With national COVID-19 case numbers at an all-time high, University administrators face a difficult task in bringing students to and from campus safely.
At Yale, decisions relating to the coronavirus largely fall to University COVID-19 Coordinator Stephanie Spangler and University President Peter Salovey. To make decisions, Spangler consults the Public Health Committee, which is made up of Salovey’s Chief of Staff, the Director of Yale Health, multiple public health experts and the Deputy General Counsel. The deans from the Yale School of Nursing, School of Medicine and School of Public Health are also on the committee. With each decision, they need to balance providing the strongest possible educational and college experience with protecting the Yale community’s safety.
Now, as students prepare for a mass migration away from campus for the end of fall semester, the stakes of the University’s COVID-related decisions are high. While Yale had few cases during the first half of the semester, almost a third of positive cases has been reported within the last seven days — 52 of the University’s 184 total cases since Aug. 1.
“If there is a substantial second wave, the big question is going to be the return of students to campus and whether it’s going to be appropriate to do it as currently scheduled,” said Richard Martinello, medical director at Yale New Haven Hospital and member of the Public Health Committee.
He said that the committee has not yet discussed any updates to spring semester plans taking into account New Haven’s rising case numbers — because so much can change before Feb. 1, when students are set to return.
Some of the most recent decisions were those regarding Thanksgiving break. Undergraduates identified as a close contact of someone who tested positive must complete their two-week quarantine and remain at the University until they are released by Yale Health, even if the quarantine period extends into the break. Students who test positive and are in isolation must also remain in the University’s isolation housing until they are released by Yale Health. Dorms used for isolation housing will stay open over break.
Martinello said that it is more important than ever for people to follow the social distancing and mask-wearing guidelines that health departments have laid out. Dean of the School of Public Health Sten Vermund added that outdoor activities, excellent air quality and physical distancing can help — especially, in anticipation of students’ return home, to protect students’ parents and grandparents, who may be at higher risk for adverse COVID-19 outcomes.
“I think what we’re all very concerned about is the possibility of what people have been referring to as a second wave,” Martinello said. “We always worry about second waves in pandemics because second waves can be worse than the first wave.”
Second waves usually last about 12 weeks, Martinello said, but it is difficult to pinpoint in the moment when one is beginning. Epidemiology professor Luke Davis said it appears that Connecticut is experiencing a second wave, as the number of daily cases in the state is about two-thirds of where it was in the spring.
At the start of the fall term, the Public Health Committee met seven days a week, at 7 a.m. That continued until early October. Now they meet about three times a week. Sometimes, if there is an emergency, Spangler calls a special meeting. But the committee does not have to hold a special meeting for the University to change the alert level, Martinello said. This decision is ultimately made by University administrators.
According to Vice Provost for Academic Initiatives Pericles Lewis, all decisions around COVID-19 are based on recommendations of the committee and all ultimately fall on Salovey’s shoulders.
The President and University Provost Scott Strobel meet twice weekly with the Vice Presidents, Lewis said.
“If there were a concern about whether [something] is a good idea, I’m sure we would all be consulted,” Lewis said. “But ultimately it would be the President’s decision.”
For school-specific decisions like a change in the academic calendar, school deans make the tentative decision and seek approval from the Provost, Lewis said. The Public Health Committee also checks these plans to ensure that they follow public health guidelines.
The Committee usually does not all agree, but the multiple viewpoints allow for discussion, Martinello said.
The Public Health Committee helps develop testing plans, responds if there is an outbreak and monitors the background epidemiological circumstances in Connecticut and on campus.
Yale professors have also created mathematical models to help administrators make choices. Ed Kaplan, professor of operations research and a member of the Public Health Committee, helped make models to inform decisions as situations arose. One example included mapping out what testing frequency and laboratory turnaround and notification times would keep infections on campus within agreed-upon safety levels. Another model identified the largest number of in-person event attendees that would keep the probability of new infections under one percent.
The models also examined questions related to the surrounding community, including if Connecticut was in danger of running out of hospital beds to care for all COVID patients requiring care. Additionally, models based on hospitalizations and coronavirus RNA concentrations observed in sewage sludge were used to examine what fraction of area residents were infected in the first wave outbreak and the effectiveness of the state’s social distancing and stay-at-home restrictions.
The models informed decision-making, but did not dictate the University’s response, Kaplan explained.
“Models don’t make decisions,” Kaplan wrote in an email to the News. “Leaders do.”
In deciding whether students can safely be on campus, there are a number of factors to consider, Davis said. One is whether the health care system has the capacity to treat more people. Another is the rate of transmission in the surrounding area as well as nationwide — if case numbers are high, students who are traveling are more likely to be infected, and it may not make sense to bring them back.
Going into next semester, Martinello said there is a general confidence that the University’s plan works. Twice-weekly testing and adherence to the community compact has kept case numbers relatively low, at 184 total positive tests since Aug. 1 — much lower than other schools that have seen uncontrolled outbreaks with hundreds of cases, Davis said.
Twice-weekly testing has been effective at keeping campus safe by quickly identifying cases and allowing the University to isolate infected students and instruct their contacts to quarantine, Vermund wrote in an email to the News. Cases at Yale can largely be traced to violations of the community compact, including unauthorized sporting events, practices or parties with more people present than advised.
Once undergraduates leave campus, the University will keep things “quiet” in December, Lewis said. Research will continue, but there will be fewer in-person activities for graduate and professional students and fewer student-facing staff on campus.
“Both with the rise of the numbers for COVID and also the risk for flu season, we just decided to keep things very quiet in December,” he said.
Yale updates its COVID-19 dashboard each weekday at 10:30 a.m.
Rose Horowitch | email@example.com