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What happened at UNC? Earlier in the day I discussed news of clusters at four residence halls on and off-campus. Later in the afternoon, the university announced all classes shifting to remote learning starting Wednesday. Let's take a look (thread): https://www.dailytarheel.com/article/2020/08/breaking-remote
Here's the thread from earlier in the day that discussed the four clusters. At the time, the exact numbers of cases were not released; the university was hiding behind FERPA laws. https://twitter.com/bhrenton/status/1295403240755007490
What caused the university to pull the plug? Let's look at these charts. Test positivity on a weekly basis jumped from 2.8% last week to 13.6% today. This week, the university recorded 130 new cases. Equally alarming is that quarantine housing is almost at full capacity.
Currently, the university says there are 177 students in isolation (on or off-campus) and 350 in quarantine. This is alarming; the school did not have enough room to quarantine all students on campus and moved people into local hotels.
Let's look at UNC's testing strategy. According to analysis I did with @faythtan, @sinabooeshaghi, @lpachter and @DrZackaryBerger, most colleges are woefully unprepared for regular surveillance testing. UNC did not test any students on arrival. https://www.medrxiv.org/content/10.1101/2020.08.09.20171223v1
What we are seeing at UNC is a reflection of the national picture this spring. They opened too fast and too early, without any necessary protocols in place. Remember what we've said: you don't have to do everything right, but you have to do enough right. They didn't do enough.
Now, UNC is faced with a host of issues regarding campus evacuation, quarantines and possible community spread. We have just begun to see the tip of the iceberg in terms of cases. Expect the numbers to continue to rise and the university should now commit to full transparency.
Students who choose to leave campus should quarantine to avoid infecting others. The university currently does not have plans to scale up testing to all students who are leaving. So what are the metrics they used to flip/flop?
- Uncontainable outbreaks
- Quarantine housing filled
- Uncontainable outbreaks
- Quarantine housing filled
The reality is it shouldn't have come to this. UNC was set up to fail. Testing is the major key to handle this disease and they absolutely blew it. We are always behind the curve of this virus and we have to understand proactive testing is the only measure that will work.
So am I concerned for other colleges that may have more rigorous testing plans? We do not have enough evidence to prove that these plans can effectively squander outbreaks. Seeing positive tests on move-in is a logical thing to happen. It means the filter is working.
In UNC's case, that filter was a dam with a giant hole in it. Remember from @ADPaltiel and @RWalensky: "We identified no circumstance in this modelling study under which symptom-based screening alone would be sufficient to contain an outbreak." https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768923
This should serve as a cautionary tale to all colleges who do not have the necessary plans in place. I expect to see many more instances of these outbreaks in the coming days and weeks. Will post about Notre Dame shortly. Also watching a case at Colorado College on move-in.
Special thanks to everyone at the @dailytarheel: @ampogarcic and her team deserve all the credit. National media: Look to them.
TLDR: Colleges need to plan for more screening testing. Fail to plan and plan to fail. UNC failed. Our thoughts go out to all for a fast recovery.
TLDR: Colleges need to plan for more screening testing. Fail to plan and plan to fail. UNC failed. Our thoughts go out to all for a fast recovery.
