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Turcinovic J, Kuhfeldt K, Sullivan M, Landaverde L, Platt JT, Alekseyev YO, Doucette-Stamm L, Hamer DH, Klapperich C, Landsberg HE, Connor JH. Transmission Dynamics and Rare Clustered Transmission Within an Urban University Population Before Widespread Vaccination. J Infect Dis 2024; 229:485-492. [PMID: 37856283 DOI: 10.1093/infdis/jiad397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Universities returned to in-person learning in 2021 while SARS-CoV-2 spread remained high. At the time, it was not clear whether in-person learning would be a source of disease spread. METHODS We combined surveillance testing, universal contact tracing, and viral genome sequencing to quantify introductions and identify likely on-campus spread. RESULTS Ninety-one percent of viral genotypes occurred once, indicating no follow-on transmission. Less than 5% of introductions resulted in >3 cases, with 2 notable exceptions of 40 and 47 cases. Both partially overlapped with outbreaks defined by contact tracing. In both cases, viral genomics eliminated over half the epidemiologically linked cases but added an equivalent or greater number of individuals to the transmission cluster. CONCLUSIONS Public health interventions prevented within-university transmission for most SARS-CoV-2 introductions, with only 2 major outbreaks being identified January to May 2021. The genetically linked cases overlap with outbreaks identified by contact tracing; however, they persisted in the university population for fewer days and rounds of transmission than estimated via contact tracing. This underscores the effectiveness of test-trace-isolate strategies in controlling undetected spread of emerging respiratory infectious diseases. These approaches limit follow-on transmission in both outside-in and internal transmission conditions.
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Affiliation(s)
- Jacquelyn Turcinovic
- Department of Virology, Immunology, and Microbiology, Chobanian & Avedisian School of Medicine
- National Emerging Infectious Diseases Laboratories
- Program in Bioinformatics
| | | | | | - Lena Landaverde
- Department of Biomedical Engineering
- Precision Diagnostics Center
- BU Clinical Testing Laboratory, Research Department
| | | | | | | | - Davidson H Hamer
- National Emerging Infectious Diseases Laboratories
- Precision Diagnostics Center
- Department of Global Health, School of Public Health
- Section of Infectious Disease, Department of Medicine, Chobanian & Avedisian School of Medicine
- Center for Emerging Infectious Disease Policy and Research, Boston University, Massachusetts
| | - Catherine Klapperich
- Department of Biomedical Engineering
- Precision Diagnostics Center
- BU Clinical Testing Laboratory, Research Department
| | | | - John H Connor
- Department of Virology, Immunology, and Microbiology, Chobanian & Avedisian School of Medicine
- National Emerging Infectious Diseases Laboratories
- Program in Bioinformatics
- Center for Emerging Infectious Disease Policy and Research, Boston University, Massachusetts
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2
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Bouton TC, Atarere J, Turcinovic J, Seitz S, Sher-Jan C, Gilbert M, White L, Zhou Z, Hossain MM, Overbeck V, Doucette-Stamm L, Platt J, Landsberg HE, Hamer DH, Klapperich C, Jacobson KR, Connor JH. Viral Dynamics of Omicron and Delta Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variants With Implications for Timing of Release from Isolation: A Longitudinal Cohort Study. Clin Infect Dis 2023; 76:e227-e233. [PMID: 35737948 PMCID: PMC9278204 DOI: 10.1093/cid/ciac510] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In January 2022, US guidelines shifted to recommend isolation for 5 days from symptom onset, followed by 5 days of mask-wearing. However, viral dynamics and variant and vaccination impact on culture conversion are largely unknown. METHODS We conducted a longitudinal study on a university campus, collecting daily anterior nasal swabs for at least 10 days for reverse-transcription polymerase chain reaction (RT-PCR) testing and culture, with antigen rapid diagnostic testing (RDT) on a subset. We compared culture positivity beyond day 5, time to culture conversion, and cycle threshold trend when calculated from diagnostic test, from symptom onset, by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, and by vaccination status. We evaluated sensitivity and specificity of RDT on days 4-6 compared with culture. RESULTS Among 92 SARS-CoV-2 RT-PCR-positive participants, all completed the initial vaccine series; 17 (18.5%) were infected with Delta and 75 (81.5%) with Omicron. Seventeen percent of participants had positive cultures beyond day 5 from symptom onset, with the latest on day 12. There was no difference in time to culture conversion by variant or vaccination status. For 14 substudy participants, sensitivity and specificity of day 4-6 RDT were 100% and 86%, respectively. CONCLUSIONS The majority of our Delta- and Omicron-infected cohort culture-converted by day 6, with no further impact of booster vaccination on sterilization or cycle threshold decay. We found that rapid antigen testing may provide reassurance of lack of infectiousness, though guidance to mask for days 6-10 is supported by our finding that 17% of participants remained culture-positive after isolation.
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Affiliation(s)
- Tara C Bouton
- Section of Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts, USA.,Boston Medical Center, Boston, Massachusetts, USA
| | | | - Jacquelyn Turcinovic
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA.,BioInformatics Program, Boston University, Boston, Massachusetts, USA
| | - Scott Seitz
- Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Cole Sher-Jan
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA
| | - Madison Gilbert
- Boston Medical Center, Boston, Massachusetts, USA.,Graduate Medical Sciences, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Laura White
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Zhenwei Zhou
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Mohammad M Hossain
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA
| | - Victoria Overbeck
- Boston Medical Center, Boston, Massachusetts, USA.,Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Judy Platt
- Boston University Student Health Services, Boston, Massachusetts, USA
| | | | - Davidson H Hamer
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA.,Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.,Center for Emerging Infectious Disease Research and Policy, Boston University, Boston, Massachusetts, USA
| | - Catherine Klapperich
- Boston University School of Public Health, Boston, Massachusetts, USA.,Boston University Clinical Testing Laboratory, Boston, Massachusetts, USA.,Boston University Precision Diagnostics Center, Boston University, Boston, Massachusetts, USA
| | - Karen R Jacobson
- Section of Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts, USA.,Boston Medical Center, Boston, Massachusetts, USA
| | - John H Connor
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA.,Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts, USA.,BioInformatics Program, Boston University, Boston, Massachusetts, USA.,Boston University Precision Diagnostics Center, Boston University, Boston, Massachusetts, USA
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3
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Turcinovic J, Kuhfeldt K, Sullivan M, Landaverde L, Platt JT, Doucette-Stamm L, Hanage WP, Hamer DH, Klapperich C, Landsberg HE, Connor JH. Linking contact tracing with genomic surveillance to deconvolute SARS-CoV-2 transmission on a university campus. iScience 2022; 25:105337. [PMID: 36246573 PMCID: PMC9554197 DOI: 10.1016/j.isci.2022.105337] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/12/2022] [Accepted: 10/10/2022] [Indexed: 11/26/2022] Open
Abstract
Contact tracing and genomic data, approaches often used separately, have both been important tools in understanding the nature of SARS-CoV-2 transmission. Linked analysis of contact tracing and sequence relatedness of SARS-CoV-2 genomes from a regularly sampled university environment were used to build a multilevel transmission tracing and confirmation system to monitor and understand transmission on campus. Our investigation of an 18-person cluster stemming from an athletic team highlighted the importance of linking contact tracing and genomic analysis. Through these findings, it is suggestive that certain safety protocols in the athletic practice setting reduced transmission. The linking of traditional contact tracing with rapid-return genomic information is an effective approach for differentiating between multiple plausible transmission scenarios and informing subsequent public health protocols to limit disease spread in a university environment. Contact tracing and sequencing provide more information than either approach alone Primary exposures in an athletic group occurred outside structured athletic events Genomic and contact tracing data can inform effective public health decisions
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Affiliation(s)
- Jacquelyn Turcinovic
- Department of Microbiology, Boston University School of Medicine, Boston, MA 02118, USA,National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02118, USA,Program in Bioinformatics, Boston University, Boston, MA 02215, USA
| | - Kayla Kuhfeldt
- Student Health Services, Boston University, Boston, MA 02215, USA
| | - Madison Sullivan
- Student Health Services, Boston University, Boston, MA 02215, USA
| | - Lena Landaverde
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA,Precision Diagnostics Center, Boston University, Boston, MA 02215, USA,BU Clinical Testing Laboratory, Research Department, Boston University, Boston, MA 02215, USA
| | - Judy T. Platt
- Student Health Services, Boston University, Boston, MA 02215, USA
| | - Lynn Doucette-Stamm
- BU Clinical Testing Laboratory, Research Department, Boston University, Boston, MA 02215, USA
| | - William P. Hanage
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Davidson H. Hamer
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02118, USA,Precision Diagnostics Center, Boston University, Boston, MA 02215, USA,Department of Global Health, Boston University School of Public Health, Boston, MA 02118, USA,Section of Infectious Disease, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA,Center for Emerging Infectious Disease Policy and Research, Boston University, Boston, MA 02118, USA
| | - Catherine Klapperich
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA,Precision Diagnostics Center, Boston University, Boston, MA 02215, USA
| | | | - John H. Connor
- Department of Microbiology, Boston University School of Medicine, Boston, MA 02118, USA,National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02118, USA,Program in Bioinformatics, Boston University, Boston, MA 02215, USA,Center for Emerging Infectious Disease Policy and Research, Boston University, Boston, MA 02118, USA,Corresponding author
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4
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Kuhfeldt K, Turcinovic J, Sullivan M, Landaverde L, Doucette-Stamm L, Hamer DH, Platt JT, Klapperich C, Landsberg HE, Connor JH. Examination of SARS-CoV-2 In-Class Transmission at a Large Urban University With Public Health Mandates Using Epidemiological and Genomic Methodology. JAMA Netw Open 2022; 5:e2225430. [PMID: 35930286 PMCID: PMC9356317 DOI: 10.1001/jamanetworkopen.2022.25430] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE SARS-CoV-2, the causative agent of COVID-19, has displayed person-to-person transmission in a variety of indoor situations. This potential for robust transmission has posed significant challenges and concerns for day-to-day activities of colleges and universities where indoor learning is a focus for students, faculty, and staff. OBJECTIVE To assess whether in-class instruction without any physical distancing, but with other public health mitigation strategies, is a risk for driving SARS-CoV-2 transmission. DESIGN, SETTING, AND PARTICIPANTS This cohort study examined the evidence for SARS-CoV-2 transmission on a large urban US university campus using contact tracing, class attendance, and whole genome sequencing during the 2021 fall semester. Eligible participants were on-campus and off-campus individuals involved in campus activities. Data were analyzed between September and December 2021. EXPOSURES Participation in class and work activities on a campus with mandated vaccination and indoor masking but that was otherwise fully open without physical distancing during a time of ongoing transmission of SARS-CoV-2, both at the university and in the surrounding counties. MAIN OUTCOMES AND MEASURES Likelihood of in-class infection was assessed by measuring the genetic distance between all potential in-class transmission pairings using polymerase chain reaction testing. RESULTS More than 600 000 polymerase chain reaction tests were conducted throughout the semester, with 896 tests (0.1%) showing detectable SARS-CoV-2; there were over 850 cases of SARS-CoV-2 infection identified through weekly surveillance testing of all students and faculty on campus during the fall 2021 semester. The rolling mean average of positive tests ranged between 4 and 27 daily cases. Of more than 140 000 in-person class events and a total student population of 33 000 between graduate and undergraduate students, only 9 instances of potential in-class transmission were identified, accounting for 0.0045% of all classroom meetings. CONCLUSIONS AND RELEVANCE In this cohort study, the data suggested that under robust transmission abatement strategies, in-class instruction was not an appreciable source of disease transmission.
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Affiliation(s)
- Kayla Kuhfeldt
- Student Health Services, Boston University, Boston, Massachusetts
| | - Jacquelyn Turcinovic
- Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts
- Program in Bioinformatics, Boston University, Boston, Massachusetts
| | - Madison Sullivan
- Student Health Services, Boston University, Boston, Massachusetts
| | - Lena Landaverde
- Department of Biomedical Engineering and Precision Diagnostics Center, Boston University, Boston, Massachusetts
- Boston University Clinical Testing Laboratory, Research Department, Boston University, Boston, Massachusetts
| | - Lynn Doucette-Stamm
- Boston University Clinical Testing Laboratory, Research Department, Boston University, Boston, Massachusetts
| | - Davidson H. Hamer
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
- Section of Infectious Disease, Department of Medicine, Boston University School of Medicine; Boston, Massachusetts
- Center for Emerging Infectious Disease Research and Policy, Boston University, Boston, Massachusetts
| | - Judy T. Platt
- Student Health Services, Boston University, Boston, Massachusetts
| | - Catherine Klapperich
- Department of Biomedical Engineering and Precision Diagnostics Center, Boston University, Boston, Massachusetts
| | | | - John H. Connor
- Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts
- Program in Bioinformatics, Boston University, Boston, Massachusetts
- Center for Emerging Infectious Disease Research and Policy, Boston University, Boston, Massachusetts
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5
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Bouton TC, Atarere J, Turcinovic J, Seitz S, Sher-Jan C, Gilbert M, White L, Zhou Z, Hossain MM, Overbeck V, Doucette-Stamm L, Platt J, Landsberg HE, Hamer DH, Klapperich C, Jacobson KR, Connor JH. Viral dynamics of Omicron and Delta SARS-CoV-2 variants with implications for timing of release from isolation: a longitudinal cohort study. medRxiv 2022:2022.04.04.22273429. [PMID: 35411341 PMCID: PMC8996632 DOI: 10.1101/2022.04.04.22273429] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background In January 2022, United States guidelines shifted to recommend isolation for 5 days from symptom onset, followed by 5 days of mask wearing. However, viral dynamics and variant and vaccination impact on culture conversion are largely unknown. Methods We conducted a longitudinal study on a university campus, collecting daily anterior nasal swabs for at least 10 days for RT-PCR and culture, with antigen rapid diagnostic testing (RDT) on a subset. We compared culture positivity beyond day 5, time to culture conversion, and cycle threshold trend when calculated from diagnostic test, from symptom onset, by SARS-CoV-2 variant, and by vaccination status. We evaluated sensitivity and specificity of RDT on days 4-6 compared to culture. Results Among 92 SARS-CoV-2 RT-PCR positive participants, all completed the initial vaccine series, 17 (18.5%) were infected with Delta and 75 (81.5%) with Omicron. Seventeen percent of participants had positive cultures beyond day 5 from symptom onset with the latest on day 12. There was no difference in time to culture conversion by variant or vaccination status. For the 14 sub-study participants, sensitivity and specificity of RDT were 100% and 86% respectively. Conclusions The majority of our Delta- and Omicron-infected cohort culture-converted by day 6, with no further impact of booster vaccination on sterilization or cycle threshold decay. We found that rapid antigen testing may provide reassurance of lack of infectiousness, though masking for a full 10 days is necessary to prevent transmission from the 17% of individuals who remain culture positive after isolation. Main Point Beyond day 5, 17% of our Delta and Omicron-infected cohort were culture positive. We saw no significant impact of booster vaccination on within-host Omicron viral dynamics. Additionally, we found that rapid antigen testing may provide reassurance of lack of infectiousness.
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Affiliation(s)
- Tara C Bouton
- Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA
- Boston Medical Center, Boston, MA, USA
| | | | - Jacquelyn Turcinovic
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
- BioInformatics Program, Boston University, Boston, MA, USA
| | - Scott Seitz
- Department of Microbiology, Boston University School of Medicine, Boston, MA, USA
| | - Cole Sher-Jan
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
| | - Madison Gilbert
- Boston Medical Center, Boston, MA, USA
- Graduate Medical Sciences, Boston University School of Medicine, Boston, MA, USA
| | - Laura White
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Zhenwei Zhou
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Mohammad M Hossain
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
| | - Victoria Overbeck
- Boston Medical Center, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
| | | | - Judy Platt
- Boston University Student Health Services, Boston, MA, USA
| | | | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
- Center for Emerging Infectious Disease Research and Policy, Boston University, Boston, MA, USA
| | - Catherine Klapperich
- Boston University Clinical Testing Laboratory, Boston, MA, USA
- Boston University Student Health Services, Boston, MA, USA
- Boston University Precision Diagnostics Center, Boston University, Boston, MA, USA
| | - Karen R Jacobson
- Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA
- Boston Medical Center, Boston, MA, USA
| | - John H Connor
- Department of Microbiology, Boston University School of Medicine, Boston, MA, USA
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
- Boston University Precision Diagnostics Center, Boston University, Boston, MA, USA
- BioInformatics Program, Boston University, Boston, MA, USA
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6
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Kuhfeldt K, Turcinovic J, Sullivan M, Landaverde L, Doucette-Stamm L, Hamer DH, Platt J, Klapperich C, Landsberg HE, Connor JH. Minimal SARS-CoV-2 classroom transmission at a large urban university experiencing repeated into campus introduction. medRxiv 2022:2022.03.16.22271983. [PMID: 35313596 PMCID: PMC8936094 DOI: 10.1101/2022.03.16.22271983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
SARS-CoV-2, the causative agent of COVID-19, has displayed person to person transmission in a variety of indoor situations. This potential for robust transmission has posed significant challenges to day-to-day activities of colleges and universities where indoor learning is a focus. Concerns about transmission in the classroom setting have been of concern for students, faculty and staff. With the simultaneous implementation of both non-pharmaceutical and pharmaceutical control measures meant to curb the spread of the disease, defining whether in-class instruction without any physical distancing is a risk for driving transmission is important. We examined the evidence for SARS-CoV-2 transmission on a large urban university campus that mandated vaccination and masking but was otherwise fully open without physical distancing during a time of ongoing transmission of SARS-CoV-2 both at the university and in the surrounding counties. Using weekly surveillance testing of all on-campus individuals and rapid contact tracing of individuals testing positive for the virus we found little evidence of in-class transmission. Of more than 140,000 in-person class events, only nine instances of potential in-class transmission were identified. When each of these events were further interrogated by whole-genome sequencing of all positive cases significant genetic distance was identified between all potential in-class transmission pairings, providing evidence that all individuals were infected outside of the classroom. These data suggest that under robust transmission abatement strategies, in-class instruction is not an appreciable source of disease transmission.
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Affiliation(s)
- Kayla Kuhfeldt
- Student Health Services, Boston University, Boston, MA USA
| | - Jacquelyn Turcinovic
- Department of Microbiology, Boston University School of Medicine, Boston, MA, USA
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
- Program in Bioinformatics, Boston University, Boston, MA, USA
| | | | - Lena Landaverde
- Department of Biomedical Engineering and Precision Diagnostics Center, Boston University, Boston, MA, USA
- BU Clinical Testing Laboratory, Research Department, Boston University, Boston, MA
| | - Lynn Doucette-Stamm
- BU Clinical Testing Laboratory, Research Department, Boston University, Boston, MA
| | - Davidson H Hamer
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
- Department of Global Health, Boston University School of Public Health, Boston, MA
- Section of Infectious Disease, Department of Medicine, Boston University School of Medicine; Boston, MA
- Center for Emerging Infectious Disease Research and Policy, Boston University, Boston, MA
| | - Judy Platt
- Department of Global Health, Boston University School of Public Health, Boston, MA
| | - Catherine Klapperich
- Department of Biomedical Engineering and Precision Diagnostics Center, Boston University, Boston, MA, USA
| | | | - John H Connor
- Department of Microbiology, Boston University School of Medicine, Boston, MA, USA
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
- Program in Bioinformatics, Boston University, Boston, MA, USA
- Center for Emerging Infectious Disease Research and Policy, Boston University, Boston, MA
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Hamer DH, White LF, Jenkins HE, Gill CJ, Landsberg HE, Klapperich C, Bulekova K, Platt J, Decarie L, Gilmore W, Pilkington M, MacDowell TL, Faria MA, Densmore D, Landaverde L, Li W, Rose T, Burgay SP, Miller C, Doucette-Stamm L, Lockard K, Elmore K, Schroeder T, Zaia AM, Kolaczyk ED, Waters G, Brown RA. Assessment of a COVID-19 Control Plan on an Urban University Campus During a Second Wave of the Pandemic. JAMA Netw Open 2021; 4:e2116425. [PMID: 34170303 PMCID: PMC8233704 DOI: 10.1001/jamanetworkopen.2021.16425] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/03/2021] [Indexed: 01/15/2023] Open
Abstract
Importance The COVID-19 pandemic has severely disrupted US educational institutions. Given potential adverse financial and psychosocial effects of campus closures, many institutions developed strategies to reopen campuses in the fall 2020 semester despite the ongoing threat of COVID-19. However, many institutions opted to have limited campus reopening to minimize potential risk of spread of SARS-CoV-2. Objective To analyze how Boston University (BU) fully reopened its campus in the fall of 2020 and controlled COVID-19 transmission despite worsening transmission in Boston, Massachusetts. Design, Setting, and Participants This multifaceted intervention case series was conducted at a large urban university campus in Boston, Massachusetts, during the fall 2020 semester. The BU response included a high-throughput SARS-CoV-2 polymerase chain reaction testing facility with capacity to deliver results in less than 24 hours; routine asymptomatic screening for COVID-19; daily health attestations; adherence monitoring and feedback; robust contact tracing, quarantine, and isolation in on-campus facilities; face mask use; enhanced hand hygiene; social distancing recommendations; dedensification of classrooms and public places; and enhancement of all building air systems. Data were analyzed from December 20, 2020, to January 31, 2021. Main Outcomes and Measures SARS-CoV-2 diagnosis confirmed by reverse transcription-polymerase chain reaction of anterior nares specimens and sources of transmission, as determined through contact tracing. Results Between August and December 2020, BU conducted more than 500 000 COVID-19 tests and identified 719 individuals with COVID-19, including 496 students (69.0%), 11 faculty (1.5%), and 212 staff (29.5%). Overall, 718 individuals, or 1.8% of the BU community, had test results positive for SARS-CoV-2. Of 837 close contacts traced, 86 individuals (10.3%) had test results positive for COVID-19. BU contact tracers identified a source of transmission for 370 individuals (51.5%), with 206 individuals (55.7%) identifying a non-BU source. Among 5 faculty and 84 staff with SARS-CoV-2 with a known source of infection, most reported a transmission source outside of BU (all 5 faculty members [100%] and 67 staff members [79.8%]). A BU source was identified by 108 of 183 undergraduate students with SARS-CoV-2 (59.0%) and 39 of 98 graduate students with SARS-CoV-2 (39.8%); notably, no transmission was traced to a classroom setting. Conclusions and Relevance In this case series of COVID-19 transmission, BU used a coordinated strategy of testing, contact tracing, isolation, and quarantine, with robust management and oversight, to control COVID-19 transmission in an urban university setting.
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Affiliation(s)
- Davidson H. Hamer
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
- Section of Infectious Disease, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
- National Emerging Infectious Disease Laboratory, Boston, Massachusetts
- Precision Diagnostics Center, Boston University, Boston, Massachusetts
| | - Laura F. White
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Helen E. Jenkins
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Christopher J. Gill
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Hannah E. Landsberg
- Student Health Services, Healthway, Boston University, Boston, Massachusetts
| | - Catherine Klapperich
- Precision Diagnostics Center, Boston University, Boston, Massachusetts
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
| | - Katia Bulekova
- Information Services and Technology, Boston University, Boston, Massachusetts
| | - Judy Platt
- Student Health Services, Healthway, Boston University, Boston, Massachusetts
| | - Linette Decarie
- Boston University Analytical Services & Institutional Research, Boston, Massachusetts
| | - Wayne Gilmore
- Information Services and Technology, Boston University, Boston, Massachusetts
| | - Megan Pilkington
- Boston University Analytical Services & Institutional Research, Boston, Massachusetts
| | - Trevor L. MacDowell
- Information Services and Technology, Boston University, Boston, Massachusetts
| | - Mark A. Faria
- Information Services and Technology, Boston University, Boston, Massachusetts
| | - Douglas Densmore
- Electrical and Computer Engineering, Boston University, Boston, Massachusetts
- Biological Design Center, Boston University, Boston, Massachusetts
| | - Lena Landaverde
- Student Health Services, Healthway, Boston University, Boston, Massachusetts
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
| | - Wenrui Li
- Department of Mathematics and Statistics, Boston University, Boston, Massachusetts
| | - Tom Rose
- Human Resources, Boston University, Boston, Massachusetts
| | - Stephen P. Burgay
- Office of External Affairs, Boston University, Boston, Massachusetts
| | - Candice Miller
- BU Clinical Testing Laboratory, Research Department, Boston University, Boston, Massachusetts
| | - Lynn Doucette-Stamm
- BU Clinical Testing Laboratory, Research Department, Boston University, Boston, Massachusetts
| | - Kelly Lockard
- Continuous Improvement & Data Analytics, Boston University, Boston, Massachusetts
| | - Kenneth Elmore
- Office of the Provost, Boston University, Boston, Massachusetts
| | - Tracy Schroeder
- Information Services and Technology, Boston University, Boston, Massachusetts
| | - Ann M. Zaia
- Occupational Health Center, Boston University, Boston Massachusetts
| | - Eric D. Kolaczyk
- Department of Mathematics and Statistics, Boston University, Boston, Massachusetts
- Hariri Institute for Computing, Boston University, Boston, Massachusetts
| | - Gloria Waters
- Office of the Provost, Boston University, Boston, Massachusetts
- College of Health and Rehabilitation Services, Sargent College, Boston University, Boston, Massachusetts
| | - Robert A. Brown
- College of Engineering, Boston University, Boston, Massachusetts
- Office of the President, Boston University, Boston, Massachusetts
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8
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Landsberg HE. The biometeorology of urbanization and housing in developing countries. Int J Biometeorol 1984; 28 Suppl:191-198. [PMID: 6544744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Abstract
Natural climatic fluctuations, even those of recent years, cover a considerable range. They can be characterized as a "noise" spectrum which masks possible global effects of man-caused increases of atmospheric CO(2) and particulates. Local modifications, either deliberate or inadvertent, measurably affect the microclimate. Some artificial alterations of the microlimate are beneficial in agriculture. Among the unplanned effects, those produced by urbanization on local temperature and on wind field are quite pronounced. The influences on rainfall are still somewhat controversial, but effects may extend considerably beyond the confines of metropolitan areas. They are the result of water vapor released by human activity and of the influence of condensation and freezing nuclei produced in overabundance by motor vehicles and other combustion processes. Therefore it appears that on the local scale man-made influences on climate are substantial but that on the global scale natural forces still prevail. Obviously this should not lead to complacency. The potential for anthropogenic changes of climate on a larger and even a global scale is real. At this stage activation of an adequate worldwide monitoring system to permit early assessment of these changes is urgent. This statement applies particularly to the surveillance of atmospheric composition and radiation balance at sites remote from concentrations of population, which is now entirely inadequate. In my opinion, man-made aerosols, because of their optical properties and possible influences on cloud and precipitation processes, constitute a more acute problem than CO(2). Many of their effects are promptly reversible; hence, one should strive for elimination at the source. Over longer intervals, energy added to the atmosphere by heat rejection and CO(2) absorption remain matters of concern.
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