Association of University Reopening Policies with New Confirmed COVID-19 Cases in the United States

Li, Y.; Ma, C.; Tang, W.; Zhang, X.; Zhu, J.; Nallamothu, B.

Reopening of universities in the U.S. has been controversial in the setting of the coronavirus disease 2019 (COVID-19) pandemic. We leveraged several publicly available data sources to study the association of county-level new confirmed COVID-19 case rates since September 1st and the number of students returning to campus across 2,893 U.S. counties with and without universities. In 1,069 U.S. counties with universities, we also studied the association of different reopening policies (online, in-person, hybrid) on new confirmed COVID-19 cases. Multivariate regression models estimated both effects of university reopening and different reopening policies. Mean number of daily confirmed cases per 10,000 county population was 1.51 from August 1st to August 31st, and 1.98 from September 1st to October 22nd. Mean number of students returning to universities was 2.1% (95% CI, 1.8% to 2.3%) of the county population and the number of students returning to campus had a positive association ({beta} = 2.006, p-value < 0.001) with new confirmed COVID-19 cases within the local county region where the institution resided. For U.S. counties with universities, the mean proportion of online enrollment within each county was 40.1% (95% CI, 37.4% to 42.8%), with most students enrolling in-person or hybrid mode. In comparison to holding class in-person, reopening universities online ({beta} = -0.329, p-value < 0.001) or in a hybrid mode ({beta} = -0.272, p-value = 0.012) was negatively associated with new confirmed COVID-19 cases. These findings could help public health officials consider policies to mitigate additional waves of infection during the upcoming winter.