The University released its guidelines Aug. 11 for the free COVID-19 testing that will be required of returning students and employees during the fall semester. The summer testing pilot program currently in place will transition to this academic-year testing initiative beginning the week of Aug. 24. The new initiative will require routine, asymptomatic testing at least weekly for students, staff and faculty returning to campus or Providence.
Students and employees coming back to campus will be required to undergo a baseline test upon their arrival. For undergraduate students, arrival may range from late August to late September given the University’s new plan, under which the majority of students will not return to campus until the week of Sept. 21. “I can’t make an absolute guarantee, but the goal is that everybody will be tested on the same day they arrive or within the first 24 hours,” University Spokesperson Brian Clark said. Afterwards, everyone must participate in routine testing at least weekly.
University community members will be expected to undergo asymptomatic testing about every three or four days, Clark added, noting that this interval may change over time.
Any student exhibiting COVID-19 symptoms is asked to notify University Health Services. Health Services will screen the student and help arrange a virtual appointment with a clinician to assess the person’s health and schedule a symptomatic test if necessary, said Vanessa Britto, associate vice president for campus life and executive director of health and wellness.
Alongside these measures, asymptomatic, routine “testing is essential and really has to be one of the foundational elements for identifying and essentially stopping the community spread of (the) virus,” Clark said. Routine testing will “enable an understanding of the incidence of novel coronavirus in the on-campus population and help identify the proportion of asymptomatic positives over time,” according to the Healthy Brown website.
Testing “will help us understand exactly how COVID is impacting our students both on and off campus” and “understand what community transmission might look like,” Britto said.
Britto stressed the fundamental importance of asymptomatic testing to maintaining an understanding of the scope of COVID-19 on campus. “When you think about the age demographic of the traditional undergraduate population … 30 to 50 percent of that population is asymptomatic. They don’t have symptoms. They (may) have the disease, they may be incubating the virus, but without testing, we wouldn’t know,” she added.
The announcement about testing guidelines follows the University’s prior decision to conduct randomized testing of those returning to Brown this summer as part of its pilot program. By assessing the testing process and considering several testing partners over recent months, the University developed an informed strategy for the fall, Clark said.
Testing Frequency
To settle on a rate for asymptomatic testing, the University sought “a balance between frequent enough testing so that you get a clear window into prevalence on campus and whether there is a community spread ... and something that’s practical to implement,” Clark said.
Testing frequency and the means of administering the test will vary on a case-by-case basis in accordance with the University’s issued guidelines. Clark explained that to help determine how frequently University community members should be tested, the University considered medical and public health experts’ recommendations to develop two categories, “with a focus on the amount of contact an individual is likely to have with other campus community members:” high contact and medium contact.
On-campus, off-campus and commuter undergraduate students and first-year, second-year and Gateways medical students will be considered high contact, and will all be tested twice each week.
Other high-contact individuals will also receive tests twice a week.High-contact individuals generally include those who satisfy the following criteria: remaining on campus for at least three days a week; learning, teaching, advising or supervising others in person; or working around students, in residences or in places where social distancing may not be feasible. Graduate students and University faculty in Providence meeting these criteria would be considered high contact, according to the Healthy Brown website.
Josh Neronha ’22 thinks this testing rate for undergraduates is “great” because “having community transmission at Brown is pretty much inevitable, and I think the best way to alleviate that is testing,” he said.
But many graduate students and faculty may fall into the medium-contact category.
Medium-contact people will only be tested once a week. This testing rate applies to graduate students or faculty who take classes or teach remotely or who work in private, on-campus offices or areas conducive to social distancing, as long as they will not be on campus for more than two days. The goal is to eventually be able to provide testing twice a week to medium-contact graduate students and employees at their request, Clark said.
Those who do not fall into either category include students and faculty who will be completely remote, meaning they will not be teaching, studying or researching on campus, as well as staff who are permitted to visit the campus weekly for at most half a day. Medical students on rotations as third and fourth-years, as well as Alpert Medical School faculty, must follow guidelines for health care workers that are separate from those of the University.
Additionally, higher-risk groups may seek access to tests prior to returning to campus, but “we’re not obligating anyone to be tested before they arrive” on campus, as doing so may prove challenging or unsafe for some, Britto said.
Depending on the public health situation in Rhode Island, testing frequency regulations are also subject to change — but likely, not in the immediate future. If, for example, “the numbers in Rhode Island are drastically less than what they are now, maybe there’s a possibility of cutting back on frequency many months from now,” Clark said.
Testing Process and Location
A nasopharyngeal swab will be used for all those who qualify for routine testing. Polymerase chain reaction, which looks for viral genetic material, will be used to analyze the test. “We have the most information about this type of testing, and so we’re trying to keep the science and evidence in front of us and base decisions on that,” Britto said.
The University will not be administering antibody tests at this time but “may consider conducting antibody tests in the future” if there are developments in public health guidance or research, according to the Healthy Brown website.
The University has chosen the Olney-Margolies Athletic Center as the location for asymptomatic tests to replace the summer pilot testing site at 205 Meeting Street in order to accommodate the influx of students, Clark said.
The University’s third-party partner for the summer testing pilot program, Verily, will continue to provide the staff and infrastructure for this testing, Britto wrote in an email to The Herald.
To maintain social distancing, asymptomatic people will typically self-administer the test while under the instruction and guidance of observing clinical personnel. If the student needs or requests assistance, the clinician can administer the test, Britto said.
Neronha received a baseline asymptomatic test this summer upon returning to campus to conduct laboratory research. He described the process as “honestly really easy. I was probably in and out in five minutes.”
Meanwhile, personnel from University Health Services will conduct all testing for individuals with COVID-19 symptoms, taking the necessary safety precautions, according to the Healthy Brown website. Summer symptomatic tests have taken place at Rhode Island Department of Health sites, but this location will change to a University facility for the academic year.
The University also plans to create a separate annex for students with respiratory symptoms within isolation and quarantine residences, and “symptomatic students will be swabbed there in the respiratory clinic,” Brito said. “It will be efficient for the student; it will be efficient from the standpoint of the consumption of healthcare resources.”
Lifespan laboratory partners in Providence will quickly process symptomatic test samples in the fall, Britto said. But the Broad Institute of Harvard and the Massachusetts Institute of Technology in Cambridge, MA will take over asymptomatic analysis with an expected turnaround of within 24 hours. It’s important that the result of a test comes back before the administration of a subsequent test for the safety of the community and so that a person who tests positive can be notified as soon as possible, Britto added.
Tracking and Scheduling
In implementing testing and symptom tracking, the University is continuing to work with Verily. Using Verily’s Healthy at Work online tool, Brown community members will have to complete a daily report of their symptoms and register for their tests.
Students who do not arrive for their scheduled test will receive follow-up communication, such as an initial reminder and request to reschedule, followed by additional measures as needed, the details of which are still under development, Clark said.
“We’re absolutely going to be mandating for those who are in isolation or quarantine to symptom track, and certainly we want people who are asymptomatic even to also be doing it,” Britto said. “On either side of this equation, it’s important.”
Britto also emphasized the importance of adhering to public health guidelines and health practices, including social distancing, hand washing and wearing face masks, regardless of the test results. “We really need people to do all three. It’s really, really important,” she said.
But if a student does test positive, PWN Health, which is the clinician network working with Verily, and UHS will contact them and provide further guidance, and the University will take appropriate action to ensure health and safety.
“If someone has a positive test, I want them to know that we’re here, we’re going to support people, we’re going to wrap services around them, we’re going to keep them comfortable, we’re going to monitor them closely, we’re going to be in partnership with them,” Britto said.
While students may feel relieved upon opening their inbox to an email from PWN Health confirming a negative test, “one of the most important things that we will stress this year is that a negative test does not mean any license to amend public health practices” since the result only applies to the time of testing and does not account for any exposure thereafter, Clark said. “There’s the danger of feeling a false sense of confidence.”
“It’s very easy for all of us, just from the standpoint of human nature, to develop issue fatigue, where over time you just get tired of following the rules. … So I would caution people to not let their guard down, to think about the fact that you may not experience symptoms but you absolutely could be incubating and therefore spreading virus,” Britto said.
A platform through which the University can publicly report data about testing results in the aggregate that are not linked to any individuals, such as, potentially, the weekly rate of positive tests on campus, is also being developed, Clark said. In doing so, the University would remain reasonably transparent without compromising privacy; individual test results would only be shared as legally required by public health guidelines and for contact tracing.
The University will employ its own contact tracing program established in tandem with the Rhode Island Department of Health. Additionally, University administrators addressing COVID-19 will receive more continuous, updated information about the quantity and location of people testing positive to better understand the pandemic’s prevalence and trends and assist with contact tracing, Clark said.
Regular testing will continue at the University for the foreseeable future. “This testing is going to be in place as long as we have folks operating on campus during the academic year here or until we get to the point many months from now when there’s a vaccine and we start to move past it. So, there’s not going to be any established end date at this point,” Clark said.
Acknowledging that not everything may turn out perfectly, Britto said, “we are doing our best to think through some of the permutations that would sort of keep the community healthy, the student population healthy (and) assessed as quickly as possible by people who are protected in the right ways, and get students the information they need quickly.”
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