The call alerting Framingham State University officials that a student had tested positive for the coronavirus came from an unexpected source: a health department several towns over, in Worcester.
After experiencing symptoms around Labor Day weekend, the female student had sought a COVID-19 test not on the Framingham campus, as called for in the school’s infection-control strategy, but in her hometown, where she had returned.
The incident, which quickly mushroomed to eight more related student infections, illustrated the critical gaps Massachusetts colleges are racing to close in their contact-tracing regimens.
State officials say the campuses must swiftly snuff out virus hot spots if Massachusetts is to avoid a resurgence this fall. Earlier this week, the Baker administration said it will take the lead in tracking down infected students, faculty, and staff at Boston College amid a spike in cases and growing skepticism about that school’s testing regimen.
Other colleges are facing their own challenges, though not as serious as the problems that confronted BC. The director of Worcester’s health department, which is working with nine area colleges on contact tracing, said they, too, are encountering snags similar to the case in Framingham, with students who test positive not showing up in the alerts sent to the schools and local health department.
“It’s not Defcon One, but it’s something we are looking into," said Karyn Clark, who directs Worcester’s health department. “We are all having the same ‘aha’ moments as this goes on.”
Weeks ago, Framingham State leaders devised a collaborative plan with the city in which school officials would investigate infections that occur on campus and Framingham’s health department would trace off-campus contacts who may have been infected.
But the system hadn’t anticipated students seeking tests outside campus, which is why the school and Framingham’s health department weren’t initially notified about the young woman’s positive test, said Daniel Magazu, Framingham State communications director.
In sorting out that issue, the school realized another hindrance for contact tracers: wrong addresses for many students. Hundreds of incorrect addresses had been sent to the Broad Institute of MIT and Harvard, the high-tech lab that is processing thousands of tests daily for Framingham State and about 100 other New England colleges.
Magazu said the Broad required the contact information for all students to be sent in early August, before Framingham State had completed student housing arrangements. The information is needed for the Broad to report its testing results. When filling out the forms, students had instinctively supplied their home addresses, not where they would be living this semester.
“Now that we have identified the issue, we have a bunch of people going into the system to update the addresses,” Magazu said.
The Broad declined to say how many other schools may have encountered the same issue, but said in a statement that most have done “an excellent job" with contact information.
“Schools are expected to input accurate student addresses directly into the databases that are used for return-of-results,” the statement said. “Earlier this week, in fact, we sent a reminder to all schools in the program to ensure this data is up-to-date precisely because of the essential role this information plays in effective contact tracing.”
As soon as they realized they had a cluster brewing, Framingham State officials quickly tested 114 students in the residence hall linked to the cluster. So far, no more thought to have been exposed tested positive, Magazu said.
On Wednesday, the state health department released new data that indicates the rate of positive virus tests across college campuses here is quite low; generally less than one-tenth of a percent of tests are positive. But the numbers also show that campus cases make up a sizable chunk of the new cases statewide on a daily basis, about 7 percent.
Amid a rapid rise of more than 100 cases at BC, the state stepped in to lead the school’s contact tracing. Governor Charlie Baker said the move was to “more effectively” coordinate tracing work among Newton, Brookline, and Boston, which surround BC, and to ensure that the state’s infection rate remains low. Most of the spike in cases at the university was tied to two off-campus gatherings where students failed to wear masks or practice distancing, BC officials said.
Baker said colleges have generally kept infections in check, but the state is reviewing the protocols for testing, quarantining, and tracing.
“Clearly, we need to make sure we stay on top of this,” he said.
Colleges have four options for tracing the contacts of infected staff, students, and faculty: Assume responsibility for the work; allow the local health department to take the lead; opt for the state to take the lead; or collaborate with either state contact tracers or staff from its local health department. State documents indicate many chose the collaborative approach.
Clark, Worcester’s health director, said her department is working on a new data collection form for colleges in that area — which include Clark University, College of the Holy Cross, and Worcester State University — to ensure they are accurately monitoring all cases.
“I think we all anticipated there would be some uptick,” she said.
In Cambridge, MIT is teaming up with the city’s health department for help tracking down off-campus contacts who might be infected, said Shawn Ferullo, the university’s chief of student health.
Thus far, MIT hasn’t had any virus clusters and most of the contact tracing has been straightforward, Ferullo said. Most MIT community members who have tested positive have only had contact with one or two additional people, he said.
But MIT officials said they are watching testing data from Sloan School of Management students. The university moved all graduate business school classes online for a week after reports of two gatherings in public parks that violated the school’s coronavirus restrictions.
Ferullo believes MIT’s testing program and its health clinic are capturing most of the students who live either on campus or locally. But if students live in another part of the state and get tested elsewhere, the university may not be made aware of the results unless the student or that locality’s health authorities inform the university, he said.
Like many universities, MIT has increased the number of health care providers doing contact tracing. In the past, the university simply had two nurses trained to contain a case of measles or mumps, Ferullo said.
Now, there’s a team of about seven people who can be called on for contact tracing. If MIT sees positive cases increasing, the university will put more health care workers on contact tracing, he said.
“For any institution having 60 or 80 or 70 cases would be challenging, but we have layers to handle it,” Ferullo said. “It’s one of those things you build it and hope you never test it.”