Just a few short months ago, college and university administrators were focused on yet another fall of dealing with COVID-19. But as cases of monkeypox in Massachusetts and nationwide have mounted, higher education leaders are racing to stay ahead of a different kind of potential outbreak, as thousands of students head back to campus in the coming weeks.
Several of the state’s largest schools this week are taking to social media, updating their websites, and sending out e-mail blasts to provide families with the latest science about the disease, as well as on-campus resources should a student be infected.
And that’s in addition to COVID-related information about testing, vaccinations, and prevention.
“It’s a lot coming at our students,” said Dr. Judy Platt, Boston University’s chief health officer and executive director of its Student Health Services.
BU scheduled a universitywide e-mail this week on monkeypox but also is in touch with student groups to coordinate information tables at events as classes begin.
Platt said they are trying to help students understand “the activities that put them at risk; if they share drinks, vaping materials, their bedding materials, their clothes, all of that has college administrators concerned about an outbreak.”
With nearly 99 percent of reported monkeypox cases in the United States occurring among men who have sex with men, Platt said school leaders are walking a fine line.
“We are trying to educate about the illness and say that right now there is a particular group that is more vulnerable,” she said. But Platt worries that transmission may spread on campuses to wider social networks in the fall.
Monkeypox is transmitted through close skin-to-skin contact. It is also spread through touching fabrics, such as clothing, bedding, or towels that have been used by someone with monkeypox, as well as through contact with an infected person’s respiratory secretions. Experts are still learning how easily the virus can spread through saliva, but college health officials are concerned that people with a lesion on or in their mouth may be able to transmit it by sharing drinks or e-cigarettes with others.
No one in the United States has died of monkeypox, but lesions and swollen lymph nodes from the infection can be painful and debilitating.
As of Thursday, the Centers for Disease Control and Prevention was reporting more than 10,000 cases nationwide, including 202 in Massachusetts.
At the University of Massachusetts Amherst, where nearly half of the 30,000 students live on campus, the school’s emergency operations team this week is walking through how it will address each aspect of suspected and confirmed monkeypox cases, from handling contaminated linens to caring for infected students who may need to be isolated for weeks and have food delivered to them.
The CDC recommends that people remain at home or otherwise isolated for the duration of their monkeypox illness, which can last for up to four weeks. Symptoms include fever, aches, chills, and a rash; the CDC recommends patients isolate until the rash has fully healed and a fresh layer of skin has formed.
If isolation is not possible, the CDC recommends wearing a well-fitting mask and also completely covering all lesions, as well as avoiding public transportation.
Jeff Hescock, executive director of environmental health and safety and emergency management, said UMass officials are adapting pages from their COVID playbook to address monkeypox.
“We have a well-oiled machine for this,” he said. “But we don’t want to leave anything to chance.”
The closest location to the UMASS Amherst campus that has the vaccine for monkeypox is in Springfield, about a half-hour’s drive away, and the school will pay transportation for students who qualify for the shot, Hescock said.
“We will eliminate all barriers,” he said.
The UMass team is trying to think expansively about repurposing successful COVID approaches for monkeypox. That includes vending machines installed last year that allow students, with their UMass ID card, to obtain two free rapid antigen COVID test kits or masks weekly. Now, the masks could also be used for those infected with monkeypox who need to leave isolation.
But monkeypox poses challenges that COVID did not, such as a much longer recommended isolation period.
Platt, from BU, said they are working through how to help students who may need to miss weeks of work or classes.
“Even if it’s a small number impacted,” she said, “it’s a significant impact.”
Spokespeople for Tufts University and Harvard University said their institutions are also sending messages to students, faculty, and staff about the latest science and how the schools plan to handle cases.
Just as COVID exposed systemic disparities in health care, with Black and brown communities shouldering a disproportionate number of infections and deaths, monkeypox appears to be following the same path. A new CDC report found that while Black and Hispanic people represent approximately one-third of the general population, they account for more than one-half of monkeypox cases for whom race and ethnicity data is available.
Carlos Rodriguez-Diaz, an associate professor of prevention and community health at George Washington University, said it’s imperative that higher education leaders communicate with LGBTQ student groups to ensure their schools’ care and communication plans are tailored appropriately, taking into account different cultures and languages, to reach the most vulnerable people.
“Colleges and universities have a lot of diversity and we need to make sure groups get the information based on their specific needs,” he said. “We cannot assume general information will be useful for everybody.”
Several schools said they are reaching out to and including diverse groups in their planning.
Emily Gowdey-Backus, a spokeswoman at UMass Lowell, said in a statement that the school’s health services office is collaborating with its LGBTQ center to “provide an overview of modes of monkeypox transmission to students who may be at risk for sexual transmission.”
As the time for students to head back to campus gets closer, Platt, BU’s chief health officer, said her office is fielding an increasing number of calls from parents asking about how the school plans to address monkeypox. She said the challenge is to balance their communications to families, to let them know they are taking the issue seriously, but not overstating the risks and creating more angst — something no one needs after two-and-a-half years of COVID.
“What we can already see, is here is the next infectious disease threatening our communities, but the mode of transmission is primarily skin-to-skin and direct contact, which is very different from COVID,” Platt tells families.
“We have to be cautious that we don’t create additional fear,” she said.
“It’s knowing who you are interacting with, and being cognizant of who you are having prolonged skin-to-skin contact with,” she said. “It’s unlikely to spread just sitting on your bed with someone fully clothed.”