S1E41: Back to Campus / Allison Slater-Tate, Amy Gorin, Eleanor Daugherty, Rochelle Walensky

“If we want to bring students back to college, we have to redefine what college is for the short term… and so we need to think about it with more innovation and depth of thought if we would if we were just applying crisis management models.” —Eleanor Daugherty, Associate Vice President for Student Affairs and Dean of Students at the University of Connecticut

The college experience will look very different for many students gearing up to re-enter schools in the fall. How can colleges prepare to bring students back on campus — if at all? Today, we hear from Eleanor Daugherty, Associate Vice President for Student Affairs and Dean of Students at the University of Connecticut; Dr. Amy Gorin, Professor of Psychological Sciences at UConn; Dr. Rochelle Walensky, Professor of Medicine at Harvard Medical School; and journalist Allison Slater Tate, about the logistics and planning required to safely resume school in the fall. They discuss social distancing and masking policies on campus, potential scenarios for testing, and the effect this will all have on students’ college experiences.

This podcast was created by Just Human Productions. We’re powered and distributed by Simplecast. We’re supported, in part, by listeners like you.

Celine Gounder: I’m Dr. Celine Gounder. And this is “Epidemic.” Today is Tuesday, August 4th.

This is our second episode looking at education during the pandemic. In our last episode, I spoke with my friend Allison Slater Tate, who was about to send one of her sons off to college for the first time.

Allison Tate: Things are changing by the day, and as a college counselor, I felt a little bit like a Debbie Downer for the past few months, because I, I do not feel great about colleges bringing kids back to campus this fall, honestly. And I was very skeptical that it was going to be able to happen.

Celine Gounder: Universities and colleges are starting to announce their plans for the fall as we record this episode… and some may change their plans again in the coming weeks. But it’s clear that many schools will welcome students back to campus this fall… at least in some form. Allison says she understands why people want to get back to campus.

Allison Tate: We’re paying a lot of money. And our kids are really excited and they’ve worked really, really hard and they want to go to college where they have campus experience, which is so much a part of the college experience.

Celine Gounder: But that experience—whatever it looks like—is going to sound pretty strange to anyone who’s been a freshman living on campus. All of her son’s classes will be online. All sports have been canceled. No clubs. No social events. But he will get to live in a dorm.

Allison Tate: He will have the experience of a communal bathroom, which I’m not sure is a bonus. And he will get to meet some of the administrators and the staff of his residential college at his college. And that’s about it.

Celine Gounder: And as a parent, Allison has another motivation to send her son away to college during a pandemic… his safety. Allison lives just north of Orlando, Florida, where cases of COVID have been spiking for weeks now. Her son is going to school in New Jersey, which, for now at least, is having a better experience with the virus.

Allison Tate: The best thing I can say about it is he might be safer than he is here. And, that’s how I feel about that.

Celine Gounder: There’s a lot of ways schools—from kindergartens through colleges—are approaching what the fall is going to look like. I just want to say we’re not endorsing any one plan here. Now, that being said, in this episode we’re going to take a deep dive into how one school is approaching education this fall with a hybrid model of in-person and remote learning: The University of Connecticut. Eleanor Daugherty is the Associate Vice President for Student Affairs and Dean of Students at the University of Connecticut. UConn is one of the universities that is bringing students back to campus this fall.

Eleanor Daugherty: If we want to bring students back to college, we have to redefine what college is for the short term. And so we need to think about it with more innovation and depth of thought than we would if we would if we were just applying crisis management models.

Celine Gounder: Crisis management helped UConn salvage the spring semester. But as the administration considered what to do for the upcoming academic year, they went back to basics.

Eleanor Daugherty: The purpose is education and connection.

Celine Gounder: But health and safety concerns in the time of COVID meant they had to ask a new question:

Eleanor Daugherty: How do we completely recalibrate given the world we’re living in right now rather than flip a switch and go online and say we got it.

Celine Gounder: The University of Connecticut didn’t have to look far to get some guidance on how to do this.

Amy Gorin: What we have is a grand challenge. COVID presents an unprecedented challenge to our colleges and our universities across the nation about you know how to minimize risks to our students, faculty, and staff, while at the same time, doing all the things that a good university does: maximize learning, support research, prioritizing the physical and mental health of our student body.

Celine Gounder: This is Amy Gorin. Amy’s a Professor of Psychological Science at UConn, and the Director of the Institute for Collaboration on Health Intervention and Policy. As the pandemic took hold of the spring semester, her Institute was suddenly in high demand.

Amy Gorin: My research focuses on behavioral management of obesity and myself and several colleagues work in fields such as weight management, HIV prevention, substance use, treatment, and we realized that we had a lot of insight to offer to the conversation about potentially reopening campus.

Celine Gounder: Amy and her colleagues surveyed thousands of students about their expectations and concerns for the fall.

Amy Gorin: And, we heard lots of different questions and concerns. You know, there were certainly many safety concerns that students shared about the fall semester. There was a strong desire to return to campus among many of our students. A lot of our students wanted flexibility. That was incredibly important. They either felt strongly about coming back to campus or felt strongly about wanting to have quality online options available.

Celine Gounder: Students had emotional concerns, too.

Amy Gorin: We also heard that the pandemic has been hard on many of our students. It’s taken them away from their college experience, there’s a sense of loss over what they’re missing out on. And there’s a real desire to return to some sense of normalcy.

Celine Gounder: Students wanted to get back to campus. Amy and her colleagues asked themselves how they could do it safely. They conducted focus groups to try to understand the ways students would—or, would not— adhere to new policies and safety regulations. Many students were worried that others would not wear masks at parties and other social gatherings; That they’d wear them in class, but once outside, all bets would be off.

Amy Gorin: They also express concerns about shame. You know, if they test positive, what will that mean for their social circle? Will they get their friends in trouble? Will they themselves get in trouble if they’ve been at a larger gathering? And so there’s just a lot of questions, even though they do want a sense of normalcy, which I think we all want, our students do express concerns about how that may actually happen.

Celine Gounder: So, using Amy’s research, they started mapping out what the university would look like this fall. The first step was to figure out classes. Eleanor Daugherty, the dean of students, says professors decided if they wanted to offer in-person or online courses.

Eleanor Daugherty: And then students choose based on the normal online course registration process. It’s just that those online courses now have designations when the student registers, so they know it’s not an in person class.

Celine Gounder: Any students who chose to take an entirely digital schedule got something like a 10% cut in tuition. But about 8,000 of the school’s 20,000 students chose to come back to campus this fall. And so, the next challenge was housing.

Eleanor Daugherty: So that’s meant reducing housing capacity by about 30%. So that’s meant putting new expectations in place for students like wearing masks, maintaining distancing, reporting symptoms.

Celine Gounder: The changes will be obvious as soon as students get to campus. They’ll get tested as soon as they move in. And then they’ll be expected to quarantine.

Amy Gorin: And the idea is not that they will come to campus and have to sit in their dorm in solitary confinement for two weeks, which would be completely unrealistic, but that we’re creating in these pods, and sort of these family units that they can socialize with.

Celine Gounder: The university looked to the students to pitch in with ways to make the quarantine as painless as possible.

Amy Gorin: So they made suggestions about online trivia and scavenger hunts and, and other things that they could do that would still be relatively low risk, but allow them the opportunity to see some of their friends and in the case of incoming students, making new connections. Even some requests to offer some programming during that period, could they start their classes online a little bit earlier. Are there any research experiences that they can engage in during those two weeks so that they, you know, just had a little bit more structure to their day.

Celine Gounder: At the end of the quarantine, the idea is to return to a campus life as close to normal as possible. But things will definitely be different.

Eleanor Daugherty: For a Division I school to rethink community is a big ask, right? We’re not all going to crowd into an athletic event now. We need to think about it differently.

Celine Gounder: The university’s 600 student-led organizations will be permitted to hold their usual events and meetings, so long as they stay within state-mandated guidelines for group gatherings.

Eleanor Daugherty: And then the university hosts programming as well, and we’ll continue to do so. We’re just reducing the scale of the size of our program and where they happen, more outside than inside.

Celine Gounder: But having a somewhat normal college experience comes with a price. Once you’re in the campus bubble you have to stay in the bubble. And there are consequences if students don’t follow the rules.

Eleanor Daugherty: The health and safety procedures are tied to the potential for conduct and potentially being removed from housing if you don’t follow them. And students are aware that they are governed by the student code of conduct as well. And certainly if there was, you know, repeated and restless behavior that would endanger the health of others, we would look to the code for enforcement. I want to make sure as we bring students back to campus, we’re not creating that false comfort. I came with a negative to everything fine, right? It’s the extensive surveillance, it’s following quarantine, that I think is going to be the only way for us to get through an academic term.

Celine Gounder: Testing is going to be a key part of that surveillance effort. But what testing looks like at different colleges and universities will vary. The resources available to small liberal arts colleges and public institutions aren’t the same as what the nation’s most elite universities will have at their disposal. This past week, a team from Harvard and Yale released a study modeling what testing would have to look like to keep students, faculty and staff safe. Dr. Rochelle Walensky was one of the researchers.

Rochelle Walensky: The question became how frequently testing would have to happen and what kind of test you would need in order to keep the kids safe and in order to have a residential environment be a safe environment.

Celine Gounder: They found that if students practiced social distancing, but didn’t wear masks…

Rochelle Walensky: They probably need to test every two or three days in order to keep people safe.

Celine Gounder: If they wore masks all the time, including in their dorms…

Rochelle Walensky: They might only need to test weekly.

Celine Gounder: And if they acted as though the pandemic didn’t exist… just went about life as though everything were normal…

Rochelle Walensky: If that were the case, then we really said daily testing would need to occur.

Celine Gounder: The team analyzed various tests, too, to determine what type of test would be needed to keep a college campus safe.

Rochelle Walensky: What we found in that piece of the analysis is that actually if you’re testing frequently, you’d much rather have a rather insensitive test but something cheap that you could do every day, every other day. So I would rather have something that’s only 70% sensitive that I might be able to do every other day than some gold standard that’s going to take nine days to return.

Celine Gounder: Even in a best-case scenario, Rochelle says, any on-campus testing program is going to be difficult.

Rochelle Walensky: There’s an enormous logistical load to try and be able to do this, both in terms of getting kids tested, ensuring that they’re accurately collecting samples, getting them their test results and then sort of doing the appropriate contact tracing and rapid isolation that might be necessary.

Celine Gounder: Rochelle’s model was based on a mid-size college… institutions with roughly 5,000 students. She’s quick to add though that at a school with a larger student body—say, UConn, for example—the logistics will be an even greater challenge.

Rochelle Walensky: It really is this dance between ensuring that the behavior is in place to make sure that whatever testing program that you have in place is going to be enough to capture all the cases that are going to be out there.

Celine Gounder: Regardless of the size of the campus, there are no guarantees. Especially when it comes to this coronavirus, which can spread rapidly between people with no visible symptoms.

Rochelle Walensky: We looked at many different scenarios where all you would do is testing based on symptoms and in each of those scenarios we were very worried that you could not create a situation that would control outbreaks if you were just simply testing on symptoms alone, and I think that was actually a really important insight that we had from this model.

Celine Gounder: But Eleanor says testing like that is not going to be realistic at a school as big as UConn.

Eleanor Daugherty: When you are a large university, it is difficult to routinely test every single one of your students and adopt that as a surveillance model.

Celine Gounder: So UConn plans to conduct symptomatic testing as well as random testing in 5-10% of the residential student population.

Eleanor Daugherty: That’s a manageable way for a large university with limited resources to fulfill, I think, an obligation to surveillance and awareness for the health of the broader community.

Celine Gounder: Inevitably, some students will get COVID. When this happens, the university will carry out contact tracing to see who else was exposed. And the infected student will have to be isolated.

Eleanor Daugherty: For students who test positive, they will be able to go home if they can convalesce comfortably at home. We have a large in-state population, so that could be something that is what they prefer to do. If not, we’ve identified several beds on campus that will be used specifically for medical isolation, for us to separate a positive student from the community until they recover. And they’ll have meal delivery, daily telemedicine, symptom checking, all the medical care that will be necessary until they recover.

Celine Gounder: Eleanor says they’ll be paying close attention to testing and any cases that appear.

Eleanor Daugherty: The nice thing is we’ll get these signals because we’re after responsible for medical care for our students. So we’ll see the tipping point, and we’ll see ourselves moving closer to it.

Celine Gounder: And if, there’s an outbreak, they will change their plans for the semester.

Eleanor Daugherty: When we start using up isolation beds rapidly and not being able to effectively contain infection on campus, then we need to start signaling to university leadership that we’re not sure how much longer we can stay open.

Celine Gounder: Plans are important. But in a few short weeks, UConn and other universities that have opted to bring students back to campus are about to find out if all their plans will work in real life. A survey from The New York Times found that more than 6,600 cases of COVID have been reported at universities and colleges across the United States since the beginning of the pandemic. That includes 112 cases in the University of Connecticut System. With a majority of states showing increasing numbers of cases as summer ends, it’s going to be an uphill battle for any institution with students on campus to control the spread of coronavirus. But ultimately, it’s up to students to follow the rules. And Eleanor thinks they have a good reason to do so.

Eleanor Daugherty: Students care about going back to college. It’s very important for them to come back. They don’t want us to close again.

Celine Gounder: It’s like what former U.S. Secretary of Education Arne Duncan said in the previous episode: the goal isn’t just to reopen school. The goal is to keep schools open.

Eleanor Daugherty: So if we make that choice to come back, we must in turn, make a choice to care for each other by following the measures we’ve put in place.

Celine Gounder: And the university is going to try to leverage that desire to keep students safe and in compliance with the rules.

Eleanor Daugherty: If you’re inspired to participate, we’ll have a better outcome than if you’re compelled.

Celine Gounder: Amy Gorin is looking for ways to make students and others on campus feel like their concerns are heard and then working with them to find ways to bring them into compliance. But she’s trying to take a pragmatic approach.

Amy Gorin: And so that may be figuring out what they don’t like to wear masks because they’re uncomfortable, they can’t breathe, you know, whatever the particular barrier is, working with them to eliminate those barriers or to understand how their behavior choice impacts those around them. So finding it sources of motivation that we can leverage so that they make healthy behavior change.

Celine Gounder: They’re also trying to head off any issues with a student ambassador program.

Amy Gorin: So if they’re out and they see someone not wearing a mask, we’re training them to have some language around how to encourage people to adopt that behavior.

Celine Gounder: Shame may seem like an obvious tool, but research shows it can easily backfire. Instead, they’re trying an approach that reminds students of the wider community.

Amy Gorin: The message of personal health may not be as motivating to young adults as it might be to other demographics. But what was really motivating was the message of keeping campus open and that we all need to be in this together.

Celine Gounder: So, the administration created a new initiative called the UConn Promise.

Amy Gorin: So part of our UConn promise is a promise of allyship and compassion. So recognizing the twin pandemics that we’re facing right now with COVID and systemic racism, and we are encouraging our entire community to make a pledge to each other, to, as I said, be an ally for marginalized groups and particularly those who have been disproportionately impacted by the pandemic.

Celine Gounder: Allison knows that her son is going to have a very different freshman year than the one she had. But she thinks the kind of collective experience students will have everywhere this fall, regardless of how or where they attend school, will be a defining one.

Allison Tate: This is going to be their story and their story as a class. And for every kid who does go to campus this year and doesn’t take a gap year and doesn’t decide to stay online at home, which is a completely valid choice, this will be a story that bonds them together and a narrative that will only, I think, make their shared experience a stronger one between them.

Celine Gounder: She thinks about when her father was in college in the late sixties, and how that was another time of great unrest in the country. Her father also had health issues that limited his college experience.

Allison Tate: And so I kind of tell my son, like you’re sort of having the same experience your granddad did. And granddad always talks about those experiences with fondness, not with, like just, you know, depression or discouragement or sadness. He says, you know, we had our class had a really unconventional end to our college career, but it was ours and it’s our story. And that class is extremely bonded. So I’m trying to look at it and reframe it as this is not what we expected. It’s not what we envisioned. It’s not what we had, but it will be his and whatever it is, that is valid, and that is special too. So it doesn’t have to be bad. It can be okay. And it can be good. It’s, it’s really about how we approach it.

Celine Gounder: “Epidemic” is brought to you by Just Human Productions. We’re funded in part by listeners like you. We’re powered and distributed by Simplecast.

Today’s episode was produced by Zach Dyer, Danielle Elliot, and me. Our music is by the Blue Dot Sessions. Our interns are Sonya Bharadwa, Annabel Chen, and Julie Levey.

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And check out our sister podcast “American Diagnosis.” You can find it wherever you listen to podcasts or at americandiagnosis.fm. On “American Diagnosis,” we cover some of the biggest public health challenges affecting the nation today. In Season 1, we covered youth and mental health; in season 2, the opioid overdose crisis; and in season 3, gun violence in America.

I’m Dr. Celine Gounder. Thanks for listening to “Epidemic.”