By Dr. John Rigilano || Retired Student Health Physician
Dr. John Rigilano is a board certified Family Physician with over 40 years of clinical experience. A retired Air Force Flight Surgeon he has held faculty appointments at the Uniformed Services University, the University of Nebraska and the Pennsylvania State University College of Medicine. He spent the last 13 years doing College Health at both Millersville University and Franklin and Marshall. He retired from clinical practice last month.
To the Editor:
Investigative reporter Daniel Robillard’s excellent review of the College’s Covid- 19 testing strategy accurately points out why the current plan to identify infected students almost certainly will be insufficient. Even the most sensitive and specific testing methods are no match for a virus that is spread asymptomatically in a person who can test negative on a Monday but begin replicating the virus on Tuesday only to spread it by airborne transmission on Wednesday. Testing is a necessary but insufficient answer to controlling the pandemic.
It is essential to understand the following in trying to decide whether in “person classes “ will succeed.
- The majority of returning students remain susceptible to this novel virus
- The virus is highly contagious; much more so than influenza, strep or mono which are the usual suspects in a college environment.
- Coronavirus causes significant morbidity the full extent of which is still not understood. Mortality is low in the college age students but it is not zero.
- A second wave of disease can be expected. The 1918 Great Influenza is instructive here. The second wave will likely occur in the fall.
- The “raison d’etre “ of the “in person “ experience is to provide a social milleau which is in fact the very thing one must avoid in a pandemic! What exactly is the “college experience” that is promised by returning to campus if it is not socialization
- There are not enough “pledges” on the entire planet to stop eager 18 year old students from their perfectly understandable normal need to socialize.
- Most students even if they adhere to mask guidelines are not wearing the type of mask that is best suited to prevent airborne transmission. For that you need an N95 mask. Just try to buy one . You can’t. And just how many noses do you have to see protruding over the mask before you realize that the virus is just laughing at us.
- Past experience at Franklin and Marshall show that only a small minority of students arrive having had their flu shots. Many excuses are offered as shots are declined by a significant percentage. Both flu shots and Covid 19 immunizations ( when available) must be made mandatory with only very limited medical exceptions and no “religious “ exemptions.
- Past experience has shown that motivated, intelligent, and responsible students still consume alcohol illegally, share illicit mind altering substances and contract STDs despite the ready availability of free protective measures. Yet we expect them to alter their behavior so radically as to avoid the passage of invisible RNA particles through the air. I can only say the notion is preposterous.
It is my opinion that a reasoned study of the above facts leads to the inevitable conclusion that significant Covid 19 transmission will occur on campus this fall.
Colleges and Universities across the country are now participating in a huge scientific study with some schools acting as “remote study “ controls while others find themselves in the “active exposure “ study arm. Perhaps instead of signing pledges, F and M students should have been offered “informed consent” releases……
John Rigilano MD FAAFP
Fellow of the American Academy of Family Physicians
Retired F&M Student Health Physician
Any questions or comments can be directed to firstname.lastname@example.org