With a multilayered approach to detect and prevent the spread of Covid-19, campus leaders at the University of California, San Diego say they have created something rare in higher education this year: a safe on-campus experience for thousands of students.
Even with Covid-19 spreading rapidly in Southern California, about 10,000 students are living on UC San Diego’s La Jolla campus this year. After avoiding any significant Covid-19 outbreaks during the 11-week fall quarter, the university welcomed students back this month and resumed instruction for the winter quarter.
Colleges with that many students living on campus are an uncommon sight this academic year. This month, Stanford University abruptly reversed its plans to allow freshmen and sophomores to move into dorms this quarter. Most campuses in California’s two four-year university systems, the UC and California State University, are also housing very few students.
But at UC San Diego, Chancellor Pradeep Khosla and other leaders say their campus is much safer for students than the outside community. Covid-19 test positivity rates within the campus community have consistently remained far below rates in San Diego County. So far, the highest 14-day average rate of positive tests among students was 1.8% earlier this month, with most of those students testing positive as they returned to the campus from winter break. At that same point, the 14-day average positivity rate in the county was 13.8%. Since then, test positivity rates among students have dropped below 1%.
Credit for UCSD’s good fortune lies with science. Students and employees at UC San Diego are tested for Covid-19 every week. A lab on campus frequently tests the wastewater in dorms and other buildings for signs of the virus. Most of the campus uses CA Notify, a mobile app that alerts individuals via Bluetooth if they have come into contact with another person who has tested positive for the virus.
The resources at UC San Diego’s disposal — including its own health care system and medical school — make those programs possible and have given the university an advantage over most other colleges and universities throughout the state.
As important as any single strategy is student behavior. The campus uses a peer engagement approach with hundreds of student health ambassadors who patrol campus to educate and ensure that students and others are following health protocols, such as wearing masks and not gathering in groups.
In an interview, Khosla called the university’s approach a “swiss cheese model.”
“The implication is that no slice is perfect. Everything has holes in it. But when you put the slices together, they form a solid block and it works perfectly,” Khosla said.
That doesn’t mean there have been no cases of the virus on the campus since its opening in October. In fact, as many as 30 on-campus students have tested positive for Covid-19 in a single day this month. But the university has found little evidence of transmission within the campus community. The vast majority of those students who tested positive have at some point left the campus — in many cases to visit family over Thanksgiving or winter break — and tested positive upon returning. UC San Diego has hundreds of isolation rooms where students are kept for 14 days after testing positive.
A very different college experience
Campus life is much different than a typical semester. Gatherings are banned and most student events are held virtually. Classes are still being delivered online, except for a few held outdoors. Dining halls are closed, with meals available only to go.
Still, Khosla said it’s important for many students to be on campus. About 40% of the university’s students are Pell Grant recipients or first-generation college students, he said. Some don’t have housing and others don’t have ideal situations at home for remote learning, whether it’s because they lack privacy, reliable internet access or the necessary equipment.
“We have all that on our campus,” Khosla said. “And since we have the room, I don’t see any reason why we should not scale it up and give access to these students to have a better experience on campus and a safer experience.”
Syreeta Nolan, a psychology major, doesn’t have housing outside UC San Diego, so living in the dorms was an easy decision. She is a member of the university’s Hope Scholars program that provides year-round housing to foster youth, homeless youth and others.
The absence of regular campus activities hasn’t been a major issue for Nolan, who transferred from MiraCosta College in 2019. Between a full class schedule and four research projects that she leads, she doesn’t have much free time.
Nolan had a moment when she wasn’t convinced that the campus would be safe from Covid-19 at the beginning of the fall quarter, when she saw a group of unmasked students gathered outside for a meal. Since then, though, she has noticed students consistently following the rules.
Nolan, who has fibromyalgia, a disorder that causes muscle pain and fatigue, is also an advocate for disabled students — both at the campus level and across the UC in her role as the UC Student Association’s Underrepresented Student Officer. She said she’s grateful for UC San Diego’s efforts to minimize the spread of Covid-19 because many of those students may be at higher risk of becoming seriously ill if they get infected.
“It gives disabled students who are at high risk a place to actually be safe,” Nolan said.
For Tony Tran, a first-year student from Vietnam, living on campus has several advantages. He suspects he would have a difficult time taking his classes as seriously if he were attending them from his host family’s home in the San Francisco Bay Area. Being on a campus and staying in his dorm are reminders that he’s working toward a college degree.
He also feels safer on campus because of the free, regular Covid-19 testing that is available.
When he’s not in his dorm room, Tran often takes advantage of San Diego’s warm weather by meeting friends and studying together outside. He also likes to go on walks around the university’s 1,200-acre campus.
“I’m a big fan of random walks,” he said. “It’s still surprising to me how many places there are on campus that I haven’t walked to.”
Tran and other students living on campus were tested for the virus twice monthly in the fall. This quarter, they are tested every week, mostly by accessing self-administered tests in vending machines that are set up across the campus. The university ramped up testing frequency this quarter because its labs have the capacity to produce more tests and because the virus is now spreading much faster in San Diego than it was in the fall.
From the start, campus leaders have been willing to fine-tune their strategies as they’ve learned more about the virus. Their thinking is shaped by mathematical modeling that simulates interactions among students, faculty and staff. The model helps them understand how the virus could spread depending on factors such as testing frequency, housing density and student adherence to masking and distancing rules.
“We’re continually assessing the situation, but I think we can say that the campus is a relatively safe place to be. And we want to keep it that way,” said Natasha Martin, an associate professor of medicine and the university’s lead modeler.
The success of wastewater testing
Wastewater testing also adds another layer of protection, giving UC San Diego a better chance to promptly identify cases of the virus. The university started by testing the wastewater in six buildings last summer and the program has steadily evolved since then. This quarter, the university will monitor wastewater in more than 200 buildings — a mix of student dorms, research buildings and administrative buildings.
Each day, wastewater samples are collected from those buildings and brought to the Knight Lab at the university’s Center for Microbiome Innovation. When Covid-19 is detected in a building, it generates a positive signal. Everyone who lives or works in that building is then tested for the virus, and those who test positive are quickly isolated.
When there have been positive signals, the university has been able to identify the infected individuals and isolate them, which then turns the signal negative. Rob Knight, who runs the Knight Lab, said there have been at least six cases of asymptomatic carriers who were identified via wastewater testing and otherwise would not have been identified until their next testing appointment.
Knight said he’s surprised by how effective the wastewater testing has turned out to be. Even one infected individual in a building with hundreds of students can cause a positive signal, something Knight wasn’t expecting when the wastewater testing first began.
“It’s far more sensitive than we were expecting,” he said in an interview.
California’s new contact-tracing app, called CA Notify, has also been used to identify cases of the virus at UC San Diego. Now available to all California residents, the app was piloted in the UC system. Individuals who use the software are notified via Bluetooth if they have come into contact with an infected person for more than 15 minutes.
The more people that use the app, the more effective it becomes, since both parties need to have the software installed for it to work properly. At UC San Diego, more than half of the on-campus student and employee population is actively using the software.
Since last quarter, the university’s staff has sent out about 50 exposure alerts and has identified several cases of the virus in individuals who received those notifications.
In the end, though, the university’s protocols and intervention strategies are effective only if the students themselves are responsible, campus leaders stressed. To make that a reality, UC San Diego’s student affairs staff has emphasized a peer engagement strategy where students hold each other accountable.
Watch for the yellow shirts
The campus hired about 400 students to be student health ambassadors who roam the campus and reinforce the university’s public health rules. They are split into nine zones across the campus.
“We know how important peer educators and peer-to-peer relationships are, particularly at this point developmentally, in terms of making good decisions, healthy decisions,” said Angela Scioscia, the university’s interim executive director of student health and wellbeing.
One of the student ambassadors is Marie Manipud, a fourth-year public health student. At the beginning of the fall quarter, Manipud spent most of her time promoting the many new campus rules. She sometimes had to remind students not to gather and to always wear their masks, even if they were outdoors and only with a roommate.
Manipud and the other ambassadors wear bright yellow shirts, making them easy to spot. When other students see them, it serves as a reminder, she said.
“I feel like as soon as they see the yellow shirts, they immediately think to make sure they are following protocols,” she said.
Now, several months into the academic year, Manipud said students rarely need reminders. In her experience, those who are more likely to not follow the rules have been campus visitors such as families, who Manipud said sometimes give her a hard time about wearing their masks.
Ambassadors like Manipud also keep extra masks and hand sanitizer on-hand to offer to students or other community members who are running low on those supplies. They also are on site at Covid-19 testing locations across the campus to answer any questions students have or help them administer the tests.
Manipud said the goal is for the interactions to be a peer-to-peer, friendly approach rather than a punitive one. She and other ambassadors even try to reinforce positive behavior by handing out $5 Starbucks gift cards to students who are following all rules.
Scioscia said student compliance has been nearly flawless throughout the year.
“We have the infrastructure of labs and technology. We can test wastewater. That’s all great. But if students were partying and breaking the rules, we’d have the virus spreading because there’s no way to stop it. The fundamental line of defense is behavior and the students have really been fantastic about it,” she said.