COVID in the Classroom
Image Credit: World Health Organization
With the closest return to in-person learning since the start of the pandemic in March 2020, the considerations and precautions we have had to take as students are different from those of the past few semesters. The Delta surge has waned in the past months, but case counts have ticked back up in portions of the country due to the Omicron variant, with the country’s seven-day rolling average at 124,709 as of the publication of this article, and there remains the likelihood of a winter surge analogous to what we saw last year. Regardless, the situation is still manageable locally, with Travis County still at Stage 3 of its Risk-Based Guidelines. Though much is still unknown about Omicron, it seems possible that it may lead to less severe disease than wild-type SARS-CoV-2. This data, coupled with the recent rollout of booster doses and the CDC’s recommendation of the Pfizer-BioNTech vaccine for children aged five5 through 11, are cause for optimism. If we continue to practice safe behaviors, it is possible that we could be in the last couple of months in which COVID has a significant effect on our collective learning experience.
Although it is true that the majority of vaccinated college students have little to no chance of encountering a severe case of COVID, risks remain. In fact, over 180,000 Americans between the ages of 18 and 29 have been hospitalized over the course of the pandemic. The peak hospitalization rate also occurred around mid-August 2021, after vaccines had already been rolled out. Additionally, we do not live as individuals in their own bubbles; there is a broader population in the city full of people who are still at risk irrespective of their vaccination status. Even if we restrict our view to just the university, there are older instructors and employees, unvaccinated people, and those who are immunocompromised, all of whom may encounter a more severe case. It is also not ideal to have a university full of students getting mild cases of COVID and having to quarantine when it can be mitigated, at least in part, with fairly little effort.
As students on a college campus, we may be prone to thinking that as long as infection rates are kept low on campus, our lives can continue as normal. However, a study at Boston University showed that infection rates on its campus were proportional to the exogenous rates in the community. Thus, the fate of our campus and the rest of the city and world are thoroughly intertwined. At the same time, the problem of mitigating SARS-CoV-2 transmission on a college campus is made tougher by the increased likelihood of students to live in higher-density arrangements, like apartments or dormitories, which are drivers of viral spread.
Now, how can students best reduce their chances of acquiring an infection and play their role in bringing the pandemic to an end? To understand and avoid the settings in which a COVID exposure is possible or likely, we have to understand the mode by which the virus spreads. The primary mechanism by which someone can acquire an infection is exposure to viral droplets that were expelled by an infected individual. Aerosolization of viral particles can actually lead to transmission at distances greater than six feet due to poor ventilation or prolonged exposure. Somewhat counterintuitively, the virus does not seem to spread by touch to any major degree, with the CDC saying that the probability of fomite transmission is less than 1 in 10000, meaning that <.01% of exposures to a contaminated surface actually result in infection.
Chart courtesy of Hannah Ritchie, Edouard Mathieu, Lucas Rodés-Guirao, Cameron Appel, Charlie Giattino, Esteban Ortiz-Ospina, Joe Hasell, Bobbie Macdonald, Diana Beltekian and Max Roser (2020) - "Coronavirus Pandemic (COVID-19)". Published online at OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus' [Online Resource]
There are a number of pillars of mitigation that have been preached since the onset of the pandemic, and those remain the most effective measures against yet another surge:
Try to wear a mask any time you are indoors, preferably one with more layers of fabric to provide the best protection.
Stay home if you feel any sort of sickness at all. It only takes one infected student to expose a class to the virus, so be overly cautious whenever possible.
Avoid large crowds. With community transmission still occurring, crowding increases the probability you will be exposed to the virus.
Ensure adequate ventilation in closed spaces. Aerosols linger in the air and spread in the absence of frequent exchanging of indoor and outdoor air.
Get tested often. Surveillance testing combined with quick and effective contact tracing has been shown to lead to reductions in case counts on college campuses
On top of the aforementioned safety measures, there is one key factor that has enabled our semester to look somewhat more normal: safe and effective vaccinations. Despite the increased transmissibility of the Delta variant, the Pfizer-BioNTech vaccine is still around 93 percent effective at preventing symptomatic infection in adolescents. Without a more widespread acceptance of vaccinations among all populations, we likely will not be able to turn the page on the pandemic without losing an even more catastrophic number of lives in the process. With that said, it is highly recommended to take the vaccine if you have not chosen to yet, in the interest of the safety of yourself and the community.
Though these mitigation strategies have remained relatively constant, the relative risk equations have changed, with more relaxed safety measures being instituted despite transmission in the community. To clarify, early on in the pandemic, the risk of someone acquiring and propagating the virus was significant enough that safety guidelines seeked to completely stop its transmission. Current guidelines, on the other hand, have been revised to weigh the risk of viral spread with the downsides of stricter quarantine measures, such as losses in quality of education and socialization stemming from virtual schooling. This change is illustrated by CDC guidance concerning travel. With the emergence of effective vaccinations and treatments, governments have essentially conceded that taking some risk with viral transmission is acceptable if it means other facets of its citizens’ lives are considerably improved. In the coming months, the relative risk equation may tip further towards a relaxation of safety measures as vaccinations continue and more effective treatments emerge.
So, looking forward to 2022, we have a lot to be hopeful for, but also some to fear. Over the course of the pandemic, case count trends in the United States seem to broadly mirror those in the United Kingdom. There, despite an initial respite from the Delta wave three months ago, case counts have crept back up to their levels at the peak of the surge despite their high vaccination rate. A similar trend looks to be occurring in the United States. Additionally, in spite of American efforts to improve manufacturing, much of the world still does not have easy access to vaccinations, which provides ripe breeding ground for SARS-CoV-2 variants, as we have seen with South Africa and the Omicron variant. This variant seems to be outcompeting Delta in New York City, where case counts have risen sharply, but some doctors are still hopeful that Omicron causes mild enough disease that too much pressure is not placed on the healthcare system. At the same time, they urge strong caution for the near future since we are still very early in understanding the dynamics of Omicron. We have seen what the Delta variant has done to countries that had seemingly gotten over the pandemic, so a new variant, especially one that may be more resistant to the vaccines, should not be counted out until we are confident it does not pose a significant threat. That being said, we have also made gains in the pharmaceutical fight against the pandemic. Pfizer and Merck, for example, have developed oral antivirals that considerably decrease the risk of hospitalization if taken early on during an infection, though both are pending Emergency Use Authorization from the FDA. The approval of booster vaccination doses, the broadening of the vaccine-eligible population, and these new treatments may be enough to ward off another major spike in the virus’ transmission.
It seems unlikely that we will eradicate SARS-CoV-2 in the near future, and there is an understanding that endemicity will be its endgame. At some point, the virus will no longer pose enough of a threat to the population that it warrants changes to our lifestyles, and we will live with it like other communicable respiratory diseases. With a couple more months of focused mitigation efforts, we can bolster the chances of this becoming a reality sooner than later.
Here’s to a better 2022.