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Most colleges and universities have now begun classes and brought students to campus all over the country. Several of those institutions, especially large ones, are now seeing outbreaks of COVID-19 among students.

Many of the most visible and serious outbreaks are in the Southeast United States.

The University of Alabama has had over 500 cases at its Tuscaloosa campus, for example, and Auburn University has seen over 200 cases this week alone. The University of Miami reported 141 after the first week of class, and the University of Kentucky has seen 250 cases so far.

In some examples, the shock of those case counts is tempered by considering high enrollment numbers and a low positivity rate. The University of Kentucky, for example, enrolls over 30,000 students, and its positive results as a share of tests reach only 1.1 percent.

In other cases, what looks high is high. The University of North Carolina at Chapel Hill, for example, has reported 635 cumulative cases among students since the first week of August. For the most recent testing period, the positivity rate was over 30 percent. The university announced last week it would be sending students home, a step none of the others mentioned have taken.

Though case counts and community spread are worse in general in the Southeast, the high case numbers among some universities may also be related to the start of classes. Colleges in the South are more likely than those elsewhere to start the academic year early in August, in line with K-12 schools in the region. Some of those colleges have been holding classes for three weeks now, which allows more time for an outbreak to develop. Chapel Hill, for example, started classes more than two weeks ago.

But geography can’t account for everything. Outbreaks have also occurred in other regions of the country. The University of Notre Dame, for example, has had 471 cases in August and last week put students on lockdown, holding classes online. The University of Missouri at Columbia reported 159 cases Tuesday, the first day of class. Iowa State University has seen 130 cases this semester.

Most of those universities are large. Iowa State, Mizzou, Auburn, Alabama, Kentucky and Chapel Hill all enroll over 30,000 students each. In contrast, Fayetteville State University in North Carolina, which enrolls under 7,000 students, has only seen 16 cases.

Pre-arrival testing at some of those universities was not as robust as it has been at some other institutions. Alabama and Auburn only required that students be tested in the 14 days prior to arrival on campus. Mizzou and Chapel Hill did not do any pre-arrival screening, an approach that is in line with recommendations from the Centers for Disease Control and Prevention.

Those universities have also seen the most attention for their case counts precisely because they have chosen to release them. At some colleges, like Arizona State University, it’s possible that outbreaks are occurring without public knowledge because the administration will not release any data, citing privacy concerns.

But amid questions about what universities with outbreaks can and should have done differently, it’s become clear that for at least one university, even keeping most classes online, closing residence halls and encouraging students to stay home was not enough to keep cases at zero. The University of Southern California did all of those things and its chief student health officer sits on the American College Health Association’s COVID-19 task force, which has been issuing guidance for institutions.

The university still reported 43 cases among off-campus students on Monday.

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