Last week, Notre Dame University announced that it would open for the fall semester — with some caveats. The university, located in South Bend, Indiana, has about 8,600 undergraduate students enrolled who will attend classes on a revised semester schedule to mitigate the spread of coronavirus. The semester will also end prior to Thanksgiving break, so as not to ask students to to risk their health with increased travel between home and campus.
The announcement comes at a time when the future of higher education is uncertain: some college and university systems, like California State University, have announced that they're taking all of their classes online come August. Other institutions, like Radford University in Virginia, have rolled out a college reopening plan similar to Notre Dame's, which calls for increased opportunities for remote learning, an extended "reopening process," and phasing faculty and staff back onto campus.
The American College of Health Advisors (ACHA) issued guidance that serves as a baseline blueprint for reopening. The extensive document offers insight about how to house students, treat them when they're sick, and maintain some semblance of a normal collegiate experience, even while current events are far from normal.
Opening up campuses for in-person learning and student activity won't look the same at all universities. A wide range of variables, from undergraduate size to flexibility of university housing to state rules regarding the management of the pandemic, will uniquely dictate if and how individual colleges are able to host students. Michael Huey, a past president of the ACHA and former associate professor of family and preventive medicine at Emory University School of Medicine, says that there is no one single path for restarting higher education. "Each of the campuses has to work very closely with their leadership team and with their COVID-19 planning and response committees," Huey tells Mic.
"There isn't a college or university that will be open without accepting risks. Those risks need to be identified, understood, and mitigated."
On the macro level, the ACHA guidance calls for an overhaul of how courses are taught and how students are housed. The organization suggests that campus administrators institute widespread and available testing as well as contract tracing measures to effectively manage the risk of community spread, Huey says. It's the "responsibility of leadership to set a plan that is flexible and can respond to circumstances," he says. "There isn't a college or university that will be open without accepting risks. Those risks need to be identified, understood, and mitigated."
Some of the suggested public health precautions are frequent hand-washing and widespread usage of face masks, which Americans are already largely familiar with and, as safety measures, are comparatively easy to implement. More difficult to execute, especially for larger campuses, is the guidance that suggests students have their own dorm rooms and access to their own single-use bathrooms. But Sarah Van Orman, the chief health officer of student health at the University of Southern California, says that the 1,600 students who remained on campus during the spring semester navigated the new pandemic-induced procedures well.
USC has about 30 different "restart" teams that are all interconnected, Van Orman says, working to develop strategies for how academic, housing, athletic, and general student life will continue in the fall. Student government leaders also play a role in developing guidelines for campus life, which Van Orman says is a critical part of being "transparent about how the fall is gonna be different. Part of it is being honest with students before they come."
ACHA guidance calls for "prioritization" of in-person instruction for classes that can't be taught easily online, like musical performance, art, or laboratory courses. Other courses that can be taught remotely or already make use of online models in some way, should continue as planned. Van Orman says that USC is working to devise a "hybrid model" of teaching, and much like the varied strategies of tackling coronavirus across universities, individual classes at USC will adjust based on their own unique needs — it "isn't a one size fits all" solution, Van Orman tells Mic.
How students eat on campus is also an area of concern, she says. Cafeteria-style dining with buffet options poses a public safety risk, as hundreds or thousands of students would be handling the same serving utensils and taking food from communal containers. As a solution, Van Orman says that USC has implemented a grab-and-go option for students, which has cut down on the risk of community spread.
Faculty, staff, and students living off campus are potential vectors for coronavirus, as are visitors to campus. After all, just like any other resident of a city in the United States, people come and go and bring germs with them. College and university "campuses are a high-touch congregate setting," Huey says, and as such, he believes that universities have to be prepared for isolating and quarantining any student who has a possible or confirmed coronavirus infection. The institutions must also be ready to supply that student with the necessary medical assistance and health care and additionally be equipped to trace the virus's route to campus. Given what we know about coronavirus — its incubation period of five days; the ability for it to be transmitted through asymptomatic carriers, who are typically younger; the variation in symptoms — college campuses are uniquely primed for viral spread.
Larger research universities might have an advantage over smaller institutions when it comes to testing. At the University of California at San Diego, university leaders implemented a method of self-testing for coronavirus for the 5,000 students on campus for the spring term. Angela Scioscia, the chief medical officer of UCSD Health, says that the institution's research and laboratory capacity allows them to devise ways for their community to test for and track potential infections. The goal is to scale testing to meet the needs of the tens of thousands of students, faculty, and staff in the fall.
As of now, Scioscia says that the university is preparing to test students on a monthly basis come fall, depending on what the conditions are. The university will also test wastewater and surface water for the virus, which will allow administrators to track the disease in ways other than testing patients for infection. Scioscia is the first to acknowledge the unique advantages available to UCSD: "We have the benefit at UCSD of incredible scientific modeling. We have that talent and expertise in our own team."
"I've worked as a college health leader for almost 20 years [and] been through a lot of potential pandemics. Campuses have actually been more on the frontline with this than other institutions."
Dictating health standards and guidelines isn't limited to the academic aspect of college life, and it's not even limited to campus in particular. Van Orman of USC says campus leaders on the "restart" team have "regular calls with the [Los Angeles County] health department," noting that the two have an "intricate inner relationship."
Still, it's hard to plan for what the fall semester looks when the conditions change day to day. As Van Orman says, it's hard to give good public health advice when we're all still learning critical information about the virus's characteristics. But she says that higher education institutions may be well-positioned for navigating so many unknowns: "I've worked as a college health leader for almost 20 years [and] been through a lot of potential pandemics," Van Orman says, noting that she helped prepare for SARS, H1N1, and Ebola. "Campuses have actually been more on the frontline with this than other institutions."
Ultimately, guidance for opening schools back up in the fall is not a matter of preventing the virus from ever reaching campus, but preparing for an "inevitable" infection, says Huey. "You don't just make a decision to reopen: It has to be gradual and it has to be phased," he says. The changing nature of the pandemic and shifting guidance as to when testing (and maybe even a vaccine) will be widely available means that predicting what will happen months down the road is a tricky game to play.
"We just need to be sure that we are doing everything we can do now to protect ourselves and protect each other," Huey says. "It's our moral and ethical obligation to protect the health and safety of the people around us."