SARS-CoV-2 Viral and Serological Testing When College Campuses Reopen: Some Practical Considerations

Abstract

The coronavirus disease 2019 (COVID-19) pandemic prompted universities across the United States to close campuses in Spring 2020. Universities are deliberating whether, when, and how they should resume in-person instruction in Fall 2020. In this essay, we discuss some practical considerations for the use of two potentially useful control strategies based on testing: 1) SARS-CoV-2 RT-PCR testing followed by case-patient isolation and quarantine of close contacts, and 2) serological testing followed by an “immune shield” approach; i.e., low social distancing requirements for seropositive persons. The isolation of case-patients and quarantine of close contacts may be especially challenging, and perhaps prohibitively difficult, on many university campuses. The “immune shield” strategy might be hobbled by a low positive predictive value of the tests used in populations with low seroprevalence. Both strategies carry logistical, ethical and financial implications. The main non-pharmaceutical interventions will remain methods based on social distancing (e.g., capping class size) and personal protective behaviors (e.g., universal facemask wearing in public space) until vaccines become available, or unless the issues discussed herein can be resolved in such a way that using mass testing as main control strategies becomes viable.

Seroprevalence Study and Cross-Sectional Survey on COVID-19 for a Plan to Reopen the University of Alicante (Spain)

“…In Spain there is no consensus among the different regions, and at the central government level only very general recommendations have been made. Even now, scientific publications are only just starting to appear with discussions, considerations, and modeling of possible preventive strategies and their cost-effectiveness when it comes to reopening the university [ 8 , 14 , 15 , 48 ].…”

COVID-19 Prevention at Institutions of Higher Education, United States, 2020 – 2021: Implementation of Nonpharmaceutical Interventions

“…A majority of IHEs required facemasks indoors and outdoors wherever six-foot spacing could not be maintained. The encouraged or required use of facemasks has been consistently cited as a core NPI utilized by IHEs in response to COVID-19 (23, 24, 48, 49). Observational reports reveal high levels of compliance with facemask mandates on IHE campuses (25), and they remain an important measure for reducing SARS-CoV2 transmission, especially in dense indoor settings.…”

Effects of Student Life on the Prevention of SARS-CoV-2 Spread at University

“…As we, UK university students, return to campuses this fall, we read the article "SARS-Cov-2 viral and serological testing when colleges reopen -some practical considerations" with interest. [2] The article considers multiple methods that can be used in controlling SARS-Cov-2 transmission in university campuses, like weekly mass testing, self-isolation and contact tracing. [2] This approach is supported by Griffiths et al (2020).…”

“…As we, UK university students, return to campuses this fall, we read with interest the article, “SARS-CoV-2 Viral and Serological Testing When Colleges Reopen – Some Practical Considerations.” 2 The article considers multiple methods that can be used in controlling SARS-CoV-2 transmission in university campuses, like weekly mass testing, self-isolation, and contact tracing. 2 This approach is supported by Griffiths et al 3 While these steps are important, and the authors provided an assumption that the social aspect of student life is a determinant of SARS-CoV-2 prevention outcomes, they do not explicitly detail the magnitude of the problem nor directly provide practical solutions to address this predicament.…”