% of whom lived on campus) implemented various public health measures to reduce transmission of SARS-CoV-2, the virus that causes COVID-19. Despite these measures, the university experienced an outbreak involving 371 cases during the first few weeks of the fall semester. The majority of cases occurred among undergraduate students living off campus, and several large off-campus gatherings were identified as common sources of exposure. Rather than sending students home, the university switched from in-person to online instruction for undergraduate students and instituted a series of campus restrictions for 2 weeks, during which testing, contact tracing, and isolation and quarantine programs were substantially enhanced, along with educational efforts highlighting the need for strict adherence to the mitigation measures. After 2 weeks, the university implemented a phased return to in-person instruction (with 85% of classes offered in person) and resumption of student life activities. This report describes the outbreak and the data-driven, targeted interventions and rapid escalation of testing, tracing, and isolation measures that enabled the medium-sized university to resume in-person instruction and campus activities. These strategies might prove useful to other colleges and universities responding to campus outbreaks. * Students received an at-home nasal self-swabbing kit by express delivery, with a return mailer for the testing facility of a national commercial laboratory, where RT-PCR tests were performed, with results transmitted to the student and to University Health Services. † Protection of Human Subjects, 45 C.F.R. part 46.

Athletes Drive Distinctive Trends of COVID-19 Infection in a College Campus Environment

“…These data were an important factor in the decision to allocate our focus and resources on efforts that increase rapid surveillance testing of student-athletes, allowing us to make critical public health decisions with limited resources. However, we cannot entirely exclude the possibility that increasing the sampling frequency of other non-athlete populations could reveal a high COVID-19 incidence in our other campus environments, which has been documented at other institutions [ 4 , 5 , 6 ]. Thus, if resources allow, more frequent surveillance of all campus populations would be the optimal approach for fully understanding COVID-19 transmission patterns in all campus environments.…”

“…COVID-19 outbreaks are characteristic of university populations, as reported at other institutions across the United States [ 3 , 4 , 5 , 6 ]. This article is unique in that it follows patterns of COVID-19 infection over an entire academic year.…”

“…In August of 2020, a university in North Carolina recorded 670 new cases of COVID-19 within 22 days of reopening [ 4 ], resulting in the university transitioning all classes to online format. Similarly, an outbreak on a university campus in Indiana resulted in 371 new cases between 16–22 August 2020 [ 5 ]. This prompted the university to transition classes online on 19 August 2020 before returning to in-person instruction on 2 September 2020.…”

Assessment of a COVID-19 Control Plan on an Urban University Campus During a Second Wave of the Pandemic

“…Although many US higher education institutions reopened in fall 2020, some experienced large COVID-19 outbreaks, forcing a return to online-only education. [17][18][19] The BU experience is important because BU has an urban campus in a community that experienced high and increasing COVID-19 incidence from August to December 2020, with no option for the university to isolate from the wider community. Despite this, BU benefited from substantial resources, including funding to establish and run a SARS-CoV-2 testing laboratory and sampling centers, a hybrid learning approach (Learn from Anywhere), and diverse expertise among university employees in medical epidemiology, modeling, biostatistics, and public health control measures.…”

Feasibility and efficacy of mass testing for SARS-CoV-2 in a UK university using swab pooling and PCR

“…Multiple outbreaks of COVID-19 have occurred in higher education institutions, often associated with large social gatherings and student accommodation, in spite of infection control measures introduced to prevent viral transmission [22][23][24] . Amongst university students (typically, healthy young adults), the rate of asymptomatic infection is expected to be higher than in the general population 25,26 .…”