The impact of phased university reopenings on mitigating the spread of COVID-19: a modeling study
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Abstract
Background
Several American universities have experienced COVID-19 outbreaks, risking the health of their students, employees, and local communities. Such large outbreaks have drained university resources and forced several institutions to shift to remote learning and send students home, further contributing to community disease spread. Many of these outbreaks can be attributed to the large numbers of active infections returning to campus, alongside high-density social events that typically take place at the semester start. In the absence of effective mitigation measures (e.g., high-frequency testing), a phased return of students to campus is a practical intervention to minimize the student population size and density early in the semester, reduce outbreaks, preserve institutional resources, and ultimately help mitigate disease spread in communities.
Methods
We develop dynamic compartmental SARS-CoV-2 transmission models to assess the impact of a phased reopening, in conjunction with pre-arrival testing, on minimizing on-campus outbreaks and preserving university resources (measured by isolation bed capacity). We assumed an on-campus population of N = 7500, 40% of infected students require isolation, 10 day isolation period, pre-arrival testing removes 90% of incoming infections, and that phased reopening returns one-third of the student population to campus each month. We vary the disease reproductive number ( R t ) between 1.5 and 3.5 to represent the effectiveness of alternative mitigation strategies throughout the semester.
Results
Compared to pre-arrival testing only or neither intervention, phased reopening with pre-arrival testing reduced peak active infections by 3 and 22% ( R t = 1.5), 22 and 29% ( R t = 2.5), 41 and 45% ( R t = 3.5), and 54 and 58% (improving R t ), respectively. Required isolation bed capacity decreased between 20 and 57% for values of R t ≥ 2.5.
Conclusion
Unless highly effective mitigation measures are in place, a reopening with pre-arrival testing substantially reduces peak number of active infections throughout the semester and preserves university resources compared to the simultaneous return of all students to campus. Phased reopenings allow institutions to ensure sufficient resources are in place, improve disease mitigation strategies, or if needed, preemptively move online before the return of additional students to campus, thus preventing unnecessary harm to students, institutional faculty and staff, and local communities.
Article activity feed
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SciScore for 10.1101/2020.08.25.20182030: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:While previous studies have concluded that frequent SARS-CoV-2 testing and contract tracing can significantly reduce disease spread, they have limitations in college and university settings. First, the models that support these conclusions assume a low number of initial active infections. Contact tracing, for example, has shown to be ineffective when the number of initial infections is greater than 40.6 Other modeling studies demonstrating the …
SciScore for 10.1101/2020.08.25.20182030: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:While previous studies have concluded that frequent SARS-CoV-2 testing and contract tracing can significantly reduce disease spread, they have limitations in college and university settings. First, the models that support these conclusions assume a low number of initial active infections. Contact tracing, for example, has shown to be ineffective when the number of initial infections is greater than 40.6 Other modeling studies demonstrating the effectiveness of frequent testing for SARS-CoV-2 assume that initial infections range between 1 and 10 individuals.3,7 These are much lower than the number of early infections from recent university outbreaks1,2 and current prevalence estimates of SARS-CoV-2.5,8 Second, the logistical contraints and high costs may challenge the ability of institutions to impelement these strategies effectively. This may be especially difficult at the semester start, where larger outbreaks are more likely to occur due to the number of high-density social events in these settings.1,9,10 Such gatherings have been the driving factor behind several university closings.1,2
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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