Joseph Helble
Welcome, everyone to your 23rd Community Conversations addressing planning, response, and operations in the time of COVID-19. I’m Joe Helble joining you from the Starr Instructional Studio in Berry Library on Wednesday afternoon, March 3, 2021.
I’m joined today, as always, by Justin Anderson, our vice president for communications, from another studio on campus. Justin and I are joined by three guests who are regular participants in Community Conversations—Lisa Adams, MD, from the Geisel School of Medicine, co-chair of Dartmouth’s COVID-19 task force and a specialist in the care and treatments of infectious disease, particularly tuberculosis. Josh Keniston, VP of campus services, vice president of institutional projects, and the other co-chair of Dartmouth COVID-19 task force.
Joining us for the first time is Mark Reed, MD, the director of Dartmouth College Health Service, known, of course, as Dick’s House, and an assistant professor of psychiatrist of the Geisel School of Medicine. Mark has been a member of the Dartmouth faculty and staff community for 30 years.
We will follow a regular format today with a brief campus update, a live Q&A moderated by Justin, a conversation with Lisa, Josh, and Mark, focusing in particular on the current status of our campus operations and planning, and then we’ll end with an opportunity for them to answer your questions directly.
My focus today will be almost on entirely to news pertaining to campus and community health, and specifically, the number of COVID cases that I suspect is on the minds of most members of the Dartmouth community, whether you’re here with us in Hanover, or far from the Upper Valley and tracking things on campus through our dashboard and through community correspondence.
Two weeks ago, in our last Community Conversation, I noted that we were just three weeks from the end of winter term classes for most Dartmouth students, and that a successful winter carnival was about to enter its third and final weekend. I noted two weeks ago that our positive test percentage or positivity was 0.02% over recent weeks for employees and students combined—an extraordinarily low level, and quite likely the lowest level for any research college or university in the country. Since then, and in fact, since early last week just over the past seven or eight days, our local story has of course changed significantly.
As of Monday, Feb. 22, we had one active local case reported on our publicly available COVID-19 dashboard, meaning one student in isolation, locally confirmed positive test. Two days later, by last Wednesday morning, that number had increased to 19 students. By the weekend, it had surpassed 100. And as of yesterday morning, the number was 138 confirmed positive student cases in isolation on campus.
All of this is a reminder of how rapidly infection can spread, if we let our guard down. All of this is a reminder of why we are constantly asking everyone to keep socially distant, avoid group gatherings keep masks, wash your hands, utilize the outdoors and avoid close personal contact, particularly, avoiding social gatherings, where you are unmasked in close proximity to one another, maybe even speaking loudly to be heard, maybe even eating or drinking—the perfect environment that promotes aerosol formation, a sure way to spread the virus. Report after report from around the country the past six months has shown that on college campuses in particular, it is social gatherings, it is parties that caused the disease to spread rapidly through the student community. And this is a stark reminder that data over the past week in the trends here at Dartmouth, that the laws of physics and here and in this context, I mean, how infection spreads are no different, on our campus, than on any other.
If we wish to have a successful close to winter term and a successful spring term, there is no other way—mask socially distance, wash your hands frequently, test regularly, avoid large social gatherings particularly indoors. And this advice, this guidance, this request is true, and it is necessary for everyone in the local Dartmouth community, not simply those students living in residence halls on campus. Again, if we are going to beat this disease and reduce our case counts on campus and do so quickly, there is no other way.
One of the reasons we have a twice-per-week surveillance testing program, which will continue throughout the spring, and I will note, which we will be supplementing with antigen testing during spring term with details to be announced later this month, is to enable us to detect infection quickly and take operational steps as needed to reduce interactions and reduce the potential for spreading the disease within the community.
This is why we shifted dining to grab-and-go dining only, as soon as we saw the initial increase last Wednesday. This is why we progressively but quickly, closed the gym and the library, shifted learning to online only, and returned to quarantine conditions that prohibit any indoor gatherings. While it remains too early to consider lifting any of these restrictions, I can report that after our seeing and reporting 40 new cases on Saturday, we reported 19 on Sunday, and for the three days since, Monday, Tuesday, and this morning Wednesday through this morning, we have averaged 10, new cases per day.
This slowing of the number of new cases is an encouraging sign. And it’s something we will, of course, continue to monitor closely over the next several days. We will announce by Friday mid-day whether closures that are presently in place will remain in place throughout the weekend, or perhaps longer.
Now I recognize that many would prefer that we announce now and today what Dartmouth’s operating conditions will be through the end of classes on Wednesday, March 10, or even through the conclusion of exam period on Wednesday, March 17, but we are going to continue to take this day to day, and have our decisions informed by the latest numbers. If the number had spiked today, we were prepared to announce a continuation of restrictions beyond Friday, but thankfully, this has not occurred. A slowing of the new case number of new cases, I will say again, is a very positive sign. And if it continues, we will be able to consider stepwise lifting of restrictions. But again, for now, we are going to await any decision, until we have the next two days of testing in front of us.
Our numbers in the context of our peers are illuminating. Overall, from the beginning of the pandemic and from the beginning of our testing program last July, Dartmouth has now conducted over 134,000 tests with an overall positivity of 0.20%. If we separate out and look at only data from calendar year 2021, as of yesterday, Dartmouth conducted over 70,000 tests in 2021, with an overall positivity, of 0.31%.
Over the past week and a half, however, through yesterday Dartmouth conducted nearly 12,000 tests. 11,956 to be precise with 145 positives in that period, and overall positivity of 1.2%. These overall numbers are of course an important factor in decisions we make about campus operations.
But as I indicated a few moments back, it is the day-to-day changes that are particularly important. Now, a brief note about the overall positive case count on our dashboard. Because the significant increase in cases began the middle of last week. And because individuals who test positive or moved to isolation for a period of generally 14 days, we do not anticipate a large decrease in the total isolation and quarantine numbers reported on our COVID dashboard, until early to middle next week. What that means most likely is that the totals will continue to increase.
In terms of trends on other campuses or other peer institutions are in fact seeing similar behavior during early 2021. For our Ivy peers reporting data for the year 2021, all of our Ivy peers lie between 0.17% and 1.1% positive. Our overall level of 0.31% for 2021 is therefore in the low end of this overall range, but there are four Ivy campuses with rates lower than ours. And just a week ago, we were by far the lowest among this per set. It shows you and shows us how quickly things can change.
Our NESCAC peers, all who are now back in session and testing regularly, are reporting positivity rates from 0.04 to 0.22% for calendar year 2021, and our local state university peers. UNH and UVM, and also UMass and the University of Connecticut are seeing positivity rates for 2021, ranging from 0.38 to 1.4%.
Now within this overall context, clearly Dartmouth is not an outlier. We are no longer the lowest among our peers, but we are within the ranges seen. Our testing data the past two weeks are in the high end of the range, however, and this is not where we wish to be. This is not where we should be, particularly in light of how extraordinarily well we did a keeping infection rates were among the lowest in the country, I will say again, up to about 10 days ago.
And while the overall health of those students in isolation remains relatively good with no one requiring hospitalization so far that does not mean that people are asymptomatic, and that does not mean that there cannot be lasting effects. I’ll ask Dr. Mark Reed more about this in a few minutes and you’ll certainly have a chance to ask questions of him yourself later in our segment.
While all indications are that this outbreak has remained within the student community it’s not a stretch to say that many in the local community, including community members who work to support our students on campus are concerned about the significant change in dynamic this past week. We are not out of the woods. I cannot say strongly enough that each of us always needs to be thinking about one another and looking out for one another. This disease can be unforgiving. Many in our community have been affected by it. Some have lost family members, too. So, I will say again what I have said here so many times—we need to be mindful of the health and well-being of our entire country. That means our students, undergraduate and graduate alike. That means our employees. That means our local business owners, that means our local residents. That means everyone
Now, to help our students through this period where we are asking all students living on campus to remain on campus, we have gotten student requests over the past two days to make some form of late-night food available to help sustain them in their late-night evening studies in their room. Thanks to Campus Services and particularly Dining Services, I can announce that starting Friday, March 5, two days from now, ’53 Commons will be open late at night for grab-and-go food. The hours will be 9 p.m. to midnight, again beginning Friday. This will continue through Tuesday, March 16, seven days week.
Looking ahead, our plan remains to start spring term as scheduled on Monday, March 29. Achieving that opening requires us to bring this infection, under control, quickly, so we have ample time to clean into turnover and prepare residence hall facilities for students before spring term move in can begin. Our plan remains to offer ample outdoor opportunities for the Dartmouth community come spring term as well.
While it won’t quite have the ring of embracing winter, and I’m open to suggestions as to the best way to characterize the spring outdoor opportunities, my colleagues in Campus Services and the Dean of the College area, including Outdoor Programs, are planning things like tents for outdoor socially distance gatherings, and perhaps even a session of a class or two, nine-hole disc golf course; e-bikes being available for student use, boat rentals at Ledyard Canoe Club, guided hiking and outdoor exploration of the local area, equipment for a range of lawn games, and even firepits continuing with Adirondack chairs scattered about as part of Collis Outdoors. These and more will be described in more detail in a few weeks, as we get closer to the start of spring term.
And finally, we continue to look forward to holding an in-person commencement in June. Commencement as it has been announced will be graduating students only, but it is an in-person ceremony, nonetheless. Achieving that however means a return—a sustained return—to the low positivity rates we saw prior to Feb. 22 of this year. Commencement is being planned, but it is not a guarantee. This is in our hands, as a community, to make this happen. And I believe we will make it happen as long as we maintain our vigilance and continue taking the steady measures and the safety steps that we know are effective to stop the spread of the virus.
Now let me end by saying, I know how hard everyone has worked. I know that the vast, vast majority of our students on campus and in the local community have taken the restriction seriously and are always masked when heading out or avoiding social gatherings and are doing all they can to support the health of themselves, their peers, their neighbors, the local merchants in these towns. And I also know that everyone, and I mean everyone, is exhausted. I see it in the endless Zooms. I hear about it in emails from faculty and staff and students and families who are doing all they can to support student education or continue in their own work. And I hear it, of course from our alumni who hear it from their friends and from the students they themselves know.
We are close, we are oh so close to seeing that light at the end of the time. National case counts are down to under 60,000 new cases per day, a level we have not seen since mid-October, a large number but a far cry from the 300,000 peak we hit in early January. A third vaccine has just been approved, and the federal government has stated it expects to have 300 million doses available by the end of May. We are so close, but we cannot, we cannot let down our guard.
To all of you who are doing the right thing, thank you. I remain confident that this community can come together and support one another and have a successful close to winter term and a successful spring term, but it is going to take all of us, each and every one of us being attentive to the policies and procedures to the rules, looking out for one another and taking the steps we need to take to protect the health of the community and. Thank you, and Justin, over to you to take any questions.
Justin Anderson:
Thank you, Joe and great to be with you as always. Today, we have a lot of questions coming in about the vaccine, about Dartmouth’s plan to get community members vaccinated, so we can save most of those for Lisa Adams. However, there are so many of them, I would like to address one to you, particularly because it sort of gets at how you ended your remark and the fact that we are so, so close.
I guess the question is, based on what I’m seeing, you know, how close are we? If we think that by the end of May, as President Biden said there will be enough vaccine for every adult in this country to be vaccinated, does that mean that sophomore summer will be looking like sophomore summer’s pre-pandemic? So, how close are we returning to normal given there is a reasonable expectation that prior to the start of summer we will have enough vaccine for all of those who are interested and able to get those shots in their arms?
Helble:
Thanks, Justin. That is a good and important question. I have to say while I am extraordinarily pleased by the announcement and heartened by the trajectory, 300 million doses being available does not mean 300 million shots in arms. It does not mean 300 million people have been vaccinated.
If the vaccine has been manufactured by that point in time allowing time for distribution and actual vaccination, I think it’s going to take us some time after that. And so that that marker of 300 million by the end of May makes me reasonably optimistic about what the fall term will look like. But I think, given that it’s likely, quite likely that Sophomore Summer will be a term of transition.
I am hoping that we will have had enough vaccination among the campus community, and among the student population that we can move towards a much higher percentage of our classes being offered in-person. We know that summer term, even with the increased demand that we are seeing for summer turn this year, we’ll be at less than full capacity because of the number of students who choose to take courses during the summer. So, I anticipate that less than 50% of our student population will be interested in living on campus this summer and I’m confident that we can accommodate those numbers in our residential facilities.
So, will it be a normal sophomore summer? The number of students on campus will feel the same as it does during a normal sophomore summer, but the number of in-person interactions, the number of in-person classes, the social activities that are a typical part of sophomore summer will likely not be a typical level, not until we have the vast majority of our population vaccinated.
Anderson:
Joe, because we have so many questions tailormade for Lisa and our other guests I’m going to ask you one more question and we can go to the guest segment. A parent writes in and this is a really important question, a parent writes in and says that her student still doesn’t feel comfortable speaking on Zoom during class.
It just makes me reflect on the fact that we have very quickly taken Zoom for granted and it has very quickly become standard operating procedure, and the norm, but the reality is that it is not the norm. It is the not what most of our students signed up for when they applied to college years ago. They did not think they would be going to college and taking class by Zoom, and so how do you think about that as the provost as you think about what we are asking of our students during the pandemic? We have asked them to sort of change the way they experience classes and so, how do you think about that as the provost and as an educator?
Helble:
That, Justin, cuts to the core of what we have been trying to navigate the past year. We have worked with DCAL, the Dartmouth Center for the Advancement of Learning, to try and survey students and faculty alike and get a sense of the student experience through remote learning. And as those of you who know me, have often heard me say things along the lines of life is a series of probability density functions or life is a series of distribution functions. There is a spectrum.
There are some students, I have heard from the students and also faculty, students are more willing to engage in conversation in a Zoom format than they are in the actual classroom, because it is more structured and orderly, and it works better for them.
There are also students, just as the student you described, who feel much less comfortable engaging by Zoom and find it hard to find their voice and express their view in that setting. There are ways to do that, of course, in the Zoom context if you are not comfortable in speaking up, there is the chat function, one can e-mail the professor in advance, but there, the best advice I can give because this is going to be individualized is to, A., reach out to the faculty member at the very beginning of the class and talk about ways that you think might enable you to participate more fully in the classroom or make the faculty member aware so he or she can reach out the student with some suggestions.
And number two, particularly as we turn to summer, where we’re hoping to increase the number of in-person courses, is to seek out those opportunities that are in-person, to seek out potentially an independent study opportunity that could be taken for credit and be done on an in-person basis.
I am quite hopeful that we have two more terms of this, that fall is starting is going to start to feel much closer to a regular Dartmouth term with more, much more of the curriculum being offered in person, and of course that’s not a promise, it depends upon so many things, including vaccination and disease progression.
But I’m hopeful that students like the student you described can make their faculty or their undergraduate dean, if they are not comfortable going directly to the faculty, aware of their challenges and work with them to see if we can find a way to draw those kinds of students into the conversation.
We want every student to be able to participate in the dialogue. We want every student to be able to contribute to the work. That’s the core of a Dartmouth education and I hate to think that after a year of this technology is presenting a barrier and we haven’t figured out how to help some students find their voice and express their voice, because we’re limited Really, really good questions. Thank you for bringing it up, Justin.
Given the questions you’ve had come in, let’s turn to our guests now I have a few questions that I’d like to ask each of them, and then we will open it to our audience. So, Josh, Lisa, and Mark, great to have you with us. Wonderful to see you all. And you know what the topic of the day is given the events of the past seven to 10 days, there is great interest in speaking about operations, epidemiology, and student health as I gestured to each of you on the screen.
So, let me start by asking a few questions of each of you and then I’m going to turn fairly quickly to Justin. And if you don’t mind, Lisa, I like to start with you given the very rapid progression of cases on this campus, it’ll be no surprise to you when I say that I’ve been asked several times this past week whether the rapid increase is due to the presence of one of the more virulent, one of the more infectious variants.
Lisa Adams:
Thank you, Joe, for this question. This is certainly the question on everyone’s mind. And the short answer is that yes, it is highly likely that what we are seeing is an outbreak of a new variant in our communities and is most likely the B117 strain that originally was identified in the U.K. Now what makes me say this? Well, first we know that the B117 variant is much more transmissible. Specifically, it has a higher R0, which you and our viewers will recall is that measure of how many new cases one infected person generates. The estimated average R0 for the original SARS-CoV-2 was around 2.6.
So, with a 50% increase in transmissibility, R0 for the more infectious variant in the same situation would be around four, and the high rate of transmission in our community seen by the high rate of contacts who are testing positive, and the somewhat explosive nature of this outbreak suggests that this is a virus with a higher transmission rate.
And the second reason that leads me to believe this is the B117 variant is that we know it has been in the U.S. since at least early January. It was first reported I believe in Minnesota on Jan. 9. And we know it is in New Hampshire, and the predictions from the CDC director among others have been that this variant will be the predominant strains circulating in the U.S. by March. And here we are on March 3. So, we are in touch with our Dartmouth-Hitchcock Medical Center colleagues and the New Hampshire state lab to explore testing to sequence one or more of our samples so that we may have confirmation in the coming weeks on a surveillance level, not necessarily an individual patient level that our hunches are indeed correct.
Helble:
Thanks Lisa so if I can follow up on that with just another question or two. So, you mentioned that a surveillance level so could you expand on that just a little bit? What does that mean? Would we be sequencing every positive would it be a subset, just looking for statistics and I gathered, that means individual students would not be identified?
Adams:
That’s correct. So, the New Hampshire state lab is approaching this on a surveillance level, and they have very specific criteria which actually none of our students’ situations. So, it has to be there has to be recent international travel or recent vaccine, some other criteria that push a sample up into the, let’s get this one sequence list. So, they are doing that on the surveillance level.
What we will try to do is work with Dartmouth-Hitchcock and the clinical lab to sequence, a just a subset of our samples. Again, I think it’s more important for us to know that this is the virus that circulated rather than whom it belongs to that. I think for our epidemiology and, you know, disease control interests are, why we will be doing this.
Helble:
So, let me ask one last question before I ask questions of Mark, and Josh. So, can you answer that question from an epidemiological perspective but what about managing the campus—would you and the taskforce be recommending to me any different actions, if we found that the variant was present?
Adams:
We are already behaving as if in the variant circulating our community, so the short answer is no. We would not change anything we are doing. However, this is a good time to reiterate, and I think this serves as a painful reminder of why we need to double down on our masking, our distancing, and our avoiding gathering together as much as all we want to do so. This is a time as Dr. Tony Fauci said to keep our foot on the accelerator.
Helble:
Thanks, Lisa. So, following on that Mark, I’d like to turn to you now from moving from the level of epidemiology, starting to ask about the individual student health situation and individual student care. So firstly, just comment briefly on the role Dick’s House plays in supporting student health during the pandemic, and particularly those who are in isolation and quarantine but also more broadly supporting student health during the pandemic.
Mark Reed:
So, like so many offices on campus, we are doing this on top of our regular work. And so, it’s an extra, you know, the Student Wellness Center, the Tucker Foundation, the Employee Wellness Center are all reaching out and figuring out ways to support our students, faculty and staff both locally and at a distance. At the health service, we are primary care. Our nursing staff and sports medicine team huddle every morning and make a plan for the day. We get our positive students. We do contact tracing. We reach out individually, by phone every day to contact the students who are in isolation and quarantine. Our nurses and primary care staff have made house calls and delivered things that they need. Thanks to Josh’s staff and facilities and engineering we now have a space adjacent to the health service that has great ventilation even negative pressure so it’s a space where we’re able to evaluate and test symptomatic students. And then from a mental health and counseling aspect, things are being done, virtually, and while we have half of our students on campus, the other half are spread out nationally and globally and figuring out ways to reach out to them. So, we’ve been creative and innovative—doing workshops, podcasts, groups doing consultations, and really any students that have urgent needs working with them until the crisis is over and getting them connected either locally or at a distance.
Helble:
Great, thanks. Let me build on that and ask you a follow-up question as well. I realize you can’t comment on any specific student or group of students, but I have gotten many questions in the community mostly by e-mail or the occasional person I’ll see masked in town on the overall health of our student community. Can you give us a sense of how the students in isolation and quarantine are doing? As I mentioned earlier, we have not seen anyone from campus hospitalized, is that correct and more broadly, how are they doing?
Reed:
So yes, thanks. Most students have mild disease, some have moderate, but locally, we have had no students who need to be hospitalized. Having said that, it is not easy for student to be in isolation or quarantine. They’re lonely. They’re separated from their community. It is tough. They are separated from their belongings. The students in quarantine can go for solo walks. The students in isolation are really stuck in the building. So, we reach out and communicate with them daily and provide any support that we can but it’s a tough 10 days for them.
While we haven’t had any students hospitalized what we started to see recently is some students are presenting with long haul symptoms. Symptoms like, fatigue, brain fog, persistent loss of smell and taste, and even some autonomic symptoms where if they try to exercise their heart rate builds up, and you know that those are disturbing. Those students had mild symptoms when they had COVID. We’ve been working really closely with the DHMC they just started some long-haul clinics. We’ve been working with specialists there and in caring for these students but unfortunately you know we’re starting to see a bit of this, and we expect to see a bit more in the coming months.
Helble:
If I’m remembering correctly and this is getting outside of my field of expertise, but this is not atypical for certain classes of coronavirus, is that correct? There is literature that has shown that with other coronavirus-driven infections there are these long-haul effects that could persist for potentially years?
Reed:
Yeah, our young healthy population, are pretty protected against serious disease, but not protected from this. Literature shows up to 10% of people can experience something like this, so that would be a fair number of people in our community.
Helble:
I use that to make the point once again that I have been making frequently, so for everyone, including the young, healthy members of our community, masking, social distancing, hand washing, avoiding large groups and regular surveillance testing essential. These are the tools we have to keep the community healthy. Thank you, Mark.
Josh, I would like to pivot to you for a few questions if I may. Your team is providing critical support to the campus infrastructure from maintaining the buildings and maintaining the grounds to overseeing the delivery of food to removal of trash and custodial support. I know that work had shifted dramatically in terms of deployments of personnel and managements over the past seven days, but what can you tell us about it? How have things changed?
Josh Keniston:
We work closely with Mark’s team at Dick’s House to understand who’s going where, we need to know who needs to go to quarantine, who needs to go to isolation. We have members of our team that have with transport that are specially trained with PPE and the vehicles they need to use. As we have seen the case count increase, it’s meant that we have needed to activate buildings that we haven’t had to activate yet. So, as we activate more buildings to create more space for quarantine and isolation, it means our team are having to support those building, meaning they have to get in there and make sure they are ready, make sure they are clean. Our dining team, we switched to grab and go, which is always painful for us. We love to have people be able to dine in with us. It is one of our favorite things to offer the wide selection, but ultimately, we are here to provide quality food and make sure everyone is fed, so we really pivoted to grab and go and to doing the deliveries. I think it is not a small task to make deliveries several times a day with people coming in and out of quarantine and isolation, so our teams have been flexible and have stepped up to help support everyone and make sure that we can do the best that we can to help ease the quarantine and isolation process.
Helble:
And as part of that, I have to thank you and your team for moving quickly after we got input from students to set up the grabbing go option that will starts at ’53 Commons that’s going to start Friday night. Any particular challenges you anticipate there, or do you fully think you’re going to be up and running at 9 p.m. Friday night as announced?
Keniston:
Yeah, we’ll be good to go. There was a period of time there where we’re trying to figure out exactly how big this was going to get, I think you know the encouraging news that we, we saw today in terms of compared to what we had been seeing relatively smaller case counts. We feel confident that with the staff we have that we can get that back open and provide that service again.
Helble:
That’s great. Thank you. Lisa, I would like to turn to you for the next question. This came up in the question that Justin asked me, vaccine deployment is on everyone’s mind, mine certainly as well. Do you have any insight in terms of when the J&J vaccine will be available in our area and how that will affect overall availability in the Upper Valley?
Adams:
Sure, let me say, begin by saying more broadly that we don’t roll out a vaccine in New Hampshire has had its challenges as I think it has been the situation in every state across the country, but I do know that New Hampshire’s registration system has been improved in its weekly shipment of vaccines has increased and those are all positive steps.
In my own experience and all that I have heard from others once you get that appointment it’s actually a rather smooth and swift process after that. So, just in terms of coverage, New Hampshire has administered over 330,000 doses statewide and over 100,000 of those have been the second dose.
So that’s over 20% of the population with at least one dose and about just over 7% with two doses so overall that’s on par and in some situations even better than the national average. So,
This is all you know again great progress, New Hampshire is now nearly done with its phase one rollout so all long-term care facility residents, health care workers, first responders, all those individuals should be vaccinated by now, and they’re beginning to work through their Phase 1B, which targets primarily those 65 and older and the medically vulnerable. And now they’re beginning to start their Phase 2A slated for early April, maybe be sooner now, which includes staff of daycare centers and K-12 schools.
So, in terms of the J&J vaccine approval, this is great news and New Hampshire is going to start administering its first shipment of about 11,000 doses of this vaccine on Saturday, in the Concord area. And, as I understand, this will be for those still in the 1A phase that haven’t been vaccinated yet and certainly in the 1B phases. So, I think you shared too that naturally J&J has pledged to provide the U.S. with close to 100 million by the end of May and when we combine that with the 200 million doses from Pfizer and Moderna the vaccines that are slated to arrive in the same timeframe there will be more than enough vaccines to cover every eligible American adult who wants one. So that is more good news. The fact that we now have three highly effective vaccines, is, is just tremendous. And I love what I heard a colleague say when asked, well, which is the best vaccine to get. The best vaccine is the one that you can get. I really want to highlight that but if you have an opportunity to get any one of these three vaccines—take it.
Helble:
Thank you, Lisa. I think that is hugely important and something we want to repeat over and over again. It is an important reminder. I have heard many colleagues debate, Moderna, Pfizer, J&J and I have echoed you to get the one that you can get as soon as you can get it. Thank you. Let me turn both to Mark and Josh for one quick final question for each of you and then we will open it up. Mark, I want to turn briefly to the subject of mental health, community mental health, but particularly student mental health. Many mental health professionals have reminding all of us that the mental health challenges are a very real part of coping with the pandemic, and this is for everyone, not just for those who are diagnosed with COVID. What do we see mental health-wise among our community and how are we and how are you and your colleagues responding to the mental health needs of the community in the midst of this pandemic?
Reed:
As people have alluded, it has been a challenge. For me, one of the main signals of wellness and strong mental health is a degree of connection that people experience. One of my favorite questions is, who you feel most connected to, who can you talk to about this?
For me, that is the main reason we’re open as a campus. There is this significant tension that we have between supporting connection between the local community and for our community that is global and national and then keeping people safe and we’re feeling that acutely right now with this outbreak.
Our students are experiencing a lot of things and they’re all struggling to one degree or another. People are experiencing loneliness, fear, disconnection, worry about their own health, worry about loved ones, grief or loss of loved ones, financial concerns, what’s going to happen, about internships and jobs—all this is happening in the midst of a sort of a national crisis around social justice issues. While we’re all experiencing this, our communities of color communities with less financial resources, our communities with less access to healthcare are experiencing this more.
And so, you know, we’re reaching out for the students in isolation and quarantine, our counselors are reaching out to them as soon as they’re admitted there and will provide appointments the very same day. You know, thanks to you and to Kathryn, in the midst of a hiring freeze we are in the process of increasing our counseling staff by 50%. We were going from 10 to 15 clinicians. We’re at 13—we have two more searches that are at the tail end. Seven of our 13 staff are people of color. It’s a quite a diverse staff that’s doing more outreach than ever and figuring out ways to connect with people both locally but also to support our students who are away from campus, you know, and their stressors to be here and even more stress or sometimes to be away from campus.
Helble:
Yeah, thanks and kudos to you and Heather Earl for moving that process forward and bringing some extraordinarily talented people to our campus that was in a commitment was important for the institution to make because it’s clearly critical to community health so thank you, Mark.
So, Josh let me, let me turn to you and ask you a really easy question to wrap this up before I turn it over to Justin to ask you questions. You know I’m a fan of the ice rinks. I’ve been speaking about the ice rink since November/December. I even got finally to experience the ice rinks myself. And then it’s gotten warm, and they’re now currently closed and of course our students are not able to access them because they’re restricted operating conditions. What’s the prognosis, Josh? How long do you think we’ll be able to keep them open or is it time to look ahead to next year?
Keniston:
We would love to keep them over through the end of the winter term, but we will have to see whether or not we can open up the quarantine that we have in place now and we need Mother Nature to cooperate. Next week is looking like highs in the 40s and 50s, which is not great for the ice. So, we’ll see. We are trying to be optimistic, but the weather is not looking great.
Helble:
Well, thanks. I may ask you about its in two weeks, but thanks, Josh. Justin, welcome back.
Anderson:
Thanks, Joe. I’m going to go right to Lisa with questions about vaccinations. As I said, there are a lot of questions. I’m going to start with a pretty basic one, which is Dartmouth’s plan for vaccination? Should we expect just as Leverone and Thompson have been converted into testing hubs, is there going to be the same type of situation for vaccinations? Will there be a Dartmouth plan or is it going to be something more involving outside health providers that would be providing the vaccine? So, what is the plan?
Adams:
So, lots of great questions in there and I want to reiterate, too, that we do remain eager to supports opportunities for all of our student, faculty and staff to get vaccinated and prepare to help distribute the vaccine when we are in a position to be able to do so.
So, we are in discussions with the state and with Dartmouth-Hitchcock Medical Center, because we would be a site under the medical center to become a POD, a point of distribution. A couple of points I will make about that. We are in discussions and we stand ready to become a pod if asked to do, that but we will be following the New Hampshire allocation scheme. That does not allow our community members to jump the queue, but we will be administrating the vaccine following the New Hampshire state’s allocation, the phase allocation scheme.
Still, we think this would be a good thing to do to provide a convenient site for those in our community. Depending on when or if this comes about, how and where we it is up to administer the vaccine and I might turn to Josh and say Josh, what do you think are the best sites for us to be doing this? Outdoors, under tents? Again, it will depend on sort of, what the timing is with the season, when we might be able to start something like this, but I certainly am very interested and eager and supportive of doing such an undertaking if we can.
Keniston:
We will have the facilities ready for you. We just need the thumbs up that we’re ready to go. We have been talking about having the staffing ready and I know Mark’s team and we have had conversations with Axiom Medical Providers. We stand ready, as soon as you give us the thumbs up that the vaccine is there for us and we have our pod designation.
Anderson:
Josh, since I have your attention, I’m going to go the to a question for you. After questions of vaccination, I think the second most popular question is about spring move-in dates. What can you say about spring move in dates, whether or not they could change, will change, might change, won’t change? I guess basically just everything you could say about moving in the spring, and then relatedly, has anything changed that we were expecting for spring, based on the current outbreak that we’re in the midst of?
Keniston:
So, we’re hoping the move-in dates for spring don’t have to change. We know this is one of the things that, you know, there is a lot of planning that goes into coming back to campus in terms of traveling and getting your belongings together, so our hope and a lot of what we have done in terms of the new restrictions and protocols that we put in place in the last week or so around this latest outbreak is really about protecting that move-in time.
I think, you know, as Joe mentioned, we have encouraging news on that front, so as long as we stay on the path that we are on, we’re looking ok for spring move-in, but if for whatever reason this outbreak goes on longer and if we are still supporting a large number of people until quarantine and isolation, as we go into spring break, we may have to revisit that.
The period of time between the end of winter term and the start of spring term is already a really quick turnover and we want to make sure we can get into those rooms, do the appropriate cleaning, so that they are ready for the next person to move in and if we have to be supporting hundreds of people in quarantine and isolation, it will be hard to do that. I would say I’m optimistic that we are headed in the right path and we will be good to goal for spring arrival as planned.
Anderson:
Mark, shifting over to you. There are a fair number of questions about that student mental health, particularly for those who are quarantining or in isolation, but you’ve addressed that, you’ve begun to address that. I have a related question which I think is a good one. How does Dartmouth balance the decision about extending quarantine with mental health, academic considerations, and physical health? So how do you balance, all of those, you know, very important factors when thinking about quarantine.
Reed:
When you say extending quarantine, do you mean the restrictions in responses to the outbreak?
Anderson:
Yes.
Reed:
That is the tension that I was talking about between connection and keeping our community safe. I think Joe has been a real advocate for supporting connection for our students and we got to a place where we crossed that line. There is certainly a gray area and we crossed it last Wednesday, I think. So there reaches a point, if we had five cases, 10 cases, 20 cases that would be something we could manage, but this was spreading so quickly that there was a real risk to our community on a physical side.
We are aware that our restrictions have mental health consequences so, that is what happen we grapple with and we talk about every day with the discussions that Lisa and Josh lead. They are at the top of our mind, and the people in real isolation and quarantine, the whole campus is also restricted, so everyone is struggling a bit and the people who are actually in quarantine because of exposure or isolation because they had the illness are struggling even more, because they are separated from their room, their floormates, and we are trying to provide extra support.
Frankly, the unsung heroes in this, a lot of people on Josh’s team. It is scary on campus now. If we had had facilities people not willing to come in, dining people not willing to come in, the whole thing would have gone underwater. We have had zero callouts. It is crazy the dedication of that staff to support. They are great. The live-in residential staff has been awesome, and these restrictions are hard. We want to pull out of it quickly, and today is optimistic, but we don’t want to have at yo-yo and pull out too quick and have another spike. While we’re cautiously optimistic, we will wait in the end of the week and keep our fingers crossed.
Anderson:
Lisa, backing to you about more questions of the vaccine. A lot of the questions are about the who, who will have access to vaccines. People are asking if I’m a student living in Vermont, what about international students, undergraduate students who are here but don’t have a New Hampshire’s driver’s license. How are we going to be able to sort all of those things out once the vaccine becomes available?
Adams:
So, our students would most likely be in the 3B category, meaning everybody else when vaccines become available to them. We are doing now the work to prepare for that are recognizing they are not going to be in the first phases. We are involving legal counsel in these kinds of decisions and really trying to see if there is precedence, which we think there is for being able to include students who are on campus, enrolled, in residence to have them considered New Hampshire residents just as they are able to vote as New Hampshire residents, so that would be great.
As you know, New Hampshire said it will not be able to vaccinate non-New Hampshire residents, so what we are looking for is the reassurance that we can consider them temporary New Hampshire residents. So, that is the avenue that we are taking and that is how we would—as I said, we are encouraged by the fact this there is some precedence for that. From the logistical point of view, it would make sense and in the public health interest if we can vaccinate the students on campus, so that is what we are going to advocate for, and that is what happen we are going to be working on in the coming weeks.
Anderson:
Josh, going back to you for a question about spring term and this is sort of you know, based on the fact that spring term will be during the spring and will be getting increasingly warmer we suspect over the course of the term. How is the taskforce thinking about how the campus might be able to open up a little bit as the weather warms and specifically, would teams be able to practice outside? Would theater groups be able to gather and rehearse outside? Could there be more classes outside? So, how are you thinking about the use of outdoor space as we move further and further into the spring?
Keniston:
Yeah, we love to activate outdoor spaces. Everything we know is the outdoors is certainly better than the indoors as it relates to ventilation and transmission, we want to make the spaces available. I was just walking around campus the other week with some of our teammates who are helping to do that planning, trying to figure out what parts of pathways or parking lots could we reclaim knowing April can be muddy and it doesn’t mean that we can be on lawn, so we are looking for the opportunities. We are looking at bringing back some of the tents we had in the fall, looking at other ways to activate those spaces so, yeah, absolutely, we are doing our best to activate outdoor spaces and make it possible to use them.
Anderson:
Mark, I’m going to go back to you and then I’m going to Lisa, so I’ll ask you to be brief on this question. This questioner writes in, once Dartmouth had placed the bulk of students, this is pertaining to the recent outbreak, once Dartmouth had placed the bulk of the students into quarantine, is that where the majority of the positive cases came from? Which I guess another way of saying, did the contact tracing in this instance work? Were the contact traces the ones that were positive or are the positives from outside of that group?
Reed:
It was both, but we had a higher positivity rate among contacts than what we had the rest of the year. It helped. I was talking to Ann Bracken this morning and so was Lisa and I think at one point, 50%-70% of our contacts that were testing positive. It was a high number, so getting people doing the contact tracing immediately, which the team did a great job with getting them into quarantine made a big difference.
Anderson:
So, contact tracing in this case seemed to work?
Reed:
It was critical.
Anderson:
We said, I’m going to go to you for the, for the last word. And I’m going to stick with the theme of asking you about all things related to vaccinations in vaccines, a bunch of questions about sort of what happens to students, once they are vaccinated. Will vaccinated students have more freedom of mobility? And then relatedly, will vaccinated students continue to be tested, along with students who are not vaccinated?
Adams:
So, we are going to continue to follow state, and federal, CDC guidance on this. So, right now, the vaccinated individuals can be exempted from contact quarantine and from travel quarantine. That is if they stay asymptomatic.
So, that is, is one policy that we’ve already started to implement. I will say there’s a question of whether that that waiver from quarantine should last just 90 days or longer. I think right now the CDC is keeping it at 90 days because they’re just waiting for the data to say that we can extend it longer and the State of New Hampshire actually doesn’t put a timeframe on it.
So there probably will be a to be determined timeframe on how long you will be exempt from, from quarantine, as long as you stay asymptomatic. So, you know that that is certainly a benefit.
In terms of testing, again, until we have the data that the Pfizer and Moderna vaccines, really do prevent asymptomatic disease and transmission, we are going to keep everyone in, who’s been vaccinated in our surveillance or screening testing pool. Now I will say that the Johnson and Johnson vaccine looks like there are data that suggests that it does prevent asymptomatic disease so another reason to get that vaccine that maybe it is not touted as being as effective.
They have the data to be able to say that the Moderna and Pfizer vaccines, they just haven’t finished doing their analysis and being able to make that claim yet. I suspect they will in time. But until we have confirmation that all three vaccines are providing that level of protection, we have to continue to include those individuals in surveillance testing
Anderson:
Got it. Thank you, Lisa and thank you, Josh, and thank you, Mark very much. Really, really insightful comments from all of you today. We really appreciate it. With that, Joe, I’m going to go back to you.
Helble:
Thank you, Justin and let me add my thanks Mark Lee said, Josh for the comments and contributions to the conversation. Obviously, there is a lot of interest on the part of the community, a lot of attention being paid to vaccinations, and to our managing campus health so thanks very much for providing input and guidance on that.
Let me end by saying, first, thanking all of you, the panel that we had today. I think it’s been clear to me that by making recommendations to act quickly, to very quickly change campus operations, and to move aggressively forward with rapid contact tracing. I don’t want to say we are through this, but we reached a peak fairly quickly and we have seen numbers come down over the past four days in terms of daily new infection rates, after increasing for just a period of three days and so that that’s quite encouraging sign.
A reminder to everyone who’s watching that we do anticipate that total numbers will continue to increase over the next several days but the day-to-day variations that we are going to be paying particularly close attention to. And again, signs the past three days have been positive.
So, let me end by saying I’m encouraged, and perhaps even hopeful that the worst has passed, but it’s a reminder to all of us that we cannot let our guard down. Even if case numbers continue to drop and drop significantly over the next several days. Monitoring the data day to day is going to be hugely important in our decision making.
It is clear that we are moving in a positive direction, but we absolutely can. And so, let’s all look out for one another. Let’s all do what we can to remain masked and distanced, get through the remainder of winter term together, and have a successful spring term. And to all of our students I will say that I am, President Hanlon, and many of us truly look forward to that moment where we can join you for an in-person commencement ceremony in June. That would be a wonderful way to bring this challenge in this year to a close.
So, thank you all. We look forward to seeing you again at the next community conversation in two weeks. Until then, stay well stay healthy and to our students, best of luck with the end of term and your exams. We’ll see you soon.
