In order to return to campus, certain health concerns must be considered, including the ability to conduct contact tracing and isolation for symptomatic individuals, and ensuring the level of immunity of students and the surrounding community is sufficient.

A ‘Hairball Of Issues’ in Store for Fall Campus Reopenings, Experts Say

By Fiona K. Brennan, Crimson Staff Writer
In order to return to campus, certain health concerns must be considered, including the ability to conduct contact tracing and isolation for symptomatic individuals, and ensuring the level of immunity of students and the surrounding community is sufficient. By Ryan N. Gajarawala

After Harvard and most other universities in the United States transitioned to virtual platforms in March, students largely hunkered down away from their dorm rooms, dining halls, and college classrooms, to abide by various social distancing measures as the coronavirus infection rate in the country skyrocketed.

Now, after the spring semester has come to a close and large portions of the country begin easing restrictions brought on by the outbreak, administrators must consider the question: what will happen in the fall?

In April, University Provost Alan M. Garber ’76 informed Harvard affiliates that classes and research would resume in the fall, though whether classes will be online or in-person has yet to be determined.

“Because most projections suggest that COVID-19 will remain a serious threat during the coming months, we cannot be certain that it will be safe to resume all usual activities on campus by then,” Garber wrote. “Consequently, we will need to prepare for a scenario in which much or all learning will be conducted remotely.”

In an interview with The Crimson, University President Lawrence S. Bacow said administrators continue to discuss various scenarios for the fall semester, but have not yet decided how it will be formatted, and if — or which — students will be allowed to return to campus.

Harvard administrators have said they will continue to monitor public health guidance in their decision-making, and aim to limit the risk of an outbreak on campus with various public health measures should they deem a return to campus possible for undergraduates.

Harvard Medical School professor Marcia B. Goldberg ’79, who serves as the director of research in the Division of Infectious Diseases at Massachusetts General Hospital, said students may be able to return to campus in the fall with certain measures in place, but no plan can guarantee that an outbreak will not occur.

“Nothing is going to be 100 percent foolproof. There will be some people getting sick, we know that,” she said. “But I think there are safe ways to return to college, where the numbers of people who are getting sick, and the numbers of people who are dying from this disease, is minimal.”

A ‘Hairball of Issues’

As university administrators around the country plan for fall, some are focusing on creating timelines and health protocols for students’ return to campus, while others have decided the risk is too high altogether.

Dean of the College Rakesh Khurana wrote in an April email to students that, in accordance with guidance from public health experts, administrators were exploring a “broad spectrum” of potential scenarios for the fall semester.

Khurana added that the planning team would decide on the status of the residential campus for the fall semester no later than July.

Richard Chait, a Harvard Graduate School of Education professor who studies the management and governance of colleges and universities, said the “multifaceted” decisions universities have to make for the coming semester are not guaranteed to remain in place even after being announced if new data or guidance is released.

“It’ll be final until it’s not,” Chait said. “I hope students will be charitable for the university if they decide that the original decision, in light of new data, is the incorrect decision.”

On most days during the school year, Harvard Yard is bustling with students and tourists, rendering it quite challenging to avoid coming with six feet of another person.
On most days during the school year, Harvard Yard is bustling with students and tourists, rendering it quite challenging to avoid coming with six feet of another person. By Allison G. Lee

Chait said amid the uncertainty, administrators have to think about a multitude of factors when deciding on the format of the fall semester. He emphasized that health and safety — for students and staff alike — was the primary concern, but educational considerations, financial issues, risk management, and athletic programs also must be taken into consideration.

“You put all those together, and you have just a hairball of issues in an environment that’s completely shrouded in fog,” he said. “No one knows.”

International students also pose a specific set of financial and risk considerations for universities to consider.

Sheela Murthy, an expert on United States immigration law, highlighted that if online classes continue through the fall, international students may be less inclined to pay the “big bucks” often required to enroll in U.S. colleges, which could contribute to further financial loss for universities.

The arrival of all students — international as well as domestic — poses a legal and reputational threat to universities, which could potentially face lawsuits if any students fall ill and die from the coronavirus while on campus.

“If kids come here and get the disease and fall ill and — God forbid — pass on, what are the legal ramifications for the university in terms of being sued?” Murthy said. “That would be way more than whatever cost that they’ve lost and result in ill will and getting a bad name overall.”

Universities also must consider the location of their campuses; for urban campuses like Harvard, University President Lawrence S. Bacow said in an interview with The Crimson administrators have to consider that many University employees rely on public transportation to commute to and from the campus.

Nevertheless, some universities have decided that with certain precautions and changes in place, a return to campus for undergraduates is possible.

Boston College announced on May 19 that it intends for on-campus classes to resume as scheduled for the fall semester with increased physical distancing and sanitization protocols, as well as COVID-19 testing and isolation procedures developed by its University Health Services.

Similarly, the University of Notre Dame announced that, with increased health protocols, students will return to campus in August. Notre Dame will conduct the fall semester two weeks earlier than previously planned, cancel fall break, and end before Thanksgiving.

Harvard College has not yet announced its plan for the fall semester, but Bacow said plans are “likely to vary by school” and will be communicated to students once administrators reach a decision.

The Medical School, however, has made a decision about the fall — it announced on May 13 that fall semester classes for first-year students would be held online.

Preventative and Reactionary Measures

In order to facilitate a return to campus, the Centers for Disease Control issued guidance that universities must work with public health officials to establish proper mitigation strategies for “before, during, and after” a potential outbreak.

Higher education institutions’ plans “should be designed to complement other community mitigation strategies to protect high risk populations and the healthcare system and minimize disruption to teaching and learning and protect students, staff, and faculty from social stigma and discrimination,” the guidance reads.

Xihong Lin, a School of Public Health biostatistics professor and co-author of a study that investigated the COVID-19 outbreak and control methods in Wuhan, China, said there are six pillars that must work simultaneously to control the outbreak — mask-wearing, social distancing, testing, contact tracing, isolation, and treatment.

On May 6, Massachusetts Governor Charlie D. Baker ’79 issued an executive order mandating that people wear face coverings in public areas, both indoors and outdoors, where social distancing is not possible.

The “six pillars” to control the outbreak are mask wearing, social distancing, testing, contract tracing, isolation, and treatment, all of which would be necessary to be in place at Harvard for students to return.
The “six pillars” to control the outbreak are mask wearing, social distancing, testing, contract tracing, isolation, and treatment, all of which would be necessary to be in place at Harvard for students to return. By Ryan N. Gajarawala

This order does not yet have an end date, but Goldberg said both wearing masks and social distancing measures will be necessary on campuses to protect people at a higher risk from getting infected with the virus.

“Although there’s a risk of a college student getting severely ill, it’s very low,” Goldberg said. “However, college students interact with older people all the time, particularly faculty on university campuses and service workers, whether it be individuals in the cafeteria or building and maintenance crews, or anybody in the local community around the college.”

In addition to these precautionary measures, Goldberg said the ability to “rapidly identify” and isolate infected students will be important, especially because expecting college students to consistently wear masks and socially distance themselves may not be realistic.

“I don’t think anybody believes that college students are not going to be socializing and interacting with one another in close proximity and likely without masks on. Everybody assumes that will happen,” she said. “The real question is, when students become infected, how to manage that so that they don’t put the older populations at risk.”

Lin emphasized that the capacity to identify people with COVID-19 on campus through testing and contact tracing efforts — in which people who recently interacted with an infected person are identified and asked to isolate themselves — is necessary to halt the virus’s spread.

“If one can identify the source of infection, pick the source of infection out of the network, then that will reduce the number of new infections,” Lin said.

At the University of California, San Diego, Cheryl A. Anderson is leading a program that is trying to determine just how possible it would be to control an outbreak on campus.

The initiative includes gathering data to determine the feasibility of having a surveillance system on campus that could detect cases of COVID-19 on campus early, conduct contact tracing efforts, and therefore halt the spread of infection.

Anderson said she hopes the gathered data can be used to help other universities make informed decisions about how possible it is to contain an outbreak if it reaches campus. She added that if colleges do choose to reopen in the fall, some level of infection is all but inevitable.

“We recognize that a campus that has activity in the midst of a pandemic will not be a campus devoid of infection,” she said. “But it would behoove any campus that wanted to have activity to have a way of detecting those infections at their earliest possible time.”

The testing of individuals with symptoms, however, may not be enough to prevent an outbreak. A recent study by the CDC estimated that about 35 percent of COVID-19 cases are asymptomatic but can still spread the infection at the same rate as a symptomatic individual. The agency also estimated that 40 percent of transmission occurs before symptoms are presented.

Stephen M. Kissler, a postdoctoral fellow at the School of Public Health and co-author of a study suggesting that social distancing may be necessary through 2022, said another type of testing may actually be the best determining factor for how the virus might impact a campus.

Serological tests, also known as antibody tests, can determine whether or not a person was previously infected with COVID-19. Scientists have not yet been able to determine, however, whether or not antibodies from COVID-19 confer enough immunity to prevent another infection, according to the CDC.

Kissler said serological testing could determine how many people at a university and in the surrounding area may have already developed some level of immunity, which, if high enough, could make the probability of a larger outbreak “very small.”

The number of people with antibodies is likely not yet high enough to significantly limit the spread of infection, however. A recent study estimated that only ten percent of the Boston population has been exposed to COVID-19, and herd immunity is only reached if over 60 percent of the population has been exposed.

According to Kissler, bringing students back to college without a high prevalence of immunity, even if Boston has been able to control the outbreak, could be a “very bad idea.”

“You would be bringing a lot of students to campus who would themselves probably not be affected very badly, but they would be starting infections in the community at a much higher rate, and it would be a lot more difficult to control,” Kissler said.

Kissler said in order to be able to control an outbreak, students would have to actively participate in preventative measures — but it still would not be easy.

“If there’s enough testing in place, if the student body is vigilant enough and willing enough to keep track of their contacts and these sorts of things over time, then I think that with enough buy-in, it would be possible to control outbreaks in the university setting,” he said. “But it would be an immense challenge.”

Universities that have already laid out plans for an in-person fall semester believe it is possible to implement necessary health protocols.

Notre Dame wrote its public health plan “will include comprehensive testing for COVID-19, contact tracing, quarantine and isolation protocols, social distancing and mask requirements, and enhanced cleaning of all campus spaces.”

Additionally, Notre Dame identified facilities where students who test positive for COVID-19 and their close contacts can be quarantined.

In his April email, Garber wrote that to assure the health of Harvard affiliates and people in the surrounding area, the University will need a variety of these systems in place.

“We will likely need adequate supplies of personal protective equipment, reliable and convenient viral testing, robust contact tracing procedures, and facilities for quarantine and isolation,” he wrote. “In the coming months we will learn more about whether these conditions can be met in time for the fall semester.”

‘A New Design For A New Age’

Even if public health concerns prevent a return to campus and classes for the coming semester must once again be held online, Garber wrote that Harvard is still determined to provide learning and research at the “highest levels of excellence.”

Deborah M. Jewell-Sherman, a professor of practice at the School of Education, echoed Garber’s determination that the education provided at Harvard would remain high quality, even if educators have to rethink their teaching methods.

Under social distance guidelines for a possible return to campus, large lecture courses held in halls like Science Center C would require a significantly different organization to ensure distance is kept between each student.
Under social distance guidelines for a possible return to campus, large lecture courses held in halls like Science Center C would require a significantly different organization to ensure distance is kept between each student. By Naomi S. Castellon-Perez

“I think that it will take a commitment that I believe we as faculty have, to do this and do it well,” she said. “We’re Harvard. We want our practice to be exemplary.”

Online classes, Garber affirmed, would not simply be attempts to imitate the experience of in-person classes, as they largely were after online classes began this semester.

“Rather than seeking to approximate the on-campus experience online, we can focus our efforts on developing the best possible remote educational experience,” Garber wrote.

Sherman said even though the changes could be challenging, she was “excited” about the way educators could adapt.

“With all the challenges of the pandemic, it gives us the opportunity to rethink education in many, many significant ways,” she said. “It’s almost like we have the opportunity to come up with a new design for a new age.”

Jal D. Mehta ’99, a professor at the School of Education, said online learning works best in interest-driven communities, where people are learning and working together with a “shared purpose or goal.”

According to Mehta, online classes therefore might function better in smaller classes within concentrations rather than in large lecture classes. Mehta said for large lecture classes, a flipped classroom setup would be ideal.

“I think the obvious thing to do in this environment is record the lectures, use the in-person time for questions and opportunities to talk with the professor and the TFs about things that people are confused about, interested in, want to follow up on, or another way to use that time in more interactive ways,” Mehta said.

Mehta added that though building relationships is more challenging and time-consuming online, it can and should be done through, for example, individual meetings between course staff and students.

“If next year were entirely online, at least in the fall, then I think spending the time to build that kind of community upfront will be critical,” he said. “Spending some time to build that will really pay itself back academically as things go on. And I think it would be good for students’ mental health.”

Mehta also acknowledged a clear positive to the transition to virtual programming — at online dissertation defenses, which traditionally have about 15 people watching, unlimited numbers of people from all over the world were able to tune in online to support the student.

Still, the positive aspects of an in-person learning experience cannot always be replicated virtually.

Adam J. Silk ’82, a psychiatry instructor at Harvard Medical School, said educators will have to try to address the “sense of alienation” that people may feel with virtual learning.

“People feel more disconnected from each other when they’re in their own homes or wherever watching a screen,” he said. “That experience of alienation from each other is an unpleasant one and not one that helps learning at all.”

Sherman said she misses the “intimacy” of in-person classes and added that a certain “magic” of learning is lost over Zoom.

During shopping week, students are free to attend any lecture that piques their interest, often leading to overcrowding.  After the novel coronavirus outbreak, exceeding occupancies of lecture halls may be a potential concern.
During shopping week, students are free to attend any lecture that piques their interest, often leading to overcrowding. After the novel coronavirus outbreak, exceeding occupancies of lecture halls may be a potential concern. By Amanda Y. Su

“There’s a rhythm to the teaching and a rhyme that’s anticipatory. I miss that a great deal,” she said. “I can try to replicate some aspects of that closeness in the learning community, but technology mutes some of that closeness and I’m not at all sure how to do that.”

The very nature of a college experience, in which students live in close quarters, learn together, and diverse groups of people constantly interact, is exactly what makes a coronavirus outbreak so dangerous on a campus. The people on a campus, Kissler said, are sharing “more than just ideas,” and university administrators continue to confront this irony as they decide on the format of the coming semester.

—Staff writer Fiona K. Brennan can be reached at fiona.brennan@thecrimson.com. Follow her on Twitter @FionaBrennan23.

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