How badly could college campuses be hit by COVID-19?

Faith & Science Conversation
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How badly could COVID-19 impact college students this year? That’s a tough question to answer, but let’s begin with a few things. (Also, If you see anything that I’m missing or have a bad estimate for, let me know. )

  1. There are about 20,000,000 college students at any given time, but about 3 million are exclusively online. [1] This number might be higher this semester than usual, so let’s go with double that will be exclusively online. This leaves maybe 14,000,000 college students returning to campus.
  2. Let’s say about 10% of them have already been infected. Some places are below this and some places much higher. This would include undetected cases which can be calculated from total tests, test positivity rate, and seroprevalence surveys. [2]
  3. Let’s say the worst case scenario is that 25% of college students get it. I am going based off of the highest seroprevalence that we’ve seen, which is about 25% in Lombardy, Italy . [3] This could in theory be 2-3x higher, depending on what herd immunity looks like for COVID-19 but let’s go with the lower end estimate for now. Since 10% already had it, this leaves 2.1 million students that will be infected.
  4. 40% of these students will potentially be asymptomatic. They will still likely contribute to the spread of the virus without knowing it, with a recent CDC estimate that they are about 75% as infectious as a symptomatic person. [4]
  5. This leaves 1.26 million students that would end up having COVID-19 symptoms. About 50% of those will transmit the virus before their symptoms develop. [4]
  6. About 80% of these will recover within 2-3 weeks. This leaves 252,000 that we will talk about at the end. [5]
  7. About 2% of detected cases in the 18-29 age range end up hospitalized. [6] But many of the cases that I mentioned in points 3-5 will not be detected. Florida data suggests that we miss about 80% of cases for the younger age group. [7] This combined puts about 7,200 college students in the hospital this year.
  8. Of those 7,200 that end up in the hospital, about 1,400 will end up in the ICU. [4]
  9. Of those in the ICU, about 700 will end up on ventilators. [4]
  10. Of those, about 144 will die. [4] This is a relatively low number compared to other causes of mortality among american college students with those returning 14 million estimate… 270 dying from cancer, 680 dying from alcohol related incidents, 860 dying from suicide, and 1500 dying from other accidental injuries. [8]
  11. The most overlooked factor, especially we we say ‘mortality is low for this age group’ is the 20% I mentioned from point #6. These are the 250,000 that will suffer from long-COVID-19. They will otherwise have no comorbidities and previously have been healthy 18+ year olds, but will now suffer with constant fatigue, shortness of breath, joint pain, chest pain, headaches, or other neurological symptoms. If this follows other coronaviruses like MERS or SARS, a good fraction of these may live with symptoms for a long time to come. [9]

These numbers could be higher or lower depending on how many college students are infected. In general, my estimate was made with:

  • 40% of those infected will be asymptomatic
  • 48% of those infected with have symptoms but recover in 2-3 weeks
  • 12% of those infected will be stuck with lasting symptoms and perhaps permanent neurological damage (~1 in 8 infected)
  • 0.57% of those infected will be hospitalized (~1 in 175 infected)
  • 0.11% of those infected will end up in the ICU (~1 in 900 infected)
  • 0.055% of those infected will end up on ventilators (~1 in 1800 infected)
  • 0.011% of those infected will die (~1 in 8,750 infected)

So for my school, let’s say 20% of the school gets infected this semester with 2,000 on-campus students:

  • 400 total infections, 160 asymptomatic
  • 192 with symptoms but recover in 2-3 weeks
  • 48 with long-COVID-19 who don’t recover, perhaps for months or years
  • 2 hospitalized
  • Probably 0 end up in the ICU, on ventilators or die. There’s about a 5% chance that a student will die from COVID-19.

And then what about faculty, where 37% of the 750,000 some full-time faculty are over the age of 55 nationwide? I’ll have to do them next… [10]

Sources:

[1] Fast Facts: Distance learning (80)

[2] COVID-19 Projections Using Machine Learning | We use artificial intelligence to accurately forecast infections, deaths, and recovery timelines of the COVID-19 / coronavirus pandemic in the US and globally

[3] Eurosurveillance | Prevalence of SARS-CoV-2 specific neutralising antibodies in blood donors from the Lodi Red Zone in Lombardy, Italy, as at 06 April 2020

[4] COVID-19 Pandemic Planning Scenarios | CDC

[5] Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020 | MMWR

[6] See cumulative hospitalization rate: COVID Data Tracker Weekly Review | CDC, plus total confirmed cases for that age group: CDC COVID Data Tracker

[7] https://twitter.com/zorinaq/status/1286170444685381638?s=20

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535338/

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071317/

[10] The Aging Faculty, Fast Facts: Race/ethnicity of college faculty (61)

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Just saw this:

A New York Times survey of every public four-year college in the country, as well as every private institution that competes in Division I sports or is a member of an elite group of research universities, revealed at least 6,600 cases tied to about 270 colleges over the course of the pandemic. And the new academic year has not even begun at most schools.

There is an interactive map in the article.

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