By Daniel Robillard || Investigative Reporter
Since the outbreak of COVID-19, health experts and government officials have repeatedly emphasized the importance of aggressive testing and screening in order to begin safely reopening businesses, colleges, and communities across the U.S.
Several private colleges in Pennsylvania have recently announced that they would be moving online for the fall semester. In July, Dickinson and Lafayette Colleges announced that they would be having an online fall semester and the University of Pennsylvania announced last week that they would not be reopening campus this fall. All three schools cited the lack of testing capacity and slow turnaround times for testing results as one of the primary reasons for moving online.
Franklin and Marshall President Barbara Altmann has, on multiple occasions, pointed to F&M’s testing contract and plan as one of the main advantages that makes the College better prepared to reopen and mitigate the risk of an outbreak than the increasing list of schools that have decided to move online.
However, recent studies and comments by numerous public health and infectious disease experts call into question whether F&M’s testing plan will actually be sufficient to mitigate the risk of an outbreak on campus this fall.
Earlier this month, the College decided that each student would be tested upon their arrival to campus and once again within a week after their initial test. After that, the College “will be doing what is called ‘surveillance testing,’ which means randomized samples and/or higher risk groups,” Altmann told The College Reporter.
Administering a second test within a week after the initial test is crucial, as recent research shows that there could be a high likelihood that an infected person receives a negative test result despite carrying and being able to transmit the virus. This is because there tends to be a narrow window for when COVID-19 diagnostic tests actually catch positive cases.
For example, a student who has been infected the day before being tested may still receive a negative test result because the virus hasn’t had enough time to build up in their body. Testing that student again a few days later, when the student’s viral load has reached its highest levels, greatly increases the chance that the positive case will be correctly detected.
Despite the College’s emphasis on its testing plan, a recent study published in the Journal of the American Medical Association (JAMA) Network Open that modeled various potential screening and isolation programs on college campuses suggests that F&M’s testing plans would not be sufficient enough to contain an outbreak this fall.
The study, conducted by researchers at the Yale School of Public Health and Harvard Medical School, suggests that “frequent screening (every 2 days) of all students…might be required to control outbreaks” on college campuses this fall. The authors of the study concluded that schools could forgo more accurate, expensive tests and instead utilize faster and cheaper “low sensitivity” tests, which are less accurate.
A recent article published in the Proceedings of the National Academy of Sciences (PNAS) last month offers insight on why F&M’s testing plan may fall short this fall. The article found that a majority of COVID-19 cases studied can be attributed to silent transmission—spread during the presymptomatic stage and asymptomatic infections, when infected individuals do not exhibit symptoms but still transmit the virus.
The researchers concluded that “over one-third of silent infections must be isolated to suppress a future outbreak.” F&M’s plan to rely primarily on symptomatic testing—in which individuals who report symptoms are tested—rather than frequent testing of all students, may not be sufficient enough to detect the amount of silent transmission on campus that the recent research suggests is necessary to prevent outbreaks.
Some colleges have started to implement more frequent testing plans, primarily in response to the emerging scientific evidence and opinions of health experts that regular testing of healthy students is needed to safely return to campus this fall.
The University of Illinois at Urbana-Champaign will test all students, faculty, and staff two times each week using a saliva-based test developed on campus that allows students to receive their results within hours. “Fast and frequent is the key,” Dr. Martin Burke, a Chemistry Professor at the University of Illinois who helped develop the saliva test, told NPR. “If you don’t get your results back for one or two days, beyond that, it’s pretty much useless,” Burke said.
Several schools that are using the same testing partner as F&M, the Broad Institute, plan on testing all of their students multiple times a week during the fall semester. Brandeis University and Tufts University, both of which plan on having hybrid fall semesters like F&M, each announced that they will be testing their students twice a week, or every three to four days. Harvard University, which stands to substantially gain financially from the affiliated Broad Institute’s testing contracts, has said that it will be testing any students living in college housing three times a week, even though the school plans to be almost entirely remote for the fall semester.
The ability to test frequently enough to safely reopen college campuses in the fall may very well come down to finances. Most of the schools that are planning to test students several times a week have significantly greater financial resources than F&M, which is already going to have to spend tens of thousands of dollars on the two initial COVID tests given to all students, estimated to be between $25–$30 per test.
Continuing ahead with reopening plans during the next week despite having a testing plan that may not sufficiently contain an outbreak on campus is likely one that will be made primarily with the College’s financial position in mind. Securing the testing capacity needed to test students even just once a week would be a huge cost for a semester that is already likely to put an unthinkable amount of financial stress on the College.
Junior Daniel Robillard is an Investigative Reporter for TCR. His email is drobilla@fandm.edu