A key component to colleges and universities being fully operational during the pandemic—including in-person learning—has been ample testing for COVID-19. Millions were administered at institutions in 2021, from mandatory swabs upon returns to campus to surveillance tests throughout the year.
Outside institution walls, appointments and tests have been difficult to procure nationwide, especially as the omicron variant has emerged. So as colleges start to bring students back (and some already have), will they be able to keep their testing momentum going even as public health experts predict further surges over the next few weeks?
The answer is likely yes at larger universities, especially those that conduct their own PCR tests and have labs on their campuses such as Arizona State University, which alone has surpassed one million tests since the start of the pandemic.
“There’s a lot of capacity. The challenge is taking in the samples and making sure to get the results back quickly,” says Mara Aspinall, a national health care leader and professor in the College of Health Solutions at Arizona State. “That’s even more important now with omicron. It becomes so much more contagious so quickly that if the results come back in four days, you’ve already missed the infectious period.”
Turnaround times have been far less than that even for tests done on-site, with results often coming within 48 hours and some the same day. Still, omicron’s transmission potential has raised some concern for smaller colleges that don’t have their own labs or rely partly on antigen/rapid tests, which are in shorter supply and costly to acquire. Gerri Taylor, the co-chair of the American College Health Association’s COVID-19 Task Force, expects there to be some challenges over the coming weeks.
“The ones who have fewer students there right now are able to test and have enough materials,” Taylor says. “However, come mid-January, I’m not sure whether they will. They’ll also need staff to do them or to facilitate the contact tracing, the isolation, the quarantining that’s going to come out of that.”
Supply and production issues have been noted by public health officials, business leaders and President Joe Biden, who promised the delivery of 500 million at-home rapid tests in January to curb the long wait times experienced by Americans. Their delivery is expected in the next week or so, according to White House officials. Many colleges have delayed starts or gone remote for a couple of weeks to try to ensure safer returns and avoid a potential storm of positive cases.
Yet, colleges have dealt with enormous challenges with the pandemic before, from handling small outbreaks to new variants such as delta to administering large amounts of tests.
“Almost all campuses have been back for more than a year now,” Aspinall says. “Omicron is putting more strain on the system, but it’s not like it’s the first time they would consider testing for COVID. They’ve been dealing with outbreaks and the potential need for testing. Some universities chose to test regularly. Some chose not to. But it’s not like this is all new.”
Some universities, blessed with an overabundance of testing capacity, have become hubs of delivery for their communities. Earlier this week, New York Gov. Kathy Hochul announced that 10 of the state’s universities plus Syracuse would be testing sites for the public. The University of Kentucky and Arizona State similarly have opened their doors to serve those outside of campus.
“The university wants to do everything it can to make it as safe as possible and as easy as possible for anyone and everyone,” Aspinall says. “ASU, like other universities, goes one step further because we’ve had a partnership with the state to provide community testing. We have the capacity in the lab, so let’s use it.”
The isolation question
Even with the availability of tests, there has been confusion about who should receive them, how frequently and whether those coming out of isolation should have to test or not. The Centers for Disease Control and Prevention late Tuesday added a recommendation for individuals to test after five days. That clarity should help institutions make more informed decisions, although colleges want additional recommendations. Next week, the ACHA is conducting two focus groups to assess the COVID-19 situation at colleges and will try to provide the CDC with more data.
“People are making different decisions and staff in health centers across the country are in a quandary over what to do,” Taylor says, referring to various reopening and mitigation strategies. “Even though not many students are back yet, at most colleges, they’re seeing high numbers of COVID. Colleges need guidance to go forward.”
Despite reports that omicron is less severe and has become the dominant strain in the U.S., there are still concerns that delta is lurking. Hospitalizations might be one indicator: they have risen in 35 states over the past two weeks. Large numbers of omicron cases are already putting additional strains on staffing at many businesses and schools. Isolation and quarantine are two major concerns. What should campuses do if they become inundated with positive results given omicron’s high transmissibility?
“If you have a huge number of cases, where do you isolate students and how long do you isolate them?” Taylor says. “Because it’s a congregate setting, should they be isolated for a longer period of time than they would be if they were in a home environment? I am a member of a group of college health directors, and there are about 40 of them. Some are testing in isolation on Day 5 and tests are still coming up positive. So they’re keeping them in isolation a little longer.”
Aspinall says some colleges that are short on isolation space could simply keep students in their dorms. “With omicron, I would say it’s a higher likelihood that a roommate might end up positive. And so it may be less important to go to an isolation dorm because the roommate very well might have it anyway.” The good news is, omicron appears to present far less severe outcomes than the delta variant, and the majority of students have done exceptionally well with COVID-19.
“If they have a high vaccination rate, then the number of young people who are vaccinated, who are hospitalized, is incredibly small,” Aspinall says. “Clearly, there will be spread on college campuses. However, with most healthy young people, the impact of omicron is muted. The question is, can you limit the spread? If there are people on campus who are much older, who are immunocompromised and not vaccinated, the key is making sure they are not exposed.”
Keeping campus communities informed is still essential. Aspinall lauded Arizona State for its continual communication throughout the pandemic, a key to keeping case counts low at a university that cannot install vaccine mandates because of a state ban. It also has testing 24/7 for students, staff and faculty.