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SARS-CoV-2 Viral and Serological Testing When College Campuses Reopen: Some Practical Considerations
Isaac Chun-Hai Fung1, Chi-Ngai Cheung2, Andreas Handel3
1Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia.
Disaster Medicine and Public Health Preparedness
|July 28, 2020
Summary
Universities face challenges implementing COVID-19 testing strategies like isolation or an "immune shield" for safe reopening. Social distancing and masks remain key until vaccines are available or testing becomes more viable.
Area of Science:
- Public Health
- Epidemiology
- Higher Education Administration
Background:
- The COVID-19 pandemic forced US university campus closures in Spring 2020.
- Universities are planning for the resumption of in-person instruction in Fall 2020 amidst ongoing pandemic concerns.
- Effective control strategies are crucial for safely reopening educational institutions.
Purpose of the Study:
- To discuss practical considerations for implementing SARS-CoV-2 testing-based control strategies in universities.
- To evaluate the feasibility and implications of two primary testing approaches: RT-PCR with isolation/quarantine and serological testing for an 'immune shield'.
- To highlight the ongoing importance of nonpharmaceutical interventions until vaccines are widely available.
Main Methods:
- Analysis of two proposed COVID-19 control strategies for university campuses.
- Consideration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) testing for case identification and contact tracing.
- Evaluation of serological testing to identify individuals with presumed immunity for an 'immune shield' approach.
Main Results:
- Isolation of cases and quarantine of contacts present significant logistical challenges on university campuses.
- The 'immune shield' strategy may be compromised by low positive predictive value of serological tests in low prevalence settings.
- Both testing strategies involve substantial logistical, ethical, and financial considerations.
Conclusions:
- Current mass testing strategies face considerable hurdles for widespread implementation in university settings.
- Social distancing measures (e.g., reduced class sizes) and personal protective behaviors (e.g., universal masking) remain essential.
- These nonpharmaceutical interventions are critical until vaccines are available or testing-based strategies become more robust and viable.
