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In August, more than 100 New England colleges launched a massive experiment: What happens if you bring students back to petri dish campuses in the midst of a pandemic, but put huge energy into prevention culture and testing them once or twice a week?
The colleges partnered with the Broad Institute, a research giant that pivoted to mass coronavirus testing, in hopes the proposition could work well enough to salvage at least a partially on-campus fall.
As many students head home or settle back into their childhood bedrooms, the interim results of the experiment are now clear. The data show "that asymptomatic testing does work," says Dr. Paula Johnson, president of Wellesley College and a leader of the group that put together the partnership. "And it works in terms of identifying cases quickly, paired with aggressive contact tracing. You identify a case, you identify the contacts. You pull them out of the system. And that really helps to prevent the spread."
She adds: "I just can't stress this enough: that must be paired with the public health measures," such as social distancing and masking, "because it's really the pairing of the two that is the answer here, at least today."
One In 1,000
The Broad Institute has ramped up its testing to the point that it’s now running more than 100,000 tests a day, says Stacey Gabriel, who leads its testing operation. It has now run nearly 6 million tests total, and of those, she says, about 3-1/2 million have been college tests.
Among those college tests, very few have been positive. "The rates overall have stayed low — around one in a thousand or so across the board," Gabriel says. "There’s been some variation; it was 0.12% for a while and it’s ticked up to 0.18% overall right now, but that’s overall."
"There certainly have been a few schools that have had some outbreaks," she adds, "and then have gone on to to deal with those outbreaks in however the local situation calls for. So that part, I think, has been great."
Around the region, multiple colleges have had outbreaks that involved more than 100 students, including Boston College early on, Providence College, Merrimack College and the University of Rhode Island. And dozens of schools have had at least a few cases. (The New York Times tracks college cases nationwide here.)
But the region has seen nothing like the huge outbreaks affecting thousands in the south and midwest. The University of Florida has had over 5,000 cases, for example, as has Clemson University in South Carolina.
"It’s my understanding that schools that have done frequent testing of asymptomatic students have kept their rates at well below 1% positivity," says Gabriel from the Broad, "whereas schools that use another approach, of only testing symptomatic or only contacts of positives, have a rate at least tenfold higher."
Of course, those schools with higher rates could also be affected by other factors, including their culture of social distancing and mask use. But it could be that testing helps with those elements as well, according to what some schools have told Gabriel.
"They think the fact that there's routine interval testing has sort of changed behavior, has improved behavior on the campuses," she says. "Because the students know that 'I'm going to be tested a couple of times this week. And I don't want to have to quarantine. So I'm going to make sure I follow protocol.'"
'When It Works, It's Completely Boring'
Dr. Michael Mina, a leading expert on testing based at the Harvard Chan School of Public Health, argues that the campus testing experience this fall amounts to more strong evidence that "surveillance" testing of people without symptoms should be used far more broadly.
College campuses are among the most fertile ground for transmission, he says, and American media play it up when there’s a big outbreak at a college or the White House, "but fail every day to say how many outbreaks are being averted, whether it’s by the White House frequent testing program, or by every academic institution in New England that continues to have small numbers of cases and stamps them out before any of them become outbreaks."
"The hard part about public health," Mina says, "is that when it works, it’s completely boring."
He cites fresh findings on the power of broad testing to stem transmission in Slovakia and China, and advocates for the extremely widespread use of tests that are cheaper and quicker than the highly accurate PCR tests the colleges use.
While Dr. Johnson from Wellesley agrees that testing is an important tool, she points out that colleges are high-risk settings, and what works there may not make as much sense for lower-risk settings.
"If we think about the state of Massachusetts or the country, it's really the public health measures that must be followed," she says. "And then you apply the testing depending upon the level of risk in a population. I think that we've learned a lot. You can't necessarily say that because we do this in higher ed on residential campuses, that it should be done everywhere. But I think that the public health aspect of it is critical."
Outside college campuses, coronavirus testing often remains hard or inconvenient to get and results can be long in coming. The Broad Institute has been expanding its capacity and will continue to ramp up, with more testing expected from public schools and employers.
But testing experts say some of the main bottlenecks in the system are not so much at the level of the test-processing labs. They’re more about the logistics of the whole process, and the capacity of the community testing sites. So the downturn in college testing as students leave campus does not translate automatically into more access or shorter waits for non-campus testing.
But the initial results from the grand college testing experiment do translate into one clear outcome: both the Broad and the colleges expect to continue the testing into the spring semester.
This segment aired on November 25, 2020.
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