How will colleges and universities respond to on-campus infections this fall?
Previously I have posited three scenarios that describe how academic institutions might proceed during the COVID-19 pandemic. One of them, Toggle Term, outlines a semester wherein campuses switch from some kind of face-to-face operations to wholly online instruction, echoing the March 2020 switch to remote education.
What would have to happen for an administration to decide to throw the switch? What criteria need to be met for a Toggle event? And will that threshold be openly published?
To get started, the essential Robert Kelchen gives us all this prompt to consider:
If I was a college president, I would be crafting a plan that tied on-campus operations to data on coronavirus cases among the college community and in the surrounding area. Some of the metrics would include:
- Number of known cases among students and employees
- Number of known cases in the county
- Capacity to quarantine on-campus students
- Available space in local hospitals (beds, ICU space, and ventilators)
- Fatalities could be a measure, but it is probably too gruesome to include even though all deaths may be impossible to avoid
A very good start for discussion.
What real-world examples are available now? So far most institutions have not openly proclaimed their Toggle intentions, as I’ve noted over the course of the summer. Which makes some practical sense, since such a proclamation might scare off on-site enrollment.
Yet we can find hints in college and university publications. Undergrad student and research fiend Benjy Renton found one precedent from Florida A&M, dated to late June. In it three or more infections would trigger some kind of unspecified administrative response.
— Andy Thomason (@arthomason) June 25, 2020
Elsewhere, a recent Wall Street Journal article by Melissa Korn and Douglas Belkin notes several potential Toggle triggers. First, for students: “100 new infections a day has been discussed as one measure for triggering a renewed shutdown.” That’s for Texas A&M University, which enrolls around 69,000, meaning a threshold of about 0.14% of the population.
Second, a trigger for faculty members: “‘If it was 100 professors a day, it would be game over,’ [Michael Young, president of Texas A&M University] said. ‘We can’t lose 20% of professors and continue to run the university.” Going by Wikipedia, 100 profs is about 2% of that campus’ professoriate.
Korn and Belkin found several others. Syracuse University has a set of tiered options based on rising infections by multiples of 10: 1-10 infected, 11-100, more than 100. The >100 level is actually two tiers, one with “moderate” confidence in identification and tracing, and other with low confidence. Only the latter amounts to a Toggle. More than 100 infections with moderate tracing yields this response:
i. Impact on Campus Operations: This scenario may require the curtailment of operations in select programs or areas, but falls short of a campus-wide response. The objective is to reduce ongoing exposures by scaling down specific programs, buildings, and areas. Select programs move back into an online-only environment with non-resident students staying off campus, resident students staying in their rooms and non-essential affected employees working from home.
ii. Impact on Residential Life: Known exposures to quarantine, potentially in bulk (e.g. entire building or more). Infections move to isolation. Others shelter-in-place (stay and study in their rooms).
Note that these numbers are from the entire population, not broken down by profession or sector.
Also in the Korn and Belkin article is another Texan example. The University of Texas-Austin cites “student death” as an event that “will result in a discussion of closure, partial closure or on-campus reduction.” I think that’s one student death, singular, based on the phrasing.
UT adds other “considerations” with more detail than I’ve seen elsewhere:
Employee absenteeism with focus on critical areas such as environmental services (ability to maintain a safe, hygienic campus)
Increases in percent positives in testing…
Personal protective equipment (PPE) shortages impacting ability to test and care for COVID-19
Inability to adequately test for COVID-19 due to supply chain issues (e.g., collection kit, processing reagents)
Clusters: If the activity from clusters overwhelms our ability to quarantine/isolate and contact trace; Number, location and type of cluster (cluster in a single hall versus multiple, widespread)
Positive tests in excess of predicted model
Upward trajectory of ILI and COVID-19 syndromic surveillance within a 14-day period over baseline rates
Upward trajectory of documented cases or percentage of positive tests (with flat or increasing volume of tests) for 14 days
Increasing cases of community transmission (no known source) in student population
Degradation of containment capabilities
Note this subheader for the first item: “Acknowledges possible under-reporting by faculty and staff and serves as a marker for illness.”
The University of Washington case suggests a higher threshold for a Toggle. They endured nearly 140 infections, almost all in fraternity houses, and still maintain a blended (albeit 80% online) fall plan.
On a related note, the NCAA shared its criteria for “the Discontinuation of Athletics”:
A lack of ability to isolate new positive cases or quarantine high contact risk cases on campus.
Unavailability or inability to perform symptomatic, surveillance and pre-competition testing when warranted and as per recommendations in this document.
Campuswide or local community test rates that are considered unsafe by local public health officials.
Inability to perform adequate contact tracing consistent with governmental requirements or recommendations.
Local public health officials stating that there is an inability for the hospital infrastructure to accommodate a surge in hospitalizations related to COVID-19.
On the other hand, maybe we really can’t offer such criteria now. David Feldman argues that we can’t set any such criteria at this point:
I haven't, but that's not a big surprise. The factors that might lead to a toggle are complex and they interact. Also, unforeseen changes in the environment (testing options, treatment options) could make a hash of any pre-commitment to a specific set of toggle criteria.
— David H Feldman (@dhfeld1) July 6, 2020
Or the threshold should be very low indeed. I’m haunted by Tressie McMillan Cottom’s tweet:
2. It is better for institutions to die than for people to die and it is unconscionable that anyone in a position of authority should suggest otherwise.
— Tressie McMillan Cottom (@tressiemcphd) April 26, 2020
I can follow up as I learn more.
Are any of you seeing such Toggle criteria?