Is a COVID-19 spring break surge inevitable?

Spring breakers celebrate on the beaches of south Florida
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College students around the nation are partaking in the annual rite commonly referred to as spring break. Many students are heading down to cities in Florida and other warm destinations to enjoy beaches and bars, socializing as only college students can during their mid-semester break.

Over the past two years, spring break has been marred by COVID-19. In 2020, much of the country was under stay-at-home orders, with colleges and universities pivoting to remote learning. Those students who took spring break excursions were highly vulnerable to infections. In 2021, many colleges canceled spring break, attempting to prevent students from leaving their campus and then bringing the virus back to infect the college community. 

Now, with over 88 percent of the adult population vaccinated with at least one dose, and the omicron surge in sharp decline, students may feel empowered to enjoy spring break as they did pre-pandemic. 

Will this create a post spring break surge in new infections?

The answer is most certainly yes. The more salient question is, what will a surge now look like, given that we are now more than two years into the pandemic?

To put this into perspective, there are several headwinds and tailwinds in place to either restrain or accelerate such a surge and the associated consequences. 

CDC face mask guidelines: The Centers for Disease Control and Prevention (CDC) recently revised their face mask guidelines, which now includes factors like area hospitalization rates in addition to the number of new cases and new infection rates. These guidelines, which now classify every county as low, medium or high risk, are reactive rather than proactive, since it takes one to two weeks after being infected for people to possibly require hospitalization. This means that in low-risk areas, students will likely go without face masks. Although personal risk to students is very small, spring break gatherings are certain to foment new infections and keep the virus circulating.  

Vaccination and prior infections: The good news is that the vaccines provide protection against severe disease. Therefore, a combination of college students being vaccinated, which is likely given widespread campus vaccination mandates, or with prior infection means that outbreaks are likely to be attenuated. With the 18- to 29-year-old age group having the largest percent of cases relative to their percent of the population, prior infection protection is high among them.  

Testing: When students return to campus, they will bring infections with them. However, detecting such infections will require widespread testing and reporting, which is not available everywhere. While rapid at-home tests are more available than previously, such test results may go unreported. In addition, given that as many as 40 percent of infections are asymptomatic, the risk of unknown virus transmission will remain high. 

With many colleges in the Northeast and Midwest located in college towns surrounded by rural areas, any combination of low vaccination rates as well as waning protection from the vaccines and prior infections may lead to new infections among locals. The resulting uptick in hospitalizations will likely push many such counties into a higher risk classification, based on the new CDC face mask guidelines. 

Government agencies like the CDC and state public health departments can provide guidelines on when it is safe to relax face mask mandates and other countermeasures. However, the virus itself always has the final say on the risks to a community and its population.

People who are immunocompromised are wise to continue to take all necessary precautions, as are those over 65 years old. College students, in general, fall into a much lower-risk groups, and as such, appear less vulnerable to the most deleterious effects of the virus, particularly over the short term. 

We now know that there is no “silver bullet” in assessing COVID-19 risk. Every action has a response and a consequence. Spring break will occur, infections will spread, and across the nation new cases will be brought back to campuses and their communities. No government policies can stop this phenomenon.

Every person residing in an area around colleges and spring break destinations will need to decide for themselves what precautions to take. Asking for one-size-fits-all protections is no longer feasible.

Many have been waiting for a return to normal. Asking people to make wise decisions for themselves and the people around them is the new normal.  

Sheldon H. Jacobson, Ph.D., is a founder professor of computer science and the Carle Illinois College of Medicine at the University of Illinois at Urbana-Champaign. He applies his expertise in data-driven risk-based decision-making to evaluate and inform public policy.

Janet Jokela, MD, MPH, is the acting regional dean of the University of Illinois College of Medicine at Urbana-Champaign. She is an infectious disease and public health physician. 

Tags CDC community spread Coronavirus COVID COVID-19 Healthcare Janet Jokela Mask Public health Sheldon H. Jacobson spring break Vaccine Virus

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