Article Text

Original research
Modelling the impact of presemester testing on COVID-19 outbreaks in university campuses
  1. Lior Rennert1,
  2. Corey Andrew Kalbaugh1,
  3. Lu Shi1,
  4. Christopher McMahan2
  1. 1Public Health Sciences, Clemson University, Clemson, South Carolina, USA
  2. 2Mathematical and Statistical Sciences, Clemson University, Clemson, South Carolina, USA
  1. Correspondence to Dr Lior Rennert; liorr{at}clemson.edu

Abstract

Objectives Universities are exploring strategies to mitigate the spread of COVID-19 prior to reopening their campuses. National guidelines do not currently recommend testing students prior to campus arrival. However, the impact of presemester testing has not been studied.

Design Dynamic SARS-CoV-2 transmission models are used to explore the effects of three presemester testing interventions.

Interventions Testing of students 0, 1 and 2 times prior to campus arrival.

Primary outcomes Number of active infections and time until isolation bed capacity is reached.

Setting We set on-campus and off-campus populations to 7500 and 17 500 students, respectively. We assumed 2% prevalence of active cases at the semester start, and that one-third of infected students will be detected and isolated throughout the semester. Isolation bed capacity was set at 500. We varied disease transmission rates (R0=1.5, 2, 3, 4) to represent the effectiveness of mitigation strategies throughout the semester.

Results Without presemester screening, peak number of active infections ranged from 4114 under effective mitigation strategies (R0=1.5) to 10 481 under ineffective mitigation strategies (R0=4), and exhausted isolation bed capacity within 10 (R0=4) to 25 days (R0=1.5). Mandating at least one test prior to campus arrival delayed the timing and reduced the size of the peak, while delaying the time until isolation bed capacity was reached. Testing twice in conjunction with effective mitigation strategies (R0=1.5) was the only scenario that did not exhaust isolation bed capacity during the semester.

Conclusions Presemester screening is necessary to avert early and large surges of active COVID-19 infections. Therefore, we recommend testing within 1 week prior to and on campus return. While this strategy is sufficient for delaying the timing of the peak outbreak, presemester testing would need to be implemented in conjunction with effective mitigation strategies to significantly reduce outbreak size and preserve isolation bed capacity.

  • health policy
  • public health
  • statistics & research methods
  • infection control
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Supplementary materials

Footnotes

  • Contributors LR: conceptualisation, methodology, writing, review and editing; CAK: projecting administration, review and editing; LS: data acquisition and review; CM: conceptualisation, methodology, writing, review and editing.

  • Funding LR, CAK and LS acknowledge salary support from Clemson University for modelling work pertaining to reopening strategies (award number: 1502394).

  • Competing interests LR, CAK, and LS acknowledge salary support from Clemson University for modelling work pertaining to reopening strategies (award number: 1502394).

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this study. R code for dynamic transmission models is included as a supplemental file.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.