With the first round of mass student testing complete and the second underway, the results so far have not given the community cause for alarm. Only two students have tested positive for COVID-19, putting Haverford’s test positivity rate at 0.19%.
Yet many still worry that the college’s decision to test students every two weeks—with the exception of certain high-risk groups, like student-athletes—is not enough. If an outbreak were to spread across campus, they fear it might not be caught until it is too late.
“I know that people at other schools like Haverford are being tested a lot more frequently, so I’m wondering why we’re not,” said Natasha Bansal ’23.
So how often should Haverford be testing? Peer schools have chosen a wide range of options. Bryn Mawr is testing its students once per month, split into several cohorts. Swarthmore, which only brought back a portion of its student body, is doing the same.
On the other hand, some small liberal arts colleges have opted for far more aggressive testing regimens. Colby College and Wesleyan University are among more than 100 New England educational institutions that have partnered with the Broad Institute to test students up to twice a week with rapid turnaround times. Like Haverford, they’re using nasal swab PCR tests, considered the gold standard for accurately detecting COVID infection.
At Yale University, another Broad Institute partner, testing has gone smoothly so far. Victoria Ellison, a second-year student pursuing a Master’s in Health Policy and Management at the Yale School of Public Health, lives in apartment-style graduate student housing owned by the university. While residents of denser dorms—including all undergraduate housing—are required to get tested twice per week, those in Ellison’s building can access COVID testing at their own discretion. To be on the same safe side, however, she’s been getting tested regularly anyway.
“In the higher-density dorms, they created testing centers in the lobby,” said Ellison. Unlike Haverford, the nasal swabs are self-administered in enclosed booths, but there are health professionals on hand to walk students through the steps of swabbing themselves and properly labeling their vials.
While the process was a bit intimidating at first, Ellison says she now feels like a pro. “People feel pretty confident with tests. They’re always available, easily scheduled, and you can get them as many times you need,” she added.
The turnaround time is quick, too: the longest she’s had to wait for test results is a little more than 24 hours. By comparison, Haverford’s tests can take up to 72 hours to process. Ellison also explained that Yale students can immediately see their test results on MyChart, an online portal used by many healthcare providers.
Through the first month of testing, Health Services has only notified students via email if they test positive. But buried in a HaverHealth Newsletter on October 7 was an announcement from Dean for Student Health & Learning Resources Kelly Wilcox that instructions for students on how to set up MyChart accounts with Main Line Health would be provided at the Founders Hall mass screenings.
During a town hall meeting on September 17, college administrators fielded several testing-related questions from students.
Asked about why the college isn’t testing its students multiple times per week, Dr. Jonathan Stallkamp, Interim Chief Medical Officer at Main Line Health, argued that Haverford has “gone above and beyond” the testing strategies pursued by many nearby institutions.
Stallkamp also noted that the college is being more aggressive than CDC guidelines, which advise against surveillance testing at colleges and universities—a recommendation that has attracted criticism from public health experts.
With COVID prevalence fairly low in the surrounding community, Stallkamp suggested that Haverford did not need to test its community more than twice a month. “If things were to change,” he said, “maybe we would test more frequently.”
A. David Paltiel, professor of public health at the Yale School of Medicine, said that this strategy risked luring the school into a false sense of security.
“If I were emperor, I would urge Haverford to start with a little more frequent screening and a little more caution and to scale it back if and when they have evidence that the situation is well in hand—exactly because it’s hard to play catch-up with this virus,” he said.
Paltiel was the lead author on a study published in July that suggested high-frequency testing—at least once a week—might be necessary to control COVID on college campuses. The precise frequency of testing recommended by the study depends on the assumptions made about the reproductive number of the virus: the average number of new infections seeded by each COVID-positive person. However, the less frequent the testing, the higher the risk that an outbreak could spread across campus without being detected.
“[Testing every two weeks] does seem lower frequency than our model would suggest, and not only because the reproductive number is probably higher than they’re suggesting, but also because of the fact that people can begin to be infectious three or four days after exposure to the infection,” said Paltiel.
In their messages to the community, Haverford’s administration has tended to stress other aspects of their COVID safety plan, such as handwashing, social distancing, and mask-wearing. While Paltiel agrees that these are crucial for infection control, he says that they cannot substitute for a rigorous testing plan.
“Our assumption was that schools were going to be vigilant and aggressive in maintaining those conditions and that even under good conditions, screening twice a week would be required,” he explained.
Interim Dean of the College Joyce Bylander took a more skeptical view of the value of frequent testing, even suggesting that it could make the campus less safe by freeing students to engage in risky behavior. This theory has not been supported by the medical literature.
“Some of the caution about that much testing is that it makes people complacent. They really believe that testing is what’s protecting them, when testing doesn’t protect us,” she said. “So you can feel like, ‘Well, I can do anything I want, because I’ll be tested tomorrow, or the day after tomorrow.’”
Notably, during the town hall, Dean Wilcox stated that the college has the ability to scale up its testing program should the infection rate increase. That suggests the administration is confident enough in its COVID strategy that it believes testing more frequently than every two weeks is unnecessary or even counterproductive.
Overall, Paltiel believes that the most likely scenario is that the campus makes it through the semester without falling victim to a widespread COVID outbreak. “But that’s small comfort when you realize that if something does go wrong, the consequences are going to be borne not so much by the Haverford students, but by the dining hall workers and the custodians and the people in the surrounding community and maybe even spread into Philadelphia,” he said.
There’s a long tail of unlikely, but very bad outcomes, and he’s worried that “everything that could go wrong needs to go right” to keep Haverford safe.
Paltiel also reflected on the importance of mutual trust and honest communication between the student body and the administration, qualities that have often been in short supply over the past few weeks.
He noted: “I would hope that a school like Haverford, with its long tradition of listening carefully to other people when they are moved to speak, might in fact recognize that it has an obligation to make resources available to you guys, rather than just finger-wagging and scolding you and telling you that, if it weren’t for the naughty behavior of students, everything would be fine.”