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As students returned to the University of Missouri, the Columbia/Boone County Department of Public Health and Human Services saw a COVID spike, with the peak reaching more than 200 new cases per day.
As the return of college students to campuses has fueled as many as 3,000 COVID-19 cases a day, keeping track of them is a logistical nightmare for local health departments and colleges.
Some students are putting down their home addresses instead of their college ones on their COVID testing forms — slowing the transfer of case data and hampering contact tracing across state and county lines.
The address issue has real consequences, as any delay in getting the case to the appropriate authorities allows the coronavirus to continue to spread unchecked. Making matters worse, college-age people already tend to be hard to trace because they are unlikely to answer a phone call from an unknown number.
“With that virus, you really need to be able to identify that case and their contacts in 72 hours,” said Indiana University’s assistant director for public health, Graham McKeen.
And if the students do go home once infected, where should their cases be counted? The Centers for Disease Control and Prevention highlighted this issue in a recent study of an unnamed North Carolina university’s COVID outbreak, stating that the number of cases was likely an underestimate. “For example, some cases were reported to students’ home jurisdictions, some students did not identify themselves as students to the county health department, some students did not report to the student health clinic, and not all students were tested,” it said.
The White House Coronavirus Task Force even addressed the problem in weekly memos sent to the governors of Missouri, Arkansas, Iowa, Kentucky and New Jersey. “Do not reassign cases that test positive in university settings to hometown as this lessens ability to track and control local spread,” it recommended late last month in the memos, made public by the Center for Public Integrity.
While the full scope of the address confusion is unclear, the health departments of California, Indiana, Iowa and Virginia all acknowledged the challenges that arise when college cases cross state and county lines.
The maze of calls needed to track such cases also lays bare a larger problem: the lack of an interconnected COVID tracking system. Colleges have been setting up their own contact tracing centers to supplement overstretched local and state health departments.
“It is very patchwork, and people operate very differently, and it also doesn’t translate during a pandemic,” said McKeen, whose own university has had more than 2,900 cases across its Indiana campuses. “It made it very clear the public health system in this country is horribly underfunded and understaffed.”
Colleges’ transient populations have forever bedeviled public health when it comes to reportable infectious diseases, such as measles and bacterial meningitis, Association of Public Health Laboratories spokesperson Michelle Forman said in an email to