College towns brace for a new wave of COVID-19

Sierra Imwalle, a real estate agent in Ann Arbor, Michigan, is taking the COVID-19 pandemic seriously. When she shows houses to clients, she takes precautions: masks, distance, hand sanitizer. She's avoiding the denser, usually crowded downtown area and steering clear of restaurants.

Other people in Ann Arbor are also sticking to public health recommendations, she says. They're wearing masks and following stay-at-home orders. "We've done a really good job maintaining a low number of cases," she says.

But Ann Arbor is a college town. Downtown brushes up against the campus of the University of Michigan, a sprawling research university that enrolls just under 50,000 students each year. It's home to Michigan Stadium (nickname: the Big House), the largest stadium in the United States, which can seat over 100,000 people.

The university plans to welcome its students back to campus for the fall semester, with classes starting on August 31st. Most classes will be offered online, but residence and dining halls are opening. The school is encouraging students to follow social distancing guidelines and mandating that they wear masks, but only students in on-campus housing (usually under a third of the student body) will have to get tests before they return.

Michigan joins hundreds of other colleges and universities around the country that are planning for an in-person or partially in-person fall semester. As students drive and fly from their hometowns back to campus, inevitably, some will carry the coronavirus with them, says Sheldon Jacobson, a professor of computer science at the University of Illinois at Urbana-Champaign and an expert in data-driven risk assessment. "Colleges and universities just are not designed for social distancing, it's not in the DNA of institutions of higher learning to keep people apart. We bring them together," he says.

When outbreaks happen, they won't stay on campus. Students rent apartments, go to grocery stores, and clog up the tables at restaurants. Professors and staffers live in town and send their kids to public schools. But most college and university reopening plans, even the best ones, are focused on their students, Jacobson says. They don't talk as much about the people who live next door.

People who live in Ann Arbor are worried. They know that there isn't an easy decision here. The University of Michigan makes the city of Ann Arbor what it is, and everyone is connected to it in some way. They're pretty sure, though, that the influx of students will mean more COVID-19 cases in their community.

"There is a bit of concern that all of the hard work and the sacrifices we've had to make will end up not being worth as much," Imwalle told The Verge.

It's always a big event in Ann Arbor when students come back to campus in the fall, says Tom Crawford, the interim city administrator. "It really changes the whole pace of life we have here," he says. "It has an economic impact, it has a social impact - it's a major thing." That'll be even more true this year, even though Crawford is still not sure what portion of the student body will end up coming back to Ann Arbor. Regardless of the numbers, their return is a risk, and he's concerned about the way it will change the dynamics of the COVID-19 pandemic in the city.

"I believe that college towns are the place to watch for the virus right now," he says. "Universities draw people from all over. It's a new phase."

"I believe that college towns are the place to watch for the virus right now"

That phase is showing up in models tracking the course of the pandemic across the US. The Children's Hospital of Pennsylvania (CHOP) PolicyLab has a model that tracks and projects the spread of COVID-19 in hundreds of counties across the country. "What's really worrisome right now is many college towns are already - even as they just start to repopulate - showing significant evidence of increased transmission," says David Rubin, the director of the PolicyLab.

Counties with college towns stand out in the projections, Rubin says. South Bend, home to the University of Notre Dame, jumps out from the rest of Indiana. Clarke County, Georgia is a red flag - it's where the University of Georgia, which already has hundreds of cases, is located. The university is in Athens, which is already out of ICU beds. Some of the struggling Michigan counties are the ones where Michigan State University and the University of Michigan are located, Rubin says. By the end of July, there had already been 6,600 cases of COVID-19 linked back to college campuses, according to The New York Times.

"I'm worried about what I'm already seeing," Rubin says. "What happens when they fully repopulate?"

Outbreaks at small colleges in mid-sized cities, or even big universities in bigger cities, may not have an effect on their local community's coronavirus transmission, Jacobson says. Their student bodies are a relatively small proportion of the town population. But larger colleges and universities based in small towns could have an impact. Jacobson works for a university with 50,000 students in a city with around 100,000 residents. Ann Arbor is about the same: around 120,000 residents and 50,000 students.

"The ratio of the students coming in to the residents is sufficiently large that it tilts the scale to having community transmission," Jacobson says.

"There is not a testing strategy that I've identified that makes any sense that could actually slow transmission"

Most of the college and university reopening plans in the US probably won't be able to keep outbreaks in check. "There is not a testing strategy that I've identified that makes any sense that could actually slow transmission," Rubin says. Screening for symptoms would not be enough to catch cases among students living on a college campus, a study in the Journal of the American Medical Association concluded. The study found that, in order to keep the coronavirus under control, the students would need to get tested every two days.

It's technically possible to live in Ann Arbor and hardly know the campus is there. If you keep away from downtown and don't go to the grocery store close to campus, the students can stay pretty invisible, Marty Lewis says. "Yet, at the same time, there's no denying that Ann Arbor is what it is because of the university's presence," he says.

Lewis is an alum and is a superintendent for a general contractor. "The university has pretty much been my only client for the last eight years," he says. Sierra Imwalle has a lot of clients who work for the university. Another local, Trisha York, is a nurse at Michigan Medicine, the university's health center, and her husband has a small business in town - it depends on the students.

There's probably an economic benefit in the town to the students coming back. "But is it worth the risk? I don't see that," Lewis says.

York says she's worried about masks. "People are coming from all over the country," she says. She's seen news reports - in some parts of the US, wearing a mask is less common than it is in Ann Arbor. "If they bring that kind of attitude with them, that concerns me." She doesn't trust that students will follow the same rules in town that the residents have been sticking to.

Colleges and universities can mandate that students wear masks and take certain precautions on campus, but it's much harder to control what they do when they head into town. Administrators can set rules for dorms, but they don't have as much oversight of students who live in apartments or houses off campus. At the University of Michigan, around 30,000 students live in off-campus housing.

"The university does not govern what happens off campus. They can only do so much," says Juan Marquez, medical director in Washtenaw County, which contains Ann Arbor.

The county health department has been working with the university since the spring to coordinate what they might do in response to any large parties or gatherings. They're worried about bars: in the nearby East Lansing, home to Michigan State University, a college bar was the source of nearly 200 COVID-19 cases. They're already getting complaints about student gatherings from members of the community.

It doesn't seem possible to Jacob Itkin, a sophomore at the University of Michigan. Itkin is from Ann Arbor and is planning on living at home with his parents while he takes classes online. People who are back on campus already aren't wearing masks. "In classes you can sort of control people, but outside of school, people are going to go out and do regular things," he says. "It seems like it's going to be a big mess."

"It seems like it's going to be a big mess"

Similar conversations are happening in college towns all around the country. The town council in Mansfield, Connecticut, home to the University of Connecticut, authorized new limits on the size of gatherings in town in direct response to students' return (they still have to be approved by the state). "Wesleyan is a big house-party, dorm-party school," he told the Hartford Courant. "And those could be incubators for this virus if people are not smart about it."

Fearing they could become a new viral hotspot, the Orange County, North Carolina health department recommended that the University of North Carolina at Chapel Hill move to online-only education. Community members told the health department that they were concerned about the students' return, a spokesperson told The Chronicle of Higher Education. The university decided not to follow that recommendation. Less than a week after classes started, there were already four clusters of COVID-19 in student housing.

If the coronavirus starts to spread on campuses and in college towns, it could strain the resources of local public health departments. Washtenaw County has a limited number of contact tracers, and the number of students returning could challenge their capacity. The university has a handful of case investigators that can handle contact tracing for students, Marquez says. The extra help could ease the county's burden to an extent. The university's contact tracers have ties with the university dorms, food services, and transportation, but it may not be enough in the event of an outbreak. The county health department still plays a role in every new COVID-19 case, student or not.

If the coronavirus starts to spread on campuses and in college towns, it could strain the resources of local public health departments.

Arizona State University professors, staffers, and graduate students pointed to the limited local resources as a major concern in an open letter calling for the university to delay in-person instruction. "The likely outbreak caused by the concentration of faculty, staff, and students will further strain critical community resources like ICU beds and medical personnel," it reads.

When outbreaks happen on campuses, universities and colleges seem to be ready to blame their students for breaking the rules, wrote epidemiologist Julia Marcus and psychiatrist Jessica Gold in The Atlantic. It's a bad strategy - students shouldn't be charged with shouldering the burden of their community's health. "Students are being set up to take the fall when the plans fail," they said. "Universities have no business reopening if they can't provide a healthy environment for students, faculty, and staff."

Back in Ann Arbor, Crawford is in regular communication with the University of Michigan. Over the next few weeks, he says, they're going to roll out messaging for both students and the local community. The university's director of community relations is in regular contact with Ann Arbor officials, university spokesperson Rick Fitzgerald told The Verge in an email. Fitzgerald said representatives from the university are meeting with local business leaders, as well. He pointed to the website where the University of Michigan has been posting its plans for the fall.

Lewis, though, hasn't found that information easily accessible. He doesn't feel like the university has reached out to the community, even if they are talking with town leaders, and he's frustrated by what he sees as a lack of communication. "I don't see any evidence that the university has done any kind of good outreach to say, 'Here's our plan,'" he says. There isn't a local, daily newspaper in Ann Arbor anymore, he says. He thinks that might be the reason why he hasn't seen relevant information about the university's plans.

While conversations may be happening behind the scenes, Itkin, the sophomore, doesn't think the safety of the town plays a big part in the University of Michigan's thinking. "If they cared, they probably wouldn't be bringing students back," he says. "It's that simple. If it wasn't just about getting more money."

The University of Michigan's plans for the fall semester center on the student body and on the campus environment. That's the focus of any college or university: the people who are formally a part of it. The frequently asked questions page covers the use of face coverings on campus, dining hall protocols, and parents weekend. It doesn't mention the residents of the town of Ann Arbor.

That's been the constant theme of return-to-campus plans, Jacobson, the risk assessment expert, says. Of all the return-to-campus plans he's reviewed, very few mention the local town. Most colleges and universities aren't talking publicly about their conversations with mayors or their partnerships with nearby hospitals. "The towns don't really have a voice to the degree that they need to," he says.

"The towns don't really have a voice to the degree that they need to"

That disconnect during the pandemic could exacerbate tensions between college towns and the institutions that are their backbone. If there aren't major outbreaks associated with the school, the relationship with the local community might stay about the same. If the pandemic starts to accelerate, though, things could deteriorate. "It's hard to shake, if those kinds of incidents occur," Jacobson says.

Ann Arbor is in a relatively good spot. So far, the state of Michigan managed the pandemic fairly well. The county has lower levels of transmission to start the school year than many other college towns, including South Bend, Indiana, home of rival Notre Dame. And normally, people in Ann Arbor have a fairly good relationship with the University of Michigan. "It's a love-hate relationship. You take the bad with the good," York, one of the locals, says. Even if there is an outbreak, she doesn't think things would sour. She expects people would be more concerned about taking care of the kids.

"I could see some people feeling resentful - probably not towards the kids, although it might come out that way, but to the university for maybe not doing more to make sure it didn't spread," York says. "It's just such a complicated thing."

Imwalle agrees. She doesn't want to blame anyone, and she knows there aren't any good answers. "It's a lose-lose. No matter how you slice it." She'd been thinking about going to a restaurant in town, though, and seeing how it felt. "The closer we get to the student's coming back, I think I may just wait and see."