再小心也无法阻止感染，美国高校疫情形势严峻

The best laid plans of colleges and universities are no assurance during a public health crisis.

University administrators tell Fortune they’re doing everything they can to ensure public safety. But at schools like the University of Alabama system, which resumed in-person classes in August, cases have risen considerably. That school system has seen nearly 2,600 COVID cases across campuses as of Sept. 10.

The first week of college is supposed to be a time of celebration and the launch of the next chapter in your life, but students across America are facing a truly bizarre entry into the world of higher education as universities grapple with the coronavirus pandemic.

Logistical problems—and downstream social consequences for students themselves—abound. And depending on which school one attends, the processes for dealing with COVID can be wildly divergent, as evidenced by students and school administrators across the country who spoke with Fortune.

“I left the Harvard Global Health Institute after 16 years to become a dean at Brown’s public health school recently,” Ashish Jha, a physician and health policy researcher who previously served as director of the Harvard Global Health Institute, tells Fortune.

This gives Jha a unique perspective. He’s a public health expert and doctor by training—but also an expert in epidemics and critic of America’s response to the COVID crisis. And in his new role as a college dean, he can speak to what does and doesn’t work in this bizarre timeline.

“I think every college and university will see some cases and some outbreaks. The question will be: Will they be small and manageable and they can go on, or will you have to shut down and go online indefinitely?” Jha tells Fortune.

Here’s the issue: A university can’t exactly rely on personal responsibility—something that politicians and college administrators alike have played up in the midst of the pandemic—to be the single course to safety.

“The problem is that a lot of universities are acting like the only thing you can rely on is behavior change on the part of students without calling out the responsibility of the universities themselves,” says Jha.

With COVID cases spiking in communities surrounding colleges, such as Johnson County, Iowa, the area around Washington State University, and the Alabama county containing Auburn University, individual schools’ approach to and enforcement of public health measures could spell the difference between new local outbreaks and a safe, if strange, new form of learning.

Divergent testing strategies

Nick didn’t even get to visit the University of Colorado at Boulder campus before showing up there a few weeks ago; a planned trip to campus got scuttled during the outbreak’s heyday in his hometown of New York City. The 18-year-old freshman, who asked to use only his first name for privacy, had to have a lot of his belongings mailed over to campus from across the country.

Before he left for college, Nick received a coronavirus test—one of the ones requiring a nasal swab—at a CityMD location in New York. He informed them that he was a student and received results back pretty quickly, within two days, before getting on the plane.

He was tested again on campus on Aug. 31 using the University of Colorado’s own proprietary COVID test developed at a campus lab. With this test, called RT-LAMP, you can simply spit into a tube and get results within 45 minutes, an easy way to identify asymptomatic individuals. Family members or guests helping students move in face a separate set of restrictions, such as allowing only one guest to enter a hall and requiring them to vacate after a set time.

Students moving into dorms also take a so-called PCR test, which takes longer to process but is more accurate in identifying an active infection. If the rapid response test comes back positive and the PCR test result hasn’t been returned yet, the student would be put into an isolation facility, according to a university spokesperson. Those who live off campus but may need to come to campus are encouraged to go to a health clinic for free testing if they show any symptoms.

The spokesperson points to the university’s live COVID dashboard as a means of controlling coronavirus spread and keeping the student body informed.

The university is also using another novel technology to monitor cases: wastewater testing—the literal testing of waste, which can detect coronavirus prevalence on a community level.

And that has shown how difficult it can be to control COVID outbreaks even with stringent testing and safety requirements. Testing information released on Sept. 2 revealed potential outbreaks at four University of Colorado at Boulder dorms, bringing the number of confirmed on-campus cases up to nearly 40.

“The next few days will be critical to our ability to maintain our current operating status,” the university’s associate vice chancellor Dan Jones wrote in a letter to students on Sept. 2, warning that cases could spike in the coming weeks. “It is imperative that we all continue to follow public health orders, avoid large gatherings, wear masks, and practice physical distancing.”

The situation has grown more dire since then. On Sept. 15, Jeffrey Zayach, executive director of Boulder County Public Health, urged all University of Colorado at Boulder students to self-quarantine for two weeks despite the school’s innovative measures.

“Boulder County Public Health has been closely monitoring the case counts and outbreaks among students, faculty, and staff associated with the University of Colorado at Boulder campus,” he wrote. “In the past two weeks 663 Boulder County residents have tested positive for COVID-19; 502 of these residents were associated with CU students (76% of all cases). The majority of CU Boulder cases come from off-campus students.”

Other schools depend more on students to conduct tests for themselves. At Chapman University in Southern California, students are given a self-administered nasal swab test that is then sent to a commercial laboratory in a partnership with diagnostics giant LabCorp.

“We sent out the procedure at the beginning of August. Everybody—staff, faculty, and students have to take a training module that we provide online: an explanation of precautions and what you have to do. And no one is allowed back on campus until we’ve certified that they’ve taken this module,” Chapman president Daniele Struppa tells Fortune.

The school has been working with Pixel, an arm of LabCorp that specializes in mailing at-home diagnostics, and says the coronavirus tests are free of charge to students. “You have to log in. They send you this test. There’s a prepaid FedEx package that you send,” Struppa says.

Those who live off campus and don’t plan on coming back to visit campus to, say, hang out with their friends don’t have to get tested. And despite Struppa’s emphasis that the school has been in clear and early communication about expectations, Chapman senior Emma Brown says there’s still some confusion.

“I’m a little unclear on all of it. Throughout summer they were sending us e-mails suggesting there would be some sort of hybrid model where some classes are virtual, some are in person. There would have to be temperature checks and social distancing at campus buildings,” says the 21-year-old.

Classes are currently all online, though Brown suspects there may come a time when the idea of a hybrid model is possible.

There’s also the ever-present matter of how long it takes a test such as the LabCorp one to come back. The company says it currently takes, on average, 24 hours to 48 hours.

Samantha Hager at Wesleyan University in Connecticut faced some confusion of her own: “Prior to coming, they were pretty confused about what they were going to do. They gave us all the option to defer for the whole semester. We could go to classes remotely from our homes or from our dorm rooms.”

Wesleyan also looked into whether or not students were moving onto campus from areas with high rates of COVID; those students were required to arrive two weeks before classes started in order to self-isolate. Students from lower-risk areas were required to arrive one week before classes began.

Hager received one test before heading to school from Brooklyn and then was required to take another one as soon as she arrived on campus: “I immediately went to a testing tent, and that was required of me before they gave me the key to my dorm.” Both of the tests she took were of the nasal swab variety, although the one she took on campus was self-administered. Since she’s not from a high-risk area, she only had to quarantine until Sept. 7.

A significant shift in college culture—for some

College students have a reputation for hanging out in groups and attending the occasional party. Meeting people in person in classes is its own form of socializing.

“I can hear people outside yelling and stuff. It’s a party school, and I’m not partying right now,” says Nick, the University of Colorado student. He can only have people from his own dorm building over to his room.

Of his six classes, five are completely virtual. The sixth has optional in-person attendance with required distancing. That comes with its own dilemma—what if a professor’s Wi-Fi goes out? Students may not be compelled to wait to deal with technical difficulties.

“I’m happy I’m not a freshman right now because I think that my dorm experience is something I never would have wanted to give up. But now I live in an apartment with my girlfriend,” says Brown, the Chapman senior. “But it’s still pretty isolating to be in my apartment 24/7. It’s pretty hard to make new friends.”

Hager says that things are relatively calm, without major parties, as far as she’s seen at Wesleyan. “There have been, like, two or three from what I’ve heard, but I haven’t seen it. But, I mean, I’m part of a Facebook group for my class, and a lot of Wesleyan upperclassmen have been complaining about kids, like freshmen, going around asking for parties.”

This semester has only just begun for America’s nearly 20 million college students. How these schools respond to a situation that’s still very much in flux, even at the most cautious campuses, could determine whether or not we see another massive nationwide spike in the coronavirus outbreak in the next weeks and months.