Colleges Are Tracking COVID, but Don't Have to Report the Cases to Anyone

On Wednesday morning, the New York Times published the results of a survey sent to nearly 1,000 colleges and universities around the country, asking about coronavirus case numbers associated with their campuses. At least 6,600 cases are tied to the around 270 schools that replied to the survey, or for which data was already publicly available; it’s the most comprehensive look at COVID-19 and college campuses so far. As the Times notes, though, it’s also an extremely rough estimate. Schools have no legal obligation to disclose coronavirus case numbers to the press or the public.

Schools can and often do report infectious disease information to local and state health departments, like when there’s an outbreak of the mumps or a notable uptick in a particular STI, but the Times story reveals an alarming problem that it’s hard to believe, the better part of a year into this pandemic, is still the case: As of now, there is currently no standardized reporting protocol for coronavirus cases at colleges, and the college-specific data isn’t tracked on a national level, despite that on-campus clinics are regularly required to report other infectious diseases to local health departments.

The Times says it got its data through a combination of what’s publicly available on university websites, and through emailed surveys. Hundreds of schools didn’t respond at all, mirroring a trend among school athletic departments that have sworn not to disclose case numbers as they resume practices for doomed sports seasons. When the survey data was first published, Texas A&M, the largest university in the country with nearly 70,000 students, was left out entirely; the original case number was 6,300, updated to 6,600 to include Texas A&M’s cases on Thursday.

If schools don’t have systems in place to accurately capture case numbers now, they almost certainly will soon: Most schools—including Texas A&M—have elaborate tracing plans and systems in place to monitor cases on campus throughout the school year to help prevent (an inevitable) outbreak. Steve Mooney, professor of epidemiology at the University of Washington, told VICE that these tracing systems also aren’t new. Schools typically have some sort of machinery in place to identify and prevent an infectious disease outbreak on campus.

“Whatever that machinery is, it’s probably the same people in the room, trying to decide how to deal with coronavirus now,” Mooney said.

Mooney added that “health care delivery systems”—which includes on-campus clinics as well as hospitals and doctors’ offices—are required to notify public health departments of “reportable conditions.” These vary from state to state and over time, but typically include highly contagious and rare diseases like Ebola, all the way down to a surprising pattern of a nonlethal STI.

“Schools have outbreaks of STIs all the time, student health services at most undergraduate institutions must have some STI screening program,” Mooney said. When schools are made aware of an STI outbreak, they may not cancel classes and send everyone home for the semester, a la coronavirus in March, but there is some precedent that schools make changes to their regular operations if and when an outbreak happens.

“If there’s a huge STI outbreak and they’re aware of it, it might change how they do sexual health education or orientation,” Mooney said. “The infrastructure is there for tracking this kind of thing: how many cases of a particular disease there are, and how to respond based on the present status.”

Most schools have plans for regular coronavirus testing in place, with tests processed at labs in the community. Mooney said those labs are obligated to report all positives to public health authorities, but that’s a degree of separation from the university, even if the school is notified that a student tested positive. While schools can (and should) know how many cases are on campus at a given time, they don’t then have to reveal that information to the public or a survey sent by a journalist.

“In this case, COVID-19 is a reportable condition, so if the university has identified cases through their health services, they are supposed to report them to the local health department,” Saskia Popescu, an infectious disease epidemiologist, told VICE. “Reporting to the public is not normally done—this tends to be a public health department responsibility.”

As colleges track this data for their own purposes, there’s a strong ethical argument to be made for making it available on a public dashboard, just like the ones we’re all so used to looking at every day to monitor the pandemic in our counties and states. As has already been demonstrated over and over again this year, an outbreak that starts out as isolated among a small student group can impact an entire city.

The infamous Cabo 44, or the group of students from the University of Texas who tested positive for coronavirus after spring break trips, kickstarted an entire outbreak in Austin this April. An outbreak in Oxford, Mississippi in mid-June was traced back to a frat party near the Ole Miss campus. Both of these outbreaks happened during a time when school was out of session, and students weren’t mixing around in crowded classrooms, dorms, and parties.

Not only do students and their families have a right to know what the current state of the coronavirus pandemic is on a campus they pay to attend, but the people who live near these schools do, as well. Without independently publishing information on campus cases, the numbers get swallowed up by the county and state data, leaving everyone to guess at what percentage can be traced back to the school.

“It’s not only the right thing to do, but also in the best interest of the public and the students to make it known if they are experiencing outbreaks or clusters, sharing safety tips, and how they’re working to address the issue,” Popescu said.

Students may be incentivized to be more careful if they’re aware of how many people around them are sick or have been exposed. But if no one knows how many cases there are on campus, schools can more easily continue with in-person classes, just like athletic departments can go on with their football games more easily if none of the fans know how many players are out on the field, struggling to breathe.

Barring any legal obligation, Mooney said that the only way more schools might start publishing coronavirus case data is if…. More schools start publishing the data. “If 90 percent of schools are reporting, then the 10 percent that aren’t look suspicious,” he said. “There’s probably going to be some kind of norm setting that will emerge over time.”

My last semester of college at the University of Texas, during finals week in early May, I got an email letting me know that someone in one of my classes had come down with the mumps. Then I got two more emails saying the same. I hadn’t yet lived through March 2020 and so I lacked the pumped up public health vocab we all have now, but it was my first brush with contact tracing. A few days after one of the emails, I woke up with a sore throat and comically swollen face. I went to the campus clinic, suspecting the obvious, where they confirmed I had the mumps, too, kicking off another string of emails to my classmates.

From there, I’m assuming my case was reported to the local health department, who, according to a local news story written at the time, had already been notified of the small mumps outbreak on the UT campus before I ever got the first contact tracing email. It was the first mumps outbreak on campus since the vaccine was approved in the `60s.

Like coronavirus, the mumps is highly contagious and spread mostly via saliva expelled when someone coughs, sneezes, or talks. Unlike coronavirus, it’s almost never fatal. But it’s still an annoying illness with a high fever that made studying for finals an even bigger bummer. If the outbreak had ever grown into the double digits, I imagine the school would’ve intervened in some way; I was explicitly told not to go to class until I recovered. But at the very least, the school reported the small outbreak and publicly identified that it was stemming from the campus.

That schools aren’t responding exactly like this now, as students migrate back to their campuses during a pandemic, speaks to how far gone and highly politicized coronavirus has become in the United States. “Prior to this pandemic, I wouldn’t have thought of an infectious disease as being a politicizable thing,” Mooney said. “What you want to do is obvious: You want to stop the infection, and not get more people infected. But everything is so politicized now, and I don’t know how that’s going to play out in terms of school response.”

Follow Hannah Smothers on Twitter.