Outdoor beer pong? Harm reduction is a safer COVID-19 strategy for colleges, experts say

With colleges around the country reporting outbreaks of COVID-19, some schools have placed the blame on students. But experts say shaming students and zero-tolerance policies may be making the situation worse.

The vice chancellor of Syracuse University called students “selfish” for gathering in the school’s Quad without observing social distancing, and a Cornell University vice president scolded irresponsible behavior for a cluster of cases that caused the campus in Ithaca, New York, to raise its alert level to yellow Friday. The University of North Carolina-Chapel Hill, which quickly moved to a virtual learning environment after an outbreak of cases at 13 residence halls, blamed students participating in off-campus activities for the decision.

In the last week, New York University suspended more than 20 students for violating coronavirus policies, and 11 study-abroad students were suspended from Northeastern University after a hotel room gathering.

While students have a personal responsibility to follow public health guidelines, experts say universities had unrealistic expectations when they were looking to safely reopen schools populated largely by 18- to 24-year-olds.

“It’s a real shame, because it was both predictable and preventable,” said Carl T. Bergstrom, a professor of biology at the University of Washington.

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Some colleges stumbled in the beginning, in part because of confusing guidance about coronavirus testing from the Centers for Disease Control and Prevention, Bergstrom said. According to the CDC website, “CDC does not recommend entry testing of all returning students, faculty, and staff.”

“The CDC obviously didn’t help at all by issuing that explicit non-recommendation for entry testing that either misled administrators or at least gave them cover to not do what they knew they should have been doing,” Bergstrom said.

Ultimately, a significant reason for outbreaks of COVID-19 at college campuses is significant community transmission where schools are located, said Dr. Ali Khan, a professor of public health at the University of Nebraska.

For example, by the time the University of Alabama allowed students back on campus on Aug. 19, Tuscaloosa was already coping with rising numbers of infection.

Dr. Selwyn Vickers, a co-chair of the University of Alabama System Health and Safety Task Force, said a spike was “due to student behavior.”

“It’s the adults’ responsibility” to drive down transmission within the community, said Khan, dean of the School of Medicine at the University of Alabama at Birmingham. “So do not blame students for your inability to do what you need to do — which is drive down cases.”

Tuscaloosa Mayor Walt Maddox closed bars for two weeks. A new executive order allowed them to reopen this week at 50 percent capacity.

New students and others returning to campuses were set up to fail, with few colleges having realistic expectations for student behavior, said Julia Marcus, an infectious disease epidemiologist at Harvard Medical School. Isolation isn’t practical on college campuses, the age group is one that’s primed to take risks, and students who have been isolated for months are now back with their friends.

“What we’re seeing now is that a lot of school administrators are blaming their students for their failure of their own public health plan, which I think is unconscionable,” Marcus said.

Shaming and blaming make students less likely to work with contact tracers and less open about symptoms they may have, said Marcus, who researches HIV prevention.

“They’re not going to tell anyone that they attended a party, because they’ve been told they’re going to be thrown off campus,” she said.

Colleges need to take harm-reduction approaches instead of imposing abstinence-only-type policies, teaching students how to safely socialize with friends, many of whom they haven’t seen in months. They should encourage outdoor gatherings, such as parties on porches with social distancing and masks or beer pong outside fraternities. That approach recognizes that students are going to socialize, and it focuses on making gatherings safer, rather than ban them outright.

“If universities really want students to stop having indoor parties, they need to provide opportunities for students to stay socially connected that are lower-risk,” Marcus said.

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Mason Howard, a student who is one of over 1,000 people to have contracted the coronavirus at the University of South Carolina, said the school hasn’t been very supportive in creating ways to safely socialize with friends.

The college’s advice has largely been “you can’t see anyone,” rather than guidance about how to see people safely or establish social bubbles.

“I think if they changed the way they’re presenting that information to provide some sort of safe way for anyone to interact, that’d be really helpful,” said Howard, 21, a senior from Virginia.

Instead of physically distanced outdoor tailgates or football games, students have largely turned toward house parties and bars. For Howard, the “lack of any sort of social aspect at all for us” has been most frustrating.

A spokesperson for the University of South Carolina said, “It’s understandable that young adults are going to socialize, but we urge them to try and do so safely.”

For University of South Carolina senior Mason Howard, the “lack of any sort of social aspect at all for us” has been most frustrating.Courtesy Mason Howard

Bergstrom praised the University of Notre Dame for encouraging safe socialization with a library lawn that has chairs, fire pits and games for students. Bergstrom would like to expand the idea to other colleges for students and faculty.

“They’d be substantially safer there then whatever else they would have been doing, instead,” he said.

Dr. Abraar Karan, an internal medicine physician at Brigham and Women’s Hospital in Boston, said he saw the negative effects of stigmatization when he worked on the Ebola outbreak a few years ago.

“It’s easy to blame students who are partying or socializing, because it takes the blame away from the leaders who reopen and puts it on the students,” he said. “And that’s where the problem lies.”

source: nbcnews.com