Colleges and universities throughout the United States are scrambling to address coronavirus outbreaks that emerged as students returned to campus this month, with some schools changing course to rely on online classes and others looking to curb behaviors that put students at risk.

Campuses welcome back students with varying safety requirements

Over the past few weeks, some colleges and universities across the country welcomed students back for in-person classes, and many had implemented strategies aimed at preventing new outbreaks of the novel coronavirus. However, according to Kaiser Health News/NPR's "Shots," some of those plans had holes that ultimately could put students and staff at risk.

For instance, "Shots" reports that one university plans to offer coronavirus testing only to people who were showing symptoms of Covid-19, the disease caused by the virus. The university said it has a team of staff that will conduct coronavirus case investigations and contract tracing in partnership with the local health department.

Some public health experts said testing only people who are exhibiting symptoms of the disease won't allow the university to contain the virus' spread. "This virus is subject to silent spreading and asymptomatic spreading, and it's very hard to play catch catch-up," said David Paltiel, a professor at Yale University who studies public health policy. "And so thinking that you can keep your campus safe by simply waiting until students develop symptoms before acting, I think, is a very dangerous game."

Instead, Paltiel said universities would need to test all people on campus every few days. He acknowledged that he's "painfully aware" of the difficulty of implementing such a strategy but said it's vital to ensuring the safety of students, staff, and vulnerable populations in the schools' surrounding communities. "You really have to ask yourself whether you have any business reopening if you're not going to commit to an aggressive program of high-frequency testing," he said.

Meanwhile, at the University of Illinois at Urbana-Champaign, the school is offering walk-up, rapid coronavirus testing in tents set up across the campus. According to "Shots," the school intends to offer the no-cost, saliva-based tests—which researchers at the university developed and for which FDA has issued an emergency use authorization—to the roughly 50,000 students expected to return to the campus this month, as well as to about 11,000 school faculty and staff members. In addition, the university will require any students and staff taking part in on-campus activities to be tested for the virus twice a week.

"The exciting thing is, because we can test up to 10,000 per day, it allows the scientist to do what's really the best for trying to protect the community as opposed to having to cut corners, because of the limitations of the testing," Martin Burke, a chemist at the university who helped create the test, said.

Other schools—such as Bethel College in North Newton, Kansas—are implementing mandatory entry testing for students, Politico reports. And some schools are requiring students to sign social contracts or releasing stringent codes of conduct to guide students' behavior, while others are implementing schedules intended to stave off crowding, according to the Associated Press.

Coronavirus outbreaks emerge

Despite even the "best-laid" plans at some colleges and universities, several already have faced new coronavirus outbreaks among their students, Politico reports.

For example, according to "Shots," two weeks after the University of North Carolina (UNC)-Chapel Hill welcomed students back to the campus, the university saw coronavirus outbreaks among its students spike from just a few cases to more than 130 within days. The school also reported five new cases among employees within a week.

The school said the outbreaks were linked to student housing, including dorms and a fraternity house, the AP reports. According to the AP, the school's student newspaper in an editorial noted that students had held parties over the weekend. "We all saw this coming," it noted.

A separate UNC school, East Carolina University, also has reported a coronavirus outbreak at one of its campus dorms, and outbreaks have been linked to fraternities at schools in California, Mississippi, and Washington, the AP reports.

In Oklahoma, a video has shown students who weren't wearing masks at a crowded nightclub and officials have confirmed 23 coronavirus cases at a sorority house located off-campus, according to the AP.

And the University of Notre Dame as of Aug. 18 had reported 147 confirmed coronavirus cases since students returned to its campus in South Bend, Indiana, earlier this month. School officials had identified at least two "off-campus gatherings where neither masks were worn nor physical distancing observed" as sources of the outbreaks.

How colleges and universities are addressing the outbreaks

Different colleges and universities are taking unique approaches to addressing the outbreaks.

UNC-Chapel Hill, for example, changed course from having both online and in-person classes to hosting all classes online. In addition, the university ordered most of its undergrad students to leave their dorms, "Shots" reports. Barbara Rimer, dean of the UNC Gillings School of Global Public Health, in a post published last week wrote, "After only one week of campus operations, with growing numbers of clusters and insufficient control over the off-campus behavior of students (and others), it is time for an off-ramp." She continued, "We have tried to make this work, but it is not working."

Notre Dame paused in-person classes for two weeks, and Paul Browne, VP for public affairs at the university, said the school is prepared to suspend or discipline students hosting parties that put people at risk of contracting the coronavirus. "We believe we have a very strong chain of health protection, but these parties represent the weak link in that chain, and they can be responsible for a disproportionate spread," he said.

Rev. John Jenkins, Notre Dame's president, also said the university could ask students to leave the campus if outbreaks can't be controlled. "The objective of these temporary restrictions is to contain the spread of the virus so that we can get back to in-person instruction," he said. "If these steps are not successful, we will have to send students home as we did last spring."

Similarly, officials at Syracuse University announced that students were facing disciplinary action after holding a large gathering on the school's quad, as the students had "knowingly ignored New York State public health law and the provisions of the Syracuse University Stay Safe Pledge."

And at Oklahoma State University in Stillwater, officials ordered the students living at the sorority house where the 23-person outbreak occurred to isolate and barred them from leaving the residence. "When you bring back 20,000 students, there will invariably be more cases related to campus," said Monica Roberts, director of media relations at the university. "We've prepared for this for five months and have protocols in place to manage the situation," she said.

The outbreaks also have led some schools to preemptively change their plans to bring back students. For instance, Michigan State University President Samuel Stanely in an announcement last week said, "Given the current status of the virus in our country," and "particularly what we are seeing at other institutions as they re-populate their campus communities—it has become evident to me that, despite our best efforts and strong planning, it is unlikely we can prevent widespread transmission of [the coronavirus] between students if our undergraduates return to campus."

As such, the university urged undergraduate students who had been planning to live in dorms on the campus to remain home.

Overall, Mildred García, who leads the American Association of State Colleges and Universities, said schools "are doing the best they can with their staff and trying to educate the students about masks and social distancing and the effects of this virus," but she acknowledged that may not be enough to prevent new coronavirus outbreaks. "They’re doing all they can—and yet these are young people. When we think back about when we were young, sometimes you think you're invincible" (Montoya Bryan, Associated Press, 8/17; McAuliff et al., "Shots," Kaiser Health News/NPR, 8/20; Quilantan, Politico, 8/17; New York Times, 8/21; Perez/Quilantan, Politico, 8/18).