The University of Tennessee at Chattanooga began routine, random COVID-19 testing for staff and students this week in an effort to detect and isolate infected individuals who could otherwise unknowingly spread the coronavirus.
Mass surveillance testing — which is used to monitor outbreaks and find unknown infections rather than diagnose sick people — on college campuses is based on research and recommendations from the U.S. Centers for Disease Control and Prevention and the American College Health Association, said Yasmine Key, director of university health services at UTC.
Key cited an article from the Journal of the American Medical Association, which found that over 50% of COVID-19 transmission occurs from people who aren't showing symptoms.
"In order to take out some of the people that are out there walking around unknowingly infectious, you really need to test people who don't think they're sick, so that was one of the driving forces behind working to mitigate some of the risk for campus," she said. "Rather than just focusing on symptomatic and exposed individuals, we wanted to find a way to test the rest of the community as well, just to try and continue to keep the campus community and our surrounding community as safe as possible."
In the early days of the pandemic, Key said testing supplies and access to reliable rapid tests were so limited that it wasn't possible to conduct routine testing on a large scale.
"The science really has evolved related to testing and availability of rapid testing. Rapid testing, specifically, has become very relevant to the way that we wanted to approach testing strategies on the campus," she said.
Bill Christian, a spokesperson for the Tennessee Department of Health, said via email that 31 higher education institutions across the state, including colleges, universities and technical schools are now conducting rapid surveillance testing through the program.
At UTC, each week 1,000 students, faculty and staff members will receive an email at the end of the week notifying them that they have been selected for routine rapid testing the following week. Those letters went out for the first time last week, with this week being the first official week of routine testing.
Participants are selected through a computer-generated formula that accounts for a larger proportion of students compared to staff.
Members of the campus community are expected to comply when called for testing, but those who are unable to be tested on a given week or are not attending on-campus activities can fill out a waiver, Key said.
Participants go online to schedule an appointment and arrive at the testing center, where they conduct their own nasal swab and wait on site for 15 minutes while results are processed.
If the test is positive, participants will be asked to take another test, and if the positive result is confirmed they will be instructed to isolate and undergo contact tracing to find others who may have been exposed.
"It's really like any of our other safety measures that we have in place," Key said. "It's an evidence-based practice that we think is worth spending the time and effort on in order to make steps towards making sure our campus is as safe as possible — just like masking and social distancing."
In the fall, UTC focused testing efforts on diagnosing symptomatic people and people with known direct exposures to other infectious people.
The new routine surveillance testing is separate from the testing for people who are sick or exposed. Members of the UTC community who have a known exposure to COVID-19 or who have had symptoms within 48 hours should be seen by University Health Services or another health care provider.
Key said there's still a big misunderstanding among people who think they should only get tested when they have symptoms. But now that new resources are available and more is understood of the science behind asymptomatic transmission, it's important to test people who seems otherwise healthy — particularly among high-risk groups such as college students, who often live in densely populated, group settings.
"There's just a higher risk for transmission, and we've got a relatively healthy population that may be very mildly symptomatic, so it can be really difficult to know," she said. "We hope this is something that we don't need forever, but it's something that we want to make sure that we're offering now because we have the ability to do it."
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