When the University of Illinois at Urbana-Champaign welcomed more than 35,000 students back to its Central Illinois campus in late August, it looked like it could be more than just another school reopening in the coronavirus (COVID-19) era. It was a real-world example of the sort of public health measures many experts long have been urging: frequent testing—even of people with no symptoms—combined with contact tracing and technology-enabled exposure notifications.
Researchers at the university, a science and technology powerhouse, designed a saliva test that would be easy to collect and process, to be taken twice a week. They developed an app that monitors results and can quickly notify close contacts of anyone testing positive. Those who test positive are instructed to quickly self-isolate. Masks are required, and large gatherings were put off-limits. Modelling developed in-house projected it would all work. With more than 255,000 tests performed, the school has done more than five per cent of the state of Illinois’s total screenings so far and accounted for nearly 20 per cent of them last week. Students, faculty, and staff at UIUC may be some of the most-tested people in the US.
It looked like the university had done everything right. Colt Pierce, 22, who came to Illinois a month ago from Texas to pursue a doctorate in geography, immediately noticed how many people in his new community were wearing masks. Ryan McLaughlin, a materials engineering major starting his senior year, was grateful for an in-person lab where he and others could learn how to mix up ceramic powder at precisely the right speed and pace, as well as peer through a high-powered microscope — something that’s not possible from a laptop in his apartment.
Nick Arroyo, a 22-year-old film major, was impressed by the testing’s efficiency — though not by some of the people he saw stumbling down central Green Street, with its restaurants and bars, not wearing masks.
On September 2, the university sounded an alarm. Over the previous 10 days, 784 positive cases had emerged, and if the trend continued the count could rise to as many as 8,000 that semester. The school cracked down on parties, told undergrads to leave their homes or dorms only for essential activities such as going to class and buying food, set up a new team to isolate positive cases quicker, and created an online form to report risky behaviour.
There are early signs that the plan is working, with new case numbers dropping. Yet critics — including some of the university’s own faculty — say the school has relied too heavily on its impressive technology and predictive analytics while miscalculating about its own students, young adults still learning how to live on their own and eager for social contact after months of isolation.
“It’s not just about testing,” says David Wilson, a long-time geography professor. “It’s about people, their daily rituals and habits. That was not really considered.”
What happens on the Illinois campus this fall will have broad implications, not just for its own community but for other reopening colleges and the US at large. Institutions are building the plane as they fly it, all the while grappling with the limitations of still-emerging science and the unpredictability of human behaviour.
The school is hardly alone in its struggles: On Tuesday, Bradley University in Peoria, Illinois, started a two-week quarantine with remote learning for all students after identifying clusters of positive cases.
While UIUC’s example illustrates how mass screenings can identify a problem early, it also shows they aren’t enough on their own to prevent virus spread.
“We’ve learned fast, frequent testing can work—because we’re seeing it work as we speak,” says Marty Burke, a chemistry professor who leads the school’s testing and tracing programme. “But we’ve also learned it’s not a silver bullet.”
Burke adds: “I think if we can achieve this, it will be an example of how it can be done.”
When Ariya Patel started her freshman year last month at the university, it was very different from that of her parents, alumni who met on its campus in 1989. Upon move-in, she received a bag of personal protective supplies, including two masks and alcohol wipes. She spit into a tube to get tested for COVID-19 and is rushing for sororities via Zoom. Only one of her classes is in person. Patel has been impressed with the university’s preparations, but she worries that virus cases will send students home and that the little bit of contact she has — such as studying together at safe distances with masks —could also be taken away. “It’s only a select group of students that are choosing to disobey the guidelines,” she says. “It’s frustrating.”
That’s where UIUC says its system recently went awry. It anticipated that students would socialise, even in large groups — the modelling laid out a scenario in which as many as 8,000 or 9,000 students went unmasked to parties three nights a week. But there was some behaviour the university didn’t anticipate.
According to the school, some students ignored the requirement to isolate after testing positive, even going to and hosting parties, and tried to game the system, including repeatedly seeking out another test and trying to get around the school’s app, Safer Illinois, which shows a badge clearing students with negative results to enter school buildings and even some local bars. One student who posted a video on social media trying to show people how to hack that app is “facing discipline”, and about six have been suspended.
These actions, by only about a dozen students, paired with parties, drove the university’s surge in cases, administrators say. The vast majority of cases have been among undergrads, Burke says. “The problem is the math is brutal,” he says. Even a small number of people who willfully break rules “can cause an extraordinary amount of damage.”
“If you don’t help people to see an alternative that is palatable, and if you don’t find ways to create an alternative that is palatable, then they’re going to go back to what they always did.”— Emily Landon, epidemiologist, University of Chicago Medicine
One major risk is that infections could spread to at-risk faculty and staff and those in the surrounding community. (The giant campus spreads through two cities with a combined population of roughly 130,000.) Students’ college experiences are also on the line. McLaughlin, the materials engineering major, knows he won’t participate in a tradition called “riding the rail,” where seniors drink different beers to get punches on a ticket at a local bar. But he’s hoping to hang on to his one in-person class.
“I am very concerned that one class is going to be taken away and made remote,” says his mother, Lisa McLaughlin. “What makes me sad is when I asked him, how does it feel to go to that one class, he said, ‘It makes me feel normal.’ I want him to hold on to that last bit of normalcy.”
Some have questioned whether the university is shifting blame to students for problems it could have seen coming. Professor Bruce Rosenstock, who teaches religion at the university and has been a vocal critic of the administration’s COVID-19 guidelines since the spring, says the school should have implemented stricter measures and more support early on, including off-campus — where the majority of students live. He also now worries that the focus on irresponsible behaviour spreading the virus could stigmatise students who test positive, making them less likely to come forward and ask for help isolating.
What happened suggests that the school could have done more to educate and support students, says Emily Landon, an epidemiologist and infectious disease expert at the University of Chicago Medicine. “They might not have done enough thinking about natural human behaviour,” she says. “If you don’t help people to see an alternative that is palatable, and if you don’t find ways to create an alternative that is palatable, then they’re going to go back to what they always did.”
Rosenstock says academics on campus specialising in social sciences should have been more involved to better factor in human behaviour. The university says behavioural experts were closely involved in its planning and noted that it did a big, months-long push to educate students, including through a voluntary pledge and required training. A promotional video released in mid-August features the chancellor affixing masks to different campus statues, including a bronze bust of Abraham Lincoln. The mask covers the shiny nose students traditionally rub for good luck.
“It’s not about putting blame, it’s about being transparent and factual about what is causing the rise in cases,” says Chancellor Robert Jones in an interview.
The university is implementing several changes, including testing higher-risk people such as those who live in fraternity houses three times a week, instead of two, and setting up a new team that seeks to more quickly isolate those who test positive using text messages instead of phone calls, which students sometimes don’t respond to. Administrators are also discussing ways to better help people with positive tests who are in isolation.
Awais Vaid, deputy administrator and lead epidemiologist with the Champaign-Urbana Public Health District, which has been working with the university and handling contact tracing, says that the university and health authorities could have focused more on how months of lockdowns at their parents’ homes might have influenced students once they returned to campus. “This is the first time in six months they actually had a chance to be by themselves,” Vaid says. “So they don’t know what restrained socialising is or doing things under guidance.”
David Paltiel, a Yale University professor of public health who co-authored a separate study in late July calling for rigorous testing at universities, says that he too did not consider that students might not isolate after testing positive, and thus overstated how effective frequent testing could be. “[However,] to expect testing is going to drive infection rates down to zero is holding it to much too high a standard,” he says. “The question is, what might have happened in the absence of a testing programme?”