Abstract
The coronavirus disease 2019 (COVID-19) pandemic prompted universities across the United States to close campuses in Spring 2020. Universities are deliberating whether, when, and how they should resume in-person instruction in Fall 2020. In this essay, we discuss some practical considerations for the use of 2 potentially useful control strategies based on testing: (1) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) testing followed by case-patient isolation and quarantine of close contacts, and (2) serological testing followed by an "immune shield" approach, that is, low social distancing requirements for seropositive persons. The isolation of case-patients and quarantine of close contacts may be especially challenging, and perhaps prohibitively difficult, on many university campuses. The "immune shield" strategy might be hobbled by a low positive predictive value of the tests used in populations with low seroprevalence. Both strategies carry logistical, ethical, and financial implications. The main nonpharmaceutical interventions will remain methods based on social distancing (eg, capping class size) and personal protective behaviors (eg, universal facemask wearing in public space) until vaccines become available, or unless the issues discussed herein can be resolved in such a way that using mass testing as main control strategies becomes viable.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic prompted universities across the United States to close campuses in Spring 2020
One university president wrote recently, “The COVID-19 virus will remain a fact of life this autumn.”[5]. University student life, including classroom instruction, cafeterias, residential halls, and sport and cultural activities, provides ample opportunities for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission
We discussed some practical considerations for 2 potential testing-based control strategies as applied to college campus reopening: reverse transcriptase-polymerase chain reaction (RT-PCR) testing followed by case-patient isolation and quarantine of close contacts; and serological testing followed by “immune shields.”
Summary
The coronavirus disease 2019 (COVID-19) pandemic prompted universities across the United States to close campuses in Spring 2020. Pros Identify individuals currently infected with SARS-CoV-2 including asymptomatic individuals Provide information for monitoring the epidemic Public confidence When performed frequently enough, it might reduce transmission below the critical threshold of reproduction number = 1 Identify individuals who have antibodies and who might be immune to reinfection Seroprevalence of the campus community Needs to be repeated less frequently than RT-PCR testing
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