UC San Diego uncertain if robust testing plan will be enough to welcome students back to campus

UC San Diego wait in line to test themselves for the coronavirus in the spring, when the university rolled out a pilot testing program.

Photo: Erik Jepsen/UC San Diego

The University of California, San Diego’s ambitious plan to allow students to return to campus by frequently testing them for Covid-19 is facing uncertainty as the coronavirus surges in many parts of California. 

Led by infectious disease experts from its School of Medicine, the university has developed one of the nation’s most detailed plans to welcome some students back to its campus in the La Jolla neighborhood of San Diego. It’s unclear how many students would return, but the university is promising to offer housing contracts to students who are eligible for a two-year housing guarantee, something other UC campuses have not pledged to do. 

Under UC San Diego’s plan, students who live on campus or attend classes in person would be tested for the virus at least once monthly. Anyone who tests positive — or comes into close contact with someone who tests positive — would be isolated in designated on-campus quarantine housing. The campus would also be reconfigured physically, with classes limited to 50 or fewer students and housing limited to single- and double-occupancy rooms. 

That’s if everything goes according to plan. 

The problem, university administrators acknowledge, is that as cases of the coronavirus continue to increase in California, it’s unclear if even its robust strategy will be sufficient by the time the fall quarter begins on Sept. 28. That uncertainty is shared by universities across California that hope to reopen in the fall but are unsure that it will be safe enough to do so.

“If the outside is exploding, at some point you don’t want to take the risk,” UC San Diego Chancellor Pradeep Khosla said in an interview. “What we are trying to do is risk reduction and risk mitigation. So it doesn’t make sense to do that while the outside is out of control. So we are very cognizant of that and that can change our plan. And I don’t know what the change would be right now.” 

Some universities across the state, such as the University of Southern California, are already cautioning students against returning to campus this fall. Administrators at that university said last week that they are encouraging students planning to live on campus to “reconsider” doing so. 

Campuses across the UC system have so far said they plan to welcome a limited number of students back to campus in the fall, but like at UC San Diego, those plans are subject to change. UC Berkeley, for example, said last month that it intended to house up to 6,500 students out of more than 30,000 undergraduates. But on Wednesday, Berkeley administrators said in a message to the campus community that with increasing cases of the virus, “it’s becoming harder to imagine bringing our campus community back in the way we are envisioning.”

Most campuses have also made clear that they cannot guarantee housing to as many students as they do in a regular quarter or semester. Berkeley has said it cannot promise housing to incoming freshmen and transfer students, who typically have priority. UCLA says it will offer on-campus housing at a “lower population density” than it does in a typical year and is not guaranteeing housing to first-year students.

So far, UC San Diego is being more accommodating, saying students “will be offered a housing contract” if they are eligible for a two-year housing guarantee. Incoming freshmen and transfer students are guaranteed housing at the university for their first two years.

In creating its plan for reopening, UC San Diego relied on a model developed by Natasha Martin, an associate professor in the university’s Division of Infectious Diseases and Global Public Health. 

Using mathematical simulations, her model determined that to detect an outbreak before there are 10 confirmed cases of the virus, the university would need to test at least 75% of the campus community each month.

“We know that if you wait too long and there are too many people that are infected, it hampers our ability to provide adequate isolation housing for cases and contacts and also just our ability to prevent further spread from that outbreak,” Martin said. 

The university would be more likely to reduce the risk of the virus if students and staff were tested more frequently, but the university’s laboratories don’t have the capacity to produce that many tests. It would also be much more expensive to produce that many tests. It will already cost the university about $2 million each month to conduct monthly testing and contact tracing. 

Martin’s model takes into account that the university will incorporate risk mitigation strategies, such as fewer housing options for students and limited in-person classes. About 30% of classes at UC San Diego are expected to be in person during the fall; the rest will be completely virtual or delivered in hybrid formats. Classes that are being held in person will be limited to 50 or fewer students. 

University administrators did not mandate that only 30% of classes be held in person. Instead, they left it up to faculty to decide which courses would be held in person as long as they fell within the class size parameters, said Chip Schooley, a professor of medicine who helped develop the university’s plan to reopen campus. 

“We actually have the physical classroom space to teach more classes if they had said they wanted to teach more than 30%. But when they looked at the course content, that was what they came up with,” Schooley said.

Alex Alvarez, a third-year student at UC San Diego, is enrolled in Gender Politics in the Middle East in the fall quarter and will be taking the course in person. The class has 45 available seats but will be held in a lecture hall that would typically have room for hundreds of additional students, which will make it easy for Alvarez and her classmates to physically distance.

Alvarez, who is currently living in Orange County with family, is also planning to stay in campus housing during the fall quarter. When arriving for move-in, Alvarez and every other student will be tested for the virus. She and other students living on campus will also be expected to monitor their symptoms on a daily basis and test themselves monthly for the coronavirus. 

Any student who tests positive will be moved for two weeks to isolation housing, where they will have access to a private bathroom and meals will be delivered to their rooms.

“I feel good about it just because I’ll be tested pretty repeatedly,” Alvarez said of returning to campus.

Students like Alvarez will self-administer the tests, which will be available at temporary stations set up on campus. They will use a swab to collect saliva and place the swab into a sealed container and then into a plastic bag. They’ll then use a mobile application to scan a QR code so that their personal information will be linked to the swab. 

The swab will then be sent to an on-campus lab to be tested for the coronavirus. The results come back in 24 hours. 

The tests are expected to be extremely accurate. Schooley predicted that the false positivity rate “will be substantially less than 1% and that the approach will be about as sensitive as testing done in hospital settings.”

He added, though, that because of the high volume of tests that will be conducted, the ability to detect an outbreak would not be “substantially affected” if the test were only 85% as sensitive as the standard test, according to the university’s model. 

The university ran a pilot program in the spring, when it tested about 1,500 students and none tested positive. Khosla said it was “good news” that nobody on the campus contracted the virus but also noted that, without any positive tests, the university couldn’t glean whether it was capable of quickly suppressing the virus. 

Although tests will be offered monthly to individuals, the university plans to space out the tests over the course of the month, rather than testing the entire campus community on the same day of each month. 

On a given day, the university may target tests to a specific dorm or cluster of dorms. On another day, the focus could be on testing a specific group of staff members. Students who live off campus but take in-person classes will also be tested. 

“We’ll just try to keep a steady flow going through the lab,” Schooley said. “It’s like having a blindfold on and feeling through a stack of hay for the needles. If you are continuously doing that and sifting through, you’ll have a better chance of picking up on them as they come along than if you do one mass testing one day of the month. That would give you 30 days for an epidemic to brew up without eyes on the problem.”

The university will also try to adapt its testing strategy as the quarter progresses and target tests toward individuals that may be more likely to have been exposed to the virus. 

For example, officials plan to test the wastewater from dorms for the virus. If they detect the virus in the wastewater, that will indicate that there may be viral activity in that specific dorm, Martin said. 

“And then we can go in and test the dorm and identify infections in a more efficient way than just relying on asymptomatic testing,” she added.

When a student or staff member tests positive for the virus, that information will be sent from a lab to the university’s contact tracing staff, who will then reach out to the individual. That person will be quarantined and will be asked to provide the names of everyone they remember coming into contact with over the previous 24 hours. 

The contact tracing staff will then immediately try to reach each of those individuals, who will also be asked to quarantine. 

“It’s fairly manual work, but the contact tracers are trained in how to do the questioning and the interviewing to get the maximum amount of information,” said Vince Kellen, UC San Diego’s chief information officer who is helping lead the contact tracing process.

Brendan Jew, a fourth-year student studying cognitive science, said the university’s plan for mass testing and contact tracing makes him feel comfortable “to an extent” about returning to campus.

Jew isn’t enrolled in any courses that will be held in person this fall, but he does have an on-campus job with the university’s marketing and events department. He said he’s worried that the 24-hour window between when individuals are tested and when they receive their results could give the virus enough time to spread rapidly, particularly if someone with the virus goes to a crowded place like a library or the student center.

“I know that they’ll do their best to contact trace, but there is that 24-hour window where it could spread quite a bit,” he said. 

It’s unclear what would trigger university administrators to place more restrictions on the campus or even cancel in-person classes completely, like they were forced to do in the spring. They plan to listen to guidance from county and state public health officials but will also constantly monitor the situation themselves. 

Martin said there’s “no magic number” of positive cases that would force the campus to shut down, but noted that the more cases there are, “the harder it is to contain.”

She added that whether the campus is in a position to reopen at all, and then stay open for the entire quarter, remains “the million-dollar question.”

“We’re trying to understand what metrics to look at and what level of community transmission would mean that we aren’t in a position to be open at all,” Martin said. “I don’t have the answer yet, but that is the biggest question right now.”