Colleges and universities that have required – not asked, not suggested, not tried to reason with – their students to follow safety protocols concerning the spread of coronavirus seem to have the fewest cases of COVID-19.

Clear evidence of this statement is Hamilton, a liberal arts college in Clinton, NY. As of September 18, it has 0 cases of COVID-19, as its record has been since before students arrived.

Hamilton, with a student population of about 1,800, has required testing for the virus before arrival and post arrival at school; has students escorted into town if they need to shop; and has assigned students into their own bubbles, size of about 10 students.

Vige Barrie, Senior Director of Media Relations at Hamilton College said the whole campus had worked hard to keep the cases at zero. The Dean of Students office wrote in an email, "We have had a small number of reports of students not wearing masks or not physically distancing from each other and that these students have received a warning. A second violation will require them to vacate campus and study remotely. Two students have been found responsible for a more significant COVID violation and are facing suspension."

According to its website, all students must live on campus.

Other schools, like Barry University in Miami, Florida, also put its foot down, insisting that all people coming to the campus fill out a questionnaire related to their physical condition; and at the University of Hawaii-Manoa, anyone on campus is required to fill out information on an app, and submit the information to authorities, every morning.

At Brigham Young University in Idaho, students knew in April that the school meant business: the school, subject to all state laws, posted on its website that any violations of state quarantine, social distancing, travel violations or more and students could be charged with a misdemeanor. Brigham Young, enrollment 20,000 or so, reported 8 student cases Sept. 18. Classes are held indoors.

Both Barry University, enrollment, 7,180, and University of Hawaii, enrollment about 17,400, reported one case each as of September 10, 2020.

Elsewhere in the higher ed world

And then there are the schools that make headlines.

Students were sent home from University of North Carolina at Chapel Hill due to a major spike in COVID cases; testing was not mandatory, and only offered to on-campus students. At the University of Alabama, restrictions came after students returned to campus. By Sept. 3,there were 1935 cases reported. Bars and restaurants were off limits for a time, and then came the punishments for violations, which include suspensions after repeat incidents.

At the University of Wisconsin-Madison on August 21, 2020 Chancellor Rebecca Blank ordered the university police to enforce the wearing of face masks.

On Sept. 15 the university stated that the number of positive COVID-19 cases had risen higher and faster than had been expected. It offered full tuition reimbursement which would expire on September 18th.

The University of Michigan was in an uproar because of its voluntary testing and tracking policies: graduate students were on strike for a time, and the faculty senate at the University of Michigan gave the chancellor a vote of no-confidence regarding what it termed a lack of transparencyon reopening decisions.

Risky behavior

There are many stories of young, healthy adults who get COVID-19 and become very ill, and some have died. When Iowa State University declared that 25,000 fans would be allowed into the stadium to watch a football game, there was outrage. The university is located in Ames, Iowa, and Ames was experiencing the worst COVID-19 outbreak in the country. The decision was reversed and the stadium remained empty during the game.

COVID-19 and heart damage in college athletes

COVID might cause myocarditis (inflammation of the heart muscle), which can be caused by viral infections. More information came to light when Ohio State recently reported heart problems in football players who had mild or no COVID symptoms. When myocarditis is diagnosed, the student cannot participate in athletics until the inflammation clears up. Whether or not COVID can cause heart damage and sideline athletes remains to be seen, but why take the risk?

Why don’t young adults to take the threat seriously

How do you get young adults to protect themselves and others from a virus that is sickening and killing people of all ages around the world?

Murali Naidu, MD, CEO of Doctors Hospital of Manteca, California, acknowledges that the spike in COVID cases at colleges and universities validates the concerns that young adults are not following the CDC recommendations. Dr. Naidu recommends modelling the correct behavior with 100% compliance by “ALL employees, ALL faculty, ALL leadership”.

Amanda Gilmore, PhD, in the School of Public Health at Georgia State University, suggests that college students and young adults in general are not “simply disregarding the guidelines.” They are trying to gain independence and develop a “social life with peers during a pandemic.”

Dr. Gilmore says that the difficulties these young adults face is related to brain development. The part of the brain that helps people make complex decisions is called the frontal cortex, which is not fully developed until the age of 25. So young adults are at a disadvantage when it comes to making the best decisions.

Dr. Gilmore suggests that students often think that in order to fit in with their peers they must engage in risky behaviors. She recommends that strategies to help college students to follow the guidelines include college policies that “encourage health promotion behaviors like social distancing, wearing masks, and avoiding large gatherings.”

There are other schools that have figured out how to get students to cooperate. On September 10, the New York Times reported that more than 160 colleges have no COVID-19 cases among the students. The article provides a search feature to view the number of cases at colleges and universities. Those with zero cases are not found in the list; they are found when searching for a particular school.

How colleges are keeping their students safe from COVID-19

With the potential short and long-term health effects of COVID-19, colleges and universities might want to consider the strategies that some colleges are using to keep their students safe.

Hamilton College in Clinton, New York, has 1,850 students and not one case of COVID-19 since students began arriving on August 17. The students were provided with very clear instructions for student behavior prior to arrival and while on campus. These included:

  • All out-of-state students were required to follow the New York state quarantine executive order
  • Scheduled arrivals to campus
  • Moving in had to be completed within the 2-hour window
  • Testing was done and reported prior to arrival
  • Testing was done on arrival to campus
  • The student was quarantined with roommate for 48 hours
  • Meals were delivered to the dorms
  • Once the negative results were known the students were permitted to leave their dorm
  • The students were assigned to cohorts of 10-12
  • All students must adhere to a distancing plan for the residence
  • All students live on campus
  • Twice a week testing continues
  • A positive test triggers the Isolation Plan

Students are escorted to and from the local grocery store and drug store as the need arises.

Only 2 students out of 1,850 have committed a significant violation, which seems to support the premise that modelling the appropriate behavior and providing clear expectations encourages students to follow the policies.

Keeping students on campus regardless of their testing status has the potential to control the spread and avoid the real possibility of community spread when on-campus classes are suspended and students are sent home from school.

It’s controlling the small groups that counts, apparently. At the University of Southern California, Sarah Van Orman, chief health officer for USC Student Health, told the Los Angeles Times, that it isn’t the frat parties per se that are the COVID-19 hot spots.

“It is 5 to 10 people getting together sharing a meal; it’s study groups and board games.”

Yvonne Stolworthy MSN, RN graduated from nursing school in 1984 and has had a varied career. Many years were spent in critical care. She has been an educator in a variety of settings, including clinical trials. Currently she is applying her nursing knowledge to health care journalism.