Ryan Chiao, Photo Editor

Faculty at the Yale School of Public Health signed an open letter calling on university leaders across the country to dispose of “unnecessarily punitive disciplinary actions” imposed on students who fail to follow all school health protocols during the COVID-19 pandemic.

Harvard epidemiologist Julia Marcus and John Hopkins Bloomberg School of Public Health Associate Professor Stefan Baral authored the letter. More than 100 other scholars throughout the nation signed onto the letter including Yale School of Public Health professors Gregg Gonsalves and Howard Forman. It condemned an “abstinence-only approach to social contact” for students and criticized it as an “inhumane” and impractical way to deal with the pandemic on college campuses. The letter was published in Inside Higher Ed on Oct. 15.

“If university leadership at institutions around the country don’t have other measures in place to reduce the chance for outbreaks on campus, from testing to environmental controls, blaming students for outbreaks is just irresponsible, punitive and deflecting attention from these [institutions’] own failures,” Gonsalves wrote in an email to the News.

Forman declined to comment on the subject when contacted by the News.

In the letter, the authors emphasized that public health infrastructures such as testing, contact tracing, quarantine measures and mask wearing are all imperative in protecting faculty, students and staff on college campuses from COVID-19. However, Marcus and Baral noted that many colleges and universities are requiring their students to implement “radical and unsustainable changes in their behavior” such as maintaining six feet of distance from all other people. 

Gonsalves declined to give his opinion on whether or not Yale has been complicit in the “abstinence-only” approach to social contact.

The authors describe that demands like these are especially harsh for students who are required to work in jobs where they interact with others and risk potential exposure to COVID-19 to simply meet the costs of tuition. They also suggest that asking students to forgo all social contact might result in adverse consequences, especially for marginalized students.

“Social contact may be particularly vital for marginalized students, whose mental health may be heavily impacted by the loss of positive social connections,” Marcus and Baral wrote. 

The authors suggest that if higher education institutions fail to consider competing risks such as the psychological impact of social isolation on college students, there could be dire consequences for student health. 

YSPH Department Chair of Epidemiology Albert Ko did not sign the letter, but agreed with the authors’ claims that a punitive approach to enforcing public health guidelines on college campuses will not work.

“I think the main body of the message is an important one in the sense that many of our actions in public health are punitive and we know how punitive actions can be stigmatizing and it can defeat the purpose of what’s intended — the overall goal,” Ko said. 

He drew parallels between the current stigmatization of students who contract COVID-19 to historical instances in which people living with diseases like smallpox, cholera, tuberculosis and HIV were publicly shamed.

He explained that this practice of blame and ostracization is detrimental and counterproductive to keeping the population safe.

“We know that if you stigmatize, it pushes people not to seek testing or diagnosis when they need to … and importantly not to seek care when they need it,” Ko said. “That kind of defeats the purpose of these public health measures.” 

Instead of an indefinite “abstinence only” approach that strives for total elimination of COVID-19 related risks, the authors suggest a “harm-reduction approach,” which they believe will be a more effective alternative on college campuses. 

The harm-reduction strategy acknowledges that the risk of viral transmission is inevitable and seeks to counter shaming by engaging community members through compassionate messaging and providing psychological support to those who need it the most.

“By facilitating lower-risk opportunities for people to address their unmet needs — in this case, for social and physical contact — this approach can help people avoid the highest-risk scenarios that will cause the most harm,” the letter reads.

The authors urge universities across the nation to permit students to have some form of non-distanced social and physical contact — through social bubbles — while still striving to keep rates of COVID-19 transmission low. At Yale, according to the Community Compact, students may have non-distanced social and physical contact with those they live with or a guest in their room. Otherwise, students are not to gather in groups greater than 10 or get within six feet of each other.

Finally, the authors ask that universities decouple contact tracing and symptom tracking efforts from punishment, similarly to how students who seek medical treatment for alcohol use are often absolved from disciplinary action for drinking underage. 

At Yale, the community compact requires students to engage truthfully with contact tracers. Any information gathered through the contact tracing process about close contacts of a COVID-19 positive student will not be used to initiate disciplinary proceedings, according to the Yale contract tracing website.

 If students do not comply with the contract tracing standard or any other rules laid out in the compact, the document asks them to leave campus. If non-compliant students do not take this step themselves, the University may take “administrative action” to prohibit these students from on-campus residence. 

“We all need human contact,” Gonsalves wrote in an email to the News. “It can be done safely in the age of COVID-19, by stressing outdoor and socially distant activities, rather than suggesting no social activity at all can happen on campus…this pandemic could well be with us through 2021 and creating opportunities for students to see each other, see faculty, in safe environments is going to become more and more crucial.”

As of Nov. 1, there have been 126 total positive cases at Yale since Aug 1.

Sydney Gray | sydney.gray@yale.edu