As colleges and universities finalize high stakes plans for reopening amid the pandemic, wide scale, frequent testing for coronavirus on campus has emerged as central to their strategy.
Thousands of college students on campuses across the state this fall will be required to swab their noses as often as twice a week, with samples shuttled to laboratories where the results will be quickly delivered back to campuses.
Many schools, including Harvard University, Wellesley College, Emerson College, and Clark University in Worcester, plan to send their samples to the Broad Institute of MIT and Harvard, which has promised to process thousands of the tests daily.
Other schools, like Boston University, are forging ahead building their own high-capacity labs to regularly test their campus communities.
But whether there is enough laboratory capacity in Massachusetts to regularly test tens of thousands of college students is an open question. So, too, is the prospect of persuading hordes of students to regularly submit to nasal swabbing and to dutifully adhere to social distancing.
The higher education plans are being firmed up as waiting times grow for test results in Massachusetts and nationwide. Some national commercial laboratories used by businesses and health centers in Massachusetts to process the tests recently acknowledged waiting times stretching longer than five days as the surging virus in Southern and Western states fuels a demand for more testing.
Plentiful and timely lab results are crucial to quickly contain future clusters of COVID-19 on college campuses and beyond, and to prevent clusters from mushrooming into larger outbreaks, health experts say.
“If we are going to [use] testing to control outbreaks, you have to get results back in one to two days, even three days is too slow,” said Samuel Scarpino, a Northeastern University disease tracker. “If I were ... anyone setting policy, I would have that on my daily dashboard and would make a lot of decisions about reopening based on that number.”
Testing is just one facet of the complex plans colleges are developing this summer that they believe will make it safe to welcome students back to campus this fall. Some schools, like BU, Northeastern, and Tufts, plan to allow all undergraduates to return to campus if they wish, while others, like UMass Boston, plan to continue almost entirely online. Harvard plans to allow freshmen on campus, but all courses will be virtual. MIT will allow only seniors on campus this fall. In normal years, Massachusetts draws 500,000 college students per year who contribute $25 billion to the state economy.
A report last month from a task force of higher education leaders who advised Governor Charlie Baker on reopening colleges suggested a multipronged approach. The ideas included social distancing, masks, improved building ventilation, and reconfigured classrooms, residence halls, and dining facilities, in addition to robust coronavirus testing programs.
The report suggested several strategies for how schools should tackle the labor and cost of testing, which is expected to run about $25 per test for schools that use the Broad’s program, the report said.
It recommended that schools organize students and staff into groups that will be tested more or less frequently depending on their risk of exposure. Essential campus workers and students who live in dormitories, for example, would be tested most often.
The report also recommended three types of testing — an initial test for everyone at the start of the semester, quick testing of symptomatic people, and routine testing at least once a week for everyone else.
“Testing broadly is the sine qua non for safety,” said Dr. Sandro Galea, dean of the Boston University School of Public Health and a member of the task force. “The more capacity we have, the better.”
The Broad Institute, known for cutting-edge biomedical research, has become a pivotal player for college coronavirus testing, recently negotiating testing contracts with several schools. In addition to Harvard and Clark, the institute is working with Emerson College, Tufts University, the University of Massachusetts Medical School, and Wellesley College.
The Broad recently expanded its daily capacity to 35,000 tests and can turn them around in less than 24 hours, a spokesman said in a statement. The lab has the ability to ramp up to 100,000 daily if needed, the spokesman said, but declined to comment further on its new college testing program.
The Broad, which opened its testing lab in March, has so far not processed more than 7,000 tests in a day, according to the website where it posts its daily output.
Dr. Ashish Jha, a global health professor at the Harvard T. H. Chan School of Public Health, said it is imperative that schools have a substantial amount of testing because relying on students to consistently practice social distancing is not practical.
And although this might be an unruly demographic, he said, students will likely submit to tests.
“I generally think there is a way that if you implement your policy well, you can probably ensure that everybody does it,” Jha said.
“Maybe I’m being too cynical, but I just feel like 20-year-olds really adhering to strict social distancing guidelines is going to be a tall order, and therefore it is that much more important that we do aggressive testing,” he added.
Jha said he is “pretty confident” the Broad will be able to handle the daily testing load it is taking on.
But if the Baker administration believes it is important for colleges and universities to reopen, officials should figure out how to increase testing capacity statewide, he said.
"The state's got to keep pushing on that, and keep trying to drive toward higher capacity," he said.
A plan the state recently submitted to federal regulators raises questions about the scope of campus testing. It indicates the administration anticipates that only about 10,000 individuals in total will be tested daily statewide in September and about twice that come October — long after campuses reopen. It is silent on expected turnaround times for results.
A Baker administration spokeswoman declined to comment about testing on campus. She said in a statement the administration is seeking to expand testing capacity but did not touch on turnaround times.
Oversight of the testing varies among local campuses. In many instances, colleges and universities are outsourcing the screenings. Several plan to ask students to swab their own noses with shorter swabs than are used in many public testing sites, where medical workers typically collect samples deep within the nasal cavity. Some schools will have medical staff observing as the students swab their own noses.
Anthony Monaco, the president of Tufts University who was a member of the higher education task force, said the group believes the biggest risk for spread on campuses will be within dorms. But he said it will be important for schools to also test students who live off campus.
Monaco said Tufts is developing an app that will let students know when they are scheduled to be tested and send reminders. The details are not finalized, he said, but there would likely be repercussions for missing a test, such as not being able to participate in a campus activity.
The testing will be a significant investment for schools, he said, on top of other adjustments like extra housing they are building to quarantine students.
“They all add up, but for one semester, perhaps two, it’s an investment we need to make,” Monaco said.