Quarantine versus Lift Quarantine Discussion

[apl68]

This isn't just a theoretical question for me.  Although the decision lies officially with our library's Board of Trustees, I have to make recommendations for them to act upon.  I've been consulting the guidance I can find on the State Library's web site, and listening to what colleagues are saying.  I've began having conversations with the staff to make sure they all have their input. 

There are lots of details to work out.  How many library computers can we let people use while maintaining social distancing?  How many people can we allow into the stacks at a time (Or DO we let patrons use the stacks, or just offer curbside service at first?).  How insistent will we be on patrons wearing masks?  Where are we going to get the masks, hand sanitizer, etc. we'll need (Placed orders today)?  Do we let children in at all?  If so, what measures are needed to keep them under control?

There's a good deal of advice to consult, but ultimately we're the ones who know our facility and patrons, and have to work out the details.  Nobody at the state level has the authority to make the decisions for us.  And I'm ultimately the one who has to make the recommendations.  It's enough to make a person nervous.

I'm just a director of a small-town library.  I don't envy leaders of universities, cities, states, or nations who have to make decisions on a much larger scale.  The bigger the responsibility, the more of a no-win situation you're put in when it comes to making decisions that the constituents will accept.  Whatever you decide, you're going to have others accusing you of all sorts of evil, and holding you to blame for all the bad stuff that happens.

[Anselm]

My own direct observations lead me to conclude that the students absolutely will not stay apart from each other at proper distances.  My other concern is that practical decisions are being made by school administrators who are not experts on public health.   Whose advice will they follow, that of the CDC, WHO or their state governor?

[spork]

Maybe I'm a jaded old man whose thinking usually devolves to "Get off my lawn!" but it looks to me like the desire to avoid financial and reputational damage is the primary driver of university administrators' decision making. If a governor says "the stay at home order is now rescinded, and you don't need to worry about socializing in groups of less than ten people," then administrators are going to open campuses. Then when people get sick in the second wave of contagion administrators can simply say they were following the governor's guidelines.

[Caracal]

Maybe I'm a jaded old man whose thinking usually devolves to "Get off my lawn!" but it looks to me like the desire to avoid financial and reputational damage is the primary driver of university administrators' decision making. If a governor says "the stay at home order is now rescinded, and you don't need to worry about socializing in groups of less than ten people," then administrators are going to open campuses. Then when people get sick in the second wave of contagion administrators can simply say they were following the governor's guidelines.

If there isn't a huge ramp up in testing and contact tracing by the fall, and a big drop off in cases, I don't think there's any way schools can reopen.
What strikes me as odd about these discussions is the way they seem to assume we can predict the future of the epidemic and responses to it. Nobody knows if there will really be a "second wave," or even if there will really be an end to the "first wave."

[mahagonny]

Maybe I'm a jaded old man whose thinking usually devolves to "Get off my lawn!" but it looks to me like the desire to avoid financial and reputational damage is the primary driver of university administrators' decision making. If a governor says "the stay at home order is now rescinded, and you don't need to worry about socializing in groups of less than ten people," then administrators are going to open campuses. Then when people get sick in the second wave of contagion administrators can simply say they were following the governor's guidelines.

If there isn't a huge ramp up in testing and contact tracing by the fall, and a big drop off in cases, I don't think there's any way schools can reopen.
What strikes me as odd about these discussions is the way they seem to assume we can predict the future of the epidemic and responses to it. Nobody knows if there will really be a "second wave," or even if there will really be an end to the "first wave."

Which means, I believe, that eventually we will attempt to resume normal life because 'there's no time like the present' and we're just tired of waiting, or getting too poor.

But that's no reason people in academia who have willfully neglected opportunities for health insurance availability are not at fault.

[Caracal]

Maybe I'm a jaded old man whose thinking usually devolves to "Get off my lawn!" but it looks to me like the desire to avoid financial and reputational damage is the primary driver of university administrators' decision making. If a governor says "the stay at home order is now rescinded, and you don't need to worry about socializing in groups of less than ten people," then administrators are going to open campuses. Then when people get sick in the second wave of contagion administrators can simply say they were following the governor's guidelines.

If there isn't a huge ramp up in testing and contact tracing by the fall, and a big drop off in cases, I don't think there's any way schools can reopen.
What strikes me as odd about these discussions is the way they seem to assume we can predict the future of the epidemic and responses to it. Nobody knows if there will really be a "second wave," or even if there will really be an end to the "first wave."

Which means, I believe, that eventually we will attempt to resume normal life because 'there's no time like the present' and we're just tired of waiting, or getting too poor.

Well, extreme social distancing isn't a long term strategy and was never intended to be one. The point is to:
1. Avoid a disastrous surge of cases that would overwhelm the healthcare system
2. Buy time to get PPEs, find better methods of treatment, ramp up hospital capacity etc.
3. Get cases down enough, while also getting contact tracing and testing up enough that you can have a chance of containing outbreaks or at least knowing when they are getting bad enough in an area that you have to put restrictions back up.

The problem, of course, is that we don't actually have a functioning federal government, and so progress on all of these things has been sporadic and fragmented. But, some form of normal life is going to have to resume. What that means for colleges is really dependent on how much the risks can be contained and managed.

[Hegemony]

My university is one of the ones planning to open up in the fall. I sat in on a very detailed description of how they're going to try to do it, and I was impressed by the professionalism, which is so sorely lacking in our national plan. They've formed a consortium with other universities in the region and have been developing a plan together, pooling knowledge and expertise. So I think they probably have what approaches as good a plan as can be made. The trouble is that the unknowns are so huge — from what condition the country will be in at that point, to whether students can be induced to keep their distance and behave responsibly outside of class. (I have my doubts about the latter, and in fact my doubts about the former.) They're really just whistling in the dark.

The most persuasive thing was the massive trouble to the university if it cannot open in the fall. The tens of millions that will be lost anyway is staggering; and if the university cannot open, we're the Titanic in the open sea. That's no reason to open at the cost of student lives, however. The plan is to monitor things carefully and go into lockdown in place if the virus exceeds a certain amount. At the moment we are in an area of the country and of the state with very little virus — less than a handful of hospitalizations this week. It's so little that they are doing contact tracing, and they plan to continue this when students return. The idea is to quarantine infected students in hotels for the duration. However, my epidemiologist friends note that this will prove pointless unless they also quarantine everyone the infected student has been in contact with for the previous two weeks.  All I can say is: we'll see how well it works. Fortunately I am on leave in the fall.

[Caracal]

My university is one of the ones planning to open up in the fall. I sat in on a very detailed description of how they're going to try to do it, and I was impressed by the professionalism, which is so sorely lacking in our national plan. They've formed a consortium with other universities in the region and have been developing a plan together, pooling knowledge and expertise. So I think they probably have what approaches as good a plan as can be made. The trouble is that the unknowns are so huge — from what condition the country will be in at that point, to whether students can be induced to keep their distance and behave responsibly outside of class. (I have my doubts about the latter, and in fact my doubts about the former.) They're really just whistling in the dark.

The most persuasive thing was the massive trouble to the university if it cannot open in the fall. The tens of millions that will be lost anyway is staggering; and if the university cannot open, we're the Titanic in the open sea. That's no reason to open at the cost of student lives, however. The plan is to monitor things carefully and go into lockdown in place if the virus exceeds a certain amount. At the moment we are in an area of the country and of the state with very little virus — less than a handful of hospitalizations this week. It's so little that they are doing contact tracing, and they plan to continue this when students return. The idea is to quarantine infected students in hotels for the duration. However, my epidemiologist friends note that this will prove pointless unless they also quarantine everyone the infected student has been in contact with for the previous two weeks.  All I can say is: we'll see how well it works. Fortunately I am on leave in the fall.

I think this is the sort of thing that more and better data about transmission and better testing will help with. From what I understand, people are probably usually only contagious for two or three days before they show symptoms. If instant tests became standard you could quickly figure out if someone has the virus and notify all their contacts during that time period. Once they hit the point where a test would show it if they were infected, you test them and they only stay in quarantine if they're positive. 

[Hegemony]

But if they've had low-level symptoms (as are most common with college-age students) for a while, and finally go and get tested after they've already had symptoms for a week, it could easily stretch into 10+ days that they've been spreading the virus. And on a campus, that's a whole lot of people they could have been near enough to transmit it.

[Caracal]

But if they've had low-level symptoms (as are most common with college-age students) for a while, and finally go and get tested after they've already had symptoms for a week, it could easily stretch into 10+ days that they've been spreading the virus. And on a campus, that's a whole lot of people they could have been near enough to transmit it.

Right, that wouldn't work, but we've seen over the last couple months that people are capable of changing their behavior. It doesn't seem hard to imagine to me that you could create new norms. Give every student a thermometer and have a bunch of posters everyone on campus about the importance of paying attention to symptoms to protect the community. I don't think it would be that hard to create a norm that if you wake up and feel cruddy, you take your temperature. If you have a fever, or some other important symptom, you put your mask on and go straight to the health center where they run an instant test.

[theblackbox]

The issue with testing is that most colleges are not going to have the capacity to do as many tests as needed. Universities that have their own hospital attached to them? Yes. Everyone else? Highly unlikely.

It's also impossible to guess how students (and their parents) are going to feel about residential college life and in-person classes in August. There may be a sizable group that refuses to do in-person classes even if legally allowed by the local/state government, or a group that is initially for it, but immediately panics once cases arrives on-campus and requires the option to move online even if in-person is still a go with required quarantining of positive cases.

My thinking is that we need a collective guideline to know what could allow for quarantining in residence in the dorms - if we keep dorms to no more than 4 people per bathroom, for example, can those residences remain open even in the face of a city/state mandating another Stay at Home order? Only then can in-person classes be seriously considered and planned for, in my mind, since we're all (presumably) at the mercy of the government as to whether we can truly be open or not, and that could be technically be revoked on a moment's notice, no?

[Hegemony]

My university is allegedly developing a test. We'll see. As many have said, in all of this we're just building the plane while we're flying it.

[clean]

"if you wake up  (ON A TEST DAY)  and feel cruddy, you take your temperature. If you have a fever, or some other important symptom (LIKE TEXT ANXIETY), you put your mask on and go straight to the health center where they run an instant test (TO GET A NOTE TO NOT TAKE THE EXAM)."

I added a few extensions.

I know that I dont want to be furloughed.  Im pretty sure that IF we had to choose between open and furlough, open is a better choice.  On the other hand, Im in the older with at least one complication group, so I wonder IF my job is worth my life?  What is the latter worth without the former (at least until my retirement account recovers AND THEN SOME?)

I wonder  about the discussion that Parents dont want to send their youngins off to college IF the virus is around applies to elementary age kids?  DO parents of children want their kids home in the fall IF the virus is still around?   

[Anselm]

Are hotels capable and willing to accept infected people who need to quarantine?  Is this really a good plan?  If you were infected with a deadly disease would any of you want to spend two weeks in a hotel room?

My own school was planning to have a few students come to campus for hands on work with labs and art studio work starting tomorrow.   They were planning to check temperatures and ask questions at certain entry points.  They then sent out a desperate email asking for volunteers to staff the entry points.  Sorry, I need to rearrange my sock drawer.  Now, they canceled all of this after positive cases in our county doubled within a few days.

[Caracal]

"if you wake up  (ON A TEST DAY)  and feel cruddy, you take your temperature. If you have a fever, or some other important symptom (LIKE TEXT ANXIETY), you put your mask on and go straight to the health center where they run an instant test (TO GET A NOTE TO NOT TAKE THE EXAM)."

I'd put that very low on my list of concerns. Just have a flexible exam makeup policy. I don't want sick students coming to class.
And please, can we all just agree that whenever classes resume, we aren't going to require doctors notes for absences? It has always been a bad idea, but the last thing we need is to encourage students to waste healthcare resources.