This past week was filled with scenes of freshmen moving into dormitories, orientation week events and other campus activities amidst the COVID-19 pandemic. The return to semi-normal university life is the result of multiple policies and efforts by administrative and campus leaders which began earlier this summer.  

On May 4, Lou Stark—Vice President for Student Affairs—and Sara Lee, MD—Executive Director, University Health and Counseling Services—sent an email to the Case Western Reserve University community, introducing a new initiative to verify vaccination records and allow administrators to make more informed decisions on university policies. Further emails throughout the summer would push students, faculty and staff to submit their vaccination records and reach the goal percentages set in each email. 

Currently, the Pfizer-BioNTech, Moderna and Janssen COVID-19 vaccines have all received emergency use authorization from the Food and Drug Administration (FDA). The AstraZeneca COVID-19 vaccine has not been approved for use in the United States. No vaccines have received full approval to date, but the current vaccines given emergency use authorization are safe and effective at protecting against COVID-19. 

In an email on June 17, Interim President Scott Cowen and Provost Ben Vinson III updated the CWRU community on the university’s vaccination verification initiative: over 60% of the students, faculty and staff had submitted their vaccination records, falling substantially short of the 80% goal. The email stated that, beginning July 1, fully vaccinated individuals no longer had to wear masks while outdoors on campus. 

The email also explained other COVID-19 policies, including daily health attestations, physical distancing, dining protocol and building access with many of those policies returning to pre-pandemic or almost pre-pandemic norms. Surveillance testing of COVID-19 was planned for students, faculty and staff at the beginning of the semester. 

Later emails would institute a vaccine lottery similar to the Vax-a-Million lottery created by the state government to incentivize Ohio residents to get vaccinated against COVID-19. CWRU selected a student and a faculty member to win each week, with the student winning prizes such as a half-year of free tuition and the faculty member receiving prizes such as free campus parking. Vaccination record uploads steadily increased in the weeks following the institution of the vaccine lottery. 

On July 15, CWRU announced that it would require students and employees to be vaccinated, becoming one of eight Ohio universities to implement a vaccination requirement. The other seven universities are Cleveland State University, Antioch College, Cleveland Institute of Art, Kenyon College, Mount Saint Joseph University, Ohio Wesleyan University and The College of Wooster. Over 600 U.S. universities have instituted vaccination requirements to date. 

In an email on Aug. 3, President Eric Kaler and Provost Vinson implemented a requirement beginning the next day that students, faculty and staff on campus wear masks while indoors, due to the rise in the positive cases per 100,000 residents in Cuyahoga County and CDC guidance. The email also included an update on vaccination record uploads, stating that 92% of the CWRU community had their vaccination records verified. 

The university also instituted a mandatory online COVID-19 training module to be completed before Sept. 1. This will likely be the last policy implementation before courses begin on Aug. 23. 

The newest challenge to safeguarding the health and well-being of the CWRU community against COVID-19 is the emergence and spread of the Delta variant, officially known as B.1.617.2. The original pathogen causing COVID-19 was a novel coronavirus named SARS-CoV-2. As time passed and the virus spread across tens of millions of people across the world, mutations occurred, aggregated and resulted in new genetic variants. The Delta variant, one of these genetic variants, has become the dominant variant among new COVID-19 cases in many regions due to its increased infectivity. 

The Delta variant has shown itself to be more infectious than the original SARS-CoV-2 virus. The CDC declared the Delta variant to be a “variant of concern” on June 15 as it started becoming the cause of an increasingly large percentage of new COVID-19 cases in the U.S. One of the other major concerns about the Delta variant is its potential ability to cause breakthrough infections, or cases in which vaccinated individuals develop COVID-19. This has not demonstrated itself to be incredibly significant in terms of total case numbers, as COVID-19 vaccines have still been largely successful at curbing the spread of COVID-19. 

While the Delta variant is currently the most pressing of the genetic variants of SARS-CoV-2, other strains also exist. The SARS-CoV-2 Interagency Group (SIG), a U.S. government group, created a system to classify genetic variants of SARS-CoV-2 as a “variant of interest,” “variant of concern” or “variant of high consequence.” A “variant of interest” is classified as having the potential to develop mutations that increase the virus’ threat, whereas a “variant of concern” has developed mutations that make the virus more transmissible or deadly. A “variant of high consequence” is a virus that causes diagnostic tests to fail, high numbers of breakthrough cases or more severe hospitalizations. Beta and Gamma variants have been designated as “variants of concern.” No variants have currently been designated as “variants of high consequence” in the U.S. 

Another relatively new discovery in the study of COVID-19 patients is “long COVID,” officially known as “post-acute sequelae of COVID-19” per the National Institutes of Health. Long COVID is a state of chronic or long-lasting symptoms that remain present after a COVID-19 infection. Two significant observations about long COVID are that younger people often are affected, and the symptoms are initially mild before becoming worse. Symptoms of long COVID include fatigue, difficulty breathing and neurologic problems. 

The state of Ohio saw a surge in COVID-19 cases in the first week of August, but it has slightly subsided during the second week. Nationally, 97% of hospitalizations for COVID-19 are for unvaccinated individuals. Vaccinated individuals have been shown to have a lower chance of developing severe symptoms of COVID-19 as well. 

The state government of Ohio had created and implemented the Ohio Public Health Advisory System in July 2020 to collect data on and track the spread of COVID-19 across the state’s 88 counties. As of May 27, the system has been cancelled and the Ohio Department of Health has taken over the role of providing data on disease spread and vaccination rates. To date, there have been 968,127 confirmed cases of COVID-19 and 20,640 deaths caused by COVID-19 in Ohio. There have also been 63,571 hospitalizations and 8,627 ICU admissions for COVID-19.There are 34,000 hospital beds in Ohio, including 2,500 ICU beds, according to http://cleveland.com. 

It remains to be seen if the policies put in place at CWRU will effectively prevent the spread of COVID-19 when the entire student body is physically present on campus.