April 14, 2021: Community Conversations Transcript

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4/14/2021
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Joseph Helble:

Good afternoon and welcome, everyone, to our 26th Community Conversation, addressing planning, response, and operations in the time of COVID-19. I’m Joe Helble, the provost at Dartmouth College, and I’m joining you from the Star Instructional Studio in Berry Library on Wednesday afternoon, April 14th, 2021.

 

I’m joined today, as always, by Justin Anderson, our vice president for communications, from another studio on campus. And Justin and I are joined today by two guests who have been with us twice before, each time at the start of an academic term, Michael Wooten, the associate dean of residential life and director of residential education, who’s been at Dartmouth working with students for more than nine years, and Dr. Ann Bracken, MD, a member of the Geisel School of Medicine faculty, and the director of clinical medical services at Dartmouth’s Health Service, known to all as Dick’s House, a position Ann has held for the past eight years.

 

We will follow our regular format with a brief campus update, live Q&A moderated by Justin, a conversation with Ann and Mike about current operations, and a look ahead to summer. And then we will end with an opportunity for them to answer your questions directly. I have several operational updates to provide today, but let me start with our regular update on testing and case counts. First and foremost, I’d like to acknowledge that lines for student testing in Leverone grew long for several days at the start of spring term and again last week. We first adjusted staffing levels at peak periods, and when that did not fully resolve the wait time problem, we returned this week to utilizing only PCR testing for routine screening as we had done throughout the summer, fall, and winter terms. And it seems, based on reports I have gotten this week and what I have seen myself as I wandered over to Leverone yesterday for my own test, that, that has taken care of the issue.

 

Given this, we will continue routine PCR testing, but for now, we will use the supplemental antigen testing only during transitional periods like arrival and as otherwise needed. This will enable us to keep the lines short for the rest of spring term and have high-accuracy surveillance testing when 15-minute turnaround that the antigen testing provides is not needed. Thank you to our students for your patience as we work through this, and based on what I saw, again, early this week, things seem to be running smoothly once more. If we find otherwise, we will certainly make future adjustments, but I’m confident that we solved the problem. In terms of the results of our surveillance testing, although case counts across the country have been flat or rising the past three weeks, at Dartmouth, we’ve seen a welcomed decrease in positive tests relative to the end of winter term.

 

Over the past two weeks, we’ve conducted more than 18,000 tests and had 17 positives, for a positivity of just under 0.1% in that period. For calendar 2021, where two-thirds of our tests have been conducted, our overall positivity is 0.27%. And since the start of testing on July 1, 2020, we have now conducted, as of yesterday, 183,378 tests as reported on our dashboard with a total of 383 positives and an overall positivity of 0.21%. Now, two weeks ago, I had said that I was encouraged by the downward trend at the beginning of that week and that I anticipated we’d see a return to the very low positivity values we’d seen in the fall. And the numbers indicate that, that has indeed happened. That’s great news for community health, and it’s also a moment for a reminder that we need to remain attentive to staying masked, staying socially distant, and avoiding large gatherings.

 

This matters even as numbers decrease, because we know that the more infectious variants are present in this country. We know that the B117 U.K. variant is now dominant in new infections in the United States. We also know that it has reached the Upper Valley, and sequencing data on our campus has now confirmed that, not surprisingly, some members of the Dartmouth community testing positive for the coronavirus this past week are in fact infected with the B117 U.K. variant. While this particular variant does not appear to result in more severe presentation of disease, it is more easily spread, and it is another reminder of the importance of staying masked, staying distant, and washing your hands frequently. Again, it matters to help support and protect the health of the overall Dartmouth and local community.

 

Now, in terms of trends on other college campuses, for our Ivy peers reporting data, for the year 2021, all lie between 0.15 and 0.71%. Our NESCAC peers are currently reporting positivity ranges from 0.05 to 0.28% for calendar 2021. And our local state university peers, UVM and UNH, are at 0.34% and 0.6% respectively for the year 2021. Dartmouth’s value of 0.27% for 2021, therefore, remains well in line with our local peers. Let me turn now to vaccination. Last week, New Hampshire Gov. Chris Sununu announced that with increases in vaccine availability in New Hampshire, starting next Monday, April 19th, New Hampshire would open vaccination to everyone in the state age 16 and over including college and university students. This welcomed development means now that all Dartmouth students in session on campus will therefore be eligible to be vaccinated in the state of New Hampshire.

 

For students and for employees residing in New Hampshire, you can register to be vaccinated through the state’s website, https://www.vaccines.nh.gov. As of yesterday, nationally, then 122 million Americans had received at least one dose, a vaccine more than 75 million Americans, or roughly 23% of the population, had been fully vaccinated. And according to the New York Times’ vaccination tracker website, in Grafton County, N.H., the home county for Dartmouth College, 28% of the population and 64% of the population over the age of 65 has now been fully vaccinated. This is impressive progress in a short period of time, but it reminds us that we have a long way to go to reach the federal government’s goal of 200 million vaccinations by the end of April and to begin approaching the levels of community immunity that will allow us to return to what we longingly refer to as normal life.

 

But with vaccines now becoming widely available in New Hampshire and across the country to all individuals aged 16 and over, with vaccination an essential tool in protecting the vaccinated from infection or serious disease and in reducing transmission to others, and with high levels of vaccination essential to achieving the high levels of community protection referred to as herd immunity that are necessary for increasingly normal operations on our campus, we anticipate that all members of the Dartmouth community will be able to be vaccinated before the start of fall term this September. Given this and given our expectation that fall term will begin to resemble the normal fall term that we all deeply desire, with full residential operations resuming, we will require all students to be vaccinated prior to the start of fall term 2021 as we had anticipated last summer and as included and articulated in our community expectations documents that were distributed to the student community at that time.

 

Students with medical and religious exemptions will, of course, be accommodated through the normal process for managing exceptions for other vaccination requirements, a process that is overseen by Dick’s House. Any individuals who are not able to be vaccinated prior to the start of fall term, will be expected to be vaccinated soon after arrival in Hanover, and we remain in contact with state and regional health officials as we explore options for providing vaccinations on campus or in the surrounding area. We anticipate having more information on what those options might look like well before the start of fall term. For both students and employees, as you get vaccinated, we ask that you submit information from your vaccination records as soon as you are able. That will enable us to track the progress of community vaccination on campus week to week, which is essential to implementing our plan to return to normal residential operations this fall.

 

If we do not reach the high levels of vaccination in our community by the start of fall term, the levels required to begin to approach herd immunity, we will not be able quite simply to return to normal residential operations. Submitting that information as soon as you are able will also allow you as an individual to reduce the required frequency of your participation in surveillance testing. Specifically, all who are fully vaccinated will begin to reduced testing regimen of only one time per week. Students are asked to submit proof of vaccination via Dick’s House with information available on the process on the Dick’s House website. Employees are asked to provide proof to Dartmouth’s occupational medicine provider, Axiom. Employees will be able to upload their records to Axiom as soon as they have received their last dose. They will then receive an email indicating that they’ve been approved for less frequent testing typically within three to five business days of submitting their information.

 

To voluntarily submit completed vaccination information to Axiom and provide consent to Dartmouth’s limited use of this information, employees should review the policy and complete the form at http://dartgo.org.vax. Any employee who does not have access to a computer or mobile device with a camera can make a five minute in-person appointment with HR to obtain assistance in completing the necessary form. All of this information, including the vaccination policy and requirement for students, will be captured in written form and distributed to campus in the days to come. As more and more members of our community are now receiving the vaccine, we are also revising our guidance regarding Dartmouth-sponsored travel. Beginning next Monday, April 19th, all fully vaccinated individuals, and this means faculty, staff, and all students, will be permitted to participate in Dartmouth-sponsored travel within the United States.

 

Unvaccinated individuals, faculty, staff, and all students, will be permitted to participate in Dartmouth-sponsored travel only within New England, with requests for Dartmouth-sponsored travel outside of New England requiring a travel exception. All international travel will continue to require a travel exception at this time. Now, while our policies are less restrictive, all personal travel continues to be discouraged. We still ask all individuals to limit all travel, including Dartmouth-sponsored travel, as much as possible. This is true whether vaccinated or not to reduce the frequency of travel to its minimum and minimize the spread of disease. This updated travel policy will also be posted shortly, and our expectation is that it will be up and available prior to the start of next week.

 

In terms of spring term operations, I now have several brief updates before we conclude and turn to your questions. First, as the Undergraduate Registrar’s Office announced Monday afternoon, the Faculty Committee on Instruction has voted to extend the deadline for students to elect the non-recording option, or NRO, for any spring term NRO eligible courses to May 19th to give students more flexibility in decision-making around this option in grading this term. Details are available through the registrar’s webpage. Second, as more members of our community become vaccinated, we will continue to reopen our facilities and our spaces as public health and safety permit. Specifically, effective today, the running track at Memorial Field and some outdoor tennis courts, specifically the top lift courts at Alumni Gym and the courts at Sachem Village, will be available for use by students approved for on-campus access and by faculty and by staff.

 

Third, by agreement of the Ivy League presidents, Ivy League sports teams are now permitted to engage in limited local non-Ivy competition this spring. Per Ivy League guidelines for Dartmouth, this means we’re eligible to compete against institutions within a 100-mile radius of Hanover. I’m happy to report that several of our sports teams are scheduled to compete starting on April 24th, with details being finalized as we speak by the Athletics Division. Specifically, we hope to enable initial limited competition starting that weekend for men’s and women’s tennis, softball, women’s and men’s track and field, later in April, men’s lacrosse, and possibly in mid-May, heavyweight rowing. Athletic competitions at Dartmouth will unfortunately not be able to host spectators, but we do anticipate live streaming, at least some of those contests. Details will be provided by athletics as we get closer to competition date, and as the details finalized.

 

Fourth, I’d like to add renewed encouragement to our community and specifically to our faculty to seek out ways to connect with students in person outdoors now that the weather is improving. Improving, as long as you ignore the three inches of snow that are in the forecast for tomorrow night? But you remember that tents with video display capability are in fact scattered around the campus. We have seven tents, five of them audio video capability enabled, and three of them available for any purpose, including scheduling class sessions or small meetings of faculty and students by working through conferences and events.

 

As I walked across campus today, I saw students utilizing the Adirondack chair scattered across the campus with their laptops or in small groups of friends to just sit and talk or to work outside. I saw no one sitting under any of the tents, utilizing the tents. These are a resource here for us to use, and I encourage you to think about creative ways to hold meetings or classes sessions, even the occasional session there, and give students the chance to connect directly.

 

And for students who are here on campus, if there’s a professor you’d like to talk with, I’d encourage you to reach out and ask them whether they’re on campus and whether they’d be willing to meet in person. Not everyone is coming to campus, not everyone is vaccinated, and so it may not be possible. But if you don’t ask, you’ll never know. Maybe it’s your academic advisor you could reach out to. Maybe it’s a 15-minute walk around the Green, but the face-to-face, even masked, connection, might well be worth the effort.

 

And fifth and finally, I know we are all seeking ways to connect, in ways to rebuild slowly and safely, that in-person community that’s so much a part of the Dartmouth experience. It’s now been more than a year since we’ve had any opportunity for gatherings of more than a handful of people together. And this is something we all deeply miss. We’re therefore going to try something a little different this spring and experiment. And on three Tuesdays, April 27, May 11, and May 25, we’re going to find an hour in the middle of the day and have three locations around campus for anyone approved to be on campus, students, staff, and faculty alike, to stop by gather, grab a small snack. I’m personally looting rooting for doughnuts, at least once, but I know that my opinion may not carry the day, and take a few moments to say hello to one another. Details will be provided in Vox Daily as the dates approach. And I do hope we’ll all take advantage and maybe even find a way, for those of us who’ve been on campus for a while, to connect with the members of the class of ’24, who were new to our campus this year and begin to enable them to start to experience this part, this small part, of community at Dartmouth.

 

Now I know that doughnuts around campus or opening up of tennis courts or taking a walk around the Green are not remotely going to bring us back to normal. We’ve all run out of adjectives describing what this year has been like. For all of us, and I mean, all of us, there’ve been moments this year of wondering how we are going to manage the stamina to see this through. But I’ve been struck by the stories of my colleagues these past few weeks, who’ve run into one another at the vaccination centers or at the testing site and spoke eloquently of how much it means to have even two minutes, even masked and at a distance, with a colleague they hadn’t seen in a year. I know the student community is feeling the same thing. So to all of us on the faculty and staff, even as we process our own challenges, please try to pause, try to reflect, and offer a student a chance to connect.

 

To the students, I know you look out for one another, but I’ll also encourage you to stop and say hello when you see a member of the faculty or staff outdoors. As I was walking into my office early this morning, a student walking past shouted hello to me. I think it was a friendly hello. And as I was walking over to Parker’s, that left me with a smile on my face. For me, that very brief moment of being connected, connected to the students and a connected part of this community, mattered after a year in isolation. Please look out for one another. It’s one of the most important things we can do right now.

 

Thank you for your attention. Thank you for your contribution to a successful start to spring term. And I look forward to your questions. Justin, over to you.

Justin Anderson:

Thanks, Joe, and great to be with you as always. I’m just going to dive in with questions about what you announced regarding mandatory vaccinations. As soon as you mentioned that, we started to get a series of questions about that very thing. So I’ll just start with why? Why are we choosing to mandate vaccinations for students, but not for faculty and staff?

Helble:

We are strongly encouraging vaccination of faculty and staff. We are starting with students because they are members of a congregate living environment on our campus. They are living in closer quarters to one another, and we know through everything we’ve learned this past year, that that’s one of the most critical areas for controlling the spread of the infection.

 

So, we are going to be doing all that we can to encourage faculty and staff to get vaccinated. Whether we will move beyond strongly encouraged by the end of the summer is to be determined. But as of today, we, like several other colleges and universities, are focusing on the importance of the student population because of the congregate living situation and also encouraging them now, we’re informing them now, so that they will have ample lead time to plan and prepare and get vaccinated before they returned to campus in September. So that’s the reason for the difference at this point in time.

Anderson:

And Joe, you certainly pointed this out in your introductory remarks. I did not point out because the questioner didn’t make this clear, but I do want to make clear that there are exceptions on a case by case basis for health and otherwise, should that be necessary. So it’s important that we, I think make that clear. So folks know if they think that they should be accepted, that that is something that they can pursue.

Helble:

Absolutely, Justin. And if I can, you didn’t pose that as a question, but if I can chime in, that would actually be a good question for us to put directly to Ann Bracken, who oversees Dick’s House, when she joins us shortly. We have expectations, in fact requirements, that students will be vaccinated against other diseases when they enroll on our campus. We do allow exceptions in those circumstances as well. Dick’s House manages the process. It has worked very smoothly and it is the same process we anticipate using here.

Anderson:

Joe, in in terms of vaccinations and we’ll stay on this for at least one or two more questions, which vaccines, or which vaccinations will be accepted? Must they be FDA-approved or is it really just any vaccination?

Helble:

So right now, we will clarify this Justin in the message. But right now we are anticipating that initially it will be vaccines that have received FDA approval, including EUA approval. And so that is currently the J&J vaccine, the Moderna vaccine, and the Pfizer vaccine. That list may expand over the course of the summer, but we are going to have a clear list of vaccines that are acceptable by the time the students return to campus in the fall. And we will make provisions for students who may have been vaccinated by another vaccine or vaccination protocol to get vaccinated through one of the FDA-approved vaccines when they returned to Hanover, if that is necessary.

 

That’s an important question. And we don’t yet have the specifics of that worked out in part because they are going to be evolving as approvals evolve over the course of the summer, but we felt, and I felt, that it was important to let students know today, particularly admitted students who are making decisions about which college and university to attend, our intention to require vaccination when they are arriving on campus this fall.

Anderson:

Joe, I said that as soon as you mentioned this in your introductory remarks, we immediately got questions. The first question was, does this mean that classes will be in person in the fall?

Helble:

That is the expectation. Classes will be in person in the fall. Now it is, and I tried to indicate this in my remarks, Justin, it is dependent upon our achieving a sufficient level of immunization, of approaching or achieving what is referred to as herd immunity, where transmission of the disease is minimal in our community because a very high percentage of our community has been vaccinated. If we do not achieve herd immunity levels and if we are vaccinated at a lower level, we will need to maintain social distancing protocols in the classroom. And we will need to revert to a mixed hybrid residential and remote learning operating mode.

 

Part of our reason, again, for announcing now that we are going to require vaccination for the fall is to provide plenty of lead time so students can get vaccinated, so we can track vaccination progress over the course of the summer and be sure that we are in fact on track to achieving our goal of being at a herd immunity level of vaccination by September. That we can offer our curriculum in person. That is the goal.

Anderson:

Joe, in addition to questions about vaccines and vaccinations, there are also a fair amount of questions about commencements. And rather than just running through the specific questions, I guess it would be helpful for folks to know whether or not the plan for commencement is set in stone or whether or not there is a possibility that it could change between now and June. In other words, or more specifically, is it possible that at some point between now and June, we might be able to say that guests will be allowed to attend?

Helble:

I’ll answer the question this way, Justin. It is highly, highly unlikely that it will change. There would need to be a significant uptake in the fraction of the population that has been vaccinated. There would need to be a significant downturn in the level of transmission. And the latter in particular, I don’t anticipate happening even by June. Few individuals do anticipate dropping to essentially 0% transmission by mid-June. I understand deeply the desire of parents to be able to participate in commencement and community members to participate in commencement. But we do not have the capability within our facilities, even with reduced social distancing practices in place, even with it being outdoors, to accommodate two guests per graduate.

 

We’ve thought about the different variations and options that one could put in place. We thought about a series of ceremonies where a fraction of the class would go through at each point in time. And I am sure there are members of the community that would prefer that, but in the end, we know how important it is to our students collectively to gather as a community and as a class. And we did not feel that any of the options that caused us to have to divide members of the Class of ’21, alphabetically or by other mechanism, into smaller groups were appropriate options for Dartmouth.

 

There’s no perfect choice and there’s no right answer, but consistent with the values of student community here on campus and the limited spacing we have available in Memorial Stadium, we made the decision that this was the best choice for our campus at this point in time.

 

I know it leaves many people disappointed, and I wish it were otherwise, but that’s where we ended up thinking about all the competing interests and trying to focus on what was best for the student community to give them a chance to gather collectively.

Anderson:

Thanks for providing that detail, Joe. I know that this is a question that we hear routinely from families and parents, and it’s so tough. It’s been extremely difficult year on so many fronts and we understand that families and parents just really want to be there for their students. And I know we’d like nothing more than to be able to accommodate them. And so I appreciate you providing just a little bit more of the rationale behind this really difficult decision.

Helble:

Yeah. It’s extraordinarily challenging Justin. And I can say, as a parent, myself, having watched my daughter graduate on a Zoom screen last year at a distance when for her, it was not even an in-person ceremony, it was prerecorded, it was still nice. And we were proud of her accomplishments and it wasn’t remotely the same thing. I understand completely.

Anderson:

We have time for just one more question and it’s really a proposal almost. And it’s a kind of cool idea, which I’ve heard floated a number of times. Someone writes in asking whether or not we would consider opening up trips to not just the ’25s who will be coming in as first years, but also to the ’24s who were unable to participate in trips last year.

Helble:

So, I’m going to say let’s direct that question to Mike Wooten. It might be better put to Kathryn Lively, but let’s direct it to Mike Wooten, who will be with us shortly. I will give you my answer, Justin. I know that’s been floated. I think the logistics of that, and again, not knowing what disease transmission is going to be like in mid-August, we want to be conservative as we have been in other things and put in place something that we are confident can succeed rather than pushing the envelope to the limit and potentially having a pull-back for everyone. So we are attentive to a deep desire to do something for the members of the class of ’24, who did not get to experience trips this past year. I’m not optimistic that we’ll be able to do that jointly with the ’25s this summer, but we are looking at ways and other moments to do that specifically for the ’24s. Mike may have more detail, or he may just deflect it to Kathryn in another week, but please, whoever asks the question rest assured, we are cognizant of the loss of this opportunity for the 24s and finding a way to offer that in an appropriate point in time in this next year. So thank you, Justin. Thanks to all for the good questions.

 

And I’d like to now ask Ann Bracken and Mike Wooten to join us. Ann, Mike, good to have you with us again. We seem to always have the two of you as a pair on community conversations. It just works out that way and always at the start of a term because each of you has so much insight and information to provide on what’s happening on campus, on the medical side and on the residential operation side and how we expect things to play out. So good to see you both.

Ann Bracken:

Nice to be here.

Helble:

So let me jump right into it. And Mike, if you don’t mind, I’m going to start with you and I’m going to refer back to our prior two conversations. You were with us in early September, right after I’d seen you biking around campus on your mountain bike, checking in on move in operations. And you were here with us again in January, shortly after the start of winter term, here we are again, and we are two and a half weeks into spring term. It’s our third residential term in the midst of the pandemic. What are you seeing now? And is it any different compared to fall and winter?

Michael Wooten:

Well, Joe, thanks for having us back. And I told Ann, I’ve decided to only do this conversation if she’s with me. So thank you. And for also joining and just making these possible. It’s good to be back. It’s good to be talking to the community about these important topics.

 

It’s great to have the ’24s and ’21s back. That’s the community that’s mostly here for the spring term. That’s of course our first years and our seniors. It’s wonderful to have them back on campus. We were able at the beginning of the spring term to reduce the quarantine process by a day, we think that was a nice start to the spring term for our students. Even during quarantine, the many staff and faculty that are invested in our students’ lives, the Dick’s House staff and nurses and doctors who care deeply about how our students are doing in these difficult times of arrival. We’re checking in with our students: How are you? What do you need? What are ideas that you have to make this place, your home for the coming 10 weeks?

 

And so, it started that way and it’s wonderful to have people back. It’s been exciting to see more facilities open on campus. We’ve been working hard on that front. Collis, the library, tents going up, Joe, that you’ve already described in which students and faculty and staff can program and have opportunities to be together in a safer way outside. My office looks out over the Green. On a day like today, I look out over the Green and I see people socially distanced sitting on the Green, having a bite to eat or looking at each other study. And that’s wonderful to see people back in this way on our campus. If you walk by Collis, there’s an outdoor stage right now that’s ready for musical acts. And again, these are all the efforts that have been put together to welcome people back.

 

And in fact, to welcome student’s good ideas about how to make this place, their home, how to be here in an engaged, exciting way for the weeks of the spring term. And that’s my last plug there, is that there are so many people that want to be engaged with you, with students in that process, our house professors, our programming board staff and students that work on that, our Collis staff, the faculty and staff that work in our many buildings and programs across campus. Talk to them if you have an idea, they would love to work on that with you and find a place to both execute the program and to make sure that we can live into this place in the ways that it deserves.

Helble:

Right. Great. Thanks. Now, it’s been great to see the students out on the Green, Mike, and I really noticed that students, as I said in the Adirondack chairs, as I was walking over here to the library this afternoon, I do miss the skating rink in the middle of the Green, but I think it’s time has come and gone for this particular year. I’m hoping we’ll be able to do that again next year, but it is great to see them out and about and enjoying the weather. So thanks to you for all your efforts.

 

So, Ann, I’d like to turn to you now, and I’d like to ask you about the vaccination news. That’s really at the top of the news this week. And it was just yesterday morning. The FDA recommended a pause in the administration of the single dose J&J vaccine while it investigates a fairly small number, six incidences of a blood clot out of over 6.8 million doses administered. So it’s a rate of less than one in a million. Nonetheless, what, what can you tell us? What do we know about what’s happening so far and should anyone who’s gotten the J&J vaccine a few weeks ago be concerned or attentive to any possible symptoms?

Bracken:

Sure. So it was pretty unsettling news yesterday to hear about this. The six cases, they were all women between the ages of 18 and 48, and they had cerebral venous sinus thrombosis, which means a clot in the brain. And it was paired with bleeding and thrombocytopenia. But the notion is that the vaccine may have induced a very vigorous immune response to platelets, causing them to activate, aggregate, clot, and then be consumed and have bleeding associated with it. These six women presented with within six to 13 days of having the J&J vaccine with headache, some back pain, abdominal pain, nausea, vomiting, and four of the six had some focal neurologic findings, including loss of speech, some nerve sensitivity and some visual disturbances. So it’s this thrombosis paired with the thrombocytopenia that was particularly concerning. The good news is, as you mentioned, it’s super rare event.

 

And the other thing is that the system of recognizing adverse events with vaccines is working. So the vaccine adverse event reporting systems, VAERS, detected this because people are reporting adverse events and it was noted, and then they could press pause. The other good news is that this has not been paired with the mRNA and a vaccine. So the Moderna and Pfizer have not had this associated with them. The AstraZeneca, which is not currently being used in our country and Europe, has also had some clotting issues, specifically this cerebral venous sinus thrombosis. And it may be the vaccine vector and the way the vaccine is created, that could cause this problem. However, it’s super rare. That’s the good news you had asked, if people had this vaccine in the past three weeks, if they’ve had severe abdominal pain, severe chest pain, severe leg pain, unexplained shortness of breath, then they should notify Dick’s House if they’re a student, or their doctor.

 

We don’t expect this to happen again, because this is such a rare event. We also know that our students are actively getting immunized now through the state and have come back having been vaccinated, and they should expect to have some side effects related to the vaccine. So not to be too nervous if they get a headache, or we know that 80% to 90% of the people who get the, the Moderna and Pfizer are going to have redness, localized pain. So they have a localized reaction. They may have Abernathy, which is lymph node in the armpit. And then 50% to 80% of people will have systemic reactions, side effects that chills and fever and body aches and joint pains. Young people have vigorous immune systems, so they tend to have a little more of the side effects. They may have them day one to three, and they should get better. Any side effects that people are worried about called Dick’s House. They can call Axiom or their primary care providers if they’re employees.

Helble:

Right. That’s really helpful. And if I could just ask you a quick, follow-up just briefly. First of all, the systems working. As you say, we’re capturing the side effects are being disseminated widely. I give those who were involved FDA and the medical establishment great credit for being so transparent and responsive in terms of publicizing this. The concern those of us have who are seeking broad vaccination, is that will frighten people from getting vaccination. But I think it’s important. That’s a leading question now, but it’s important to put that in the context of the more than 560,000 people in the United States alone who have died from COVID-19 versus thus far, I believe you said one death associated with administration of the vaccine. So how do you discuss vaccine safety with your patients who might have concern or questions about whether they should go forward? What’s your advice?

Bracken:

Well, first of all, you mentioned close to 120 million people have been vaccinated in the U.S. so huge numbers of people, and we have the system to detect adverse events. That system is working. Most of the students that we’re engaged with, want to get vaccinated, and they’re desperate to get vaccinated. So we’re really trying to enable that. We meet with students on an individual level to talk about contraindications to the vaccine or precautions related to the vaccine. So on an individual level, we give advice before we give any vaccine.

 

But I have found that the Dartmouth students are highly motivated to get vaccinated to protect themselves, to protect their community, to protect their grandparents. And also, as you mentioned, they will have some more liberties. The testing cadence can be reduced for those who have completed their vaccine process. So there’s that piece too, as a piece of motivation, but we have really found that students are very enthusiastic about trying to get vaccinated.

Helble:

Great. Thank you, Ann. Yes, it’s testing reduction and frequency, and it’s also a greater travel flexibility for Dartmouth sponsored travel, which will be next week. And we anticipate a little bit more freedom will develop over the course of spring term as well. So thank you. Mike, let me now turn back to you with a question about summer, and there’s a good chance just looking at the numbers that there will be more students on campus in residence than we have typically in a summer sophomore summer this year will include, I believe almost all the sophomores as it typically does. Plus it will include juniors or the rising seniors, many of whom deferred their sophomore summer experience from last year. So what can you tell us about summer move in facilities and operations as you seek to manage what is going to be, as I understand it, a 30% to 40% increase in the typical number of students on campus?

Wooten:

Yeah, that’s a great question, Joe. And we’re thinking a lot as you would expect about the summer right now We know the summer is a beautiful time in New England. It’s a great time to be on campus, and so we expect that people want to be here, right? But one way to understand how we’re imagining the summer is that it is both a continuation of many of the COVID protocols that we have in place to ensure the safety of our community, and it begins the, the on-ramp to what is, what you’ve described as a more normal fall experience, right? And to do both as a bit of a trick, right? Because the summer term goes all the way until the end of August. And we know that we have many people who return beginning even in August, who are here, what is the fall, but come for all sorts of orientation experiences, athletics, trip leaders, all these things.

 

So, what we expect is that the summer will be a mix of both those scenarios, right? We, we know because we will not be fully vaccinated yet in the community that in some ways the residential experience on campus will resemble some of what we’ve been having and experiencing for the last year. We need to have those protocols in place until the vaccination is required, until we have enough vaccination across the community to ensure the safety of the community. And we know that we need to start planning and preparing for what will be a closer to normal fall term. So we have all sorts of expectations to be able to use the outdoors in ways that it’s harder to do in the winter and spring. We have the opportunity to really make the most of the college experience here in Hanover in new England, in ways that we’ve not been able to do, knowing that we’re moving closer towards a normal experience than we’ve had up until now.

Helble:

Right. Great. Thanks. Thank you. And those words, closer to a normal experience, I know are words that we are all so desperately willing to implement. That’s what we’re all seeking. And I will say that I remain more than cautiously optimistic. I remain optimistic that summer is going to be a period of transition, and we are moving forward towards a normal fall residential operating term. Particularly if, and as students and members of the faculty and staff are getting vaccinated over the course of the next several months.

 

So, Ann, let me turn to you with a final, very short question. Before we open it up to our audience, who I’m sure have questions for the both of you. And my question is we’re asking, and in fact, we’re requiring even those who’ve been vaccinated to continue to practice masking, continue to practice social distancing when they’re on campus, whether they’re indoors or outdoors. So for you as a physician, why does that remain important?

Bracken:

Well, Joe, we still have a lot of people who are not vaccinated on campus and people can have breakthrough with even being vaccinated with getting COVID. In fact, we’ve had two episodes of people who’ve been fully vaccinated, have a breakthrough and have COVID infection. We know that masking can reduce the R0 of the infection rate, which is typically 2.5, so one person who’s infected can spread it to 2.5. We can reduce that R0 from 2.5 to 0.5 and really halt the transmission. So it’s so critical. We had that big outbreak in March, early March, which was a struggle and affected so many students on campus. And so by masking and distancing, we can continue to enjoy not being isolated, not being in quarantine and be able to enjoy each other and be outside. And as the herd immunity increases, then the use of masks may be reduced. But I think we’ll be with masks for a while. So get your fashion masks and be outside. You’re going to reduce risk.

Helble:

Great. Thank you, Ann, and what you say implicit in that is what’s so important for all of us to remember the vaccines, even as they were being rolled out, we were reminded they are not a guarantee that they stop infection. They reduce infection or reduce the severity of the disease that ensues if one does get infected. So the vaccines are working exactly as they’re advertised, but they are not a guarantee that there will not be breakthrough infection, something important for us all to remember. So Justin, with that, why don’t I turn to you and let’s see what questions are coming in from the community for Ann and Mike.

Anderson:

Thanks, Joe. And let’s stay with Ann. Ann, you just mentioned that most students are desperate to get the vaccine and to get vaccinated, but not all. And so what’s the rationale for mandatory vaccination? I mean, obviously lots of schools are beginning to do this.

Bracken:

Right.

Anderson:

Joe talked a little bit about the importance of having students vaccinated versus faculty or staff, who don’t live on campus and in close proximity. But if most students are going to get it, anyway, why make it mandatory? What’s sort of the public health rationale behind that?

Bracken:

Well, we have a lot of vaccines that are required for students who are living in congregate living situations. If you look at the Dick’s House website and you go to the medical records option, you can see what the immunization requirements are for our different populations. So undergraduates, because they’re in congregate living situations, have different risk profile than our medical students, who are interacting in healthcare and have a lot of vaccine requirements, versus our graduate students, who might live off campus in the community. So it is a typical process to have required vaccines to protect the community, like measles, mumps, rubella, varicella vaccine or documentation of illness, the tetanus, diphtheria, acellular pertussis vaccine, the meningitis vaccine for undergraduates, not for people who are graduate students not living in congregate living.

 

So, there’s a long history of requiring vaccines to protect the population. As Joe and you both mentioned, there’s a waiver process. So people can have a medical waiver or a religious waiver. We find I usually communicate with people who waive the vaccine for medical or religious reasons and call up the first year students, just to have a discussion. Sometimes they think about changing their mind. Particularly students who were traveling a lot before and not having vaccines is a risk when you travel. But we can accommodate religious exemptions and medical waivers. So this is kind of a typical process that, as Joe and you’ve mentioned, we’ve been in this business for a long time. There’s usually very little resistance in the student population to requiring vaccines.

Helble:

Justin, if I may interject, and just to put an exclamation point on what Ann’s saying, I think it’s really important for the community to remember this is not a radical departure from policy. This is not a new policy. All we are doing here is adding another vaccination to the expected vaccination portfolio that students will present when they enroll.

Anderson:

Thanks for clarifying that, Joe. Mike, if I could go over to you, in your exchange with Joe, we talked about how during the summer, we’re going to have more students on campus potentially, because in addition to the typical sophomore summer, we’ll have more juniors than usual. Then in the fall, we’re hoping to be back up at full residential capacity in terms of the students who will be coming to campus. From a numbers standpoint, from a housing standpoint, how are you planning for what could be record levels of students wanting to live on campus, both in the summer and during the fall, while also presumably having to maintain a space for quarantine?

Wooten:

Yeah, it’s an important question. So just to clarify summer, so the summer numbers will not be as high. They never are as high as the other three terms. So that gives us ... again, I’ve been using the language of an on-ramp into what is the intensity and the density of the fall. We will have time to do some of that work in ways that we wouldn’t ordinarily, because two classes is still not the capacity of campus. So the summer is a little bit less dense. I think for the fall, this question of do we need ... It goes back to some of the important things that Joe has been saying and Ann have been saying about the amount of both herd immunity and vaccination efforts for our students and the importance of a mandatory vaccine. So if we can get the community to a vaccination level, we may not in fact need quarantine and isolation beds in the way that we use them now. That’s not fully determined right now, but we may not need those beds in the same ways that we’ve had for the last year.

 

So that’s part of the calculus as we think about the fall. There is no doubt ... So the fall is always our fullest term. The fall will be a full term. We will be back to having roommates. We’ll be back to using all of our spaces in the ways that we’ve had to use in the past. I think that’s part of what makes a residential experience special, and it’s worth noting we’re coming out of a pandemic. So there’ll be some challenges with having a density that we’ve not seen for a year on our campus that we’re thinking about now, that we know that as much as we all want to come back and we all want to be back on our campus, it comes with a lot of people. There can be some anxiety that will come with that. So we’re working through that. We’re trying to figure out the best way through that and those challenges.

Anderson:

Ann, back to you with another vaccine-related question. Obviously, people were pleased that the governor decided to open up vaccine distribution for out-of-state college students in New Hampshire. So that’s going to be a big boost for many of our students. We’ve gotten a bunch of questions, though, about the logistics of that and out-of-state students who will be on campus who don’t have cars and would be unable to travel very far to get vaccinated. So can you talk about how we are planning to manage the logistics of distribution of vaccines for all students, but specifically for out-of-state students, for whom there may be additional hurdles?

Bracken:

Well, we’ve already been trying to support some of these students. Some of them have been able to get appointments down in West Lib, and actually Michael’s shop, we’ve been just trying to figure out how we can get kids rides down to West Leb. We’re also really hoping that soon we will be offering the vaccine on campus, and that will make a huge difference for students. We’ll be doing a second round of vaccines for people, for some employees and students, on April 28. Tom Schutzius, our emergency planner, has been working very industriously with the state to get more vaccine available so that we can vaccinate people on campus. That’s our primary goal. But until we’re able to do that, we’re going to support students to try to help them get to vaccine sites. Thankfully, Advanced Transit goes down to West Leb, and that’s been a site where a lot of people have been getting vaccinated. Some pharmacies are going to be opening up for vaccination.

Anderson:

Mike, back to you with a question that I posed to Joe about trips. I’m coming back to that because just the mere introduction of trips on camera spurred even more questions about it. So I’m wondering if you could talk about the idea of perhaps merging trips for the ’24s and ’25s and turning it into supersize trips, which I know presents lots of logistical challenges. But we were all about logistical challenges this year. So could you talk about how you’re thinking about those possibilities?

Helble:

Before you answer, Mike, I’ll just point out that supersize is a word that should still give all of us pause at this moment in the pandemic.

Wooten:

That’s true. Supersize is a problem. So Justin, look, let’s be really clear. One of the things that makes this place really special is the outdoor experience. Students come here for that reason. That’s a hat tip to the trips directorate, to Coz and his staff in outdoor programs. It is amazing, the opportunities to ... This is a unique characteristic of Dartmouth. So, there is no surprise that people have lots of questions about—how do I experience the trips experience, because I didn’t have a chance to?

 

The other observation I would make is that the experience for the ’24s has not been the same as it’s been. That’s true for all classes, but for the incoming class, that’s been really difficult, and we’ve heard that clearly from the ’24s. So it’s a natural thought that there are some opportunities here to do more throughout our programs, through the trips directorate to mirror some of the opportunities of what happens in trips at the end of August, early September, as the first-year class returns. I want to be careful to not shoehorn my good colleagues who have to do that thinking and do the logistics on that and commit them to things that are not mine to commit them to. But I know that we’re all eager to support our students in what is really one of the jewels of the experience of being at Dartmouth, which is the outdoor experience.

Anderson:

Ann, I’m going to go back to you for a final question. I don’t want you to leave without giving you an opportunity to weigh in on efforts that we are making to support the mental health of students. We get this question every week. We hear about this constantly from students and from parents. It’s a huge, huge issue that we’ve obviously been addressing all year long. So I don’t want to let you go without giving you an opportunity to just talk about that a little bit. The specific question was about how are we doing, basically, on not letting students fall through the cracks?

 

Bracken:

It’s been, as you know, a really rough year for everyone’s mental health. When students are in isolation and quarantine on campus, all of those students are called every day. They’re also surveyed, too, and have an opportunity to comment on mental health. Counselors reach out to students in isolation, quarantine. So there’s that effort. We’ve also hired a lot of new counselors. Counselors that are doing a lot of outreach and communicating particularly with the ’24s have been ... It’s been a rough year for ’24s, and there’s a lot of outreach related to mental health.

 

In primary care, we do a lot of mental health. So we do telehealth visits, phone visits, and in-person visits for basic mental health problems. Anxiety, depression are things that are very common practices for primary care providers to engage in. So there’s a lot of attention and support related to mental health. With students, I feel like students are reaching out to us when they’re concerned about their peers, too. So we continue to try to really engage with students related to their mental health. We want to hear from them if they’re worried about themselves or a friend.

Anderson:

Ann, just to be clear, if students do want to reach out on behalf of friends or for themselves, how should they do that?

Bracken:

They can call counseling at (603) 646-9442, and they can leave a message with a counselor, too. They can talk to a counselor about a friend. They can call primary care, 646-9401, and make an appointment with a primary care provider. They can call nursing 24/7, 646-9440, and talk to a nurse if they’re worried about ... So there’s a lot of people who are here. We want to hear from people if they’re worried about friends or themselves.

 

Anderson:

Thank you, Ann, for that very much. Thank you, Mike and Ann, for joining us again. Mike and Ann, Ann and Mike, we have to have you guys together.

Bracken:

Yep. We’re a team.

Anderson:

We are committed to bringing you back together at some point in the future. But thank you very much for joining us. That was really interesting conversation. We appreciate your time. We appreciate all you do for Dartmouth. So thank you, and with that, Joe, I’ll go back to you.

Helble:

So, thank you, Justin and Ann and Mike. Let me add my thanks. It’s particularly helpful and wonderful to have you with us at the start of term, when there’s so much that’s changing at the start of every term. Just given the conversation we’ve had today about residential operations plans for the summer, what that means for students who want to go on trips, and all the questions around vaccination that are on everyone’s minds, employees, students, and the alumni and parent community alike, really helpful to have this clarification and explanation of the things we’re trying to do, moving forward.

 

So let me just say from that, make a few comments that are a little bit broader. I couldn’t help but reflect as I was getting ready to sit down here at the desk for today’s community conversation that we’ve now been engaging in these conversations with the campus community for a year. This is our 26th community conversation. We’ve been doing these roughly every two weeks, and we started them in April of last year in an effort to provide a different vehicle for communication and to supplement and complement information that we were posting on websites and sending around by email. Neither Justin nor I ever imagined that we would be doing this a year later, but we’ve found it is certainly, for us, a helpful way, even if we can’t answer all the questions, to get the questions that are immediately on the minds of the community.

 

We try to be as transparent as we can. I know we don’t often reach the bar that many, including our students, are hoping for, but we do earnestly try to take your questions and answer what’s in progress and what our decision-making process is and what we’re thinking about down the road as best we can. If you have thoughts on other topics we should address related to COVID, please let Justin or me know.

 

We are committed to continuing these certainly through the spring term and doing our best to keep the campus informed in the face of changing conditions all the time as we work through spring term and anticipate a transitional summer and hopefully, hopefully, if we can achieve herd immunity, a return to normal operations this fall. Thank you, everyone. Stay well and be well, and we look forward to seeing you again in two weeks. Have a good afternoon.