Students, symptoms and self-declaration

As well Levi’s blog, there’s my warning on the site back in May about pre-drinks, and this fantastic piece from Durham SU’s CEO on resisting the temptation to treat students like children. I also thought I should probably quickly write up thoughts on something I’ve been thinking about a lot since lockdown – symptom declaration.

Much of the focus so far has been on Covid-secure campuses, social distancing and “parties”. But right now one of the problems with NHS Test and Trace (and its equivalents around the nations) is that for some citizens, the disincentives hugely outweigh the incentives when it comes to the declaration of coronavirus symptoms.

For example – Manchester Mayor Andy Burham repeatedly raises the issue of people on zero-hours contracts not wanting to lose their opportunity to work. Any analysis I’ve seen on students in North America has them as highly reluctant self-declarers, and the student officers I talk to in the UK confirm these fears.

There’s a mixture of reasons to be worried. Many students will want to assume (hope) that their symptoms are a hangover, or freshers flu. Some won’t want to miss the tiny slice of face to face teaching or socialising that’s on offer – especially at the start. Lots of students won’t want to give up part time work. And crucially – most students will want to become public enemy #1 with their house, halls floor or flat by causing them to have to self-isolate for a fortnight.

One way around the problem of significant asymptomatic transmission amongst students would be regular compulsory testing, but it looks like that’s not going to happen for whatever reason. Bits and bobs of testing like this announced by Leicester (which doesn’t look like it covers De Montfort and won’t be compulsory) may not be enough.

As a result, even though symptoms take time to show up, self-declaration, household self-isolation and decent tracing is all we have to slow transmission in a sort of “better than nothing” kind of way – but we have a disaster in student cities if there is widespread non-compliance on self-declaration amongst students, and if many thousands of them return home at weekends regularly (a phenomenon far too many people don’t seem to have noticed).

Now, if it was up to me we’d require all universities (with some funding) to have their own strategy on self-declaration, a sector wide symptom-tracking app and tracing capacity that understood students – ideally dedicated capacity for universities run by universities given their size and the nature of the problem. It that beyond the sort of partnerships that might be possible now much of tracing is being devolved to local authorities?

But even if we can’t get there, I think we really ought to have every HE provider tell us its plan on symptom self-declaration and self-isolation. That would need all sorts of strands (ticking all three approach boxes) – off the top of my head, things like:

• A general commitment to education for all students on the spread of Covid, including translating guidance/training to main foreign languages. Not all new students will be familiar with the relevant vocabulary or context.
• Really clear guidance for students on symptoms, what should be reported and when in the context of having lots of hangovers.
• Comms steps taken to de-stigmatise infection.
• A standardised approach to attendance monitoring (for tracing purposes) of face to face activity and use of facilities.
• Specific institutional financial and educational carrots/cushions that reassure students if they are having to miss work or F2F study.
• Lots of PBSA and HMO landlord liaison to make sure that students who are self-isolating are OK and can get food, etc.
• The gamification of participation in declaring health state (which could with appropriate safeguards also include mental health declaration) via the app each day.
• Absolute clarity over what counts as a household in university and private halls.
• Synthesized and common approaches where there’s multiple HEIs in a city.
• Clear guidelines on returning home at the weekends – ideally students would be advised only to do this if they get tested.
• Bespoke comms for international students – we don’t want them thinking they’ll be deported for fessing up they went to a house party. Better the threat is about not fessing up.
• Tracing capacity that “gets” students and knows the student haunts, patterns of behaviour and campuses.
• Where there are disciplinary sticks/threats, these should be focussed on not declaring symptoms rather than “having parties” or visiting others’ houses – because if it’s the latter, guess what the impact on self-declaration and contact declaration will be!

If you have other ideas, do let me know in comments below.