A team of Penn State professors, scientists and Ph.D.s recently published a COVID-19 report on fall infection projections at University Park, finding — among other things — that testing all vaccinated students once every three weeks could potentially reduce the total number of university cases by about half.
The monthslong project, headed by the science team from the faculty-based group Coalition for a Just University, which has advocated for a vaccine mandate, ran 10,000 simulations on different scenarios by using proven COVID models created by Ivy League researchers. The team’s three main suggestions, based on the data:
- Mandate vaccines to reduce symptomatic cases and possible hospitalizations and deaths among students, faculty and staff
- Start testing all vaccinated individuals, a strategy “totally absent in the present PSU plan”
- Implement mitigation measures during home football games, such as mandatory submission of negative COVID-19 test results or holding games with a reduced attendance
Based on the current Penn State plan, the CJU science team projects a median number of university fall infections at 5,948 (750 symptomatic; 5,198 asymptomatic). By testing the vaccinated once every three weeks, it projects that number would drop to 2,937 (387.5 symptomatic; 2,459.5 asymptomatic).
“That’s one of the main messages in our report: The vaccinated can get infected, and Penn State is not testing the vaccinated,” said one co-author, who spoke to the Centre Daily Times on the condition of anonymity because they feared retribution by the university. “That is a mistake.”
None of the co-authors, from the College of Engineering and the Eberly College of Science, are named in the report because they feared similar retribution. But they’ve posted the full report online, in addition to defining their calculations and explaining how they arrived at each conclusion.
‘A big danger’ or an overreaction?
Experts appear split over whether it’s necessary to test vaccinated students, and at least one outside infectious disease specialist wondered aloud about the related projection from the CJU science team.
Because the delta variant is still relatively new, and more variables are at play this year compared to last, many unknowns and uncertainties remain. The Providence (R.I.) Journal polled a half-dozen experts around Brown University on the topic, with opinions ranging from outbreaks still being possible in high-vaccination settings to tests involving the vaccinated being “probably unnecessary.”
Penn State, which requires weekly tests for the unvaccinated, does not require testing from vaccinated students — although voluntary testing remains available. Other universities throughout the nation — such as Harvard, Stanford and Cornell — still require tests of the vaccinated, although none of the five Big Ten schools without vaccine mandates require such tests. The Centers for Disease Control and Prevention also does not call for routine testing of the vaccinated.
“In addition to following CDC guidance, our current testing strategy prioritizes the use of tests where we are most likely to find cases,” Penn State spokesman Wyatt DuBois said in a written statement. “Therefore, we have walk-up testing for individuals who have been exposed, have been named close-contacts or have otherwise been put at risk. Further, while vaccinated individuals can become infected and spread the virus, they are at lower risk for both acquisition and onward transmission because of their vaccinated status.”
One of the CJU study’s co-authors said all that was taken into account in the projections. Although it’s likely that every variable hasn’t been addressed, the co-authors were confident in the projections while pointing out that the extra layer of protection in testing the vaccinated was something PSU could easily implement. Such testing would require less than 2,800 daily tests when, at the height of the pandemic, PSU had a capacity of a little more than 3,000 daily tests, they said.
“Most of these breakthrough infections are not dangerous to the (vaccinated) person that got it because the vaccine works pretty well, but you can infect others,” the co-author said. “You can go back home and infect your children. And that’s a big danger.”
It wouldn’t be the first time both CJU and Penn State disagreed over COVID transmission or related policies. Last year, the same CJU science team estimated there would be 2,500 fall COVID cases before Thanksgiving break — a projection that seemed extreme at the time, given the fact the county had only a few hundred cases over the previous five-month period. Despite Penn State railing against the study, the science team’s reason for concern proved true as roughly 5,000 cases were confirmed and in-person teaching ended early.
Still, Amesh Adalja, an infectious-diseases doctor at Johns Hopkins University, told the CDT he felt testing the vaccinated was likely not the best use of university resources. That is not what’s driving transmission, he said, wondering aloud how virus transmission among the vaccinated might have been represented in the models.
“In an asymptomatic breakthrough infection in a vaccinated person, the period of being contagious is very abbreviated. In those individuals, the viral load slams down pretty quickly,” Adalja said. “Even though there is a non-zero risk of a vaccinated person transmitting this to an unvaccinated person, I don’t think it’s a very high risk — and I think that’s acceptable because you’re not going to get cases to zero.”
The CJU science team said there’s not yet any definitive data confirming the abbreviated window, though they acknowledged some experts have suggested the possibility.
Since the day before Penn State classes on Aug. 22, there have been 428 confirmed cases involving students and staff at University Park. Cases have declined this week compared to last, with 101 cases from Sept. 9-15 compared to 163 cases from Sept. 2-8.
But the co-authors noted those numbers are already well above where their projections thought they would be, based on their report written Sept. 3. In fact, the 428 infections are higher at this point than in 99.8% of the 10,000 simulations the team ran on the current scenario, with simulations that take into account both confirmed and unconfirmed cases.
How a mandate would lower infections
Despite the controversial nature of the CJU science team’s recommendation to test the vaccinated, experts — including Adalja — backed up the team’s other two suggestions.
If Penn State implemented a vaccine mandate, assuming that would lead to an actual vaccination rate of at least 95% due to exemptions, the CJU science team projected that overall fall infections would decrease about 31% with the more serious symptomatic infections dropping by 78%.
“The virus isn’t going anywhere; we’re going to have COVID cases 10 years from now,” Adalja added. “Our goal has always been to prevent serious cases, and that’s what’s happening in the unvaccinated. So I would’ve liked to have seen Penn State mandate the vaccine as a condition of enrollment and as a condition of employment, and I’d like the governor to push for that because it’s a state-related school.”
Nine Big Ten schools have mandated the vaccine in some way, whether for all students or simply those living on campus. And more than 1,000 colleges and universities nationwide also boast a mandate. Despite the urging of the faculty senate, student governments, faculty groups and community leaders, the university has stuck to its initial plan of “heavily incentivizing” the vaccine and encouraging it — but not requiring it.
In an open letter last month, university President Eric Barron alluded to several reasons for not mandating the vaccine — such as a Quinnipiac poll that showed a nation split among university mandates, mandates that face legal challenges and a (Republican-controlled) state legislature that oversees part of the university’s funding. State Senate President Pro Tempore Jake Corman, R- Benner Township, previously told the CDT he would not vote to withhold funding if PSU opted for a mandate — but could not speak for his colleagues.
As of Sept. 15, Penn State reported that 82.8% of students and nonunionized employees have indicated that they are vaccinated.
Beaver Stadium a ‘super-spreader’?
Maybe the biggest oversight in Penn State’s current COVID plans is the lack of mitigation involving Beaver Stadium, the world’s fourth-largest stadium, per the CJU science team.
Even back in June, when Centre County infections remained low, outside expert Dr. Ali Mokdad — the Institute for Health Metrics and Evaluation’s chief strategy officer of population health — told the CDT that any stadium operating without vaccine mandates or reduced capacity would be “a big concern.” Adalja, unaffiliated with the CJU science team, echoed those concerns earlier this week.
“If I were Penn State, I would require vaccination as a condition of entry into Beaver Stadium. That’s what they should have done,” he said. “In lieu of that, I think they need to test heavily in the unvaccinated cohort because that’s where the spread is going to be from.”
Penn State requires masks within indoor settings at the stadium, such as the suites, but few other serious mitigation factors are in effect. Penn State does not require vaccinations for attendees, and it does not test before entry — similar to Michigan’s “Big House” but unlike harder-hit LSU, which requires either a negative test or proof of vaccination for entry. As a result, the CJU science team estimates that about 200 students will become infected every game, not to mention other fans and the potential community spread happening elsewhere.
According to the CJU science team’s projections, testing attendees before home football games would drastically reduce cases. Without such testing, if there were a vaccine mandate and required student/staff tests every two weeks, there would be about 1,558 median fall cases. If football attendees were also tested in that scenario, that number would fall to 253 median fall cases and just 10.8 symptomatic cases.
“Any competent epidemiologist in the world would tell you how bad an idea it is to bring close to 107,000 people together — a mix of people from outside and students — in a geographical region with increased cases of the delta variant and not very high vaccination rates by first-world standards,” the CJU science team told the CDT. “It is known how SARS-COV-2 outbreaks occur in clusters or ‘super spreading’ events. The potential for the games acting as such events cannot be exaggerated.”
In an email to the CDT, CDC public affairs specialist Jade Fulce acknowledged large gatherings pose a greater risk — and said such gatherings “should be determined based on state, tribal, local, or territorial safety laws and regulations.” She added that event organizers should also work with local public health officials. (The CDC currently has no recommendations regarding gathering-size limits.)
The CDT reached out to both the state Department of Health and Mount Nittany Health for comment. A Mount Nittany spokesperson responded via email but did not directly address the posed question of Beaver Stadium, and the state DOH declined to comment. A Penn State spokesman pointed out the university is following CDC requirements.
“The university recommends that everyone, particularly those who are not vaccinated, wears a mask in the stands and in the concourses,” added DuBois, a university spokesperson. “This guidance has been communicated to fans. The university is focused on consistently monitoring the state of the pandemic and has contingency plans in place should circumstances change and further mitigation measures are needed.”
Six out of seven public health experts from the Kaiser Family Foundation, a nonprofit that focuses on health issues, said earlier this month that it is not safe for fans to attend a packed stadium right now — even if vaccinated.
It is not known what the vaccination rate is on game days inside Beaver Stadium, although less than 60% of the commonwealth’s population is fully vaccinated. Some 71.2% have received at least one dose, however.
Looking at the big picture
Although the CJU science team’s report focused on the university and primarily students, the main fears associated with the report don’t involve Penn State. Because students are vaccinated at a higher clip than the commonwealth — and because they’re young, vaccinated and more likely to experience milder cases — the concern doesn’t lie with them.
Instead, the main fear is that student infections could spill over into the greater community, the CJU science team said. Not only are unvaccinated adults at risk but also children in elementary and middle school who are too young for the shots. In Pennsylvania, there are 10 times as many COVID-19 cases in school-aged children than at this time last year, per state health secretary Allison Beam. Nationally, infections in children have also increased nearly 240% since July and children currently account for 29% of all COVID cases.
“For all the folks that did this report, what we really started to be very scared of was to see the the number of total infections and, especially when they are asymptomatic, because we know that will spread into town, essentially,” one of the report’s co-authors said. “And, in town, there’s thousands of children that cannot be vaccinated. And there are also people that are not vaccinated.”
Last week, Mount Nittany Health officials said COVID hospitalizations were almost double what they were at that time last year. And, on Friday, officials shared even more troubling news: The number of COVID patients this week more than doubled the previous week, from 17 to 42.
“We are alarmed at the escalating rate of COVID positive hospitalizations,” Mount Nittany Health Chief Medical Officer Dr. Upendra Thaker said in a written statement.
The state has required masking in schools — not without some local pushback — and State College Borough has mandated masks indoors in businesses and other buildings open to the public.
The co-authors were open about their report’s shortcomings, about how the median projection of 5,948 fall PSU cases doesn’t take into account any changes the university might make and how projections were more difficult to formulate this year. “We guarantee our recommendations would make things better,” the co-author added. “How much is uncertain, but we guarantee it’s going to be orders of magnitude better.”
To prevent Mount Nittany from filling up, to stop children from getting infected, and to protect the community, experts unanimously agreed that steps need to be taken beyond the university. By sheer numbers alone, because students account for roughly a quarter of the Centre County population, that has a significant impact — but the experts said there’s one simple way to reduce all these dangers.
Get vaccinated.
“Our best defense as a community to minimize the spread of COVID is for everyone in our community to practice vigilance — get vaccinated, wear a mask, practice social distancing and wash your hands frequently,” said Mount Nittany Health spokesperson Nichole Monica, adding a majority of local COVID hospitalizations are from the unvaccinated.
Josh Moyer of the Centre Daily Times (State College, Pa.) wrote this story.
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