College students and their parents face a daunting challenge this Thanksgiving: How can students go home for the holiday without bringing the coronavirus with them?
The logistics of Thanksgiving break in the midst of a pandemic are tough. College campuses have emerged as hotbeds of infection in some parts of the country, accounting for more than 252,000 infections and at least 80 deaths. While students are at relatively low risk for complications related to Covid-19, the worry is that an asymptomatic student could unknowingly bring the virus home to vulnerable family members.
While some students plan to skip the family gathering, dorms are closing on some campuses, and many students are required to leave and complete finals at home. Others will return to classes after the short break, making prolonged quarantines impossible.
The good news is that some colleges have been vigilant about controlling the virus through frequent testing, contact tracing and restrictions on students that have kept cases low. But other campuses have less rigorous testing programs or large numbers of students who aren’t taking the virus seriously.
“When college students come home, they’ve really got to be careful,” said Dr. Anthony S. Fauci, the nation’s top infectious disease expert. “It depends on where they’re coming from and what the level of infection is in the community they are in.”
To start, each family needs to decide how much risk a college student with an undiagnosed case of Covid-19 would pose to other family members.
“There is no right or wrong answer. It’s about the relative risk you’re willing to take,” said Dr. Fauci, director of the National Institute of Allergy and Infectious Diseases. “It depends on the contacts in the home you’re going to. If you have an immunosuppressed person or a grandfather who’s 92 years old, the risk is great. If you’re going into a home with a healthy 45-year-old father and mother and a brother and sister in their teens, the chances of there being a problem are much less.”
Here are answers to some common questions parents and students are asking about staying safe during Thanksgiving.
What can students do to lower risk before coming home?
Parents should have a heart-to-heart with their student about the risks of Covid-19 to family members. Don’t mince words. Ask students to restrict contacts for at least a week before coming home.
“You approach it with empathy, concern and mutual respect,” said Dr. Asaf Bitton, executive director of Ariadne Labs at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. “You can say, ‘You’re coming home, and I want to ask you to commit to five or seven days before you come home. Please don’t go to a bar. Please don’t go to a house party. I need to ask you a favor because I care about you, and I know you care about me.’”
Ian Zohn, 20, a junior at St. John’s University in Minnesota, has decided not to go home to his family in Warren, N.J., for Thanksgiving. He has six roommates who he says are careful, but in some classes, students aren’t wearing masks properly.
“It’s kind of a bummer that I don’t feel like it’s safe” to go home, he said. “A lot of people are not willing to follow the rules. I’m not putting any of my family members or friends at risk.”
Should students get tested before leaving campus?
Yes. Many colleges are offering coronavirus tests to students before they leave campus. At Indiana University, for instance, all students can receive a free test the week before they leave for the holiday break.
“We’re hoping that testing before people leave campus will give them that extra confidence in their viral status,” said Dr. Erika Cheng, deputy director for mitigation testing and an assistant professor of pediatrics at Indiana University School of Medicine. “We certainly don’t want anyone unsure about their health status to hop on a plane to go visit their grandmother.”
Testing isn’t a guarantee that a student isn’t infected, since the tests are not always accurate, but a negative result makes it less likely. It’s also possible that a student who tests negative before leaving campus could pick up the virus on the way home. Despite those concerns, Dr. Fauci advises students to get tested before returning home.
“You don’t want the perfect to be the enemy of the good — you can’t be 100 percent on anything,” Dr. Fauci said. “Between the testing place and going home you could get infected. But if you’re careful, you wear a mask and you test negative, you’ve diminished dramatically the likelihood there’s going to be a problem.”
How should students travel from campus to home?
If parents drive to pick up a student, or the student rides home with friends, all passengers in the car should wear a mask and ride with windows open if possible. If it’s too cold outside, open the car windows at regular intervals to let out contaminated air. Make sure the car heater or air-conditioner is using outside air rather than recirculated air.
Students traveling on buses, trains or planes should keep their masks on as consistently as possible, wash hands frequently, sit near empty seats when possible and avoid crowded areas.
Should students isolate or wear masks when they get home?
While it’s optimal to quarantine for two weeks after arriving home, even a few days of isolation, avoiding close contact with family members and mask-wearing inside the home lowers the risk that a student will unknowingly transmit the virus to others. If possible, a swab test after the student arrives home offers additional reassurance.
“After they’ve traveled, don’t hug and have them take a shower,” Dr. Bitton said. “Try to find a place in the house where they won’t be in super-close proximity, at least for the first couple of days. If there’s a person who has high-risk health issues in the house, maybe everyone wears a mask for the first couple days.”
Confused by the terms about coronavirus testing? Let us help:
- Antibody: A protein produced by the immune system that can recognize and attach precisely to specific kinds of viruses, bacteria, or other invaders.
- Antibody test/serology test: A test that detects antibodies specific to the coronavirus. Antibodies begin to appear in the blood about a week after the coronavirus has infected the body. Because antibodies take so long to develop, an antibody test can’t reliably diagnose an ongoing infection. But it can identify people who have been exposed to the coronavirus in the past.
- Antigen test: This test detects bits of coronavirus proteins called antigens. Antigen tests are fast, taking as little as five minutes, but are less accurate than tests that detect genetic material from the virus.
- Coronavirus: Any virus that belongs to the Orthocoronavirinae family of viruses. The coronavirus that causes Covid-19 is known as SARS-CoV-2.
- Covid-19: The disease caused by the new coronavirus. The name is short for coronavirus disease 2019.
- Isolation and quarantine: Isolation is the separation of people who know they are sick with a contagious disease from those who are not sick. Quarantine refers to restricting the movement of people who have been exposed to a virus.
- Nasopharyngeal swab: A long, flexible stick, tipped with a soft swab, that is inserted deep into the nose to get samples from the space where the nasal cavity meets the throat. Samples for coronavirus tests can also be collected with swabs that do not go as deep into the nose — sometimes called nasal swabs — or oral or throat swabs.
- Polymerase Chain Reaction (PCR): Scientists use PCR to make millions of copies of genetic material in a sample. Tests that use PCR enable researchers to detect the coronavirus even when it is scarce.
- Viral load: The amount of virus in a person’s body. In people infected by the coronavirus, the viral load may peak before they start to show symptoms, if symptoms appear at all.
If possible, give the student their own bathroom to further reduce household risk. Open windows throughout the home to improve ventilation. “Even cracked is better than none,” Dr. Bitton said.
Sofia Pelaez, 21, left her Texas A&M University, San Antonio, campus three weeks earlier than planned to travel to her home in League City, Tex., because cases in her dorm were on the rise, but she worried about putting her mother, who has high blood pressure, at risk. “I feel like if something would happen to her, it would be my fault,” said Ms. Pelaez, who is studying psychology and child development.
She did her best to minimize contacts at school, and was tested two days before leaving campus. On the four-hour bus ride home she wore a mask and wiped down her seat. (Fortunately, the bus company kept the seat near her empty.) She even changed her clothes at the bus station after she arrived.
She got tested again in League City and wore a mask at home until she got the negative results. “I am not too worried about getting my mom sick because I know I am taking the right precautions,” she said. “I keep a mask with me 24-7. It’s like wearing shoes.”
We have students coming home from different colleges. Can they quarantine together?
If possible, siblings returning home from different campuses should isolate in separate rooms rather than staying together, particularly if they haven’t been tested. You don’t want one infected student exposing a sibling who didn’t bring the virus home.
Cathy Neumann, who lives in Downers Grove, Ill., has three adult children attending three different schools — Iowa State University, Western Michigan University and Illinois State University. All three students will be tested before returning home, but she knows they may not have the result before they enter the house.
“If one of the kids is positive, we do have the option of them sleeping in our camper on the driveway, or we have enough hotel points to book a hotel room for them,” Ms. Neumann said. “We haven’t really talked about that though. The boys also live in a house off campus, so if they’re positive we could also say, ‘Nope, you can’t come home.’ But I will seriously cry for days if that happens.”
What can I do to lower risks during the holiday meal?
The safest plan is to move your holiday celebration outdoors. If that’s not possible, open windows and turn on exhaust fans. Give college students their own serving spoons and have them keep some distance during the meal.
A computer simulation from Japanese researchers suggests the seating arrangement at the table can affect risk, and it’s best to avoid sitting next to or directly across the table from a person who might be infected. The person seated at a diagonal from the infected person is at lowest risk. When you’re not eating or drinking, wear a mask.
You can find more tips on how to lower risks in our story: “Serve Up Some Extra Precautions at Your Thanksgiving Table This Year.”
What should I do if all these precautions aren’t possible?
Every small precaution you take lowers risk. Just do your best.
“Sometimes our public health recommendations don’t reflect the complex reality of people’s lives,” said Julia Marcus, an infectious disease epidemiologist at Harvard Medical School. “That’s not a reason to not try to mitigate risk in small ways. Some combination of testing before travel, mitigating risk during travel and then trying to keep some distance, wearing masks at least a few days after arriving — those can all add up to some amount of risk reduction.”
Amanda Nugent of Wilmette, Ill., realized it was too risky to bring her 21-year-old son, Thomas, a senior at Colorado College, home for the holiday. Ms. Nugent said her son has been careful, but it’s tough to avoid possible exposures on campus. Instead, Thomas will skip the family meal and go camping with close friends who are part of his “bubble” in Colorado Springs.
Ms. Nugent said she is second-guessing her decision, but her son, though disappointed, said he doesn’t want to put his family at risk. “It’s crushing, but we know it’s the right call,” Ms. Nugent said. “We will take very careful precautions in December so we can safely welcome him home over Christmas.”
Do you have a health question? Ask Well