Colgate University's science-based approach to in-person classes

Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.

AMA Chief Experience Officer Todd Unger talks with Brian Casey, PhD, JD, president of Colgate University about the extensive measures the school is taking to mitigate the spread COVID-19 on campus as classes begin.

Learn more at the AMA COVID-19 resource center.

Speakers

• Brian Casey, PhD, JD, president, Colgate University

Unger: Hello, this is the American Medical Association's COVID-19 Update. Today, we're taking a behind-the-scenes look at one university's science-based approach to bringing students back to campus during COVID-19. My guest today is Dr. Brian Casey, president of Colgate University in Hamilton, New York. I'm Todd Unger, AMA's chief experience officer in Chicago.

Dr. Casey, I know you're very busy with students returning to campus this week, so thanks for being here today. Why don't you start by telling our audience where you are and why?

Dr. Casey: All right, well, first of all, Todd, thank you for letting me join you in this busy time. I am in West Hall, which is the oldest residence hall at Colgate University. It was the original building at Colgate, built in 1826, and I am in room 100. So I am in one of the dorm rooms, because I have joined the students in a mandatory 14-day quarantine. And we're on day five of this quarantine.

Unger: So you're having all your meals delivered to you and experiencing what all the other students are doing? That's a lot.

Dr. Casey: Yeah, due to this quarantine, we are delivering meals to just over 2,500 students, three times a day. So I'm eating all the food they're eating, living by their rules that they're living by. The building's un-air conditioned and loud. I'll leave it with loud.

Unger: Well, that is a sacrifice, and I appreciate your efforts there to endure what all the other students are doing. It sets quite an example. So as you know, obviously, I have a daughter and she's at Colgate University as a junior this year. And so I've been following all of your planning very carefully, and I've been really impressed with the directness and type of your communication. So I'd like to start back with those initial conversations, when your planning began, about how and why you decided to give in-person learning a try, as opposed to beginning the year remotely, as many other universities are doing.

Dr. Casey: Okay, this all began in April. We shut down, as did all other universities, in March, and we watched an entire school convert from face-to-face instruction to remote instruction. And I think we did well with it, but we also felt that what was happening remotely was not as valuable as what happens when you're here together, learning face-to-face.

So we started with the assumption of how could we get back together? Could we do it safely? Could we do it fairly? So I called together a task force of epidemiologists, biologists, virologists, but we also added in an ethicist. We added in sociologists, anthropologists, behavioralists, and we said, "How would we ever bring back 2,900 students safely?"

We wrestled with every option that every other school wrestled with: bringing back some, bringing back just the senior class, just the freshman class. But we also were struck by the notion of equity, because not every student has a great home environment in which they can learn with quiet, with great internet access. We also were watching other institutions, when shut down, students deciding to live locally. And so we said, "If we shut down, we might wake up one day and in our small village have 400 to 500 students just living here without any guidance."

So we came up with a very robust system to bring them back safely, with the idea of being that being together was worth it if we could pull this off.

Unger: Now, you're fortunate enough, too, that New York's numbers have stayed relatively low. That's an important factor, I'm assuming, in your decision?

Dr. Casey: Huge factor. This county moved below a one percent infection rate several, several weeks ago. We kept looking at it and we watched the infection rate increase for the rest of the country, and that made us nervous. And then what happened, and maybe it was a stroke of luck. It felt like a stroke of bad luck. The State of New York implemented a mandatory 14-day quarantine for students or for anyone arriving from a small number of states. The states grew to about 33, at its highest. We knew that over half of our students would be required to be in quarantine.

So we said, "Maybe this is, instead of being a hurdle to get over, it's an opportunity that if we can somehow manage a quarantine, we will up the safety of our students." So we kind of took a deep breath and said, "We're going to ask every single student, whether they're coming from an unquarantined state, a safe state, or not, to come to campus and stay in their room, stay in their townhouses or apartments for 14 days." We made the decision to do it with everybody, and then we set up a set of tests that matched with it.

We sent at-home test kits to every Colgate student. We just said, "Take a test before you show up. Take a test when you arrive. Move into quarantine and take a third test on either the seventh, eighth or ninth day before we release people from the first phase, the quarantine phase."

Unger: So you've implemented kind of a phased approach, I think. In the spirit of the Colgate University, you were calling them gates, as I believe?

Dr. Casey: Yes.

Unger: And I know that other universities are turning to you for guidance. Can you take us through the initial phase of that plan?

Dr. Casey: Yeah, so right now, we're in Gate Zero, which is you're in quarantine. Gate One allows students to move within what we're calling family units, those groups of students in which they're sharing kitchen facilities, bathroom facilities. We're allowing them to move into certain public spaces that we know we can de-densify and clean, and we're going to let them move into the village in small pockets.

If we can do this and keep our 22 data points that we're measuring every six hours. If those numbers stay good, we can move to the next phase, and every phase just has a wider opening. Students can gather in more places, can gather with more people, until the final gate, Gate Three, which is we then comply fully with what the New York State guidelines are, which is you can gather up to 50. But we knew that it couldn't be a binary of you're locked down and then all of a sudden, it's wide open. We just wanted to keep the data driving how we move through all of these phases.

And I don't know if you know that from your daughter. Every day, we're pushing this information out to the students. They can, at any moment, go to this dashboard and see exactly where we are. For a while there, we thought maybe we'll sort of give the message, and we're like, "No, they're college students. This is science. Show them the data."

Unger: Indeed, I think that is the way to go. The communications have been direct, and I think that does hold them responsible. In particular, your video message last week, which really challenged them to hold themselves to a higher standard for the sake of their community. What was the feedback to that?

Dr. Casey: People liked it. It's so easy to assume that college students will move to the lowest common denominator. My experience is if you ask them to retire, more often than not, they'll go to where you expect them to be. Will they be perfect? No, but it's sure worth asking them to try, because I think that's also something else. We're teaching them about science. We're teaching about a virus. And we're teaching about their responsibilities to a community. And those are hard things for 18-year-olds to learn, but we're in the learning business, so we might as well try.

Unger: Well, many universities are struggling right now with the very thing that you just brought up and getting students to adhere to guidelines. Some are seeing outbreaks as a result, even before classes begin. It's very early in the stage for you. How are you handling those challenges at Colgate?

Dr. Casey: We had a party emerge. A tiny little party, but a party nonetheless, the Tuesday after ... They moved in on the weekend and Tuesday night, a group of first years had gathered. They gathered, actually, down the hall from me. This party was actually down the hall from my room, which might not have been the smartest thing, even though I wasn't the person who saw the party. And we asked them to leave. We had asked every single student to sign a commitment to each other, a commitment to public health. And we said, "If you can't hold up this commitment, you have to go."

And it was hard. There were a lot of tears, a lot of disappointment, but it was also necessary, because if I let a group of students make that decision that potentially harms others, how can I ask anybody to keep it? So that was hard. We're going into our first weekend, which is a little nerve-wracking, so we'll see.

Unger: So you've talked a lot in your communications about how your planning is guided by science, and you mentioned the cross-functional team that got this up and running. Now who are your science advisors and how do you adjust in what is a continuous learning process where lots of developments are happening?

Dr. Casey: We have put together a group, both internal people and external people, called The Health Analytics Team, the HAT Group. The HAT group wears hats that say HAT, so it's very clear who they are. But we have a group that's endlessly monitoring these data points, looking at the CDC, looking at the State of New York. The difficulty is actually where the data is qualitative data, rather than quantitative data. We can look at test results. We're doing wastewater testing. I don't know if your daughter knows this, but we have measures on all of our residence halls. We're doing wastewater testing to see if signs of the virus appears earlier than appears in most typical tests. So we're looking at that.

But in some ways, it's the qualitative data that's harder. Are students complying with distance? Are they not gathering? Are they walking around and keeping six feet of distance? So it's art as much as science, but the science is there.

Unger: So if you make it through to that next gate, post-universal quarantine, what does instruction look like? What's the campus look like in this new era?

Dr. Casey: So in the second gate, all those classes that are in person ... And well over half of them are in person. Some of the classes will stay remotely, because the faculty members feel safer teaching remotely. They'll then move into our classrooms. Every single classroom was modified over the last three months. We pulled out all the chairs. The lecture halls with fixed chairs, all the chairs that you can't sit in are blocked. We expanded the daily schedule, so there's a longer period of time between every class. We have hand wipes for everybody, so we're asking our students: As you leave the classroom, clean your desk. As you come in, clean your desk. There's hand sanitizers everywhere. Yes, it was a lot. It was whole lot to do.

Unger: Should someone test positive, how have you integrated contact tracing into your plan and working with local public health officials?

Dr. Casey: So we do have positives. We finished our move-in cycle and we have 22 positives. Shows you how quickly the virus ... Everyone came here with a negative, and just a few days later, there's 22 positives. It's below one percent testing rates, so we're feel good about this. Those who test positive will move into isolation. We got control of a local hotel, so they're moving into the hotel, into isolation space. Those that we know are close contacts, roommates, move into a new quarantine space, but we've also alerted the county health authorities, because they're the ones who actually are in charge of contact tracing. But obviously, we're hand-to-glove with them, because we know how they move, more than the county does. So we have a strong pipeline to the county public health authorities. So we are doing contact tracing.

So that movement is happening today, and I need that number to stay where it is. Just a very quick point: We never thought the plan would have no infections. The trick is when you have them, what do you do? And I can say for a fact that the 22 positives, we saw a movement fully asymptomatic, so we have a sense that maybe these students were fine. The trick is what do you do when you have a positive case? We separate them, monitor them, do the contact tracing, and see if we can get through this.

Unger: Well, last question. This is a lot for everyone to undertake. Is there a learning moment in all of this, and if so, what is it?

Dr. Casey: You know, I look at our students, and they're entering a complicated world, and if they can learn that science can inform what they do and that they can achieve something only available through group effort, that's not a bad thing to learn for them as they go into the world. So I'm sending out daily videos to all of them, encouraging them. So we're all in this together.

Unger: Well, Dr. Casey, thank you so much for being here today, and I wish you a very speedy quarantine and the best to you, your faculty, and your students in the coming school year, especially because I have moved my office into my daughter's bedroom, and I need the space.

That's it for today's COVID-19 update. We'll be back tomorrow with another segment. For resources on COVID-19, visit ama-assn.org/COVID-19. Thank you for joining us today, and please take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.