Student gatherings and congregate living settings likely contribute to the rapid spread of COVID-19 at universities, according to an analysis published Tuesday by the Centers for Disease Control and Prevention (CDC).
Universities that resume in-person learning should reduce the capacity of on-campus housing, increase consistent use of masks, increase testing for COVID-19 and discourage student gatherings, the authors of the CDC report concluded.
The report looked at one university in North Carolina that experienced a “rapid increase of COVID-19 cases and clusters” within two weeks of opening campus to students.
Between August 3 and 25, nearly 700 COVID-19 cases were identified, mostly among patients 22 or younger, suggesting most cases were among undergraduate students.
While the report doesn’t name the university — a common practice for CDC reports — the demographics and statistics listed match up with the University of North Carolina Chapel Hill, which ended in-person instruction two weeks after classes began following outbreaks of COVID-19 on campus. Students also were not required to quarantine or get tested for COVID-19 before arriving on campus.
Thirty percent of cases were linked to at least one cluster, defined by the CDC as five or more linked cases, such as a common residence, sports team, or membership of a fraternity or sorority.
The CDC identified 18 clusters in total, the largest one connected to a university-affiliated apartment complex.
“Student gatherings and congregate living settings, both on and off-campus, likely contributed to the rapid spread of COVID-19 within the university community,” the authors of the report wrote.
By the time the university moved to online instruction Aug. 19, more than 330 COVID-19 cases had been reported to the local health department, despite taking a number of mitigation measures, including decreasing the capacity of dining halls and classrooms.
Still, residence halls had opened at between 60 percent to 85 percent capacity, with most students in double rooms, according to the CDC’s report.
About 5,800 students — 30 percent of enrolled undergraduates — were living on campus as of August 10.
Among undergraduate students who tested positive for COVID-19, 36 percent lived on campus, and at least 8 percent were members of a fraternity or sorority. Eight percent were student athletes.
As of Aug. 25, none of the students were hospitalized or had died, according to the report, but any longer-term complications are unknown because of “limited clinical follow-up,” according to the report.
While healthy children and young adults are unlikely to face severe COVID-19 illness, they can spread it to others who are at higher risk for complications, according to a separate CDC report published Tuesday. Colleges and universities should take mitigation steps to prevent the spread of COVID-19 on campuses to protect instructors, staff and their surrounding communities, CDC Director Robert Redfield and others wrote in a JAMA editorial published Tuesday, accompanying the two CDC reports.
"At the beginning of the fall of 2020, the opening of colleges and universities poses new challenges and accompanying risks for transmission on campuses and in their surrounding communities.
"Although the risk of severe health outcomes from COVID-19 in young adults without underlying health conditions is relatively low, faculty, university staff, and close contacts of college students at home and in the community might be at a considerably higher risk for severe illness and death if they were to become infected."
That report found a 55 percent increase in COVID-19 cases among 18-22 year-olds between Aug. 2 and Sept. 5. While many colleges and universities required students be tested before or after arriving on campus, the increase in cases is not solely related to more testing, the authors of the report wrote.
"It is likely that some of this increase is linked to resumption of in-person attendance at some colleges and universities," the authors wrote.
Neither of the reports looked at the effect of college campuses reopening on states or cities they reside in. But another study published last week by researchers at the University of North Carolina at Greensboro, Indiana University, the University of Washington and Davidson College estimated that colleges reopening drove a surge of 3,000 new cases per day. It has not yet been peer-reviewed.