Hit or miss in virus testing
Outbreaks at schools statewide show inconsistencies in pandemic planning
Before Marian Milton’s granddaughter returned to SUNY Oneonta in August for her sophomore year, she made sure to get a coronavirus test in consideration of her roommate. “Fortunately, she was negative,” Milton said.
A week into the fall semester, the campus went “on pause” after 100 students were found to be infected with the virus. On Thursday, after screening 3,000 students, officials with the college
and the SUNY system announced that the tally of positive tests had risen to 389 and everyone would all be sent home for the remainder of the fall semester.
Officials blamed the outbreak on student parties and other irresponsible behavior, but Milton has her doubts. “Why didn’t SUNY Oneonta require every student to be tested before they could go through the gate?” she said. “I’m not an epidemiologist, but I question that 400 cases came about in the five or six days kids were on campus. I suspect that many youngsters came on grounds already unknowingly positive.”
The stunning outbreak at Oneonta and another that unfolded at University at Buffalo last week have exposed wide inconsistencies in mask enforcement, social distancing and testing protocols at New York colleges, including within the sprawling SUNY system.
The chain of events at SUNY Oneonta contrasts sharply with how the return to class has unfolded on the nearly adjacent campus of Hartwick College, where students were required to get tested twice — once right before and once after they arrive on campus — and then every other week until in-person classes end. Despite its proximity to SUNY Oneonta — students at both schools are allowed to cross-enroll in classes — Hartwick saw a very different outcome: As of Friday, only five Hartwick students have tested positive. As a precaution, the college moved classes online for two weeks.
“We want to take every step that we can now to stop possible further spread of the virus,” Hartwick President Margaret L. Drugovich wrote to students and employees.
Oneonta’s shutdown also contrasts with the experience of Binghamton University, the only SUNY campus that tested every residential student upon arrival — as they came through the gate, to borrow Milton’s phrase.
Securing the tests was not easy. Months ago, school officials anticipating product scarcity placed multiple orders for more kits than they expected to need. David Hubeny, executive director for SUNY Binghamton’s office of emergency management, called the aggressive procurement effort “a calculated risk.”
Only one of those orders — from a vendor the school had worked with for years — came through, but it got them the tests they needed.
Campus volunteers tested about 1,000 people per day for a week, and 28 came back positive. The infected students were then isolated in residence halls until they were cleared to resume normal activities. There’s been one positive test at the school since the Aug. 19-25 move-in week.
Binghamton has also been testing wastewater on campus as an early warning sign for outbreaks, and is building up a random testing program.
But despite numerous meetings and the establishment of task forces as well as guidance from the state Health Department, by early August few New York colleges and universities had the capacity to perform large-scale coronavirus testing. School officials are now discovering that “surveillance testing” — ongoing randomized testing of the student body to detect outbreaks early — may be the most effective way to prevent the asymptomatic spread of the highly contagious respiratory illness.
A number of private colleges, including Skidmore in Saratoga Springs, have announced partnerships with the Broad Institute, a collaboration out of the Massachusetts Institute of Technology and Harvard University for COVID-19 testing, but the service didn’t come cheap. Other partnerships fell through because of demand for COVID-19 tests in other hard-hit states.
In the final days before classes began, the Albany College of Pharmacy and Health Sciences managed to secure an antigen-based screening device that could process tests within an hour for students and faculty on its own campus and at the College of Saint Rose, Albany Law School, Russell Sage College and Maria College.
At those five schools, students were required to provide documentation of a negative test before arriving on campus. But each college purchased thousands of additional tests for students who show symptoms or think they have been exposed. Two
students at the College of Pharmacy tested positive pre-arrival; only one has been diagnosed with COVID-19 on campus.
Schools with extensive research facilities, including SUNY’S University at Albany and Rensselaer Polytechnic Institute in Troy, have been able to develop in-house surveillance testing protocols.
As more SUNY schools identified positive cases and saw students defying social distancing orders, newly appointed SUNY Chancellor Jim Malatras began to tour campuses to investigate disease prevention practices and talk up a surveillance testing program designed by a team of experts at SUNY Upstate Medical University.
On Friday, following questions from the Times Union, SUNY put out a press release announcing that the surveillance testing program would be made available to all 1.4 million students, faculty and staff at 64 campuses across the state. Upstate Medical had the capacity to test each student every two weeks, according to SUNY officials.
“By installing regular surveillance testing of our on-campus population, we will be able to much better identify non-symptomatic carriers who otherwise may not have known to get tested,” Malatras said in a statement.
Over the summer, the United University Professors union pressed SUNY leaders to require students to be tested before they arrived on campus, but campuses were allowed broad autonomy in designing their own reopening plans.
“I think what Malatras is trying to do is bring about consistency,” UUP President Fred Kowal said Friday. “Some (campus
“I’m not an epidemiologist, but I question that 400 cases came about in the five or six days kids were on campus. I suspect that many youngsters came on grounds already unknowingly positive.” — Marian Milton, SUNY Oneonta sophomore
reopening plans) went further than the minimal standards, but the real problem was the way those plans were rubberstamped back in July without really studying what the implications would be and where the plans were weak.”
In response to the
SUNY outbreaks, Gov. Andrew M. Cuomo announced that colleges will be required to return to remote learning for at least two weeks if there were 100 COVID-19 cases or if 5 percent of that institution’s population tests positive.
The state’s initial guidance for colleges and universities, released over the summer, offered baseline standards for social distancing and mask-wearing and recommended “at minimum” that students arriving from out of state be tested on arrival.
But by the time the state’s guidance came out, many colleges and universities had already spent months planning for how to have students safely come back to school.
As UUP’S Kowal noted, many schools have gone well beyond the state requirements and research colleges have innovated new surveillance methods, from wastewater analysis to “pooled” saliva-based tests that can screen multiple students at once.
Rensselaer Polytechnic Institute, for instance, will test every student upon arrival, require two weeks of quarantine for everyone, and then continue testing every undergraduate twice per week or after any time they leave campus.
RPI’S chemical and biological engineers established a lab to perform RTQPCR testing, a relatively rapid COVID-19 test that produces results within 24 hours, according to Leslie Lawrence, the school’s director of student health services.
The university nicknamed its health and safety protocols after a mathematical equation: T³SQ — for testing, tracking, tracing, surveillance and quarantine. (“Of course, because we’re a math and science school we have to have an exponent in our nickname for it,” Lawrence said.)
The school has done around 7,400 tests since Aug. 17 and anticipates conducting roughly 6,000 every week. Two RPI students have tested positive since the start of the semester, though one case was later determined to be a false result.
“We think we have a good chance of making it through November with a very rigorous set of protocols like this,” Lawrence said. “I hate to say (we’re) confident — I’m not going to say that out loud — but I think we have as good of a chance as making it as any university thanks to our very, very robust plan.”
Researchers at Ualbany have been studying the disease since March. A collaboration between two campus entities — the RNA Institute and the School of Public Health — has engineered a surveillance testing system similar to the Upstate Medical program.
All 20,000 students were required to submit a negative COVID-19 test before arrival. Faculty and students — whether they live on- or off-campus — will be tested at random at least three times each semester, according RNA Institute Director Andy Berglund, who in March shifted resources previously focused on muscular dystrophy in order to study how COVID-19 has mutated in the region.
The Ualbany test is selfadministered: Students spit into three test tubes, wipe down the exterior of each with disinfectant, and place the tubes in a biohazard bag, which can be turned in at 10 locations on the sprawling campus.
According to Berglund, the institute has already screened 15,000 students with tests that can produce results within 24 hours.
The test is modeled after an Fda-approved diagnostic tool, but can’t by itself be used by the Ualbany lab for diagnosis. “It allows us to be a little more nimble,” Berglund said. “It’s a surveillance — the first stage in detection. When those presumed positive pools come up, you can move quickly for isolation, diagnostics and quarantine.”
So far, the system seems to be working. Despite multiple reports of offcampus partying, which resulted in the recent suspensions of four students, the Ualbany campus has only seen one COVID-19 case since the start of the semester.
“It is important to highlight that this incident demonstrates that the
safety nets the university has constructed are working as designed: An individual self-reported potential exposure and the University acted swiftly to isolate the person and arrange testing,” Ualbany COVID-19 Safety Officer Kevin C. Wilcox wrote to students at the time.
There is no cost-effective way to routinely test an entire student body. Making matters worse, virtually every school is reeling financially in the wake of March’s closures, which in most cases meant the loss of income from room and board. At private colleges in New York, the lost revenue added up to more than $1 billion, according to figures from the Commission on Independent Colleges and Universities.
But private schools have made the investment in testing while experimenting with screenings like pool testing and wastewater monitoring that are less intrusive than the nasal swab, according to CICU spokeswoman Emily Morgese.
“Bringing students back to college campuses is really difficult and fraught, but its also an opportunity, because there are a lot of innovative people who have the capacity to come up with different solutions,” Morgese said. “If there is a silver lining, our colleges have been able to be really creative in how we respond.”
Berglund, the RNA Institute director, also sees an upside amid the crisis. “One thing that would at least for me be fascinating ... is to know how many asymptomatic people are walking around,” he said. “I think that’s neat, to understand the virus and how it spreads.”
“I hate to say (we’re) confident — I’m not going to say that out loud — but I think we have as good of a chance as making it as any university thanks to our very, very robust plan.” — Leslie Lawrence, RPI’S director of student health service