Control of COVID-19 transmission on an urban university campus during a second wave of the pandemic

Hamer, D. H.; White, L.; Jenkins, H. E.; gill, c. J.; Landsberg, H. N.; Klapperich, C.; Bulekova, K.; Platt, J.; Decarie, L.; Gilmore, W.; Pilkington, M.; McDowell, T. L.; Fari, M. A.; Densmore, D. M.; Landaverde, L.; Li, W.; Rose, T.; Burgay, S. P.; Miller, C.; Doucette-Stamm, L.; Lockard, K.; Elmore, K.; Schroeder, T.; Zaia, A. M.; Kolaczyk, E. D.; Waters, G.; Brown, R. A.

Importance: The COVID-19 pandemic had a wide-ranging impact on educational institutions across the United States. Given potential financial challenges and adverse psychosocial effects of campus closure, as done in the spring of 2020 in response to the first wave, many institutions of higher education developed strategies to allow campuses to reopen and operate in the fall despite the ongoing threat of COVID-19. Many however opted to have limited campus re-opening in order to minimize potential risk of spread of SARS-CoV-2. Objective: To analyze how Boston University (BU) fully reopened its campus in the fall of 2020 and controlled COVID-19 transmission despite worsening transmission in the city of Boston. Design: Multi-faceted intervention case study. Setting: Large urban university campus. Interventions: The BU response included a high-throughput SARS-CoV-2 PCR testing facility with capacity to delivery results in less than 24 hours; routine asymptomatic screening for COVID-19; daily health attestations; compliance monitoring and feedback; robust contact tracing, quarantine and isolation in on campus facilities; face mask use; enhanced hand hygiene; social distancing recommendations; de-densification of classrooms and public places; and enhancement of all building air systems. Main Outcomes and Measures: Between August and December 2020, BU conducted >500,000 COVID-19 tests and identified 719 individuals with COVID-19: 627 (87.2%) students, 11 (1.5%) faculty, and 212 (25.5%) staff. Overall, about 1.8% of the BU community tested positive. Infections among faculty and staff were mostly acquired off campus, while undergraduate infections were more likely acquired in non-classroom campus settings. Of 837 close contacts traced, 86 (10.3%) tested positive for COVID-19. BU contact tracers identified a source of transmission for 51.5% of cases with 55.7% identifying a source outside of BU. Among infected faculty and staff with a known source of infection, the majority reported a transmission source outside of BU (100% for faculty and 79.8% for staff). Conclusions and Relevance: BU was successful in containing COVID-19 transmission on campus while minimizing off campus acquisition of COVID-19 from the greater Boston area. A coordinated strategy of testing, contact tracing, isolation and quarantine, with robust management and oversight, can control COVID-19 transmission, even in an urban university setting.