Joseph Helble:
Welcome everyone to our seventh community conversation, addressing planning, response, and operations in the time of COVID-19 at Dartmouth College. I’m Joe Helble, the provost at Dartmouth College, joining you from Starr Instructional Studio in Berry Library for take two of our seventh conversation after a brief hiatus, one we planned and one last week when I was not quite 100%. Thanks to all of you for your patience and well wishes, but we’re back with an update this week. I’m joined again, and as usual, by Justin Anderson, our vice president for communications, who’s joining me from an adjacent studio on campus.
And today, once again, we’re pleased to be joined by two individuals who can speak to some of the considerations that all colleges and universities are facing relating to testing and contact tracing considerations for all of us as we anticipate the return of our undergraduate and graduate student community in larger numbers to campus this fall. They are Dr. Joanne Conroy, a member of the Dartmouth Class of 1977, MD, CEO, and president of Dartmouth-Hitchcock and Dartmouth-Hitchcock Health. And she is joining us from her office at the Dartmouth-Hitchcock Medical Center in Lebanon, N.H.
And we are also joined by Neal Katyal, a member of the Dartmouth Class of 1991, a practicing attorney, the Saunders Professor of National Security Law at Georgetown University, and the former acting solicitor general of the United States. Neal is joining us from his home in Washington, D.C. Both of our guests will be with us today in their personal capacities as alumni and Neal, also as a Dartmouth parent of an undergraduate student. As always, I’ll provide a brief campus update. We’ll take your questions live moderated by Justin, and then have a conversation with campus and community leaders, in this case, Joanne and Neal.
Today, I’d like to focus on providing brief updates on our research and libraries reopening once again because progress continues to be made in the phased reopening in both of those areas that are so important to the members of our scholarly research and teaching communities who are here resident in Hanover this summer, and an update on our academic and operational planning as we look ahead to fall 2020 and beyond. First, I’ll start with the research update. We are now halfway through the fourth week of what has been and remains an intentionally and thoughtfully phased reopening.
Phases 1, 1A, and 1B as we’ve referred to them each lasted approximately one week and we are now presently in what we are referring to in conversations with our laboratory principal investigators, phase 1C. In all phases, several aspects of what we’ve been requiring has not changed by design. First, we are asking everyone who can work remotely to continue working remotely. Our basic rule at this time remains one person per lab, disinfecting the work surfaces and equipment before and after each work shift in the research laboratory. Core facilities are accessible only if an environmental health and safety approved plan is in place.
And we are asking everyone both in the laboratories and not who is accessing campus facilities to conduct a daily check in using the TSA questionnaire. And we are asking principal investigators, laboratory leaders, PIs, to verify the adherence of their research community to the protocol and remind them daily of the importance in doing so. I said a moment ago, we’ve moved to phase 1C, what phase 1C permits is an extension of the hours of operation now to encompass the beginning of weekends. Specifically, this weekend, Saturday, June 27, Saturday only, facilities will be open from 8 a.m. to 5 p.m. for research.
During the weekdays, facility hours have been extended to 8 a.m. to midnight, Monday to Friday. The following weekend, July 4, and yes, I’m aware that July 4 is a holiday weekend, but nonetheless, our staff has committed to helping our research community make this work. The facilities will be open both Saturday and Sunday, July 4 and July 5 from 8 a.m. to 5 p.m. Now, in terms of the details, if someone is working only in a distinct core facility, they do not need to count against the one person per lab limit.
So students or faculty or post-doctoral researchers and research staff who may be working in facilities like the electron microscope facility, the flow-cytometry lab, the light-microscope facility, the advanced-imaging core center at the Norris Cotton Cancer Center, and many other of our core facilities do not count against the one person per laboratory limit. If faculty members can enter their offices without entering the lab, they also do not need to count themselves against the one person per lab limit. And what we have seen from the numbers with this phased and staged and thoughtful reopening from one, to 1A, to 1B, to 1C is indeed a gradual ramp up of activity, which we had hoped to see in undertaking this transition in this measured way.
According to vice provost for research, Dean Madden, as of Friday, June 5, in phase 1, the final day of phase 1, we had 169 researchers visiting nine of our main research buildings. At the start of phase 1B, Monday, June 8, 211 individuals, an increase of 25 percent over the end of phase 1. And a week later as of Monday, June 15, 246 individuals working in the research facilities, an increase of 46 percent over the end of phase 1. Now, I also want to acknowledge that many faculty, particularly those with larger groups and laboratories, and many of whom I heard from directly this weekend have been asking when multi-person access to the labs will become possible.
This is what the working group and the task force have characterized as phase 2 operation and it is a phase we hope and in fact, intend to be able to enter in early July. So, I ask the research community for just a little bit more patience as the task force and working group work through their checklist of considerations that need to be addressed so we can continue to go down this path in a thoughtful, measured, and structured way. We have been able to do this with adherence to the protocols and without incident across the board through phase 1A, 1B, and now 1C, and we are optimistic that by continuing adherence to protocol, phase two can be equally successful.
With July right around the corner, I anticipate more detail on our phase 2 reopening very soon. Also, worth noting in the area of research before I move on to the libraries is the increase in research proposal volume that we have observed as against one year ago. Comparing data from March 2019 to March 2020 and April 2019 to April 2020, in terms of grant proposal submissions, we found that 2020 mirrored 2019. There was virtually no change in the number of proposals submitted. However, according to Vice Provost Madden, the number of submissions, which included some supplements related to COVID-19 work in May of 2020 was up 25% over May 2019.
For those who track this kind of thing, it means to me certainly, and to others, that our researchers clearly used this period of working from home to focus on writing proposals and presumably writing papers and journal manuscripts as one might expect and hope, an encouraging sign for the research activity at Dartmouth during this challenging period. In the area of libraries, and as I’ve said before, I often speak of these together because of the importance of both laboratories and the libraries to our teaching mission and to our research mission, we are moving forward with plans to begin a phased reopening of the libraries very soon.
I’m pleased to report that the library remains on track to consider the first phase of reopening by mid-July and perhaps even sooner. Initial access will be to Baker-Berry stacks and the research collections and initial access will be for Dartmouth ID holders only. Dartmouth ID holders encompassing faculty, staff, and students who are authorized to be here and working on campus during the summer. Special collections, including Rauner, will have more limited access and will be by appointment only, but they too will be accessible in this early phase of reopening. And I anticipate more details prior to the July 4 holiday, again, with the goal of reopening the library facilities to limited use in very early to mid-July.
Either way, depending upon the exact progression, we’ll be sharing in writing the details with the campus and we will include the update on our COVID-19 website once this has been finalized. Now, let me turn to budget briefly before I address the larger topic that’s I think on everyone’s minds right now with our June 29 announcement date right around the corner, and that is budgetary planning. As the president, and I have said repeatedly, our operations this fall, of course, depend upon the number of students we will have on campus and also what those operations will look like.
I have said in the past, and I will say again this afternoon, that fall operations are highly, highly unlikely to be what we would characterize as business as usual operation. Large gatherings, whether for social events, performance events or fully filled classrooms are not likely. This is something that we are seeing mirrored in announcements that other campuses and organizations are making around the country around their fall terms and it applies to us here at Dartmouth as well because of our attention on community health and public health in making operational decisions.
As we work on our academic planning, which again, I’ll discuss shortly, we continue to work on a challenging financial picture. The uncertainty regarding the number of students back on campus, the mix of remote and residential students, and a result, uncertain levels of private support from individuals and organizations that help support our operations in the face of a challenging national economy, this being the case for many nonprofit organizations, including colleges and universities like Dartmouth, mean that it is difficult for us to project a typical optimistic financial picture for the year ahead.
Given that, I and the campus leadership continue to meet with different committees and the president senior leadership group to review updated projections on FY20 close, the fiscal year that closes next Tuesday, June 30, to look at and adjust as appropriate and needed in the face of core operations, FY21 budgets, and to begin to develop plans for fall term operations and the year beyond. We do know that we will be asking, and I will be asking, all units on this campus to start by making adjustments in their non-compensation spending as an important first element asking each of us to look carefully at what we have all done so successfully in reducing non-compensation spending in the fourth quarter of fiscal year 20.
The level that we will be asking is reduced from the fourth quarter of FY20 when spread out over a year, recognizing that it is extremely challenging to maintain that for a full year, but leaders will have discretion. Specifics will come from deans and unit leaders in the coming weeks as we work out the details of individual FY21 non-comp and overall budget targets with each of the unit leaders in the days to come.
And let me close by speaking about academic operations in the fall. I’ll say again, and I can’t stress this often enough, from the outset, President Hanlon and I have stressed our goal of supporting the maximum number of students we can return to campus guided first and foremost, by the application of appropriate public health standards. Community health, our students, our faculty, our staff, and the broader Upper Valley community is at the forefront of our minds in our decision making. Our decisions are informed by input and recommendations from many groups first and foremost, federal and state guidance, including updated guidance from the state of New Hampshire, Department of Education, specifically for institutions of higher education, which we anticipate being released within the next several days. Our task force working diligently since the very beginning of 2020, helping provide recommendations and options through its many working groups and helping me and others in leadership make decisions about operations, again, with campus safety and security and public health at the fore of our considerations.
The academic working group consisting of deans, associate deans, and two members of the faculty, the teaching faculty and the dean of the college helping advise on academic options and decision makings and a health working group working jointly with Dr. Joanne Conroy and her colleagues at DHMC to make decisions related to testing and monitoring of community health. Now, I said in our last gathering, taking into account the input and guidance from all of these groups, that we were diligently moving toward a full-year solution rather than a fall-term-only solution.
I can state with certainty today that our plans that will be announced this coming Monday, June 29, will in fact reflect our planning for the full year and not just the fall term. The full academic year will mean the full academic year, fall term 2020 through summer term 2021, a full four-quarter, integrated, academic term. We anticipate and fully expect that all Dartmouth undergraduate students will have the opportunity to be here residentially for part of their education in the upcoming academic year, but they will not all be able to be here on campus at exactly the same time.
Our academic terms will be full-term and not divided with students coming and going in the middle of the term. A full quarter will be a full quarter for those students who are in residence during that quarter. First-year students will be treated as a cohort and thus have the same residential terms and our goal for all students is to offer two residential terms for every returning student who can and chooses to be on campus this upcoming academic year. We anticipate that beyond the first-year class, other students will be able to express some preference in determining which terms work best with their academic plan of study, which terms work best for them to be physically present in Hanover.
And these are some of the details that we are finalizing and are not prepared to announce today but will be outlined in the final announcement that we will release, President Hanlon and I, on Monday of next week. Now, we also anticipate that, as many others have announced, much of our teaching may well be done via remote learning, even for those physically present in Hanover, at least for the fall term. Details on numbers, sequence, approach, and incorporation of student preference, all of these important details that I am sure are on the minds of every student who’s tuned in to hear us this afternoon, are things that we will be announcing by Monday, June 29, as part of our comprehensive announcement. We do anticipate that we will be asking everyone who returns to campus, every student, to consent to testing for the virus upon arrival. This will be PCR-based viral testing, utilizing Dartmouth-Hitchcock Medical Center, Dr. Joanne Conroy’s colleagues, as our local partner. We presently anticipate retesting all students shortly afterwards, so-called double-testing, to do our best, to have a good handle on whether or not there are levels of infection present in our community that need to be addressed through quarantine and isolation as students return.
We are also examining a variety of methods to screen for infection in our community and recognize, and ask our students and our community to recognize, that additional surveillance testing may well be part of our protocol and expectation for all who choose to be with us on campus during the fall term. In other words, and I’ll say this as clearly as I can, additional testing in some manner will occur throughout the term and in an evidence-based manner, details and frequency being two of the things we are working on finalizing and being able to announce to the extent that we can in Monday’s announcement. We will also be asking all students to consent to contact tracing, and we are exploring both what I call analog or human-based and digital technology-based approaches. As is the case for all colleges and universities, we recognize that this contact tracing and this testing, this combined protocol, raises very important questions about privacy, which need to be thought through by all of us. And that, in fact, is one of the reasons why I’m pleased to have our alumnus Neal Katyal joining us today.
Fall will be different than a typical term for residential students here and elsewhere. As I’ve said repeatedly at this time, we anticipate that large gatherings, social gatherings, and classroom gatherings will simply not be permissible. At this time, we also anticipate that masks in common areas and the limits on the size of gatherings will be in place certainly throughout fall term. And that consistent with these guidelines, we will be asking students to acknowledge and accept these conditions as a statement of community principles to help ensure we are doing everything we can collectively to support and protect the health of every member of our community. I should also note that we are currently planning for the fall academic term, if I haven’t said this already, to start on time on Monday, Sept. 14.
Now, I share these details this afternoon to let you know the current thinking of the task force and of our leadership, rather than remaining quiet and asking you to wait until Monday’s announcement. But I also share these and ask you to understand that details can change, in fact, between now and Monday, and certainly between now and the time that our students return to campus in September. I know that the outlines of the approach that I have just articulated will elicit many questions. How many students will be back at any one time? Will it differ term to term? Who will they be? How will we decide which students get preference? When will students need to come back? Will they need to quarantine? When and where will that occur? These are many important questions, and these are among the details that we are finalizing and will be addressed again in our final announcement of plans by June 29.
So, let me simply stop there and say thank you again to the Dartmouth community. Thank you to everyone who’s asking such important questions about reopening of research in the laboratories. Thank you to those who have been working so diligently to ask questions about maintaining social distancing and public health protections in classrooms and our research laboratories. Thanks to all of you who have been asking about steps we can take to make the remote learning experience for our students who will be engaging in remote learning either well, physically present in Hanover or well working from home during a remote term in the upcoming academic year as engaging, stimulating, and challenging as possible, and part of a true Dartmouth educational experience. And let me say to the full community, not only do I appreciate your patience as we work through these difficult questions, but your continuing dedication to the learning of our students and the research and scholarship that’s conducted here on this campus to support the advancement of knowledge in society is truly inspiring. So, thank you, and I’m happy to pause and take a few questions before we turn to Joanne Conroy and Neal Katyal to continue the discussion. Justin?
Justin Anderson:
Thank you, Joe, and it’s truly nice to see you today, back in the chair and in front of the camera, updating us and taking questions. The first question that I’m going to ask is really based on news of today, and it’s premised on the news that there’s a large uptick in cases. Before we came on the air, I saw that reported cases today are at the highest number since April. And so, this questioner asks, are there any concerns for the fall plan given the current increase of infections across many states in the country?
Helble:
That’s a really good question, Justin. The best answer I can give, to some of you who know me, I’m data obsessed. I collect and monitor data because it’s important in helping me make my own decisions based on input and recommendations and feedback I’m giving. And I have been tracking infection rates in this country from a variety of sources, and also fatality rates in this country from a variety of sources since early March. And there certainly has been nationally, a fairly noticeable uptick in the number of infections over the course of the past week. Meanwhile, the number of daily fatalities associated with COVID-19 has continued to decline. So, these are two pieces of information that the task force, that our health management working for us, and I will be watching very, very closely. Because there’s so much attention being paid to it, because there is so much conversation about the need potentially in some states to re-tighten restrictions, to reverse trends that are starting to emerge, I’m going to remain cautiously optimistic that given where we are in late June and given that students will not be returning to campus until late August to the early September timeframe, that we can take steps to bring this back under control to a level that we’re comfortable having students return to campus from across the country.
And even having said that, we are intending to put in place the testing and monitoring protocol precisely to be able to isolate infected members of our community very quickly and do our best to prevent them from contributing to community spread. So, it’s an important thing for us to watch. We’re watching the numbers. We’re taking the guidance of state and federal officials quite seriously, and we are also fully cognizant that the situation in four weeks could be different than the situation it is today in either direction, and we need to be prepared to make operating-decision adjustments accordingly.
Anderson:
Joe, given your mention of testing in the open, getting a lot of questions about testing. One question here says, “Do you feel Dartmouth has the capacity to adequately test a high number of people on campus?” And this will be a good question for you to speak with Joanne about, how many tests can D-H process a day?
Helble:
I could answer that question, but I’d rather put that one to Joanne since she will be, she and her colleagues, providing the testing capabilities. So I’ll let her speak to numbers, but the answer is yes, this is something that our colleagues, the joint working group that Joanne and I put in place well over a month ago, these are precisely the kinds of questions that they’ve been addressing, and they are confident that D-H has the capacity and will have the capacity to provide the testing needs that we need to help test and support the health of the community. We will be likely bringing students back over a period of several days, rather than having everyone move in on a single day, and part of the reason for doing that, the details again, to be announced on Monday, are so that we can effectively test everyone as they arrive, using the resources of D-H that will be devoted to supporting Dartmouth in this effort.
Anderson:
Also, Joe, a lot of questions about who will be returning in the fall and beyond. And I know you’ve touched on this multiple times, but I think it’s important to perhaps touch on it again; is thought being given to students who may need resources such as laboratories and machine shops for their research? And then likewise, what about consideration being given to students who might not have access at home to a reliable wifi connection or laptops?
Helble:
Yep. So again, I will say these are the details we are working out. But in terms of broad principles, we are going to give students the opportunity to express some choice in the terms that they would like to be on campus. We will be asking that they do that consistent with their need to access facilities and the progress they need to make toward their academic degree. We will be taking into consideration certainly students’ economic circumstances, home circumstances, ability to travel, and ability to work in an environment at home with perhaps more limited access to technology, as considerations that we will use in deciding when certain students may need to have priority access or preferred access to our facilities.
And so broad brush, we will be indicating preferred terms for different groups of students, but we have not yet finalized those details. That will be one of the two terms. The other two terms, students will be in a position to express choice. The first-year students, however, will be together as a cohort, so we will look to keep all of them here on campus, the same two residential terms to community amongst that class at the very start of their Dartmouth education. And for students who have other compelling reasons that make it important for them to be here at particular times, we are going to be doing everything we can to accommodate those individual needs. I’ll ask the community to be patient and work with us, because I promise you there will be many students who have questions they need to ask, and we will not physically be able to answer all of those in the first few days, but we are going to do our best to work through individual student questions and take individual circumstances into account.
Anderson:
And then, Joe, in terms of when students come back, a questioner asks about on-campus living as opposed to off-campus living and whether or not all students who return will have to live on-campus or whether or not living off-campus will be an option.
Helble:
We anticipate, Justin, that there will be a small number of students who will be living in private housing off-campus. So, we are working on the parameters testing and otherwise for those students, because they are an important part of the Dartmouth and Upper Valley community, and we will be asking them to adhere to the same protocols for students who are living in our living spaces. We are designing this with the expectation that the vast majority of students who are here with us will be living in on-campus residence halls. De-densified on-campus residence halls but living in on-campus residence halls. So, dare I say, the short answer, yes, there will be some students living in private housing in the community. Details will be more fully articulated in the announcement on Monday.
Anderson:
And we have time for one more question before we go to our guests. But before I get to that, I just want to recognize that I’m getting a lot of questions about the status of athletics. And I want to let everyone know that that will be a decision that’s made by the Ivy League, which we are expecting in July. So, more detail and more specifics about the athletic seasons to come by next month. And Joe, the last question is, like the former question about living spaces, a questioner points out the importance of singles, both as a protection from the virus and your ability to isolate as well also as your ability to take online courses. So, the questioner wants to know, is this something that is being considered?
Helble:
Short answer is yes. We are, as I said, de-densifying our residence halls. And although the details will be more fully articulated on Monday, I am comfortable saying today that students will either be assigned to singles or two students to a two-room double where every student will have their own bedroom. So, we are very aware of the importance of students having individual space that is theirs. Very aware of individual students having individual space that is theirs to study, not just to live and sleep. We are maintaining space within our residence halls for quarantine and isolation space as well. We are trying hard to do our best to utilize our facilities in a way that enables us to manage student health through utilization of the facilities. This is one of the reasons why we are de-densifying in the way that we are, rather than trying to maximize the number of students we can house in our residence halls. I’ve said this before, it’s intentionally [inaudible] approach.
Justin, I lost you for a second there. So, thank you, Justin. Thank you for the questions. And so, given that, and thank you all for the questions that have come in from outside. I’d now like to turn to our two distinguished guests, alumni guests, who are here with us today. As I said, we’re joined by Dr. Joanne Conroy, the CEO of Dartmouth-Hitchcock, and Neal Katyal, member of the Dartmouth class of 1991, professor at Georgetown University, and former acting solicitor general of the United States. Neal, Joanne, great to see you, great to have you with us almost back in Hanover on screen this afternoon. Thanks so much for joining
Joanne Conroy:
Happy to be here.
Helble:
Joanne, I’d like to start with a question for you given the number of questions Justin has already put my way about testing. Testing’s clearly, as the questioners indicated, a really important component, not only of our diagnosis of symptomatic individuals, but monitoring and supporting Dartmouth community health. You were asked directly, or I was asked directly and I’m passing it to you, about capacity. And let me expand on that and ask about the kinds of tests that you will use. What can you say broadly about what D-H is doing and then perhaps more specifically about what will be used to support the Dartmouth student and faculty and staff community through Dartmouth-Hitchcock’s partnership?
Conroy:
Sure. We do a nasopharyngeal swab currently. That is really the most reliable way to actually collect the sample for coronavirus. Many people have asked us about saliva testing, but we really have not been able to validate that that has the sensitivity and specificity that we would need.
We can do 1,000 tests a day and we expect to receive a third machine, which would actually expand our capacity to 1,500. You get results overnight, so it’s actually quite fast. And for actually the majority of the students that come back on campus and faculty, there is a way to really create a cadence for testing, so people get their results very quickly. And then can enter into either quarantine or go about their business with the knowledge that at least at that moment in time they were negative.
Now, let me say that if people don’t have symptoms, the test is a snapshot. We do know that there are additional tests that actually we’re doing some research on right now, which is testing a wastewater. And we know that the virus is actually excreted in the stool five to seven days before people have symptoms. So, we’re working with your leadership in order to figure out how we can use that as a surveillance tool. We’re also working with the towns of Lebanon and Hanover, and people are really excited about it. They’ve been doing it in Europe for a long time, and it’s just something we’re integrating into a level of surveillance here.
Helble:
As a scientist and former environmental engineer, although this was not my specific area of expertise, I have to say I was quite thrilled to hear about this development and our ability to partner with you and also with the community to explore this. And so is it fair to say, Joanne, based on what you’ve just said, that we have a protocol in place today that we know we could use and will deploy when students return, but we are also exploring alternate modalities of sampling and testing, which may mean that when the students are in fact here in early September, the protocol and testing modality that we employ is a little bit different than what we envision today, we’re going to take these next two months to make sure that we have exactly the right set of strategies to monitor community health? Is that fair?
Conroy:
That’s true. Actually, the research is starting, I think, next week. So, we think it’s actually going to proceed very rapidly to do a pilot. And then we may have another way of doing surveillance. That’s a little bit more less intrusive than a nasopharyngeal swab. So, let’s put it that way.
Helble:
Thank you, Joanne. So, next, I’d like to turn to Neal now, because some of the things you said raise questions about ... You talked about the potential level of intrusion that some may feel with a nasopharyngeal swab being used to collect sample. And that’s the question of my own personal privacy. So bringing students back to campus in an environment that’s prioritized supporting community health means of course that we’re asking students and members of the campus community to consent to testing such as what Joanne just indicated, and to agree to take protective measures such as social distancing, the wearing of masks in public places, and consent to contact tracing, perhaps even using technology as well as human contact tracers. Many colleges, universities, and private sector organizations are certainly grappling with these same issues. And although you are here in your capacity as an alumnus and a Dartmouth parent, you certainly have some knowledge in this area having argued many major privacy cases, including before the Supreme Court over the course of your career. So how do you personally think about these privacy considerations, about communicating them to students, and the things we will be asking students to in fact give a little on in exchange for the ability to get an education?
Neal Katyal:
Well, thank you, provost. Maybe before starting, I just want to say I’ve never been prouder to be a Dartmouth alum than now, and I’m always darn proud of it, but from start to finish the way that the College has handled coronavirus has been inspiring. I just remember from the very early days I saw President Hanlon give a speech about how coronavirus underscores the real need for a Dartmouth education, a liberal arts education that’s broad based, and particularly with the race relations and Black Lives Matter stuff, that Dartmouth education is so important. And the thoughtful way I think that the College has been going about this underscores this.
I teach at Georgetown Law School. Harvard Law School just did the simple thing and said, “Oh, we’re not going to let anyone back next year at all.” And I think the College, from just watching what’s been going on, has tried every way in trying to balance things really seriously and understand the cost to not having an on-campus experience. And so, what you’re saying today about, for example, having the first years be together as a cohort just moves me so much because if that’s what Dartmouth is about, is trying to keep our community together, even when there’s unprecedented threats.
The way I think about your question is I think it’s often false. There’s a lot of people who say the trade-off is always privacy versus security, and it’s pitted that way as if they’re mutually exclusive. But often, you have privacy or liberty on both sides of the equation. And I think coronavirus is a really good example of that because, if we don’t restrict our students’ liberties in some way, we just can’t open at all as a college. And that’s a far greater intrusion of liberty and imposition on them. And so, for that reason, I think schools have historically tried to balance health and wellbeing with student liberty, and so, for example, everyone’s got to get a certain number of vaccinations before they can attend a college. There’s got to be doctors’ examinations and things like that. And so, some steps, when we talk about testing, the swabs and stuff, seemed to me firmly within that tradition and what we’ve done before.
I think more broadly, as we think about having students wear masks or having certain social distancing, that’s not all that different than schools that have codes of conduct, that bar unhealthy behavior that has externalities or harm to other students. We ban hazing, things like that. Schools do have some ability and should have some ability to restrict absolute student freedom for the sake of the community. And so, I think the question is, what does that process look like? How is it done? Is it done in a slapdash manner, in a thoughtful one? And on all of that, I think it’s gone marvelously well from my external perspective, as both an alum and a new Dartmouth parent. I’m really pleased.
The one other thing I would just say about this is sometimes people say, “Oh, consent, you consent to go to Dartmouth. Therefore, the College can do whatever.” And that, I think, is a pretty mindless way to think about it. It’s true that everyone does exercise a certain amount of volition in going there, but it is different, particularly if you’re already at the College. I don’t think it’s enough to just simply say, “Oh, you’re a senior. You choose to come back, therefore we can do whatever we want as a College.” Because, after all, they don’t fully have a choice to come back. They want to graduate from the College and the like. And so, I think balancing those kinds of student liberty, privacy concerns still are important, and I’m pleased with how it’s been going so far.
Helble:
Thank you, Neal. Thanks very much. That’s really helpful to hear, and it’s always nice to hear perspective of an alum who has a sense to see many organizations and institutions and has helpful thoughts on how Dartmouth has been approaching this.
Joanne, I’d like to turn back to you and just ask a question about how you’ve managed things within DHMC. And we’ve spoken about this before in another context, it was an alumni forum. But I note that in addition to being our testing partner, DHMC is of course the major medical center for the Hanover region. And you attracted some attention, or I’ll say we attracted some attention, for having the first confirmed case in this region several months ago. But since then you have managed this disease extraordinarily well as a community. What did you learn from that first case, or your first few cases, and what steps have you taken to protect patients and visitors as well as your employees that might be relevant to institutions of higher education who are faced with exactly the same need?
Conroy:
That’s a really big question. So, let me first talk about the first case that we had. That was an employee. And I think we’re on the pages of the New York Times and Boston Globe, because they chose not to stay in quarantine. They chose to go to a party. And we learned from that, that, number one, we have to be really explicit with people about what our expectations are when they are symptomatic. And we become very explicit. When you’re in quarantine, you go home and you’re home for 14 days. And we pay you if you’re an employee. We pay you to stay home. And we expect you to meet all the expectations that we give you on quarantine.
What that first patient did, though, which was actually on February 28, is it activated the entire Upper Valley. So, we started canceling large meetings, we canceled many fundraisers. And I’d have to say the Upper Valley community has been a great partner. They’ve taken this to heart. They self-quarantine if they’re ill, they stay at home, they wear masks, they obey all the rules to stay healthy.
However, we have over 6,000 employees here. And we have people coming in and out of the institution all the time. How do you keep it safe for people? Number one, we have a mandatory masking. So, everybody wears a mask, everybody that works here. I’m in my office and that’s the only reason why I don’t have a mask on. If you’re in your office alone, you can take your mask off. The second thing is we know that the virus actually is spread through the mucus membranes of your eyes. So, when you have patient-facing contact, we actually have people wear face shields. And we also have all of our employees really committed to not coming to work if they have a temperature. We monitor temperature and we ask people whether or not they’ve been out of state and whether or not they feel well that day when they come in the institution. But right now, employees know that it’s OK to remote-in, that it’s not a negative to say, “I don’t feel well. I think I’m going to call in for my meetings.” And that’s really helped keep the institution safe.
I can tell you, though, that we have had employees become positive because of community spread. And at any one time we will contact trace throughout the organization and put people that have been close contacts on quarantine. So, I could have 50 to 150 people on quarantine at any time. We’re very aggressive about it. And that’s actually how you stop the spread of the disease, is identify everybody’s close contacts.
I never thought that I might have to tell people, give a list of people who I was with five days ago. You never really thought about that, but that’s the type of contact tracing we are trying to do so we can really isolate and contain any community spread.
Helble:
Right. Great. Thank you, Joanne. So, Neal, let me turn to you for one last question and then we’ll open it up to our audience. I know you’ve done some work around the world in this area, and I just wanted to ask if you’ve seen any organizations or governments do this particularly well. Use contact tracing and testing to manage and eventually reduce the spread of the disease. And if they have, how have they done that while managing to balance the privacy considerations that we spoke about a moment ago?
Katyal:
I’ve been particularly impressed with South Korea. I’ve seen a bunch of briefings from the folks who’ve run the response there. The leader of whom is Dr. Jerome Kim, who used to be a colonel in our army and went over there. And they first had MERS back three or four years ago and learned a lot from that. And I think that there’s three elements to what they’ve done, and they’ve reduced new infections to almost zero, even though they had the first patient the same time we, the United States, did.
The first part is massive testing. They ordered a bunch of tests, they test everyone, and they test them frequently. The second is visitor quarantines, so that if you come into the country, you’ve got to be quarantined for a period of days. I think it’s 14. And then the third is digital tracing. There is stuff on your cell phone, and basically it alerts you if you have been in contact with someone else who has tested positive.
What they found is that actually anonymizing the data helped with digital tracing. That is, people were afraid of being traced, where they were going and things like that. And so, as a result, what they’ve done is hide a lot of personal identifying information so that you get this information and you use it, but it’s not as if it’s big brother using it in some way, shape, or form.
I think all three of those things together have been incredibly important. It was moving to the point of tears to see what South Korea had done in reducing the spread and how they’re able now essentially to function much like the pre-COVID era and compare it to what’s happened in the United States. Certainly, I don’t think the United States as a whole could do everything South Korea did. But a smaller college like Dartmouth, I think, is wise to consider steps that as a government, we can’t impose, but as a small, somewhat geographically or remote private place, I think could. And then the last thing I’d say is, as we think about returning to college in the fall, our students are different now. This is not March of 2020, where this is just hitting and we’re all scrambling to figure out what we’re doing.
They’ve now lived with social distancing for a long period of time. They’re used to masks, they understand the power of masks in reducing the R0, the infection rate and the like. So, I do think while it might’ve been very dangerous to bring some students back earlier. Now they’ve all and will continue to live with a lot of these restrictions even before they get back to campus. And that gives me a lot of hope that this solution will work.
Helble:
Great. Thank you, Neal. So, thanks to both you and Joanne for some great and really insightful answers, Justin, I’d like to turn to you and see what questions our audience is asking of Neal and Joanne.
Anderson:
Yeah. Thanks Joe. And thank you, Joanne and Neal for joining us today. Some interesting questions have already come in, but Joanne, I want to start with a question for you. That’s similar to a question posed to Joe and that’s about the increase in cases across the country. I’m wondering what you make of that and how we in the Upper Valley should think about that, given that our rate thankfully remains so low.
Conroy:
So, our prevalence rate (of positive COVID-19 tests) in the community is less than 2.5% and that’s a positive rate, very, very low. We watch the numbers of positive cases every single day by county. When Massachusetts was exploding, we were watching the southern part of the state. And what’s interesting is we actually did not see a migration of those cases up 93 or Route 3 from Massachusetts, as we expected. I think that what it really gets down to the three things that we already talked about. It’s about managing symptoms and aggressive testing. It’s about contact tracing and it’s about quarantining. And as long as you’re really aggressive about doing those basic public health approaches to keeping the community safe, we believe we can actually contain this.
Anderson:
And Neal, I want to go back to something that you and Joe were talking about, and that is Dartmouth’s ability or right to impose testing on its community. I want to flip that around, based on a question that I got in terms of the rights of students or faculty or staff. And are they able to basically say, “I don’t want a test. I don’t want to be tested.” So how would that be handled?
Katyal:
Yeah, well, I think the thought gets into the realm of the law. I’m really only here in my capacity, more an alum and kind of scholar. So, I suspect that there may be some challenges that someone might want to bring it to some college or university that did that. I would hope here though, that folks recognize that the community’s health in this unique pandemic depends on everyone doing their part. That means everything from submitting to testing, to possibly digital tracing, to as Joanne was saying, don’t come to work if you’re sick or don’t come to class, if you’re sick or got a fever or something like that.
I can’t underscore enough that the successful models around the world like South Korea are ones in which people took that community responsibility really seriously. And again, that’s what gives me hope, because if any place can do that in this country, even though we’re so divided on so many things, it’s Dartmouth with its shared sense of community and respect for one another. So, there’s the legal or rights question on one side, but there’s also just what’s prudent and thoughtful as a member of a community on the other.
Anderson:
Joanne in terms of testing, someone writes in to ask whether or not the test results will be private. If and when someone tests positive, who is informed of that, and then just sort of more broadly, are you doing research right now that might involve some of these tests of community members?
Conroy:
So, let me answer the second question first is, I think we submitted about 25 proposals between March and the end of April to do COVID research. It’s not just research on the numbers because I think a lot of people are looking at that, but we have a number of people looking at and working with the people that they’re to kind of look at may be overnight at-home testing and what it would take to pull that off. And working with companies to commercialize it.
So, the whole area of research and testing is moving very quickly. We also do antibody testing here and so we can do serology. We do a lot of work in all of that space. In terms of, I don’t know what the College is going to do with the test results. I can tell you that when somebody is registered as a patient and they’re assigned into my chart, because of patient privacy, HIPAA issues, they get their test results and that becomes their healthcare privacy responsibility. I don’t know what the College has arranged with the students to have them then self-report back to the College, but it is owned by the patient, the individual owns their test result.
Anderson:
Neal, back to you, just building off of what you said about the great job that South Korea has done in sort of managing the outbreak. Have you seen or do you know of any examples in this country of institutions of higher education or just institutions in general that have had similar luck by approaching it either in a way that South Korea did or in a sort of a modified approach?
Katyal:
Yeah. Nothing yet because I think the country’s just starting to reopen, so we don’t have very many models. I mean, we can look at, I guess, hospitals and how they’ve managed because they’ve had to stay open or Amazon or something like that. But nothing to my mind has been tremendously moving or have enough data on. The one thing I’m very optimistic about is the Notre Dame plan of bringing students back earlier, starting there a couple of weeks before I think maybe August 20 or so. As opposed to their normal start date in September, ending school before Thanksgiving. Notably, that’s exactly the Dartmouth plan already in terms of ending school before Thanksgiving. So that gives us, again, I think, a unique structural advantage over some of our other institutions. It sounds that’s something that the College is leveraging a bit and as they think about the solution.
Anderson:
And Joanne back to you with a specific question based on something you said earlier about the wastewater treating. Which I think that possibility is interesting and a viewer writes in to ask how targeted can that be, would it be, you would be able to determine if it was a specific residence hall, would it be that or could it be potentially that specific?
Conroy:
Well, we’ve been working with a college and our research team is delighted to find out that we can actually target residence halls at Dartmouth, which is great. As we work with the towns, there are certain ways that the wastewater effluent actually enters into the treatment facility. And sometimes it’s not that specific. So, we have a real opportunity here to really identify if there’s a residence hall that we need to kind of put on quarantine. I guess the challenge is how do you make quarantine cool for these students? Because I don’t know, sitting in my dorm room for two weeks is not too cool. So, we’re going to have to figure out how to make quarantine cool for these students.
Katyal:
It’s not Harvard, we’ll figure out a way to make it cool.
Conroy:
That will be our challenge.
Anderson:
Yeah, Neal, so how do you make quarantine cool? That would be my question to you.
Katyal:
You’re asking the uncoolest guy in the room.
Helble:
Justin, I think the answer is obvious, just huge volumes of homework, wouldn’t that be cool?
Anderson:
Right. Right. Right. Right. Well, we have time for one more question and I’m going to go back to the cool guy, Neal, with a question about digital tracing. So, we’ve talked a lot about digital tracing and cell phones. What does that actually mean? How do you do that successfully? What are the options for digital tracing?
Katyal:
Let me give you an example, Dr. Kim gave me and some others. So, everyone has to download this app on their phone, and you bring the phone with you. And one person brought the phone to a bar in South Korea and came out of the bar and four days later got a notification that someone else in the bar, within 15 minutes of him being there tested positive for coronavirus. That person then went and got tested and turned out the low and behold, he was along with I think 59 other people from that one person who walked into a bar who had coronavirus.
But they were able to take those 59 people and then isolate them and quarantine them for 14 days, reducing the further spread. I think there was a little bit of spread after that, but I think it was under 200 total cases. They compared that to another situation in which the digital tracing didn’t work, that another nightclub and one person actually resulted in at least 6,000 cases that they knew of. So, by using this technology and I understand people are worried in this country, in any country about giving that information or allowing, enabling an app like that. And it could be abused in all sorts of ways.
But again, it’s a pretty different thing from a government doing it and a private entity like Dartmouth doing it. Particularly if, as I understand from my conversations with the provost, they’re committed to that information being anonymized and restricted to really only those who need to know it for an absolute community health rationale.
Anderson:
Thank you for that, Neal. And thank you to both you and Joanne for taking the time to join us today. That was really interesting and quite helpful. So, thanks a lot for joining community conversations. Joe, before I go back to you, I just want to comment on a question we got about the Monday announcement and whether or not it would be in the form of a community conversation or in the form of an email? I just want folks to know that it will be a message to the community that will be delivered over email. There will not be a community conversation on Monday, but (in) future community conversations I’m sure we’ll be dealing with the fall and the year that follows. So, we look forward to those conversations. So, Joe, I’m going to go back to you.
Helble:
Great. Thank you, Justin. And that’s absolutely right. We will take a pause, I believe, next week in the community conversation to give people time to formulate questions associated with the written announcement that will go out Monday, which is going to be highly detailed. We anticipate being back on Wednesday, July 8, to continue the conversation. So, thank you again, Justin, for moderating and for relaying such helpful and insightful questions. Thank you to our guests, Joanne Conroy and Neal Katyal for a great discussion about both work in your sphere and some of the broader issues that are so important to us as we lead up to this announcement and move forward to reopening Dartmouth to undergraduate students in the fall.
I have to say, I’d like to close just with something you said, Neal, right at the end. What gives me hope and encouragement is this shared sense of community and the respect for one another, that Dartmouth, Dartmouth students, Dartmouth staff, Dartmouth faculty, and the local community share. That leaves me excited by the challenge in front of us and the opportunity to reassemble the academic community here in Hanover this fall. So, thanks to everyone. We look forward to sharing the announcement with you on Monday. Keep the questions coming and we will look forward to being back with you again for another community conversation soon. Take care, be safe, and have a good week everyone.
