Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.
In today’s COVID-19 update, a follow-up look at Colgate University’s science-based approach to bringing students back to campus during COVID-19—an approach that appears to have paid off.
Learn more at the AMA COVID-19 resource center.
- Brian Casey, PhD, president, Colgate University
Unger: Hello, this is the American Medical Association's COVID-19 Update. Today I'd like to welcome back Dr. Brian Casey, president of Colgate University in Hamilton, New York, who's going to talk to us about the University's science-based approach to bringing students back to campus during COVID-19 and keeping them on campus successfully throughout the semester. I'm Todd Unger, AMA's chief experience officer in Chicago.
So, Dr. Casey, first of all, congratulations are in order. I know most of the students are departing today after the successful on-campus portion of this particular semester, in particular one special student, my own daughter, is on her way back home after that. So, August seems like a million years ago when this all started. When we spoke last then you talked about the University's unique approach to bringing students back to campus safely. So, looking over the last few months, I'm going to say the approach clearly worked and I'd love to learn about some of the highlights. So why don't you take us through kind of the key aspects of the plan, and then we'll get a little bit more deep into it.
Dr. Casey: Okay. Well, Todd, thank you for welcoming me back. I think I last spoke to you, I was in a dorm where I lived for a while.
Unger: This is a bit more comfortable.
Dr. Casey: This is a little more comfortable. Well access is part of what happened. We adopted a plan that had multiple layers to it, not just testing, contact tracing, but we had put together a series of what we call gates. Everything at Colgate is about gates. So, we had put together a series of behavioral frameworks that the students would move their way through, from most restrictive to least restrictive. And what we were going to do is we were just going to have the science dictate to us how we moved our students through this sequence of gates.
So, we brought all the students. We quarantined 2,700 18- to 22-year-olds in residence halls. They took a test before they showed up. They took a test upon arrival, and a test nine to 10 days in. We looked at the data and we let them come out of quarantine. But every two weeks, as long as the science led us, as long as our numbers were looking good, we would just move them through a more expansive way of being on this campus. That was the structure. Then we put together a series of analytical teams that were looking at our wastewater tests, that were just endlessly looking at the data. We just kept going back to the numbers.
Unger: With each of these gates, what did that kind of allow everyone to do as they passed through one and two and beyond?
Dr. Casey: Gate number one was go to your room. Knowing that was difficult, that was when I decided to move into quarantine myself. So, you literally could go to your room. You could go to the bathroom down the hall, and for two short periods every day you were allowed outside for socially distance, just being outside. We brought food, books and mail to everyone. So that was the first gate.
The second gate we'd let them move amongst their floors. The third gate was when they could really go to each other's dorm rooms. Not dorm rooms. They could never do that. But they could go to each other's common spaces and other people's residence halls. We had limits as to how many people you could be in a crowd with starting with just your family unit, who you live with. Then it was 10. Then it was 25, and 50 through the gates. So, it was pretty structured. It was structured.
Unger: Well, you talked about testing, and we know from our prior conversation about contact tracing thing that were key parts of your strategy. Can you talk about how you leveraged these tools throughout the semester, and why and how they were successful?
Dr. Casey: So, we did multiple levels of testing. We had purchased rapid testing machines, but we knew that those were not enough to be used in special circumstances. We had a regular surveillance test. And so, every week a certain percentage of the students, faculty and staff were tested. You just had to show up once you got an email. I was randomly selected twice so I showed up.
But we also had a layer of wastewater testing. We put readers on all the buildings that the university owns to look for traces of the virus, which show up earlier in wastewater than it does in a typical test. So, while we were doing surveillance testing, if we thought we had any sign in a dorm or an apartment complex or anything, we would tailor testing toward areas we were concerned with.
Once someone is identified, we went through robust contact tracing. We bought a hotel just outside the campus. So that was 105 rooms, and we took two other buildings that we could use as our quarantine and isolation space. So, we were just moving students in. Once they moved into quarantine or isolation space, they went through a more rigorous testing cycle to get them out. So, it was a lot. It was a lot.
Unger: I suppose, perhaps when this is all over, that means I'll be able to get a hotel room.
Dr. Casey: No. It's very hard to get a hotel room. And I am the official innkeeper, that is the person who holds the license. I'm the innkeeper of a hotel now. I did not know that would be my life
Unger: I'm curious. What were the biggest challenges or setbacks that you didn't foresee and how did you deal with those?
Dr. Casey: The hardest, the hardest hurdle to get over was convincing, as I said, just under 3,000, 19-, 20-, 22-year olds to abide by these regulations. That's hard to do. I mean because if we think about it, in many ways given their age, and given this setting that we're in, they were sacrificing much of their college experience. But you can't see the devastation outside the campus. And so just to convince them, keep your mask on, don't gather in big groups. That's hard when you're 19 and you're a freshman in college. So that was the hardest thing.
The other thing that we really committed to was endlessly communicate to everybody. We sent out videos every day. Here's where we are. Here's where we are. Just constantly give the message of we're in this together. We're in this together. So that was a lot of work, but that was worthwhile. But again, making this a collective goal was the hardest work, but the most satisfying ultimately.
Unger: Well, other universities have turned to you for guidance. And we've seen obviously many other universities shut down over the last few months, something Colgate managed to avoid. What do you think made Colgate successful while other colleges had such a different experience?
Dr. Casey: Three things. One, we had a plan, and it wasn't just testing. I mean, we knew. We had testing. I've seen a lot of other institutions who said, "Oh, we'll just test." We had testing connected to gates, connected to communication, connected to commitments, written commitments, to public health. So, we had a plan.
Two, everyone felt like they were part of the plan. It wasn't just me. You know, I wonder sometimes when you see public officials like a governor, sort of be the person who is espousing this plan. We had everyone felt like they were part of this. And I can't overemphasize that.
And the third was information, information, information, information, information. Any member of the Colgate community, I don't know if you did this yourself. You could every day go to a webpage and see exactly how we were doing across 23 metrics. How we were doing the counting. How we were doing locally. So, we felt from the beginning that information was our friend, even on tougher moments when we had some positives. So again, it was a plan, involvement, and information.
Unger: I was going to ask you next if any parts of your plan or parts of your overall approach were exportable. Obviously those three things that you just laid out are exactly what we hope communities and across the country would be saying. I'm just curious. The resistance that we've seen in particular to things like mask wearing out there, did you run in any of that on campus?
Dr. Casey: Yeah, I would say 80% it wasn't resistance. It was sort of benign neglect. You know, you'd pass by some students and the mask had sort of fallen below their nose and you'd be like, "Hey, you know, pull it up." We did see some students not wanting to abide by the principles, and we had to send them home. That was really hard, but if you can't commit to something that is only doable in common, then go home. You can take all your courses online, but if you want to be here, you've got to commit to each other.
Unger: You talked before about, in your communications and really your entire approach is guided by science. We've obviously learned a great deal about the pandemic over the past few months. Did you have to make any adjustments as you learned your way through the semester, and what were those?
Dr. Casey: We learned that we couldn't open up as quickly as we wanted to. We thought we'd click through these gates and get to 50 right away. We in our, I want to say second to third week, we saw a little spike, but the contacts, just the number of students who were caught up in this contact was quite high. So, all of a sudden our hotel was filling up, and we just said, "Look at the numbers. We're staying in this gate for a while." And then when we moved to the gate, we didn't jump to 50. We stayed at 25 for longer than I think people were expecting.
But again, back to the science, anyone could go to the dashboard we set up and see, "Oh, that's why." It's not arbitrary. We saw a spike and we saw contacts. I cannot tell you how important is to keep coming back to the science. The virus doesn't have plots, but it's plottable. You know? So, it's easy for us to come across as disciplinarians, but we're like, "No. This is the plan. This is what the numbers are showing us. This is how the testing is working." And we just kept coming back. So, we adjusted along the way. We had to.
Unger: Well, it must be a great relief to see students departing campus today. They're heading home for Thanksgiving. And then I think they'll be completing the rest of the semester online and then returning in the new year. What's instruction and campus life look like post holidays, next semester? Will you do it all over again? What happens?
Dr. Casey: We'll do it all over again. You know that you're a parent, when we announced that there was going to be a universal quarantine, I think most people thought we were insane. Now when I talk to students, they'll all say, "That worked." So, we're doing it again. Now, we'll be a little bit better about it. We're better about food. We know how to deliver food. One night our food services decided to deliver 2,700 pieces of cod to students, and that was unsuccessful. So, we'll be a little bit better on food delivery.
But it worked, so we're going to do it again. And the proof is in the pudding. We had about 380 students last semester say right off the bat, "We're going to stay at home. We're not going to come to campus." The overwhelming majority of them are coming back next semester. I was on the phone with one of them. I said, "You do know you have to stay in your room for 14 days," and it's like, "Happy to do it." And I'll be back. I'm moving back into my dorm room when the kids come back.
Unger: Well, that's it for today's COVID-19 update. Thank you, Dr. Casey, for sharing your perspective and your learnings. We wish you and your faculty a wonderful holiday. As a parent of a Colgate University student, I'd like to thank you personally for the time, effort and care that you put into creating a successful and healthy semester for the many students who were able to experience just a little bit of normal in an otherwise unpredictable time.
Today marks our final episode before Thanksgiving break. We'll be back Monday with a new COVID-19 update. Until then please have a safe and healthy holiday. For resources on COVID-19 visit ama-assn.org/COVID-19. Thank you for joining us, and 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.