Preparing for Coronavirus

Students at several U.S. universities are tested for possible cases of a novel coronavirus. Experts weigh in on how colleges can prepare for the virus.

January 27, 2020
 
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The coronavirus has come to U.S. campuses. Arizona public health officials announced Sunday that "a member of the Arizona State community who does not live in university housing" had tested positive for the novel coronavirus (2019-nCoV). The person had recently traveled to Wuhan, China, where the virus originated.

Baylor University announced that one of its students was being tested by public health officials. Baylor said the student had recently traveled to China.

A student at Wesleyan University who developed a cough and fever after traveling through an airport where a patient identified to have coronavirus traveled is also being tested, the Hartford Courant reported.

A Tennessee Tech University student who was tested for the virus tested negative. A Texas A&M University student who was tested also tested negative.

Meanwhile, in China, Duke Kunshan University has announced that it will suspend classes in all programs until Feb. 17. Although Duke Kunshan is a partnership between Duke University and Wuhan University, the campus is located in a city almost 500 miles from Wuhan. 

As of Sunday evening there had been five confirmed cases of the coronavirus in the U.S., including the case of the individual connected to Arizona State. The Centers for Disease Control and Prevention says those infected with the virus experience mild to severe respiratory illness with symptoms of fever, coughing and shortness of breath. CDC officials believe the symptoms can manifest as few as two or as many as 14 days after exposure.

The CDC said it considers the virus a serious public health threat and that outbreaks of novel viruses are always a cause for concern. Nonetheless, the agency considers the immediate risk to the American public to be low at this time.

The agency recommends against nonessential travel to China's Hubei Province, including the city of Wuhan.

At least 80 people have died from the virus, and Chinese authorities reportedly announced Sunday that Wuhan, a city of about 11 million people, may have 1,000 more cases. China has imposed strict travel restrictions for residents of Wuhan and at least 12 other cities in Hebei Province. The CDC last week began screening incoming travelers from Wuhan at five American airports.

With colleges being international hubs, home to internationally mobile students or faculty, it is possible they may see more cases from students or scholars who traveled to affected regions in China during the winter break.

China is the biggest country of origin for international students in the U.S., and Wuhan is the 18th-largest city of origin, according to data from 2008-12 compiled by the Brookings Institution. At that point there were about 8,000 students from Wuhan in the U.S.

Asked if there are special precautions colleges should take to screen faculty or students who have recently traveled to affected areas in China, James R. Jacobs, the chair of the American College Health Association’s Emerging Public Health Threats and Emergency Response Coalition, said that foremost is to follow the advice of the CDC and local health departments.

“At a minimum, health-care workers should inquire about travel history whenever evaluating a patient with fever,” said Jacobs, the executive director of Vaden Health Services at Stanford University.

“Coincidentally, we are in the middle of influenza season in the U.S., so institutions should already be in aggressive flu-prevention mode (hand washing, cough etiquette and so forth),” he added. “Further, institutions should continue to encourage seasonal flu vaccine for those who have not already received it, as anything that can be done to reduce the number of flu-like illnesses on campus will help to limit confusion if coronavirus illness begins to spread.”

"Many strains of coronaviruses are ubiquitous and are often responsible for symptoms that we attribute to the 'common cold,'" Jacobs said. "Similarly, coronavirus 2019-nCoV seemingly causes no or mild symptoms in most people infected by it." 

Jacobs said guidance for pandemic planning is available on ACHA’s website. "[T]he World Health Organization has not declared spread of coronavirus 2019-nCoV to have reached pandemic status, but the work of pandemic planning done by most campuses during the past 20 years for other respiratory viruses, such as SARS, H5N1 and H1N1, will be useful in preparing to respond to the appearance of 2019-nCoV," he said.

Other experts also emphasized the importance of planning. "I would be thinking about communication plans to keep everyone appraised of the nature of the respiratory threat and where to get advice, and where to get health care if their signs and symptoms meet that advice," said Gregory C. Gray, a professor of infectious disease at Duke University. "I would be thinking about trying to allay the fears that might cause the worried well to seek care unnecessarily."

In addition to a good communications plan, Gray emphasized the need for “a good strategy for how you would handle a high volume of people in your clinic,” including strategies for triage and for safely transporting individuals to hospitals as needed.

“I think that your student health service ought to be asking any student who comes in with a respiratory infection two questions: Have you been in China recently, and if not, have you had close contact with anybody who’s been in China recently? It’s low-tech, no-cost, but it’s terribly telling in selecting individuals who might be possible cases,” said William Schaffner, a professor of preventive medicine at Vanderbilt University.

Schaffner also said that educational outreach is critical. “In general, let the student body know about this and if you’ve been to China or had close contact with somebody who’s just returned from China that at the very first sign, don’t tough it out. Students have a tendency [to say], ‘Oh well, I’ll see how I feel in the morning.’ Don’t do that. Come [to the student health center] immediately and let us know in advance that you’re coming.”

"I would recommend to people that they stay ahead of the game," said Ron Waldman, a professor of global health at George Washington University. "This is a rapidly evolving situation; it could go south, and colleges should be prepared to implement the next step."

"We have the benefit of not being at the very front end," he added. "In China, they’ve basically cordoned off huge metropolitan areas."

As a final note, Waldman cautioned against potentially stigmatizing international students from China. “No stigma and no panic,” he said. “This is a call for caution, vigilance and surveillance.”

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