BackgroundEffective vaccines, improved testing technologies, and declines in COVID-19 incidence prompt an examination of the choices available to college administrators to safely resume in-person campus activities in fall 2021. ObjectiveTo develop a decision support tool that assists college administrators in designing and evaluating customized COVID vaccination, screening, and prevention plans. DesignDecision analysis linked to a compartmental epidemic model, quantifying the interaction of policy instruments (e.g., vaccination promotion, asymptomatic testing, physical distancing, and other non-pharmaceutical interventions), institutional priorities (e.g., risk tolerance, desire to resume activities), and assumptions about vaccine performance and background epidemic severity. ParticipantsHypothetical cohort of 5000 individuals (students, faculty, and staff) living and working in the close environs of a residential college campus. Main Outcome(s) and Measure(s)Cumulative infections over a 120-day semester. ResultsUnder Base Case assumptions, if 90% coverage with an 85%-effective vaccine can be attained, the model finds that campus activities can be fully resumed while holding cumulative cases below 5% of the population without the need for routine, asymptomatic testing. With 50% population coverage using such a vaccine, a similar "return to normalcy" would require daily asymptomatic testing of unvaccinated individuals. The effectiveness of vaccination in reducing susceptibility to infection is a critical uncertainty. Conclusions & RelevanceVaccination coverage is the most powerful tool available to college administrators to achieve a safe return to pre-pandemic operations this fall. Given the breadth of potential outcomes in the face of uncontrollable and uncertain factors, even colleges that achieve high vaccination coverage should be prepared to reinstitute testing and distancing policies on short notice.
Assessing COVID prevention strategies to permit the safe opening of college campuses in fall 2021