“The town which had no cases of coronavirus until the students went back” says the headline on the front page of WalesOnline.
“Did the authorities do the right thing in letting students return to Aberystwyth?”, asks the piece. It never really answers that question – but does discuss in some detail various trade offs – competing risks to (different types of) students, risks to university staff and university finances, and the potential major implications for communities (both economic and health).
So are students causing (or at least helping to cause) an increase in infection around the country? Are they then causing the imposition of tougher restrictions? If so should they, or their universities, or the government be blamed? And if this happened in September and October, what should we do about January, February and March (assuming that we can answer who the “we” might be)?
Copy, paste, tweet
One of the things you’ll have seen lots of people use to try to answer the first question, both on social media and in written articles, are the graphs that the Office for National Statistics (ONS) has been producing off the back of its infection survey.
The exercise is designed to estimate the number of current positive cases in the community, including cases where people do not report having any symptoms, and the graphs are very much designed to be shared.
Here’s the graph for the 16 October release that, for example, many have said shows the impact that students and the “return to campus” has been having on infection rates:
But there’s a problem here. Halls of residence are missing by design – the survey doesn’t cover “institutional settings” like care homes, barracks, prisons and halls (even the posh private ones).
Maybe the survey is picking up HMOs? Maybe not. Survey fieldwork for the pilot study began in England on 26 April 2020 – when a ton of student HMOs had already been disbanded. ONS then expanded its sampling at the end of May, and again at the end of July. You see the problem here.
If university students are showing up in these figures, they’re commuters – so maybe the figures are worse for the relevant age group when students are included. It certainly seems that way to Matt Hancock, who this week attempted to reassure listeners by making clear that York is a tale of “two pandemics” – one amongst largely locked down students and another amongst the wider population.
Of course in simplistically “othering” students, all he did was stir up community tension.
The more you test the more coronavirus there is
There are other ways to try to guess how many students have Covid-19. If anyone involved in Pillar 1 or 2 testing is capturing whether a citizen is a student, they’re certainly not compiling those figures for us – and the problems in even allocating student tests to the right geographical area have been all over the news.
Maybe you could ask universities – in England, the Department for Education (DfE) certainly has been, a function set to be taken over by the Office for Students over the next week or so. But DfE hasn’t been doing anything with that data other than letting Michelle Donelan reveal the totals when she’s asked, so let’s not hold our breath for a dashboard.
And even if we had numbers, we’d need the sophistication to assess them in the context of extra testing, some additional sophistication to set that in the context of campuses and franchise provision and course type and mix of commuters and “boarders”, and even then we’d need to be confident students getting a test in the first place.
We could be mass testing, but we’re not. We either can’t afford it as an institution or as a nation. And as SAGE notes, testing alone will not reduce transmission if people cannot or will not self-isolate following the receipt of a positive test.
While testing is voluntary, I’ve still not seen anyone coherently explain to me the steps being taken to follow the science and design a proper set of supports and interventions to cause students (particularly those not in halls) to get a test. If they’re not getting tested, they’re probably not self-isolating. Guess what happens next?
And stop apologizing for the things you’ve never done
On the question of community spread, all the evidence – and we’ve summarised enough of it on the site – points to the glaringly obvious conclusion that if you ask a large number of young people to live in very densely populated accommodation, the virus will spread quickly and the pandemic becomes amplified in those settings.
Much of that evidence then points to worrying impacts on the community. In this new preprint (usual caveats about preprints not yet being peer-reviewed apply) although the majority of cases were among student-age individuals, researchers identified rapid transmission of the virus into more vulnerable populations:
Our study highlights the very significant risks imposed by college administrator reopening decisions, not just on college-associated populations, but on vulnerable individuals in surrounding communities.”
We found out this week that back in September SAGE itself said that a shift to “mainly online” teaching would be associated with a 0.3 (0.2-0.5) reduction in the R number, and that mitigations short of closure “should include strong steer towards online learning for all but essential practical activities”. What we don’t know is whether that calculation was based on students whose teaching moves online staying put, moving “home” (where they’re not a commuter) or some hybrid. We need to know, really.
Some have said that maybe students only amplify already high transmission rates. This preprint (again caveats apply) modelled the impact of students’ return to campus in a city with low levels of Covid-19 activity. They found that the return of a relatively large student population substantially increases the total number of infections in the community – and even where they reduce contacts with others by a quarter, the total number of infections in the community increases by 87%.
That’s because students have higher than average contacts than the general population due to densely populated accommodation, their use of public transport, high-density academic and social activities, and employment in the services sector. In other words, to avoid the problem we would need to ask them to move out, get off the university bus, spend most of their week online, and give up their student job. Not come back after Christmas, in other words.
Better stop dreaming of the quiet life, ’cause it’s the one we’ll never know
All of which brings us roundly and neatly to the big decision facing universities in the coming weeks.
“I think there will be every effort to keep schools open”, said world-renowned immunologist Sir John Bell on the Today programme at the weekend, “but just to paint the picture there are universities in this country which have fifty, sixty, seventy per cent of their kids in quarantine. I mean oh my god, what kind of a university is that?” It’s a question being asked by staff, students, parents and communities across the country. But is it a picture we’re going to paint again in the new year?
The point he went on to make in the interview was that the sort of testing and tracing mitigations required when you bring together young people into densely populated spaces are either not perfected yet or unaffordable – which does rather raise the question: if the mitigations aren’t there, should the risks be taken?
UUK agrees. It says:
It is more important than ever that the government commits to a mass testing strategy for university students and staff, with rapid turnaround of results and effective tracing of contacts.”
So again, even if it is more important than ever, if the government doesn’t come through do we continue on as normal? How important is important? Are we just following the guidance, which doesn’t seem to take into account the science and mitigations required? In a week when every news day gave more of a sense of a distance between policymakers and scientists, should universities pay more attention to the elected or the experts when deciding what to do in the new year?
Time is short and life is cruel but it’s up to us to change
Some have characterized the decision as whether or not to move up the DfE “tiers of restriction” and move increasing proportions of face to face teaching to online delivery. I can understand why the practicality or viability of the delivery is the focus of some, but for me we ought principally to do what we’ve been encouraged to do for a few years now and focus instead on outcomes.
Whatever a given university decides to do in relation to January when it comes to face-to-face teaching, there will almost certainly be impacts one way or another on the number of students that return to university towns and cities. In turn, one way or another, that will result in some pretty negative physical and mental health outcomes. Some of those impacts can be mitigated somewhat, some can’t.
We now have a pretty clear understanding of the help that will be on offer and the level of support we’ll have to deliver the mitigations that our own scientists say are necessary. It’s also now clear that nobody else – not regulators, funding councils, government departments or local public health teams – are going to synthesize the data, balance the trade offs and make the decision for us – and even if we pretend they have (by “following the guidance”), we’ll get the blame in the end.
It’s a tough decision, and no wonder nobody really wants to take it. It involves money and buildings, staff and students, teaching and learning, health and community, regulators and funders and reputation. It involves all of the things that every training event for members of university governing bodies says they are responsible for. It’s a decision that involves being accountable to students, staff and stakeholders for a change, rather than just accountable for the work of the university.
But in a year where bikeshedding, falling back on broken KPIs and prodding the odd senior manager won’t work, it’s a decision that does have to be taken – actively, in public, by the governing body. What is it for if it’s not for decisions like this?