With many colleges and universities housing students on campus, these institutions are grappling with significant challenges, but none bigger than how to provide a safe on-campus learning experience during an ongoing pandemic. Colleges need students on-campus to remain financially viable, and students want to be there. However, this is only possible and sustainable if students and their families believe they are safe living on-campus. While frequent testing is a key component to identifying infected individuals, the process currently includes a time delay between infection, testing, and results, which makes it very difficult to avoid outbreaks.
As residential care facilities have seen, the ability to detect and respond quickly to a potential infection in self-contained housing developments, such as dormitories and residence halls, may be the difference between a targeted quarantine and a dorm- or campus-wide shut-down.
Containment requires a reliable method of anticipating positive tests and acting aggressively to minimize exposure to the wider population. Preliminary data indicates that biomarkers of SARS-CoV-2 appear in wastewater days or even weeks before positive COVID-19 results are obtained and reported through individual testing. The science is still out on how far in advance of the positive results these biomarkers appear but one thing is clear: testing of wastewater can provide indicators of an outbreak for asymptomatic individuals who might not have otherwise been tested.
Several universities across the country have successfully identified COVID-19 infections in a dorm before any individual student tests positive. The process can be then be narrowed to specific floors and focused testing can identify individual students while a dorm is placed on temporary quarantine. The process has been credited with containing the spread and stopping outbreaks at the University of Arizona, Notre Dame, Syracuse University, and the University of Colorado Boulder to name a few.
Woodard & Curran has helped universities develop routine sampling and testing protocols to provide the early warning needed to implement early identification and containment measures. In designing a program, we begin by identifying appropriate sampling locations for each building, assessing sampling equipment options, and defining a sampling frequency and approach that will yield the data needed for rapid decision-making. We then recommend sampling equipment appropriate to the university or college.
Minimizing the turnaround time between sample collection and receipt of results is critical to facilitate effective decisions and communication around needed containment steps. Many institutions have facilities staff that can perform the sampling once trained to do so, and on-site laboratories that may be able to complete the testing, while others may not. Where on-campus laboratories are not available, partnering with another nearby institution or relying on commercial labs can also be effective. Woodard & Curran has a network of vendors and partners to help identify testing facilities that that can accommodate the institution’s needs.
Applying the approach to other settings
Sampling individual buildings is the most effective way to locate potential infections, but the approach can also be applied to clusters of buildings and small neighborhoods that can be sampled from a single location. This could be particularly relevant to self-contained developments or senior housing villages, for example. The principle is the same: early detection of the virus allows for targeted public health response.
There is still much that we don’t know about the SARS-CoV-2 virus, but we now have enough experience to understand the value of using wastewater to help pinpoint new hotspots long before any individual tests positive and contact tracing is performed. A well-designed and executed program can support our public health efforts to reduce the spread of the disease and mitigate the impact to communities and institutions.