Penn State Shares More Details on Plans for COVID-19 Testing and Contact Tracing
Updated 4:30 p.m., July 31, 2020
With students set to begin returning to campus in just a few weeks, Penn State officials on Thursday offered the most insight so far on how the university will conduct COVID-19 testing and contact tracing for the fall semester.
The plan includes pre-arrival testing of 30,000 students, faculty and staff coming from high-risk areas; daily surveillance testing of 700 university community members; and rapid-result testing of symptomatic individuals.
A "robust" contact-tracing program will partner with Pennsylvania Department of Health efforts while utilizing university resources, including 36 contact tracers.
The details were discussed during a virtual town hall that comes as Centre Region elected officials and community members have increasingly called for Penn State to provide more specific information about its return-to-campus plan, including for testing and contact-tracing.
"As we have stated since the beginning of this unprecedented time we will make our decisions based on the best medical advice and sound scientific reasoning," Penn State President Eric Barron said. "Thus, we don’t make any specific announcements until our plans are detailed and can be accomplished. Since the university’s announcement of its 'Back to State' plan, which will meet or exceed the governor's guidelines for universities, we have been developing a layered plan to provide testing, tracing, isolation and quarantine as well as monitoring."
All university community members are being asked to self-quarantine for at least seven days before returning to campus, but Dr. Kevin Black, interim dean of the Penn State College of Medicine, said a team mapped prevalence of COVID-19 across the country by zip-code and the pre-arrival tests are being sent to students, faculty and staff returning to campus from the highest risk areas.
"This pre-arrival testing strategy, focusing on individuals returning from areas of high disease prevalence, provides us the opportunity to begin the semester with a far lower number of asymptomatic but COVID positive individuals on campus, which is essential toward allowing the campuses to remain open throughout the semester," Black said.
Those selected for pre-arrival testing are being sent a saliva test along with a pre-addressed UPS envelope to be returned to the contracted private lab Vault seven to eight days prior to return to campus.
"There are clearly logistical considerations for an operation of this magnitude," Black said. "To have a test completed four weeks prior to arrival does not contribute meaningfully to reducing disease prevalence upon return to campus. We really want the test submitted as close as possible to return to campus to have the greatest possible beneficial effect."
Results will be available 48 hours after the tests are received, Black said, and will be made available to the individual and the university.
"Individuals that have a positive result should not return to campus or to the university community unless they have been cleared by a health-care provider in accordance with CDC criteria," he said.
Vice President for Student Affairs Damon Sims later said that involves isolation for 14 days and at least 72 hours of no symptoms.
The university acknowledged that it cannot directly prevent an off-campus student who tests positive from returning to the surrounding community, but emphasized cooperation and personal responsibility for following public health directives are key to campuses being able to stay open.
"As Damon discussed in the town hall, the University doesn’t have jurisdiction in off-campus venues, but is relying on personal responsibility and the desire that students have expressed for the University to remain open," a Penn State spokesperson said on Friday. "As you heard in the town hall, we know we can’t do this alone and we are having conversations with local municipalities and hoping that they will enact ordinances along with what the University has in place, that will serve as a deterrent. The virus demands we all act in ways to minimize the threat to us and others, and we must all commit ourselves fully to acting responsibly."
The 30,000 saliva tests represent about 28% of Penn State's students, faculty and staff at all locations (not including World Campus students or Penn State Health employees).
Staff and student workers who are involved in high-density arrival and move-in activities, such as check-in, also will be given the at-home test or if already in the State College area will be required to be tested in the new Testing and Surveillance Center at University Park.
Once the semester begins, students, faculty and staff that develop COVID-19 symptoms will be tested at designated campus locations.
Those plans are being finalized but Black said there will be rapid turnaround time for results.
"We are finalizing plans at present with a well-known, high-quality national reference laboratory that is committing to excellent turnaround times for any suspected cases and the contacts of any confirmed cases at our campuses," Black said. "This type of rapid turnaround time will allow us to isolate the necessary individuals, initiate the contact-tracing program quickly and quarantine for the most appropriate length of time."
A Penn State spokesperson said on Friday that turnaround time for symptomatic testing will be 24-48 hours.
Commercial lab Quest Diagnostics says its average turnaround is two days for priority patients and seven days for all others — though some may receive results in as few as two days or as much as two weeks after testing. Another major private vendor, LabCorp says its current average turnaround time is two to three days.
The university will conduct required daily tests of 700 asymptomatic individuals, who will receive electronic notification in advance to go to a designated location.
"The rationale behind daily surveillance testing of individuals without symptoms lies in its ability to monitor changes in disease prevalence and inform us regarding if and when additional mitigation steps are required prior to a possible outbreak occurring," Black said.
Surveillance testing will initially prioritize those who were not tested pre-arrival, "then shift to a combination of random and risk-stratified surveillance," Black said.
Testing primarily will be performed by the Testing and Surveillance Center, which is working with experts and existing university resources and will conduct batch testing for efficiency. Each batch will test five samples at a time. Those who test positive will then be tested individually and directed to quarantine until results come back.
For Commonwealth Campuses, the at-home saliva test will be used for surveillance testing.
Surveillance testing results are expected in 12 to 36 hours, depending on the tests are done on campus at the TASC or sent to a private lab, a university spokesperson said on Friday.
Students will be required to comply, according to the university, which expects designate quick-testing areas around campus.
"Faculty and staff may be asked to be tested if there are concerns about a specific building or area of campus in which they work," a follow-up news release from the university said.
The university expects campus community members will comply with the testing protocols, but processes are available to deal with those who refuse.
"We believe that people understand what is at risk and know of the absolute need to follow requirements and participate in random testing for their own health and for the health of our community," a Penn State spokesperson said. "In the event that an individual does not adhere to the University’s COVID-19 safety plan requirements, then disciplinary measures can be taken through our HR policies or, as indicated above, the Office of Student Conduct for students."
An overall goal of the university's three-tiered testing strategy, Black said "is to prevent an increase in disease prevalence such that we do not exceed the ability of the university to quarantine or isolate students, or the capacity of the local health care system."
While the state Department of Health has responsibilities for contact tracing, Sims said that the university is scaling up and unifying its own existing contact tracing programs it has had in place for years for both students and faculty and staff.
The "hub-and-spoke" model will be centralized at University Park and reach out to other campuses, where Sims said campus nurses will be the primary liaisons.
When someone is identified as being positive, they will be provided the necessary resources and information and asked for their recent close contacts, defined as someone who has been within six feet of that person for at least 10 minutes no more than 48 hours prior to the onset of symptoms or prior to being tested. A contact tracer will reach out to those close contacts to give them instructions about testing and quarantining.
Sims also implored those who receive a phone call from a university number to answer because it may be regarding contact tracing.
Students, faculty and staff who are tested at an off-campus location are urged to notify the university, Sims said.
Lorraine Goffe, vice president for human resources, said employees are being provided with guidance and should notify their supervisors and the university's occupational medicine office.
Pennsylvania DOH, meanwhile, currently has 654 contact tracers statewide. On Friday the health department announced it will be hiring and training 1,000 more paid contact tracing staff to collaborate with local and regional health entities across Pennsylvania.
Quarantine and isolation
For students who test positive, or who are identified as a close contact of someone who has, space will be available on-campus for isolation and quarantine.
Three residence halls in the Eastview Terrace complex have been identified for isolation and quarantine. Each of the 400 available rooms has a private bath, and Sims said the university will have a "case manager" system that will assist students with daily needs such as food, laundry and personal items, symptom monitoring, academic issues and mental health concerns.
"All students living on our campuses in residence halls will be provided appropriate space for quarantine and isolation when they need it," Sims said. "Students living off-campus will also be provided isolation space to the extent our space available will allow. There are limitations to that space. Off-campus students however are also encouraged to anticipate the possible need for appropriate plans for quarantining or isolating. We’ll offer them advice and assistance as that issue arises but I think it’s best for them to anticipate it may arise and they may have to find resources or arrangements for themselves if we can’t provide that space to them."
At other campus locations, space will be provided on campus or at hotels.
When to "pivot"
Penn State has established a COVID Operations Center at University Park that will oversee everything from data management to testing and contact tracing to supply procurement. The center will be led by Kelly Wolgast, a nursing professor and retired U.S. Army colonel who served as a hospital commander and senior nurse executive of the U.S. Army Medical Command.
Monitoring of COVID-19 in the university and surrounding community will be key to decide if and when Penn State needs to "pivot" to remote instruction at all or some of its campuses.
Black said the university will be looking at multiple data points in determining those decisions, including number of positive cases on campus and in surrounding communities; number of students in quarantine or isolation at a campus relative to capacity; and COVID-19 hospitalizations in a community relative to the local health system's capacity.
Mount Nittany Medical Center, where there are currently a total of two COVID-19 patients hospitalized, has a capacity of on average one COVID-19 admission per day "on a sustained basis," Black said.
"We will not wait to reach that number before mitigation steps are initiated," he said. "Rather, we will look at all the data that is collected not only a daily basis but sometimes hourly, as well as trendlines, to not only measure current disease but also predict both increases and decreases in disease prevalence and adjust our mitigation efforts accordingly."
Barron said the university's plan isn't an "on/off switch" but is designed to respond to different circumstances.
"One circumstance might by the governor making a decision about the entire state. A circumstance might be in the monitoring of a particular hall that there is an issue," he said. "We have potential to take action based on that circumstance. It could be a ramp down or a pause or it could be going fully remote. I think that combination of prediction and nimble course delivery and capability allows us to address that need very effectively."
The university will roll out a dashboard with public reporting of COVID-19 data it collects, and while it's expected to have at least case and test numbers, neither Black nor Barron went deep on specifics.
"To the degree that we can share data with the community, meaning that we want to protect individual privacy, but the degree that we can share data with the community, we actively want to do that," Black said. "The communication really needs to be a bi-directional process. We have had participation from individuals from the community involved in our task force work. That will be a fundamental principle we will adhere to going forward."
Barron added that he expects it to be more detailed than what the athletic department currently reports, which is a biweekly count of total test numbers and positive cases among student-athletes.
"We are going to do our best to be transparent, maybe not every single detail of what’s going on but certainly we want to make sure that they have a sense of both our commitment to the safety of our communities and also have a sense of information that might be important for them to assess how it is COVID might be evolving, including ... in terms of reporting the numbers of cases," Barron said.
A committee representing local government, business and the university is working on community-wide issues related to testing, contact-tracing, quarantining/isolation, enforcement/compliance and communication.
As of Thursday, Centre County had 353 total COVID-19 cases since the first was reported on March 20 and 91 in the past two weeks. At least one has been reported for University Park's 16802 zip code. Penn State Athletics reported on Wednesday that eight student-athletes have tested positive as of July 24.
Penn State classes begin on Aug. 24. Sims said on-campus move-in will begin a week earlier with students scheduling times to arrive in phases. Downtown apartments are scheduling move-in times throughout the first three weeks of August.