What happened in halls in October?

But in fact the only bits of UK based modelling that we’ve seen tumble into SAGE have come from and about Warwick and Bristol universities respectively, which are actually fairly atypical if you think about it.

Some of the assumptions and predictions were bang on and some were famously faulty – and given the high number of Covid cases in student halls this term, there’s been plenty of speculation on whether students represent reservoirs for viral transmission to the rest of the population.

So props to the team at Bristol who spent some time earlier this term investigating the contribution of the university to transmission, with a view to informing policy both around Christmas and students’ return post-Christmas.

As ever the usual caveats on preprints apply – medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Bristol’s model was all about contacts – and something the university runs called CONQUEST (COroNavirus QUESTionnaire) is a helpful online survey of contacts, behaviour, and symptoms for its staff and students. Here researchers analysed survey results from the start of the academic year (14 Sep to 1 Nov) to try to enhance knowledge of student contact patterns to inform future infection disease mathematical modelling approaches.

The findings are fascinating. First year undergraduates were more likely to be isolating within the prior 7 days and to have tested positive for Covid-19 in the prior two weeks than other year groups, with higher percentages of respondents isolating that lived in catered and self-catered halls than other accommodation types. In other words, as Bristol predicted and the term has told us, the epidemic was concentrated among first years living in large, shared living residences.

There was high compliance to isolation guidelines among students who had had a positive test in the previous two weeks, but not so much for those with symptoms – only just over half of those who had them self-isolated. The number of contacts of the isolating students was often not as low as might be expected, but the majority of contacts that took place were with people they lived with, who were also likely to be isolating. Landlocked cruise ships, in other words.

Most students reported a low number of daily contacts on the previous day, but 8 per cent of students reported over 20, indicating that these could be individuals with increased likelihood of catching Covid-19 and infecting others (so-called “superspreaders”). Over a third of reported contacts involved touch, and around a half of contacts among the students were with other UoB students or staff. Students did appear to mix mostly with other students, but the results indicate that there is still potential for considerable crossover of Covid-19 from students to the non-student population – around 40% of student contacts were with individuals not affiliated with the university, which has comparatively few commuters than many others.

The other interesting aspect here is the finding that students in their 4th year of study had a higher numbers of contacts than those in year 1, despite living in households with fewer members and adjusting for isolation status. The authors figure that’s probably because students in later years already have established social networks that are less disturbed by Covid rules than the social networks being formed by first years.

What then comes through clearly is the potential for loneliness, and the devastating choice being faced by students who either break the rules and spread the virus, or abide by the rules and end up friendless. Overall, this is further evidence that students behaved – researchers found a lower mean number of daily contacts among Bristol’s student population (6.1) than was found in Warwick’s social contacts survey from 2009 – either among their entire sample (26.8) or among the students in that sample (29.9).

Whether staggering students’ return to landlocked cruise ships will remove the problem we saw in October, and whether if students follow the rules there are ways to satisfactorily alleviate the mental health problems that isolation seems to generate, remain open questions. There’s not a lot of evidence so far that suggests the policy solutions on offer will solve the problem.