Young people have less risk, but in college towns, deaths rose fast

When college students returned to campuses around the country this fall, spurring a spike in new coronavirus infections nationwide, people such as Phyllis Baukol seemed at little risk.

A classical pianist who, at 94, was ill with Alzheimer’s, she lived tucked away in a nursing home in Grand Forks, N. D., far from the classrooms, bars and fraternity houses frequented by students at the University of North Dakota.

But the surge of the virus in Grand Forks, first attributed to cases among students then ballooning through the community, eventually reached Baukol. She tested positive this fall, and three days later, staff members pushed her bed up against a window at the nursing home so her daughter could say goodbye.

As coronavirus deaths soar across the country, deaths in communities that are home to colleges have risen faster than the rest of the nation, a New York Times analysis of 203 counties where students compose at least 10% of the population has found.

In late August and early September, as college students returned to campus and some institutions put into place rigorous testing programs, the number of reported infections surged. Yet because serious illness and death are rare among young coronavirus patients, it was unclear at the time whether the growth of infections on campus would translate into a major health crisis.

But since the end of August, deaths from the coronavirus have doubled in counties with a large college population, compared with a 58% increase in the rest of the nation. Few of the victims were college students, but rather older people and others living and working in the community.

Health officials and family members of some people who died in such counties described large surges of cases involving students followed by subsequent infections and deaths in the wider community.

“When the rate of transmission in the surrounding community is high and increasing,” said Jennifer Nuzzo, a public health researcher at Johns Hopkins Bloomberg School of Public Health, “you are going to see more deaths.”

Since the pandemic began, a Times survey has identified more than 397,000 infections at more than 1,800 colleges and universities. Those cases include more than 90 deaths involving college employees and students.

The link between an outbreak at a college and a coronavirus death in the wider community is often indirect and difficult to document, according to public health experts, especially without extensive contact tracing, which many local health departments in the United States lack resources to pursue. Deaths have soared in recent weeks, making it difficult to distinguish between outbreaks tied to campuses and health emergencies linked to other causes.

Yet in September and October, when deaths were well below earlier peaks and fairly steady, they were rising in many college communities. That trend highlighted a central fear of health officials — that young adults with limited symptoms may unwittingly transmit the virus, increasing the possibility it ultimately would spread to someone more vulnerable.

Experts suggest an array of ways such spread might happen, including one simple possibility: More than 1.1 million undergraduates work in health- related occupations, census data shows, including more than 700,000 that serve as nurses, medical assistants and health care aides in their communities.

But researchers have begun finding evidence of ties to college students. Using genetic sequencing to track COVID- 19 cases around the University of Wisconsin- La Crosse, Paraic Kenny, a cancer geneticist at the Kabara Cancer Research Institute of the Gundersen Medical Foundation, has found links between infections at the university and cases and deaths in the surrounding region.

Kenny, who wrote about his findings in a study that has yet to be peer- reviewed, said he has identified at least 18 deaths in long- term care facilities and in the La Crosse community that occurred after a virus outbreak at the college in September and had the same genetic fingerprint as two strains that drove the college student outbreak.

“The genetics really allows you to join the dots between all of these seemingly unconnected situations,” said Kenny, who is also an adjunct associate professor at the university in La Crosse.

Even without genetic evidence, Linda Vail, health officer for Ingham County, Mich., said it was likely that some deaths in her area could be attributed to a surge of cases in September involving hundreds of Michigan State University students and employees.

“The number of cases just exploded on us,” she said.

Students make up more than 18% of the population in Ingham County, home to Michigan State. Classes were suddenly moved online for most undergraduates in August, but tens of thousands of students returned to the area, many renting off- campus housing.

Some colleges and health officials have said that viral transmission in classrooms and during official campus events has been limited, but they have pointed to gatherings outside of classes as a root of spread.

In Ingham County, the virus rapidly bloomed. “The students came back anyway and swooped down on bars and restaurants and other places and caused outbreaks in the community,” said Debra Furr- Holden, a

Michigan State public health researcher and associate dean for public health integration. The university quickly pivoted, she said, trying to reach students and offering testing, but found it was difficult to convince them to follow rules.

The county went from having about 300 new infections in August to about 1,800 in September.

In mid- October, Dennis Neuner was driving home from a hospital in Lansing, having just dropped off his wife, Sharon, who was admitted. They had tested positive for the coronavirus, and she developed a nasty cough.

Neuner took a shortcut on MAC Avenue, home to some of Michigan State’s sororities. He said he saw some 200 students dotting the lawns, celebrating a football game. “I didn’t see one mask,” he said.

He recovered. His wife died.

In another college town, the University of NebraskaKearney has been holding online and in- person classes this fall.

Students make up about 12% of the population of Buffalo County, where infections began to surge in mid- August before fall classes started. The county of about 50,000 residents, which had about 330 cases from the start of the pandemic until August, saw cases more than triple by the end of September.

Jeremy Eschliman, health director for the Two Rivers Public Health Department, which covers Buffalo County, said the department could clearly “connect the dots” between students and deaths in high risk populations.

“That is what has started the forest fire here,” he said.