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再小心也無法阻止感染,美國高校疫情形勢嚴(yán)峻

SY MUKHERJEE
2020-09-23

美國高校正在艱難應(yīng)對新冠肺炎疫情,因此學(xué)子們將以一種非常奇怪的狀態(tài)上課。

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在公共健康危機(jī)期間,即便高校制定最完善的計(jì)劃也難保萬無一失。

高校管理者告訴《財(cái)富》雜志,他們正在竭盡全力保證公眾的安全。但在阿拉巴馬大學(xué)(University of Alabama)等8月已經(jīng)恢復(fù)課堂授課的高校中,確診病例大幅增加。截至9月10日,高校共報(bào)告近2,600例新冠肺炎確診案例。

大學(xué)開學(xué)第一周本應(yīng)該是慶祝的時(shí)刻,是學(xué)生們開啟人生新篇章的時(shí)刻,但美國高校正在艱難應(yīng)對新冠疫情,因此學(xué)子們將以一種非常奇怪的狀態(tài)接受高等教育。

學(xué)生要面對物流運(yùn)輸?shù)膯栴},還要考慮下游社會(huì)影響。從接受《財(cái)富》雜志采訪的學(xué)生和學(xué)校管理者的話中可以看出,美國各地不同學(xué)校應(yīng)對新冠疫情的方式千差萬別。

醫(yī)生兼健康政策研究員阿希士?杰哈曾經(jīng)擔(dān)任哈佛大學(xué)全球健康研究所(Harvard Global Health Institute)的所長。他告訴《財(cái)富》雜志:“我在哈佛大學(xué)全球健康研究所工作了16年,最近前往布朗大學(xué)公共健康學(xué)院任院長?!?/p>

因此,杰哈可以從獨(dú)特的視角來看待這個(gè)問題。他是公共健康專家和專業(yè)醫(yī)生,同時(shí)也是一位流行病學(xué)專家,一直在批評美國應(yīng)對新冠疫情的做法。作為一所高校的院系負(fù)責(zé)人,對于在這個(gè)異常時(shí)期哪些政策行之有效,哪些措施不可行,他很有發(fā)言權(quán)。

他告訴《財(cái)富》雜志:“我認(rèn)為每一所高校都會(huì)出現(xiàn)一些病例,甚至可能爆發(fā)疫情。問題是:疫情的嚴(yán)重程度較小,能夠得到控制,使學(xué)??梢岳^續(xù)運(yùn)行,還是校園必須關(guān)閉,改為無限期的網(wǎng)上授課?”

有一個(gè)問題:雖然在疫情期間,政客和高校管理者都在依靠個(gè)人的責(zé)任心來控制病毒傳播,但高校不可能將個(gè)人的責(zé)任心作為保證安全的唯一途徑。

杰哈指出:“問題在于許多高校單純依靠學(xué)生的行為改變,卻沒有重視高校自身的責(zé)任?!?/p>

當(dāng)高校周邊社區(qū)的新冠肺炎確診病例激增時(shí),比如華盛頓州立大學(xué)(Washington State University)周邊的愛荷華州約翰遜縣以及奧本大學(xué)(Auburn University)所在的阿拉巴馬縣等,學(xué)校的應(yīng)對方式和對于公共健康措施的落實(shí)力度不同,會(huì)產(chǎn)生截然不同的結(jié)果,既有可能造成新的局部疫情大爆發(fā),也可能創(chuàng)造一種人們不太習(xí)慣但可以保證安全的全新學(xué)習(xí)方式。

各式各樣的檢測策略

尼克在幾周前來到科羅拉多大學(xué)博爾德分校(University of Colorado at Boulder),在此之前他甚至沒有機(jī)會(huì)參觀校園;在家鄉(xiāng)紐約市疫情最嚴(yán)重的時(shí)候,他的校園參觀計(jì)劃徹底泡湯。18歲的尼克是大一新生,他只能把自己的大量物品郵寄到學(xué)校。為了保護(hù)隱私,他要求隱去全名。

在出發(fā)去學(xué)校之前,尼克在紐約市的一家CityMD接受了鼻拭子新冠病毒檢測。他告訴檢測人員自己是學(xué)生,因此他在坐飛機(jī)前兩天內(nèi)就很快拿到了檢測結(jié)果。

8月31日,他在校內(nèi)再次接受了檢測,使用的是科羅拉多大學(xué)的實(shí)驗(yàn)室自行開發(fā)的專有新冠病毒檢測方法。這種名為RT-LAMP的檢測方法只需要將唾液吐進(jìn)試管即可,45分鐘內(nèi)就能夠拿到檢測結(jié)果,可以輕松檢測出無癥狀感染者。如果有家庭成員或訪客幫助學(xué)生入校,他們要遵守一系列單獨(dú)的限制措施,例如大廳僅允許一名訪客進(jìn)入,并且必須在規(guī)定時(shí)間之前離開等。

學(xué)生搬進(jìn)宿舍之后還要接受PCR檢測,這種檢測耗費(fèi)的時(shí)間更長,但能夠更準(zhǔn)確地識(shí)別活動(dòng)性感染者。該校發(fā)言人表示,如果學(xué)生的快速響應(yīng)檢測結(jié)果呈陽性,在拿到PCR檢測結(jié)果之前,他將被轉(zhuǎn)移到隔離設(shè)施內(nèi)接受隔離。學(xué)校建議在校外居住但需要來到校園的學(xué)生,一旦出現(xiàn)任何癥狀,應(yīng)該前往健康診所接受免費(fèi)檢測。

發(fā)言人稱,該校的新冠疫情實(shí)時(shí)信息告示牌,是控制新冠病毒傳播和向?qū)W生團(tuán)體及時(shí)通報(bào)信息的有效途徑。

該校還使用另外一項(xiàng)新技術(shù)進(jìn)行疫情監(jiān)控:廢水監(jiān)測。顧名思義,這種技術(shù)通過檢測廢水來監(jiān)控社區(qū)層面的新冠病毒流行情況。

該校的檢測結(jié)果表明,即使執(zhí)行了嚴(yán)格的檢測和安全要求,要控制疫情爆發(fā)依舊很難。9月2日發(fā)布的監(jiān)測信息顯示,科羅拉多大學(xué)博爾德分校的四間宿舍可能出現(xiàn)了傳染,使校內(nèi)的確診病例達(dá)到近40例。

該校的助理副校長丹?瓊斯在9月2日致信全體學(xué)生,警告未來幾周確診病例可能激增。他寫道:“學(xué)校能否維持正常運(yùn)營的關(guān)鍵就在未來幾天。我們必須繼續(xù)遵守公共健康命令,避免大規(guī)模人群聚集,一定要佩戴口罩和保持距離?!?/p>

在那之后,情況變得越來越糟糕。盡管科羅拉多大學(xué)博爾德分校采取了各種創(chuàng)新措施,但9月15日,博爾德縣公共健康局(Boulder County Public Health)的常務(wù)局長杰弗瑞?扎亞赫呼吁該校所有學(xué)生自我隔離兩周。

他寫道:“博爾德縣公共健康局一直在密切監(jiān)控科羅拉多大學(xué)博爾德分校的學(xué)生和教職員工的病例數(shù)量和疫情傳播情況。過去兩周,博爾德縣有663位居民新冠病毒檢測呈陽性;其中502位居民與該校的學(xué)生有關(guān)(占所有病例的76%)??屏_拉多大學(xué)博爾德分校的大部分病例都來自在校外居住的學(xué)生。”

其他學(xué)校的疫情防控措施更多依靠學(xué)生自己完成檢測。在南加利福尼亞的查普曼大學(xué)(Chapman University),學(xué)生需要自己執(zhí)行鼻拭子檢測,然后將樣本發(fā)送給與診斷巨頭LabCorp合作的商業(yè)實(shí)驗(yàn)室。

查普曼大學(xué)的校長丹尼爾?斯特魯帕告訴《財(cái)富》雜志:“我們在8月初就公布了返校流程。無論是教職員工還是學(xué)生,所有人都必須接受學(xué)校提供的在線培訓(xùn),培訓(xùn)中解釋了各種防護(hù)措施,告訴所有人應(yīng)該怎么做。任何人必須證明參加了培訓(xùn),才能獲準(zhǔn)返校?!?/p>

該校的合作伙伴是LabCorp旗下的Pixel。Pixel從事郵寄式居家診斷檢測。學(xué)校稱新冠病毒檢測對學(xué)生免費(fèi)。斯特魯帕說:“首先你需要注冊。然后,Pixel會(huì)給你寄一份檢測試劑。其中包括一個(gè)預(yù)付郵費(fèi)的聯(lián)邦快遞(FedEx)包裹,你可以使用它寄回樣本?!?/p>

在校外居住并且不打算到校園參觀訪友的人不必接受檢測。雖然斯特魯帕強(qiáng)調(diào)學(xué)校一直在盡早向人們傳達(dá)校方的預(yù)期,但該校的二年級學(xué)生艾瑪?布朗表示,她依舊有一些困擾。

21歲的布朗說:“我有些不太確定學(xué)校的規(guī)定。學(xué)校在暑假給我們發(fā)來電子郵件,表示將采取混合授課的方式,有些可能是虛擬授課,有些是面對面授課。在校園建筑內(nèi)需要接受體檢和保持社交距離?!?/p>

目前學(xué)校所有課程都采取了網(wǎng)上授課的方式,但布朗懷疑是否有一天能夠真正采取混合授課的模式。

還有一個(gè)始終存在的問題,那就是LabCorp的病毒檢測需要多長時(shí)間才可以出結(jié)果。該公司表示,目前檢測需要的平均時(shí)間為24至48個(gè)小時(shí)。

康涅狄格州衛(wèi)斯理安大學(xué)(Wesleyan University)的薩曼塔?黑格有自己的困惑:“在返校之前,學(xué)校的管理者不知道該怎么做。他們給我們提供了各種推遲整個(gè)學(xué)期的方案。我們可以在家里或者在宿舍里遠(yuǎn)程上課?!?/p>

衛(wèi)斯理安大學(xué)還曾經(jīng)研究是否有學(xué)生來自疫情高風(fēng)險(xiǎn)地區(qū);這些地區(qū)的學(xué)生需要在開課前提前兩周到校,進(jìn)行自我隔離。來自低風(fēng)險(xiǎn)地區(qū)的學(xué)生要在開課前提前一周到校。

黑格從布魯克林前往學(xué)校之前接受了一次檢測,但到校后被要求再接受一次檢測:“我立刻前往進(jìn)行檢測的帳篷,因?yàn)槲冶仨毻瓿蓹z測才能夠領(lǐng)到宿舍的鑰匙?!边@兩次檢測都是鼻拭子檢測,只是在校園做的檢測由自己操作。她并非來自高風(fēng)險(xiǎn)地區(qū),因此只需要隔離到9月7日。

在部分學(xué)生眼中,高校校園文化發(fā)生了顯著變化

眾所周知,大學(xué)生喜歡成群結(jié)隊(duì)在學(xué)校里閑逛,偶爾會(huì)參加派對。在教室里面對面上課,也是一種社交方式。

科羅拉多大學(xué)的尼克說:“我可以聽到外面有人在叫喊。學(xué)校里派對盛行,但現(xiàn)在我不再參加派對?!彼荒苎堊约核奚針抢锏耐瑢W(xué)到自己房間。

他的六門課中,有五門全部采用虛擬授課。第六門可以選擇課堂授課,但需要保持距離。這帶來了一個(gè)難題——如果教授的Wi-Fi掉線怎么辦?學(xué)生們可能不愿意等著教授解決技術(shù)故障。

查普曼大學(xué)的二年級學(xué)生布朗說:“我很高興自己現(xiàn)在已經(jīng)不是一年級新生,因?yàn)槲也幌脲e(cuò)過住宿舍的經(jīng)歷?,F(xiàn)在我跟女朋友住在一間公寓里。但整天待在公寓里,同樣讓人感到與世隔絕。你很難交到新朋友?!?/p>

黑格說,在衛(wèi)斯理安大學(xué)里的生活相對平靜,沒有大型派對。“我聽說過有兩三次派對,但我沒有親眼見過。不過我加入了班級的Facebook群組,而且有許多高年級的學(xué)生一直抱怨新生到處打聽派對的消息?!?/p>

對于美國近2,000萬大學(xué)生來說,這個(gè)學(xué)期才剛剛開始。目前,疫情的形勢仍然在不斷變化,即使最謹(jǐn)慎的高校也不能放松警惕。高校如何應(yīng)對這種局面,將決定未來幾周或者幾個(gè)月,美國是否會(huì)出現(xiàn)新一輪疫情大爆發(fā)。(財(cái)富中文網(wǎng))

翻譯:劉進(jìn)龍

審校:汪皓

在公共健康危機(jī)期間,即便高校制定最完善的計(jì)劃也難保萬無一失。

高校管理者告訴《財(cái)富》雜志,他們正在竭盡全力保證公眾的安全。但在阿拉巴馬大學(xué)(University of Alabama)等8月已經(jīng)恢復(fù)課堂授課的高校中,確診病例大幅增加。截至9月10日,高校共報(bào)告近2,600例新冠肺炎確診案例。

大學(xué)開學(xué)第一周本應(yīng)該是慶祝的時(shí)刻,是學(xué)生們開啟人生新篇章的時(shí)刻,但美國高校正在艱難應(yīng)對新冠疫情,因此學(xué)子們將以一種非常奇怪的狀態(tài)接受高等教育。

學(xué)生要面對物流運(yùn)輸?shù)膯栴},還要考慮下游社會(huì)影響。從接受《財(cái)富》雜志采訪的學(xué)生和學(xué)校管理者的話中可以看出,美國各地不同學(xué)校應(yīng)對新冠疫情的方式千差萬別。

醫(yī)生兼健康政策研究員阿希士?杰哈曾經(jīng)擔(dān)任哈佛大學(xué)全球健康研究所(Harvard Global Health Institute)的所長。他告訴《財(cái)富》雜志:“我在哈佛大學(xué)全球健康研究所工作了16年,最近前往布朗大學(xué)公共健康學(xué)院任院長?!?/p>

因此,杰哈可以從獨(dú)特的視角來看待這個(gè)問題。他是公共健康專家和專業(yè)醫(yī)生,同時(shí)也是一位流行病學(xué)專家,一直在批評美國應(yīng)對新冠疫情的做法。作為一所高校的院系負(fù)責(zé)人,對于在這個(gè)異常時(shí)期哪些政策行之有效,哪些措施不可行,他很有發(fā)言權(quán)。

他告訴《財(cái)富》雜志:“我認(rèn)為每一所高校都會(huì)出現(xiàn)一些病例,甚至可能爆發(fā)疫情。問題是:疫情的嚴(yán)重程度較小,能夠得到控制,使學(xué)??梢岳^續(xù)運(yùn)行,還是校園必須關(guān)閉,改為無限期的網(wǎng)上授課?”

有一個(gè)問題:雖然在疫情期間,政客和高校管理者都在依靠個(gè)人的責(zé)任心來控制病毒傳播,但高校不可能將個(gè)人的責(zé)任心作為保證安全的唯一途徑。

杰哈指出:“問題在于許多高校單純依靠學(xué)生的行為改變,卻沒有重視高校自身的責(zé)任。”

當(dāng)高校周邊社區(qū)的新冠肺炎確診病例激增時(shí),比如華盛頓州立大學(xué)(Washington State University)周邊的愛荷華州約翰遜縣以及奧本大學(xué)(Auburn University)所在的阿拉巴馬縣等,學(xué)校的應(yīng)對方式和對于公共健康措施的落實(shí)力度不同,會(huì)產(chǎn)生截然不同的結(jié)果,既有可能造成新的局部疫情大爆發(fā),也可能創(chuàng)造一種人們不太習(xí)慣但可以保證安全的全新學(xué)習(xí)方式。

各式各樣的檢測策略

尼克在幾周前來到科羅拉多大學(xué)博爾德分校(University of Colorado at Boulder),在此之前他甚至沒有機(jī)會(huì)參觀校園;在家鄉(xiāng)紐約市疫情最嚴(yán)重的時(shí)候,他的校園參觀計(jì)劃徹底泡湯。18歲的尼克是大一新生,他只能把自己的大量物品郵寄到學(xué)校。為了保護(hù)隱私,他要求隱去全名。

在出發(fā)去學(xué)校之前,尼克在紐約市的一家CityMD接受了鼻拭子新冠病毒檢測。他告訴檢測人員自己是學(xué)生,因此他在坐飛機(jī)前兩天內(nèi)就很快拿到了檢測結(jié)果。

8月31日,他在校內(nèi)再次接受了檢測,使用的是科羅拉多大學(xué)的實(shí)驗(yàn)室自行開發(fā)的專有新冠病毒檢測方法。這種名為RT-LAMP的檢測方法只需要將唾液吐進(jìn)試管即可,45分鐘內(nèi)就能夠拿到檢測結(jié)果,可以輕松檢測出無癥狀感染者。如果有家庭成員或訪客幫助學(xué)生入校,他們要遵守一系列單獨(dú)的限制措施,例如大廳僅允許一名訪客進(jìn)入,并且必須在規(guī)定時(shí)間之前離開等。

學(xué)生搬進(jìn)宿舍之后還要接受PCR檢測,這種檢測耗費(fèi)的時(shí)間更長,但能夠更準(zhǔn)確地識(shí)別活動(dòng)性感染者。該校發(fā)言人表示,如果學(xué)生的快速響應(yīng)檢測結(jié)果呈陽性,在拿到PCR檢測結(jié)果之前,他將被轉(zhuǎn)移到隔離設(shè)施內(nèi)接受隔離。學(xué)校建議在校外居住但需要來到校園的學(xué)生,一旦出現(xiàn)任何癥狀,應(yīng)該前往健康診所接受免費(fèi)檢測。

發(fā)言人稱,該校的新冠疫情實(shí)時(shí)信息告示牌,是控制新冠病毒傳播和向?qū)W生團(tuán)體及時(shí)通報(bào)信息的有效途徑。

該校還使用另外一項(xiàng)新技術(shù)進(jìn)行疫情監(jiān)控:廢水監(jiān)測。顧名思義,這種技術(shù)通過檢測廢水來監(jiān)控社區(qū)層面的新冠病毒流行情況。

該校的檢測結(jié)果表明,即使執(zhí)行了嚴(yán)格的檢測和安全要求,要控制疫情爆發(fā)依舊很難。9月2日發(fā)布的監(jiān)測信息顯示,科羅拉多大學(xué)博爾德分校的四間宿舍可能出現(xiàn)了傳染,使校內(nèi)的確診病例達(dá)到近40例。

該校的助理副校長丹?瓊斯在9月2日致信全體學(xué)生,警告未來幾周確診病例可能激增。他寫道:“學(xué)校能否維持正常運(yùn)營的關(guān)鍵就在未來幾天。我們必須繼續(xù)遵守公共健康命令,避免大規(guī)模人群聚集,一定要佩戴口罩和保持距離?!?/p>

在那之后,情況變得越來越糟糕。盡管科羅拉多大學(xué)博爾德分校采取了各種創(chuàng)新措施,但9月15日,博爾德縣公共健康局(Boulder County Public Health)的常務(wù)局長杰弗瑞?扎亞赫呼吁該校所有學(xué)生自我隔離兩周。

他寫道:“博爾德縣公共健康局一直在密切監(jiān)控科羅拉多大學(xué)博爾德分校的學(xué)生和教職員工的病例數(shù)量和疫情傳播情況。過去兩周,博爾德縣有663位居民新冠病毒檢測呈陽性;其中502位居民與該校的學(xué)生有關(guān)(占所有病例的76%)。科羅拉多大學(xué)博爾德分校的大部分病例都來自在校外居住的學(xué)生。”

其他學(xué)校的疫情防控措施更多依靠學(xué)生自己完成檢測。在南加利福尼亞的查普曼大學(xué)(Chapman University),學(xué)生需要自己執(zhí)行鼻拭子檢測,然后將樣本發(fā)送給與診斷巨頭LabCorp合作的商業(yè)實(shí)驗(yàn)室。

查普曼大學(xué)的校長丹尼爾?斯特魯帕告訴《財(cái)富》雜志:“我們在8月初就公布了返校流程。無論是教職員工還是學(xué)生,所有人都必須接受學(xué)校提供的在線培訓(xùn),培訓(xùn)中解釋了各種防護(hù)措施,告訴所有人應(yīng)該怎么做。任何人必須證明參加了培訓(xùn),才能獲準(zhǔn)返校?!?/p>

該校的合作伙伴是LabCorp旗下的Pixel。Pixel從事郵寄式居家診斷檢測。學(xué)校稱新冠病毒檢測對學(xué)生免費(fèi)。斯特魯帕說:“首先你需要注冊。然后,Pixel會(huì)給你寄一份檢測試劑。其中包括一個(gè)預(yù)付郵費(fèi)的聯(lián)邦快遞(FedEx)包裹,你可以使用它寄回樣本?!?/p>

在校外居住并且不打算到校園參觀訪友的人不必接受檢測。雖然斯特魯帕強(qiáng)調(diào)學(xué)校一直在盡早向人們傳達(dá)校方的預(yù)期,但該校的二年級學(xué)生艾瑪?布朗表示,她依舊有一些困擾。

21歲的布朗說:“我有些不太確定學(xué)校的規(guī)定。學(xué)校在暑假給我們發(fā)來電子郵件,表示將采取混合授課的方式,有些可能是虛擬授課,有些是面對面授課。在校園建筑內(nèi)需要接受體檢和保持社交距離?!?/p>

目前學(xué)校所有課程都采取了網(wǎng)上授課的方式,但布朗懷疑是否有一天能夠真正采取混合授課的模式。

還有一個(gè)始終存在的問題,那就是LabCorp的病毒檢測需要多長時(shí)間才可以出結(jié)果。該公司表示,目前檢測需要的平均時(shí)間為24至48個(gè)小時(shí)。

康涅狄格州衛(wèi)斯理安大學(xué)(Wesleyan University)的薩曼塔?黑格有自己的困惑:“在返校之前,學(xué)校的管理者不知道該怎么做。他們給我們提供了各種推遲整個(gè)學(xué)期的方案。我們可以在家里或者在宿舍里遠(yuǎn)程上課?!?/p>

衛(wèi)斯理安大學(xué)還曾經(jīng)研究是否有學(xué)生來自疫情高風(fēng)險(xiǎn)地區(qū);這些地區(qū)的學(xué)生需要在開課前提前兩周到校,進(jìn)行自我隔離。來自低風(fēng)險(xiǎn)地區(qū)的學(xué)生要在開課前提前一周到校。

黑格從布魯克林前往學(xué)校之前接受了一次檢測,但到校后被要求再接受一次檢測:“我立刻前往進(jìn)行檢測的帳篷,因?yàn)槲冶仨毻瓿蓹z測才能夠領(lǐng)到宿舍的鑰匙?!边@兩次檢測都是鼻拭子檢測,只是在校園做的檢測由自己操作。她并非來自高風(fēng)險(xiǎn)地區(qū),因此只需要隔離到9月7日。

在部分學(xué)生眼中,高校校園文化發(fā)生了顯著變化

眾所周知,大學(xué)生喜歡成群結(jié)隊(duì)在學(xué)校里閑逛,偶爾會(huì)參加派對。在教室里面對面上課,也是一種社交方式。

科羅拉多大學(xué)的尼克說:“我可以聽到外面有人在叫喊。學(xué)校里派對盛行,但現(xiàn)在我不再參加派對?!彼荒苎堊约核奚針抢锏耐瑢W(xué)到自己房間。

他的六門課中,有五門全部采用虛擬授課。第六門可以選擇課堂授課,但需要保持距離。這帶來了一個(gè)難題——如果教授的Wi-Fi掉線怎么辦?學(xué)生們可能不愿意等著教授解決技術(shù)故障。

查普曼大學(xué)的二年級學(xué)生布朗說:“我很高興自己現(xiàn)在已經(jīng)不是一年級新生,因?yàn)槲也幌脲e(cuò)過住宿舍的經(jīng)歷?,F(xiàn)在我跟女朋友住在一間公寓里。但整天待在公寓里,同樣讓人感到與世隔絕。你很難交到新朋友。”

黑格說,在衛(wèi)斯理安大學(xué)里的生活相對平靜,沒有大型派對?!拔衣犝f過有兩三次派對,但我沒有親眼見過。不過我加入了班級的Facebook群組,而且有許多高年級的學(xué)生一直抱怨新生到處打聽派對的消息?!?/p>

對于美國近2,000萬大學(xué)生來說,這個(gè)學(xué)期才剛剛開始。目前,疫情的形勢仍然在不斷變化,即使最謹(jǐn)慎的高校也不能放松警惕。高校如何應(yīng)對這種局面,將決定未來幾周或者幾個(gè)月,美國是否會(huì)出現(xiàn)新一輪疫情大爆發(fā)。(財(cái)富中文網(wǎng))

翻譯:劉進(jìn)龍

審校:汪皓

The best laid plans of colleges and universities are no assurance during a public health crisis.

University administrators tell Fortune they’re doing everything they can to ensure public safety. But at schools like the University of Alabama system, which resumed in-person classes in August, cases have risen considerably. That school system has seen nearly 2,600 COVID cases across campuses as of Sept. 10.

The first week of college is supposed to be a time of celebration and the launch of the next chapter in your life, but students across America are facing a truly bizarre entry into the world of higher education as universities grapple with the coronavirus pandemic.

Logistical problems—and downstream social consequences for students themselves—abound. And depending on which school one attends, the processes for dealing with COVID can be wildly divergent, as evidenced by students and school administrators across the country who spoke with Fortune.

“I left the Harvard Global Health Institute after 16 years to become a dean at Brown’s public health school recently,” Ashish Jha, a physician and health policy researcher who previously served as director of the Harvard Global Health Institute, tells Fortune.

This gives Jha a unique perspective. He’s a public health expert and doctor by training—but also an expert in epidemics and critic of America’s response to the COVID crisis. And in his new role as a college dean, he can speak to what does and doesn’t work in this bizarre timeline.

“I think every college and university will see some cases and some outbreaks. The question will be: Will they be small and manageable and they can go on, or will you have to shut down and go online indefinitely?” Jha tells Fortune.

Here’s the issue: A university can’t exactly rely on personal responsibility—something that politicians and college administrators alike have played up in the midst of the pandemic—to be the single course to safety.

“The problem is that a lot of universities are acting like the only thing you can rely on is behavior change on the part of students without calling out the responsibility of the universities themselves,” says Jha.

With COVID cases spiking in communities surrounding colleges, such as Johnson County, Iowa, the area around Washington State University, and the Alabama county containing Auburn University, individual schools’ approach to and enforcement of public health measures could spell the difference between new local outbreaks and a safe, if strange, new form of learning.

Divergent testing strategies

Nick didn’t even get to visit the University of Colorado at Boulder campus before showing up there a few weeks ago; a planned trip to campus got scuttled during the outbreak’s heyday in his hometown of New York City. The 18-year-old freshman, who asked to use only his first name for privacy, had to have a lot of his belongings mailed over to campus from across the country.

Before he left for college, Nick received a coronavirus test—one of the ones requiring a nasal swab—at a CityMD location in New York. He informed them that he was a student and received results back pretty quickly, within two days, before getting on the plane.

He was tested again on campus on Aug. 31 using the University of Colorado’s own proprietary COVID test developed at a campus lab. With this test, called RT-LAMP, you can simply spit into a tube and get results within 45 minutes, an easy way to identify asymptomatic individuals. Family members or guests helping students move in face a separate set of restrictions, such as allowing only one guest to enter a hall and requiring them to vacate after a set time.

Students moving into dorms also take a so-called PCR test, which takes longer to process but is more accurate in identifying an active infection. If the rapid response test comes back positive and the PCR test result hasn’t been returned yet, the student would be put into an isolation facility, according to a university spokesperson. Those who live off campus but may need to come to campus are encouraged to go to a health clinic for free testing if they show any symptoms.

The spokesperson points to the university’s live COVID dashboard as a means of controlling coronavirus spread and keeping the student body informed.

The university is also using another novel technology to monitor cases: wastewater testing—the literal testing of waste, which can detect coronavirus prevalence on a community level.

And that has shown how difficult it can be to control COVID outbreaks even with stringent testing and safety requirements. Testing information released on Sept. 2 revealed potential outbreaks at four University of Colorado at Boulder dorms, bringing the number of confirmed on-campus cases up to nearly 40.

“The next few days will be critical to our ability to maintain our current operating status,” the university’s associate vice chancellor Dan Jones wrote in a letter to students on Sept. 2, warning that cases could spike in the coming weeks. “It is imperative that we all continue to follow public health orders, avoid large gatherings, wear masks, and practice physical distancing.”

The situation has grown more dire since then. On Sept. 15, Jeffrey Zayach, executive director of Boulder County Public Health, urged all University of Colorado at Boulder students to self-quarantine for two weeks despite the school’s innovative measures.

“Boulder County Public Health has been closely monitoring the case counts and outbreaks among students, faculty, and staff associated with the University of Colorado at Boulder campus,” he wrote. “In the past two weeks 663 Boulder County residents have tested positive for COVID-19; 502 of these residents were associated with CU students (76% of all cases). The majority of CU Boulder cases come from off-campus students.”

Other schools depend more on students to conduct tests for themselves. At Chapman University in Southern California, students are given a self-administered nasal swab test that is then sent to a commercial laboratory in a partnership with diagnostics giant LabCorp.

“We sent out the procedure at the beginning of August. Everybody—staff, faculty, and students have to take a training module that we provide online: an explanation of precautions and what you have to do. And no one is allowed back on campus until we’ve certified that they’ve taken this module,” Chapman president Daniele Struppa tells Fortune.

The school has been working with Pixel, an arm of LabCorp that specializes in mailing at-home diagnostics, and says the coronavirus tests are free of charge to students. “You have to log in. They send you this test. There’s a prepaid FedEx package that you send,” Struppa says.

Those who live off campus and don’t plan on coming back to visit campus to, say, hang out with their friends don’t have to get tested. And despite Struppa’s emphasis that the school has been in clear and early communication about expectations, Chapman senior Emma Brown says there’s still some confusion.

“I’m a little unclear on all of it. Throughout summer they were sending us e-mails suggesting there would be some sort of hybrid model where some classes are virtual, some are in person. There would have to be temperature checks and social distancing at campus buildings,” says the 21-year-old.

Classes are currently all online, though Brown suspects there may come a time when the idea of a hybrid model is possible.

There’s also the ever-present matter of how long it takes a test such as the LabCorp one to come back. The company says it currently takes, on average, 24 hours to 48 hours.

Samantha Hager at Wesleyan University in Connecticut faced some confusion of her own: “Prior to coming, they were pretty confused about what they were going to do. They gave us all the option to defer for the whole semester. We could go to classes remotely from our homes or from our dorm rooms.”

Wesleyan also looked into whether or not students were moving onto campus from areas with high rates of COVID; those students were required to arrive two weeks before classes started in order to self-isolate. Students from lower-risk areas were required to arrive one week before classes began.

Hager received one test before heading to school from Brooklyn and then was required to take another one as soon as she arrived on campus: “I immediately went to a testing tent, and that was required of me before they gave me the key to my dorm.” Both of the tests she took were of the nasal swab variety, although the one she took on campus was self-administered. Since she’s not from a high-risk area, she only had to quarantine until Sept. 7.

A significant shift in college culture—for some

College students have a reputation for hanging out in groups and attending the occasional party. Meeting people in person in classes is its own form of socializing.

“I can hear people outside yelling and stuff. It’s a party school, and I’m not partying right now,” says Nick, the University of Colorado student. He can only have people from his own dorm building over to his room.

Of his six classes, five are completely virtual. The sixth has optional in-person attendance with required distancing. That comes with its own dilemma—what if a professor’s Wi-Fi goes out? Students may not be compelled to wait to deal with technical difficulties.

“I’m happy I’m not a freshman right now because I think that my dorm experience is something I never would have wanted to give up. But now I live in an apartment with my girlfriend,” says Brown, the Chapman senior. “But it’s still pretty isolating to be in my apartment 24/7. It’s pretty hard to make new friends.”

Hager says that things are relatively calm, without major parties, as far as she’s seen at Wesleyan. “There have been, like, two or three from what I’ve heard, but I haven’t seen it. But, I mean, I’m part of a Facebook group for my class, and a lot of Wesleyan upperclassmen have been complaining about kids, like freshmen, going around asking for parties.”

This semester has only just begun for America’s nearly 20 million college students. How these schools respond to a situation that’s still very much in flux, even at the most cautious campuses, could determine whether or not we see another massive nationwide spike in the coronavirus outbreak in the next weeks and months.

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