Return of students may double COVID-19 infections in university towns
Research recommends aggressive testing strategy
LONDON, Ontario – September 22, 2020 - A new study projects that the return of university students can lead to a doubling of infections over a single semester in mid-sized communities with previously low levels of COVID-19 activity. More than two-thirds of infections attributable to the return of the university students occur in the general population, leading to increased COVID-19 hospitalizations and death.
The new research paper, titled Impact of university re-opening on total community COVID-19 burden, is publicly available on the pre-print repository medRxiv.
Researcher and lead author, Lauren Cipriano, Associate Professor of Management Science at Ivey Business School, who is also cross-appointed to the Department of Epidemiology and Biostatistics at Schulich School of Medicine & Dentistry, said the findings are important to public health decision-making, and suggests that mass and high-frequency testing of students can really make a significant difference.
The research, funded by the Western University Catalyst Research Grant and a grant through Johns Hopkins University, uses a model of COVID-19 transmission and hospital resource utilization in London, Ont. as a representative mid-sized city with a relatively large post-secondary student population. This model identifies the number of infections expected in the university student population, the general population, and long-term care residents, with and without the return of the university student population, and incorporates a dynamic population response to increased cases, hospital utilization, and COVID-19 mortality in the community. The model confirms the findings of other studies, indicating that high-frequency testing of students, such as every five days, can reduce the number of infections attributable to the return of university students by more than 40 per cent in some scenarios.
To the research authors’ knowledge, this is the first study to evaluate the impacts of high rates of COVID-19 transmission among university students on the community in which the university is located and the first to evaluate the benefits of a potentially more feasible, one-time testing event following a surge in social activity on campus.
University students live, work, and socialize both on and off campus, creating significant potential for transmission spillover into the community. According to the researchers, if students return to school, it is critical for the community to adopt high levels of protective behaviours, including mask-wearing, limits to the sizes of social gatherings, restrictions on the types of businesses that can open, and the implementation of an aggressive testing strategy for the community.
“The choices communities make around what types of businesses to open, diligent masking, and the amount of physical social interaction will determine the feasibility of maintaining essential activities like in-person primary and secondary education and continued access to elective surgeries,” said Cipriano. “Fortunately, university students are an identifiable high-transmission group and our research shows that even a one-time mass screening event early in the term can identify asymptomatic infections and influence the transmission trajectory.”
High-frequency screening in a large student population is challenging. Unique to this work, the authors evaluated the benefit of a one-time mass screening event at the end of September. Identifying and isolating a large fraction of asymptomatic infections in the student population all at once can interrupt transmission and reduce community spillover. Mass testing can provide information about the prevalence of infection in students, which can guide future decision-making. Given the recent surge in cases and demand for testing across Ontario, testing for prevention requires enhanced co-ordination.
“We have a limited opportunity to make a significant difference in the course that this virus will take in our community, and the time for a coordinated mitigation event is now,” says Dr. Wael Haddara, study co-author and Chair/Chief of Critical Care Medicine at London Health Sciences Centre. “As authors of the study, we are hopeful that we can work together to build on the strong partnerships that are already in place between the city, university, public health, primary care, long-term care, and the hospitals, to bring our evidence-informed mass screening solution to practice.”
A copy of the paper can be found here: https://www.medrxiv.org/content/10.1101/2020.09.18.20197467v1
Research funding:
This work was supported in part by the Gordon and Betty Moore Foundation through Grant GBMF9634 to Johns Hopkins University to support the work of the Society for Medical Decision Making COVID-19 Decision Modeling Initiative (co-PIs: Cipriano and Enns) and by a Western University Catalyst Research Grant (PI: Cipriano). Cipriano is supported by the David G. Burgoyne Faculty Fellowship. Greg Zaric is supported by the J. Allyn Taylor and Arthur H. Mingay Chair in Management Science.
About the researchers:
These findings result from new collaborative research from Drs. Lauren Cipriano, and Greg Zaric at the Ivey Business School, Dr. Wael Haddara, Chief of Critical Care for London Health Sciences Centre and St Joseph’s Hospital, and Dr. Eva Enns at the University of Minnesota School of Public Health.
Dr. Lauren Cipriano, the study’s lead author, is an Associate Professor of Management Science at Ivey Business School and in the Department of Epidemiology and Biostatistics at Schulich School of Medicine & Dentistry.
Dr. Wael Haddara is the Chief of Critical Care for London Health Sciences Centre and St Joseph’s Hospital and an Associate Professor of Medicine at the Schulich School of Medicine & Dentistry.
Dr. Greg Zaric is a Professor of Management Science at Ivey Business School and in the Department of Epidemiology and Biostatistics at Schulich School of Medicine & Dentistry.
Dr. Eva Enns is an Associate Professor in the Division of Health Policy and Management at the University of Minnesota School of Public Health.