Last update: Tuesday 12/28/21
During the first half of 2021, the U.S. focused on vaccinating its residents; but its focus shifted to living with the virus in the months that followed. Other countries have also refocused. Unfortunately, efforts to refocus have been impeded by large unvaccinated segments of the populations and by the emergence of substantial breakthrough infections. Although breakthroughs have been overwhelmingly mild or asymptomatic, they contribute to the continuing presence of the virus by thwarting the achievement of herd immunity.
Editor's note: This note is an update of the original version that was posted on 11/16/21. That version was based on entries on its "Live Update" page of Inside Higher Ed (IHE) from 8/2/21 to 11/16/21; this version covers 8/1/21 to 11/30/21. Not much changed during the added weeks in November when the campuses were still dominated by the Delta variant. Therefore the word cloud and text are more or less the same. The next version will be published during the Spring 2022 semester and will reflect the abrupt, unexpected emergence of Omicron as the dominant variant.
Headline stories in the media a few weeks after the predictable post-Thanksgiving Omicron surge portend substantial shifts in the pandemic management policies of U.S. colleges and universities during the early months of the Spring 2022 semester:
- "Colleges move exams online, urge boosters as coronavirus cases rise and omicron fears grow", Susan Svrluga and Lauren Lumpkin , Washington Post, 12/14/21
- "Georgetown, GW, NYU and Princeton Change Course", Scott Jaschik,
Inside Higher Ed, 12/16/21 - "Omicron surge pushes elite colleges back into 2020 mode", Ivana Saric, Axios, 12/20/21
- "COVID-19 Changes Plans for Next Semester", Scott Jaschik,
Inside Higher Ed, 12/20/21
A. Living with the virus in other countries
The pandemic has become so politicized in the U.S. that it is often difficult to perceive broad similarities between the pandemic policies of red states and and the policies blue states, similarities that are more readily perceived in the policies pursued by the governments of other countries in Europe and Asia; so this section considers broad trends in other countries.
The pandemic has become so politicized in the U.S. that it is often difficult to perceive broad similarities between the pandemic policies of red states and and the policies blue states, similarities that are more readily perceived in the policies pursued by the governments of other countries in Europe and Asia; so this section considers broad trends in other countries.
Most countries that achieve high vaccination rates, e.g., at least 60 percent, tend to abandon distancing and mask requirements in outdoor spaces (including sports stadiums and concerts), abandon distancing in indoor spaces, but limit admission to concerts, theaters, restaurants, and other indoor spaces to those who wear masks and show proof of vaccination; however, penalties are often imposed on the unvaccinated. These countries do not test all residents frequently, so breakthrough cases go largely undetected. The governments of these countries reimpose masks, social distancing, quarantines, and even lockdowns if surges in new cases get out of hand. For example:
- "Austria announces a lockdown and vaccination mandate for all.", Christopher F. Schuetze and Elian Peltier, NY Times, 11/19/21
- Australia, "Covid Zero Is No Longer Working for Australia", Edward Cliff and Brian Fernandes, NY Times, 9/8/21
- Great Britain, "Rise in Cases and Deaths Tests Britain’s Gamble on Few Virus Restrictions", Mark Landler and Stephen Castle, NY Times, 10/21/21
- China, "Near-Daily Covid Tests, Sleeping in Classrooms: Life in Covid-Zero China", Vivian Wang and Joy Dong, NY Times, 11/5/21
B. Living with the virus on the campuses of U.S. colleges and universities
Unfortunately, our major media do not devote much coverage to Covid on campuses except where cancellations or postponements of important athletic events are involved. Nor do government agencies provide convenient tabulations of collegiate infections, hospitalizations, and deaths at the state or national levels. Fortunately, useful insights can be gained from the "Live updates" page of virus-related events that is published on the website of Inside Higher Education (IHE), one of the nation's leading academic news publications. Here's a link to a copy of an extensive excerpt from IHE's update page as it appeared on 11/30/21 ==> Live Update on 11/30/21
As the reader will see, the excerpt includes 93 brief summaries of Covid news reports about events that occurred at various U.S. colleges and universities between August 2, 2021 and November 11, 2021. It is not a random sample of all collegiate Covid events, just those events that the IHE editors thought were worth their readers' attention. Reading one short summary after another is like listening to a well-informed reporter giving his or her opinions as to what you really need to know in order to keep up with the latest developments.
As will be shown in the following paragraphs, the IHE summaries suggest that U.S. colleges and universities are more or less following the same strategies as highly vaccinated countries with regards to living with the virus.
Summarizing the IHE summaries via a word cloud
Word clouds provide concise summaries of narratives like the IHE updates. The word cloud in the upper left hand corner of this page contains the words that occurred at least 10 times in the 93 summaries in the excerpt. Notes on which words were included, which were modified, etc appear on this page ==> IHE Word Cloud Notes
- The 3 most frequent words were:
1. student (196) ...black
2. vaccin (156) ... red
3. mandat (119) ... blue
Campus pandemic strategies implied by the IHE excerpts and its word cloud
The three biggest words at the center of the cloud -- "students", "vaccinations", and "mandates" -- tell the tale. Just as countries in Europe and Asia have lifted pandemic restrictions when vaccinations rose to high enough levels, so too have U.S. colleges and universities returned to face-to-face classes on campus once a mandated high percentage of their students has been vaccinated. But there is a significant difference with regards to mandates. U.S. higher ed, especially its private institutions, can achieve high levels of vaccination by refusing to allow unvaccinated students to attend classes or by expelling them permanently. National governments can also issue mandates. However their mandates often encounter extensive vaccine hesitancy or outright refusal, and the governments can't expel citizens who continue to disobey their mandates.
The three biggest words at the center of the cloud -- "students", "vaccinations", and "mandates" -- tell the tale. Just as countries in Europe and Asia have lifted pandemic restrictions when vaccinations rose to high enough levels, so too have U.S. colleges and universities returned to face-to-face classes on campus once a mandated high percentage of their students has been vaccinated. But there is a significant difference with regards to mandates. U.S. higher ed, especially its private institutions, can achieve high levels of vaccination by refusing to allow unvaccinated students to attend classes or by expelling them permanently. National governments can also issue mandates. However their mandates often encounter extensive vaccine hesitancy or outright refusal, and the governments can't expel citizens who continue to disobey their mandates.
Breakthrough cases
The word cloud is informative for the words that it includes; but it is also informative because of the words it does not include, for example: "breakthrough" as in breakthrough cases.
Delta has produced far more "breakthrough cases", i.e., infected far more vaccinated persons, than any previous variant. Some have estimated that breakthroughs now account for 20 to 30 percent of all new infections. But the overwhelming majority of breakthroughs have been asymptomatic or mild. Indeed less than two percent of Covid hospitalizations in the U.S. have been breakthroughs.
This overview can be misleading because the severity of breakthroughs varies widely from the youngest to the oldest age groups. Recent findings from the United Kingdom are depicted in the following graph that was published by the NY Times.
- "When Can the U.S. Declare Victory Over Covid?", Spencer Bokat-Lindell, NY Times, 11/17/21
The graph shows the number of persons in the United Kingdom who were hospitalized between September 6 and October 3, 2021. The dark bars show the number of unvaccinated persons per 100,000 who were hospitalized; the light bars show the number of breakthroughs per 100,000 vaccinated persons who were hospitalized. As per the general observation cited above, the graph shows that the dark bars (unvaccinated) add up to far more hospitalizations than the light bars (breakthroughs).
The vast majority of college students fall into the 18 to 29 age group. The graph confirms that most breakthrough cases within this group were asymptotic or mild, which is why so few were hospitalized; by contrast, breakthroughs in the oldest age group are moderate to severe, which is why so many were hospitalized. Now let's take a closer look:
- The number of unvaccinated persons who were hospitalized was small, 3.8 out of 100,000 unvaccinated persons who were infected; and the number of breakthroughs who were hospitalized was even smaller, much less than 1.0 out of 100,000 vaccinated persons. In other words unvaccinated persons who were infected were at least 4 times as likely to be hospitalized as vaccinated persons who become infected.
- Assuming that hospitalization patterns similar to those observed in the United Kingdom are also present in the U.S., few unvaccinated students will become sick enough to be hospitalized if they are infected by Delta; and far fewer vaccinated students will be hospitalized.
To be sure, Delta infections will occur among vaccinated students, especially if they abandon masking and social distancing in inappropriate circumstances; but they are highly unlikely to become sick enough to be hospitalized. The absence of the word "breakthrough" from the IHE word cloud suggests that the experience of U.S. colleges and universities thus far is consistent with this conclusion.
Covid-Zero at Harvard University
Covid-zero means no infections; no infections means no severe illness; and no severe illness means no deaths -- truly admirable results for the nations and institutions of higher learning that can afford their pursuit. So far only one nation, China, and only one U.S. institution of higher learning, Harvard, are known to have maintained unwavering commitment to Covid-zero.
Of course new infections will occur from time to time, so the trick is to test every member of a community at least once each week in order to identify newly infected persons as soon as possible, isolate them so they can't infect other people, then perform contact tracing in order to identify the spreader events at which the new infections occurred, i.e., the places/events wherein masks and social distancing were abandoned inappropriately. Note again that testing every member of a community must be implemented at least once each week in order to detect breakthroughs because the breakthrough cases will probably be asymptomatic or too mild for the infected persons to notice.
Under Covid-zero policies, if "enough" new infections occur, even if no one is hospitalized, a government must send a newly infected community into lockdown or, if the community is a campus, its administrators must suspend on-campus classes and move course instruction to online venues. Here's the IHE summary of the suspension of online classes by Harvard's School of Business when a cluster of breakthrough cases was detected in September 2021
- Sept. 30. Harvard University’s business school moved all in-person classes for first-year M.B.A. and some second-year students online this week, CNBC reported. The business school blamed transmission of COVID-19 on students attending social events without appropriate safety considerations. “Contact tracers who have worked with positive cases highlight that transmission is not occurring in classrooms or other academic settings on campus,” business school spokesman Mark Cautela said in a statement. “Nor is it occurring among individuals who are masked.” -- Scott Jaschik
Note: The Wall Street Journal also covered this story and cited the requirement that "At HBS, all students were expected to be vaccinated before returning to campus this fall" which is why the HBS cases were breakthroughs ... HBS = Harvard Business School ... The Journal also reported that "HBS plans to increase the frequency of testing to three times a week for all students"
Needless to say, Covid-zero is a very expensive and very intrusive pandemic management strategy that requires lots of power and/or lots of money to implement. Harvard has lots of money; the Chinese government has lots of power and lots of money; but most U.S. colleges and universities have lots of neither.
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Recent notes on this blog:
- "From one pandemic to two overlapping endemics" -- Last update: 11/3/21
- "Let's stop repeating COVID myths" -- Last update: 11/1/21
- "Acceptable costs of living with the virus", Last update: 10/24/21
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