Health Care

The Deeper Dig: Preparing for Covid on campus

Vault Health administered a saliva test to returning University of Vermont students. Photo by Sawyer Loftus/VTDigger

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While communities near college campuses remain concerned about the spread of Covid-19, state health officials say they’re prepared for whatever the fall may bring.

About 12,000 University of Vermont students are returning to Burlington under what the school calls one of the “most extensive” reopening plans in the country. But concerns over risky student behavior have led the city to enact new limits on gathering sizes and alcohol sales.

Meanwhile, the health department is planning for the worst-case scenario of simultaneous outbreaks on multiple campuses, said Deputy Commissioner Kelly Dougherty. The state laboratory has conducted “surge planning” exercises to simulate processing a glut of new tests, and the department has trained additional contact tracers and call center staffers in case the department needs to quickly expand its capacity.

“Hopefully we won’t need it,” Dougherty said. “Hopefully we will have minimal outbreaks, and not every situation will turn into an outbreak.” But with on-campus tests taking place largely outside the department’s purview, containing the virus will depend on the success of each school’s testing plan.

**Podcast transcript**

Sawyer Loftus: Ok, I am opening my test kit…

Our summer intern Sawyer Loftus is getting ready to return to UVM. This week he took the first of what will be several Covid tests required by the university.

Sawyer Loftus: “Open your test package and enter the kit ID number…”

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You got tested, how was it?

Sawyer Loftus: It was really kind of bizarre. 

Okay, and now I have to enter the tracking number…

First, the packaging is really interesting. It’s this really small square bubble wrapped package that’s really, like — you don’t even know it’s from a health company. It kind of looks like any other package you’d get off of Amazon, except for in the back it says where it’s from: “Vault.” 

And then inside is this little square box that I can’t show you because it’s already in this giant laboratory bag that I had to seal on camera. 

And now I am in the testing waiting room… Just waiting. 

Then I had to wait for like 10, 15 minutes while my Zoom was just kind of open, waiting. And then this woman appeared on the screen there. And was like, okay, we’re gonna run through this test now.

It felt like forever because it was just me and her sitting like you and I are now on Zoom, just her watching me spit into a tube. It can’t be the bubbly spit. It has to be, like, real liquid spit.

She’s walking you through this. She’s telling you exactly what they need.

Sawyer Loftus: Yeah. You’re not allowed to eat drink or chew anything for 30 minutes beforehand—

I’m assuming that would compromise your spit? 

Sawyer Loftus: Yep. And that was that. Then I sealed it up in front of her, and now I just drop it off.

What are you thinking as you go through this process?

Sawyer Loftus: It was really weird. I kept feeling bad, like, I’m wasting your time trying to like spit in this tube. She’s just sitting there watching me.

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It’s not something you do every day, is try to spit into a tube.

Sawyer Loftus: I know, and it’s not like you can really talk either, because you had to focus on the task of spitting in the tube. I kept apologizing and being like, I’m sorry it’s taking so long. And she’s like, it’s okay — you’re pretty average in terms of time. There’s some people that, I guess, did it really quickly, and some people that I took forever to do. And her job is just to sit there, make sure you do it.

So why do you have to do this in the first place?

Sawyer Loftus: If I understand correctly, it’s part of the phased reopening plan for UVM. And it’s meant to be like a screening. So it’s meant to make sure that if there are any positive results, that those folks who are positive stay home longer before they come to campus. 

Got it. So this is sort of the initial wave of testing before everybody comes back to Burlington. 

Sawyer Loftus: Yep. And then on the 24th, according to the most recent newsletter that the university sent out this morning, the full in-person testing is going to be in full swing. So next week, I go and do my — it’s called the “day zero test.” And then I’ll do it again in a week.

And then how often are you going to be tested after that?

Sawyer Loftus: As classes get going, just once a week. And then that goes until mid-September, and then they have said that they’re going to reevaluate and see if that means we’re going to have more testing — do we need to do more testing? Or do we need to do any testing at all? Or keep the course? So I guess we’ll see.

Sawyer is one of about 12,000 students expected to return to Burlington in the coming days. And all of them are expected to follow that same protocol – a preliminary saliva test by Vault Health, then a weekly nose swab test that’s being processed by the Broad Institute in Massachusetts. That’s about 11 to 12 thousand tests a week. 

Think about it this way – that’s more from one campus than the Vermont Department of Health processes in a typical week for the entire state. Which means Vermont is about to enter into a phase of Covid testing on a completely different scale than it’s seen so far. And the health department is looking closely at the ramifications.

Kelly Dougherty: As we’re looking ahead to schools going back in session, college students returning to the area, we really want to be sure that we are going to have supplies on hand to handle any kind of outbreak situations or things like that.

This is Kelly Dougherty. (No relation.) She’s the deputy commissioner of the health department working on testing strategy. She said the state is ready to respond to outbreaks, as they have been all summer — but there is a risk that colleges and schools could strain the system.

Kelly Dougherty: In the beginning, we were really focused on wanting to make testing widely available, partly so that we could really get a sense of what our positivity rate in Vermont is and how widespread Covid was in Vermont. And we’ve achieved that. Looking ahead again to potential disruptions in the supply chain, not only as we in Vermont go back to schools and universities, but across the country in places where things maybe aren’t going so well, we know and we have seen in this response that sometimes Vermont is not a priority for receipt of supplies.

Kelly said right now the department is emphasizing that people who don’t need to get tested shouldn’t get tested. 

Kelly Dougherty: The message that we want to get across is you shouldn’t be tested just because you’re curious. If you have not had contact with someone who’s positive, if you haven’t been exposed, and you have no symptoms, and you have no reason to believe that you’ve been exposed, then testing may not be the best thing for you.

And what’s what’s the risk there — for somebody to get tested when they might not necessarily need to be tested? What’s the downside?

Kelly Dougherty: The downside is, it may provide a false sense of security. What we don’t want is for people to say, “Oh, I’m negative. So I don’t need to wear my face covering, I don’t need to be as careful, because I know I’m not going to infect anyone around me.” But that could in fact make someone susceptible themselves, and also could put others at risk. 

And also, it isn’t a wise use of our supplies. So as we look to, again, wanting to make sure that we are ready to respond to outbreaks with testing, we want to make sure we have all the supplies that we need.

I asked Kelly whether the health department was concerned that so many more Covid tests will be taking place outside of their purview. She said they’re actually glad this is happening. It lets the health department focus on specific outbreaks in places like prisons and long term care homes, and on running their own pop up testing sites.

Kelly Dougherty: We want testing to be happening in as many places as possible. Hospitals are doing testing prior to certain medical procedures and for their staff, and also for people who are referred by their primary care provider to a hospital based testing site. We would like primary care providers and federally qualified health centers to do the testing for people wanting to get out of quarantine. And actually, just yesterday, we sent out a health alert message to providers across the state, letting them know that they can now — starting Monday — order nasal swab kits from the health department so that they can start doing more testing in their offices. Because we know that supplies was one barrier to that.

The health department cannot meet the demand for testing on its own. We need primary care providers, federally qualified health centers and hospitals to do a lot of that testing because we just simply do not have the capacity to do it all on our own.

The capacity issue makes sense. I wonder about how — for example, the situation in Manchester last month, we saw, put the health department in kind of an awkward situation, where the accuracy of those tests was somewhat in question. And so the messaging to the public, and particularly in that community, seemed to get a little bit confusing. And I wonder, how do you avoid that that similar kind of situation in the future, with more testing happening outside the health department’s jurisdiction?

Kelly Dougherty: Actually, another health alert is supposed to go out tomorrow, I believe it’s under review right now, where we are going to really spell out the different types of tests that are available out there, and when they should be used and when they shouldn’t be used. And the Manchester Medical situation was a good example where they were using a test that is really, per the manufacturer and the FDA, should only be used in symptomatic patients within their first five days of symptoms, and also in higher prevalence areas, so where you have much more disease in the community. That was not the case in Manchester. And so it did cause a bit of confusion.

It seemed like a big question there was on the reporting end, too — people are looking so closely at these daily numbers that are reported by the health department, and I think that it seemed like that was a point of confusion. I wonder with an institution like UVM coming back and conducting all these tests, if there were, say, a rash of positive tests from the company that they are contracting with out there, do we know yet exactly how that will be both handled by the health department and messaged to the public?

Kelly Dougherty: So, Covid is a reportable disease. Any provider and laboratory that has a positive test has to report it to the health department. So we will know. We have an electronic relationship with the testing facility that they’re using, and so the health department will be aware of the test what they’re doing and the positives that come in. So they would be counted. 

One question that’s come up that has not yet been resolved is, you know, we typically only report Vermont residents. And so for college students, for the purposes of our reporting, will we include them as Vermont residents in our county? And that’s a question that just came up this week. We do have out of state counts on our dashboard as well. So they’ll be counted. We just don’t know in which category.

You mentioned that in terms of the public message, that the priorities are changing, in terms of really trying to emphasize to people when they might need a test and when they don’t. I wonder, is there also a procedural change coming down the pike in the next few months? 

Kelly Dougherty: We’re not talking about that right now. I don’t think we would turn anyone away. We’re not looking to, at this point — there haven’t been conversations about restricting our testing. I think the only thing that we are looking ahead toward is again, as we prepare for schools and colleges to return, that our regular pop-up testing schedule might get disrupted if we find ourselves with several outbreaks on our hands. We have had to do that, to some extent, a very small extent, here and there when situations have arisen. And we’ve had to like, on the fly, change our schedule, because we just didn’t have the capacity to do all the testing that was needing to be done. But in the absence of that, we have not talked about changing our testing strategy anytime in the near future. 

It sounds like there’s a lot of active planning for the contingency of what would happen if there were multiple outbreaks. Is there a sense of how likely that might be with things on the horizon?

Kelly Dougherty: I don’t know if we know the probability, how likely. We know there will be outbreaks, and so what we’re doing right now is in different aspects of our response, we are doing some surge planning. 

Our laboratory, the public health lab, just did a little exercise to sort of play out if there were a scenario where there were multiple outbreaks at colleges, and how we would handle all of the specimens from a laboratory perspective. We’re doing the same sort of exercise on the testing side — so how much of a surge could we handle with our current staffing on the ground to collect the specimens and all of that? And then also for case contact tracing, we are training up additional contact tracers now. In the event that we have a surge, we can immediately pull them in. We’re also training additional people for our main call center, because anytime things happen, we get a surge in calls. 

So we are exercising and planning in a variety of areas for a potential surge. Hopefully we won’t need it. Hopefully, we will have minimal outbreaks, and not every situation will turn into an outbreak. So ideally, we will identify cases early and do all the contact tracing that we need to do and make sure that people are isolating and quarantining as appropriate to limit the spread.

I know this is wildly oversimplifying, but as you look at this surge planning process, are we ready for the fall, as a state?

Kelly Dougherty: I think we are. I think that we are in good shape. And Vermont has really done a good job sort of looking ahead all along. We have been exercising different scenarios throughout this response. And I think that we’ve had a lot of people who have been thinking about return to school for quite a while. I know that it’s on most people’s minds just recently, with the school guidance that came out and then the revised guidance that came out. But we’ve been planning for this for a while. Even though we weren’t sure what was going to happen with schools, we wanted to make sure that we were prepared. So we started talking about this months ago, so that we could be sure that we’re ready. And I think that we are ready, up to the limits of the capacity of the system nationwide. 

Got it.

Back in Burlington, Sawyer Loftus is waiting for the results of his saliva test. I should mention that Sawyer is also the editor of the Vermont Cynic, the UVM student newspaper. So I asked him what he’s been hearing from people close to campus.

You’re seeing this from a lot of different sides here. I’m curious, what’s the general vibe right now — on the cusp of people coming back, and gearing up for a lot of testing, but also a lot of in-person education — what’s the mood in the area right now?

Sawyer Loftus: It’s definitely really tense. I think there’s a lot of conflict. And I think we’ve seen that in a lot of the reporting that’s been coming out, both from VTDigger and other places, between — they’re referred to as the permanent residents of Burlington, and the student population. 

Obviously the City Council, at the very least, is upset, and grilled UVM officials last week at the City Council meeting about the reopening plan, and the gaps that they saw in it, and what they were hearing from their constituents. A lot of it is fear and alarm and anxiety. 

And then additionally, there is a pocket of students on campus, that are returning to campus in some extent. They’re a student group called the Union of Students, which is, in university-speak, they’re not recognized by the university. So they’re not an official club. But they are trying to be this counter organization to the student government. They have definitely been on the front lines of, like, “This is a terrible idea. We should not be coming back to campus. It shouldn’t even be an option.” Even going so far as to post on Instagram saying that the university’s plan is going to kill people. 

That’s a perspective for sure. I don’t think it’s the majority perspective of students on campus, just from my own networks. We all feel uneasy about it, but it’s kind of a question of: Well, what choice do we have? I am going into my senior year. So the question for me was, “Well, am I going to be able to do all that take all the classes that I needed to take this semester to make sure I’m on track to graduate?” I think that that was a really big concern. But I think with the right safety measures, it’ll be stressful, but I think it’ll be okay. I think Vermont is in a really unique situation compared to the rest of the country. But there are definitely concerns. For sure.

On Thursday, the Burlington City Council passed an emergency order that limits indoor residential gatherings to 10 people and outdoor gatherings to 25. It also bans alcohol sales in bars and restaurants after 11 p.m. UVM students — at least, the ones who have passed their saliva tests — are arriving back on campus now.

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Mike Dougherty

About Mike

Mike Dougherty is VTDigger’s digital editor. He is a DC-area native and studied journalism and music at New York University. Prior to joining VTDigger, Mike spent two years as a program coordinator for the Vermont Humanities Council. Before moving to Vermont in 2015, he spent seven years managing recording operations for the oral history nonprofit StoryCorps, assisted Magnum photographer Susan Meiselas, and contributed to the Brooklyn-based alt-weekly L Magazine.

Email: [email protected]

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