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COVID-19 Testing Strategies for Colleges and Universities
Pages 1-30

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From page 1...
... A comprehensive approach requires the application of epidemiology and science; rapid isolation of positive individuals and quarantine of those with potential exposures; contact tracing; environmental management; mask wearing; physical distancing; and engagement with the community, particularly local public health officials. Decision making related to testing strategies occurs in context, and choices are made on the basis of many intersecting factors that affect the educational needs of students and the health and economic needs of students, faculty, staff, and the surrounding community.
From page 2...
... INTRODUCTION The David and Lucile Packard Foundation asked the National Academies of Sciences, Engineering, and Medicine to produce a rapid expert consultation describing the various COVID-19 pre-arrival, arrival, and post-arrival testing strategies that colleges and universities are employing; the range of testing capabilities they possess; the testing types and frequency; the metrics routinely tracked; and who is tested. 1 This document summarizes what is known at this time to be effective with respect to COVID-19 testing on campuses from both available research and university experience and underscores lessons learned for planning for campus reopenings during the spring 2021 semester and beyond.
From page 3...
... Colleges and universities unable to participate in the webinars provided descriptions of their testing programs through an online questionnaire. This rapid expert consultation focuses specifically on asymptomatic surveillance testing.
From page 4...
... . Rapid Expert Consultations on Critical Issues in Diagnostic Testing for the COVID-19 Pandemic (November 9, 2020)
From page 5...
... Additional mitigation efforts, such as contact tracing, isolation of individuals with positive tests and quarantine of those possibly exposed to the virus, environmental management, use of personal protective equipment where appropriate, exposure notification, wastewater and other group surveillance methods, health communication, and messaging to promote adoption of protective behaviors need to be considered as part of a comprehensive response.
From page 6...
... CONSIDERATIONS FOR CHOOSING COMPONENTS OF A TESTING STRATEGY This section describes components of the various COVID-19 testing strategies currently employed on some college and university campuses, including the type of diagnostic testing employed, the frequency and targets of testing, response to positive tests, and efforts to ensure compliance with testing requirements. Reporting metrics to students, faculty, staff, and the public is also an important component, and examples of data dashboards and the metrics included are described in Box 2.
From page 7...
... 5 A recent rapid expert consultation produced by the National Academies' Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats reviews critical issues in diagnostic testing for the COVID-19 pandemic. Its findings include the following.
From page 8...
... • Total tests • Total positive tests • Total tests last 14 days • Total positive tests last 14 days • Weekly wastewater sampling for the presences of SARS-CoV-2 Tulane University (see: https://tulane.edu/covid-19/dashboard) • Tests completed • Cumulative positive tests (students and employees)
From page 9...
... . Rapid Expert Consultations on Critical Issues in Diagnostic Testing for the COVID-19 Pandemic (November 9, 2020)
From page 10...
... 9 The institutions that participated in the webinars held to inform the development of this rapid expert consultation highlighted a number of key considerations that have shaped their decision making around the type of test to administer on their campus, including the accuracy of the test; the availability and accessibility of the test (e.g., supply chain considerations) ; the timeliness of the reporting of results; available laboratory capacity; costs; the prevalence of the virus in the community; and the willingness of students, faculty, and staff to participate in the testing (e.g., more invasive nasopharyngeal swabs versus anterior nasal or saliva testing)
From page 11...
... . Rapid Expert Consultations on Critical Issues in Diagnostic Testing for the COVID-19 Pandemic (November 9, 2020)
From page 12...
... . Rapid Expert Consultations on Critical Issues in Diagnostic Testing for the COVID-19 Pandemic (November 9, 2020)
From page 13...
... In addition to having a robust walk-in testing program, the University of Arizona engages in asymptomatic random testing -- targeting weekly about 500 to 800 employees and 50 percent of the students who live on campus -- with serial surveillance testing (more frequent testing on a routine basis) for active, high-risk groups (e.g., athletes, performing arts students, and those living in campus housing)
From page 14...
... Response to a Positive Test Key to any testing strategy is a plan for and capacity to respond to a positive result. Testing is effective only if the testing strategy includes a way to quickly communicate results, rapidly isolate affected individuals, provide supportive measures and care to those who test positive (including mental health services)
From page 15...
... Findings from neuroscience and developmental psychology, summarized in the previously cited rapid expert consultation on adaptation of strategies for promoting COVID-19 protective behaviors among college and university students, show that exploration, risk taking, and making mistakes are normal and expected parts of development during this period. 22 Colleges and universities might choose to establish public health ambassadors within the student community who could provide feedback on what is happening among students.
From page 16...
... But testing alone is not a silver bullet. Rather, it must be part of a comprehensive approach that includes the application of top-notch epidemiology and science; rapid isolation and quarantine; contact tracing; environmental management; mask wearing; physical distancing; use of personal protective equipment where appropriate; and engagement with the community, particularly local public health officials.
From page 17...
... While most of the college and university testing programs discussed have yet to be formally evaluated, many of the webinar participants remarked that, in their opinion, their ability to remain open for the entirety of the fall 2020 semester was in and of itself a successful outcome of their testing strategies. DELAWARE STATE UNIVERSITY Delaware State University (DSU)
From page 18...
... After the initial testing, the university switched to a surveillance testing program, with mandatory testing for students. Samples are collected from students at 20 different test sites around the campus, where observed self-administered nasal swabs are performed.
From page 19...
... Looking to the future, Hampshire College plans to carry out increased testing on a weekly basis for the spring 2021 semester. Representatives from Hampshire College noted having a supportive and engaged college president; exercising clear communications; and having strong relationships with directors of health centers, local public health nurses, and the public health department as key components of their testing strategy.
From page 20...
... After the initial testing, which identified 49 positive cases out of 14,000 individuals, the university shifted to a surveillance testing program. The original plan was to test everyone monthly except undergraduates, who would be tested more frequently.
From page 21...
... Another major element of the testing strategy is the implementation of asymptomatic random sampling after initial move-in testing for all students living on campus. The random sampling included approximately 500–800 asymptomatic employees who had been on campus at least once in the prior week, who were randomly selected for PCR testing, and approximately 50 percent of the on-campus students, who were selected for antigen testing per week.
From page 22...
... This testing consists of four stages: • Stage 1: PCR/antibody testing upon entry, followed by a period of quarantine and education regarding mitigation strategies • Stage 2: weekly surveillance • Stage 3: tiered testing based on risk ­ Dancers: daily antigen testing ­ Higher-risk sports: tested twice per week ­ Lower-risk sports: tested once per week • Stage 4: ­ High risk: weekly PCR tests/daily antigen tests ­ Antibody tests offered weekly, biweekly, every 3 weeks, or monthly ­ No testing for 90 days with PCR or antigens after an active infection Because the institutional review board (IRB) –approved statewide antibody research study was expanded to include all University of Arizona students and employees, antibody testing has been expanded to provide more opportunities to undergo an antibody test on the main campus in addition to locations around the state.
From page 23...
... When a positive test result is identified, students are isolated, contact tracing begins, and close contacts are quarantined and monitored for symptoms. As of October 28, 2020, positivity rates on campus for employees and students were roughly 0.2 percent and 0.3 percent, respectively, compared with a positivity rate in the surrounding county of roughly 3 percent.
From page 24...
... The student is then withheld from campus, and his or her status is available on the student dashboard and sent automatically to that student's professors. The university also has a strong partnership with the local public health department, and using crossmatching, can identify cases that were not tested through the on-campus system.
From page 25...
... Representatives from the university identified several lessons learned or key ideas from its testing program. First, as noted throughout this rapid expert consultation, testing is not a silver bullet, but just one critical component of a comprehensive, multimodal approach that includes physical distancing, mask wearing, contact tracing, and rapid isolation, among other measures.
From page 26...
... As a result of the university's testing strategy, classes this fall are taking place mostly in person, but online courses continue to remain available. The university ordered enough supplies early on to last an entire semester, and it credits some of the success of its testing program to this foresight.
From page 27...
... ACKNOWLEDGMENTS We thank the David and Lucille Packard Foundation, which sponsored this rapid expert consultation and the public information-gathering webinar series. We also thank the sponsors of SEAN -- the National Science Foundation -- and of the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats -- the U.S.
From page 28...
... Curry, College of Public Health, The University of Iowa and Bobbie Berkowitz, Columbia University School of Nursing. They were responsible for making certain that an independent examination of this rapid expert consultation was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered.
From page 29...
... , Georgetown University DOMINIQUE BROSSARD, University of Wisconsin, Madison JANET CURRIE, Princeton, University MICHAEL HOUT, New York University ARATI PRABHAKAR, Actuate ADRIAN E RAFTERY, University of Washington JENNIFER RICHESON, Yale University Project Staff: MONICA N
From page 30...
... DUCHIN, University of Washington ELLEN EMBREY, Stratitia, Inc BARUCH FISCHHOFF, Carnegie Mellon University DIANE GRIFFIN, Johns Hopkins Bloomberg School of Public Health ROBERT GROVES, Georgetown University MARGARET HAMBURG, Foreign Associate, National Academy of Medicine DAN HANFLING, In-Q-Tel JOHN HICK, Hennepin County Medical Center KENT E KESTER, Sanofi Pasteur PATRICIA KING, Georgetown University Law Center JONNA MAZET, University of California, Davis School of Veterinary Medicine PHYLLIS MEADOWS, The Kresge Foundation TARA O'TOOLE, In-Q-Tel ALEXANDRA PHELAN, Georgetown University DAVID RELMAN, Stanford University MARK SMOLINSKI, Ending Pandemics DAVID WALT, Harvard Medical School Project Staff: LISA BROWN, Senior Program Officer AUTUMN DOWNEY, Senior Program Officer CAROLYN SHORE, Senior Program Officer SCOTT WOLLEK, Senior Program Officer AURELIA ATTAL-JUNCQUA, Associate Program Officer EMMA FINE, Associate Program Officer MICHAEL BERRIOS, Research Associate BRIDGET BOREL, Administrative Assistant JULIE PAVLIN, Senior Director, Board on Global Health ANDREW M


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