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Young adults driving COVID-19 case spike; experts monitoring for spread, hospitalizations

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MADISON (WKOW) -- Wisconsin has set new single-day records for confirmed new cases of COVID-19 twice in the past five days. Cases among people between 18 and 24 years old are driving the trend as colleges across the state rush to tighten protocols.

On Monday, UW-Madison Chancellor Rebecca Blank answered questions about the spike on the campus of the state's flagship university. Blank defended the decision to bring back students amid criticism that such outbreaks at colleges across the U.S. were inevitable.

"I know not everyone is going to agree with this next statement but I do believe the decision to open campus this fall was the right one, for several reasons," Blank said. "In-person instruction is the better way for most students to learn."

Blank added thousands of students already had apartments rented in Madison and said in-person classes were more likely to keep those students in a regimen.

UW-Health Chief Quality Officer Jeff Pothof said he understands the criticism because college living is inherently more risky during a pandemic.

"When you're in college, you typically don't have the resources to have your own apartment," Pothof said. "Many people are in dorms so we create congregate living that would also help accelerate transmission of COVID-19."

Pothof added it was a challenging decision for university administrators because there was no way to know for certain outbreaks would occur, let alone to the extent they have in Madison, where Blank said Sellery Hall -- one of two dorms now under a two-week quarantine -- has an infection rate of 20 percent.

"I think people will look back on that and say 'how could (avoiding outbreaks) have possibly been expected?' But I think it's just hard to know," Pothof said. "There's clearly a benefit to trying to get these folks back on campus, to have something meaningful as far as education goes."

Pothof said he's now tracking the case information as broken down by age. Every age group except the 18-24 demographic is either declining or staying the same in terms of new case rate. If that trend spreads to other groups, Pothof said that would signal community spread has extended beyond campuses.

"That age bracket would start to shift a little bit so you'd get outside of that 18-34, you would start to see a little more in that older age group," he said.

The other metric Pothof said he's watching is hospitalizations. In Dane County, the number of COVID-19 inpatients has ranged between 22 and 30 going back to August 25.

"If we started to see trends in hospitalizations uptick, that might be an early indicator that this has gotten outside that campus group and you're starting to see more illness in those populations that won't fare as well," Pothof said.

Blank said no UW-Madison students have required hospitalization. Pothof said that's not surprising given the low rates of hospitalization in young adults who contract the virus but added there are some students who could still get extremely sick and that it takes time for symptoms to worsen to the point where people feel they need to go see a doctor.

"Clearly, it's something we all have our eye on 'cause that would be the next logical thing," Pothof said. "If it starts hitting other populations, you would expect those case rates to start going up in hospitals."

The deadline for UW-Madison students to withdraw and receive a full tuition refund was last Friday. However, Blank said Monday the university was exploring extending that deadline. She added that if the dorms close for the semester or school year, residents would receive a prorated discount.

Blank said the university was investigating about 380 students for violation of COVID-19 protocols with eight students under review for emergency suspension.

Testing doesn't explain it all

Pothof said one reason for the dramatic spike in cases among largely asymptomatic college students is the testing regimen that's in place on campuses. UW-Madison requires students to get tested for COVID-19 every two weeks.

Blank shared a theory Monday that case rates would increase across the state if all residents took tests as often as students.

"It is possible that the presence of COVID out in the state, where we're doing very little testing, is higher than people realize and people have brought a higher instance here to campus," Blank said.

Pothof said he agrees the rates would increase across the board with more testing but did not think it would match the rate of spread at some of the state's universities. Pothof added testing resources are not vast enough to support testing at such a scale.

"If there were unlimited resources and everyone got tested at some sort of interval, you would see higher case numbers," Pothof said. "I doubt it would be as high as what you're seeing on campus."

One decision, then possibly another

Blank said the university will continue to monitor the testing data between now and September 23, the date through which all classes have moved online and Witte and Sellery Halls will remain in quarantine.

She said some of the metrics that will go into a decision to reopen the university, or to send students home, include rate of positive tests, whether spread is confined to parts of campus, and if the virus is spreading to faculty and staff.

"We're on a two-week hiatus, I hope we might bring these numbers down, that we might see some changes," Blank said. "And we'll be evaluating whether we reopen or not."

Pothof said it will be a critical stretch for the university.

"I think what we'll have to see in the next couple of weeks is... is it time to throw in the towel if we can't get this stuff under control and then having campuses being willing to make those hard decisions if that data seems to prove that," he said.

If the university does decide to close the dorms and send home students, Pothof said that would be an extremely sensitive situation from a public health perspective. He said any students exposed to COVID-19 should clear a quarantine period before returning home.

"Hopefully, the students you're able to send home, you can send home with some assurance they're not going to seed these smaller communities who likely have less resources to deal with a COVID outbreak," Pothof said.

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