COVID-19 brought the lives of college students to an abrupt standstill. Sitting in a classroom, a dormitory, at a dining hall table with friends — all became risky activities overnight.

How did universities navigate the impossible trade-off between having students on campus with the risks of the coronavirus, and keeping students remote — potentially placing their education in peril?

Find out on the latest episode of The Dose podcast with Michael Drake, M.D., president of the University of California. Drake, who is also chairman of the Commonwealth Fund’s Board of Directors, explains the decisions he made to keep students safe — and learning — on and off campus.

Transcript

SHANOOR SEERVAI: COVID-19 has disrupted countless aspects of normal life. So for young people in many parts of the U.S. this has meant that their school or college has been closed since March. These are intended to be places where young people come together to learn, but what happens when public health guidelines are saying that coming together is exactly what could endanger your health? On today’s episode of The Dose, we’re going to talk about how the pandemic has impacted institutions of higher education.

My guest is Michael Drake, president of the University of California system. Even if you’re not from California, you’ve probably heard of UC Berkeley or UCLA. Michael is going to take us through the journey of what it’s been like to run a university system that includes 10 campuses with almost 300,000 students in the middle of a global pandemic.

Michael, welcome to the show.

MICHAEL DRAKE: Very nice to see you.

SHANOOR SEERVAI: As we get started, take me back to when the pandemic first hit. You were then the president at The Ohio State University. What was that moment when you realized that you were going to need to send students home in the middle of the semester?

MICHAEL DRAKE: Yes. Well, I remember that well actually. We had seen the epidemic as it grew from Wuhan in China, and we watched that and watched the extraordinary means to which the government there had locked down 60, 70 million people. And then we watched as things progressed through January and into February, but it wasn’t getting better as quickly as we thought, and in fact, we were seeing now spread to the U.S. with the State of Washington and other cases popping up around the country associated with travel that continued through February and our conversations continued.

And then in early March, it really seemed that there were really now outbreaks here in this country. Over the weekend of March 6, 7, 8, I was in conversations with people. My cabinet came together and were saying, “Gosh, things are not looking so good.” Now there had been outbreaks at the University of Washington and at Stanford and so it was clear to me that it was just a matter of time until we had an outbreak.

We met intensively on the Sunday and Monday, and by about noon on that Monday the 9th, it was clear that we needed to have students go home for spring break and then stay home. So they’re escalating series of events.

SHANOOR SEERVAI: You say spring break, and that sort of indicates this temporary thing like, “Okay, it’s just for a little while, and then things will go back to normal.” When did you realize that it was not just for spring break?

MICHAEL DRAKE: Really it was that week. On the Monday, the 9th, when we decided that we were going to have to go to remote education, it was going to be through spring break and a little bit longer. At that time there’d been no cases in the State of Ohio. None had been found yet. The goal there was to keep it from getting into the campus community and the dorms and spreading that way. We thought we were going to suppress its arrival and dissemination. That was on Monday.

By Tuesday and Wednesday we started seeing that it was popping up in more and more places around the country. At that time I was also saying, “Gosh, it’s going to be more than just two or three weeks. It really is going to be longer.” And so then we began to develop a plan to have students, as they returned from spring break, move out of the dorms and go to their permanent address, wherever that happened to be.

SHANOOR SEERVAI: I guess, one of the things that’s been on my mind a lot when I think about my own time being an undergraduate is that we don’t go to campus to be socially distant; we go there because we want to be around people our age, we want to learn, we also want to go to parties. On the one hand, you should be able to explain to an 18-year-old, this is really dangerous, this is how you have to behave, but on the other, how do you stop 18-year-olds from being the college students that they wanted to be?

MICHAEL DRAKE: Yeah, that’s really been an interesting thing for us. There are a couple thousand residential college campuses across the country, and there’ve been a variety of different experiences. We really worked hard with the students here to have them be partners in creating circumstances that would let them come and live on campus. You mentioned we have 10 campuses and we’ve had 10 slightly different approaches. What we found though, was that our students have done a really remarkably good job of behaving in ways that make this all work.

A couple things to say. First, appreciate the way everyone switched to online learning. Faculty had to switch thousands of courses on a dime, students had to get used to a new way of learning. It hasn’t been easy for everyone or anyone, but it’s worked better than we would have expected, honestly, in many cases. Not perfect or ideal, but better than we might’ve expected, so that’s been good.

Second, some of the campuses have relatively few students, only a few hundred students at Merced living on campus. Some, like UC San Diego, have closer to 10,000 students living on campus. They’ve had different ways of approaching, welcoming the students back and then helping them to adapt to this new way of living and it’s worked well. I don’t want to say that it’s been great because there’ve been real challenges. It’s not been ideal. It’s not what anyone would have wanted, but I’m really proud of the way the students have made themselves flexible. The faculty have been flexible. The staff have been flexible. Everyone’s been working hard to make it work. And it’s been good from a public health point of view as well.

SHANOOR SEERVAI: Could you give me an example of how this flexibility has helped maybe in one instance where people have returned to campus and maybe another where they’re continuing remote learning?

MICHAEL DRAKE: Let me just talk about the returning to campus. The San Diego program has the greatest number of students on campus. They’re calling their program Return to Learn. It’s faculty returning to teach and students returning to learn, staff there to support them.

The living arrangements at San Diego are such that there are the normal number of students living on campus, or about 15,000 or so. The arrangement of the campus housing is that many of the rooms have an associated bathroom. They’re more suite-like than the 1950s sort of long hallway with a bathroom at the end. And so students are able to be put into single rooms for the most part with a bathroom that’s their own, and that’s how they were able to get up to the nearly 10,000 students on campus. There are graduate students and families living on campus. There are exceptions to that rule, but it’s been a great way to get a lot of students there.

Then when the students came back there was testing and then isolation and retesting. There’s surveillance testing of the students on a regular basis. At San Diego, they do wastewater surveillance of buildings. They look to see if there are viral fragments in wastewater, and then if that’s the case, to go back in and test everyone in the building. And actually cases have been found doing that.

They’ve done things like had tents outside WiFi in San Diego. The weather is good and in the fall particularly, and so there are WiFi-enabled tent. So students can actually be in places where there are other students, but appropriately socially distance and outdoors.

All of those things have been done to try to make the campus a safer place. In general, the positivity rate, the infection incidence rate has been extremely low, in the 0.1, 0.2, 0.3 percent range until just recently after Thanksgiving. But even now it spiked up to about 0.5. 0.4 on campus, and 0.6 overall for students on campus and in the area just off campus. So the students and the faculty and the staff are behaving in ways that are able to keep the infection rates in order of magnitude or more lower than those in the surrounding communities, which has been great.

SHANOOR SEERVAI: What happens if someone does test positive?

MICHAEL DRAKE: What we’ve done is really just use basic science, not meaning laboratory basic science, but sort of foundational science, common sense, good data, and followed the public health guidelines as strictly as we can. So if someone tests positive, that person goes into isolation, contact tracing is done, and the close contacts are placed in quarantine. The campus has hundreds of beds available for isolation and quarantine and does that monitoring itself.

SHANOOR SEERVAI: Could you give me an example of a campus where your students are still remote?

MICHAEL DRAKE: Yes. There’s lots to say. I’d mentioned 10,000 students at San Diego, but there are 35,000 students there. So the majority of students there are remote and they have the greatest number of students on campus. So in a place like UCLA, there’ll be a few thousand students on campus, but 35,000, 38,000 students remote. What we found there is that we have students on campus, we have students in the Perry campus area, and then we have students that are living with their parents at home, in a different country even, so those we don’t have the data on. We test our students on campus and we offer testing the students in the Perry campus area.

The range as rule of thumb, whatever the positivity rate is on campus, the two-week or one-week rolling average positivity rate, then it’s about two to three times that high in the Perry campus area, and whatever it is in the Perry campus area, it’s two to five times higher in the community. So if the community is seeing 5 percent, the Perry campus area might be seeing something like 1 percent, and the campus would be seeing 0.3 percent. I just gave numbers. I use percentages. All of those are variable week by week by the different campuses, but on average those are the kinds of numbers that we were hearing, and we all actually get together every week and share those numbers. But across the system, those are the kinds of numbers that we’re hearing.

Interestingly to me, those numbers will be similar at UCLA with small numbers of students living on campus out of the total population, at UC Davis and Irvine with intermediate numbers, and at UC San Diego with the highest numbers living on campus. So there wasn’t a progression. Having fewer students on campus was not associated with lower positivity rate.

SHANOOR SEERVAI: There are students who have been able to return to campus, and there are students who have been able to go home, probably for most of them, that means going to where their parents live. But then there’s the issue of people who can’t return home. The pandemic has revealed health disparities and college campuses are no different. There are students who are low income, who don’t have stable homes to go home to. Where did these students go?

MICHAEL DRAKE: From the very beginning, and this was the case in Ohio as well, from March there were students who couldn’t go home. So even when we sent everyone home quote, that still meant a thousand or 1,500 students in Ohio and similar numbers on campuses here remained with us because they didn’t have another home, or they didn’t have a safe home, their families were experiencing homelessness at the time. We had international students where there were literally no flights back to their home country. You literally couldn’t get there. So we’ve had students who’ve lived with us from day one, and we worked very hard to make sure we support those students, that we meet their basic needs. So we’ve always had food and health care and other things that are necessary. We’ll continue that.

Over the breaks that was the case certainly over the Thanksgiving holiday. It will be the case with the winter break coming up. So we at some point always have a baseline of making sure that we can support the basic needs of those students who, for a variety of reasons, have the campus be the best place that they can be.

It’s a very challenging time for us. Everyone thinks of it from different points of view. I have friends who have got grandchildren, who they’re not going to see for months or a year. I have friends who have grandchildren they’ve never met; born in the spring or just before. Grandchildren evolve, they have stages and phases, and if you miss it you never have it. They’re real dislocations in the things that are the anchoring points of our lives, and I think we’re all just trying to support each other through these things.

SHANOOR SEERVAI: The light at the end of the tunnel is this vaccine. Now, earlier this year, you made it mandatory for students, faculty, and staff who are on campus to get the flu vaccine, and you strongly recommended the entire community to get the vaccine. When the COVID vaccine is widely available, do you think that it will be a requirement for students who want to come back to campus?

MICHAEL DRAKE: We’ll see. We’re working on policy as we speak. We’ll have to make sure that we do all we can to keep the campus safe and to keep the community safe. We don’t want it to be that anyone is able to be exposed. We have a whole series of requirements now; masks and distancing, et cetera, et cetera, those will remain in place. And then we will work on a vaccine program that we think is appropriate to make sure we do all that we can to keep the campus safe.

We’ll see. You’ll have to call me in March or April and see. I’m believing that people are going to want the vaccine. Barring any strange reactions or things that come up many months later, which is so unusual for vaccines. So as things look like they’re going, the vaccine is going to be the most valuable commodity on our planet. We’re most concerned now about making sure we can make it available and do what we can to get it to people safely, effectively, as quickly as they can. And then as we look toward bringing students back to campus again, we’ll have policies that are appropriate to make those activities as safe as they can be.

SHANOOR SEERVAI: We’re speaking at the time of year when, in a pre-COVID world, students would be wrapping up, they’d be getting ready to go home for the holidays. If you look back on this past semester, the fall semester, what is one thing that you’re incredibly relieved about?

MICHAEL DRAKE: Well, I mentioned that we have 280,000 students. The majority of them were not on campus. I should know the numbers more accurately, but 80, 90 percent of the students were not on campus. Ten, 20 percent of the students were, depending. Up as high as about, as I said, 50 percent or 60 percent of campus housing was filled at San Diego, but in general, we had the vast majority of students off campus. Also, the overwhelming majority of students took their classes online.

The thing that I’m most pleased about is that the case positivity rates on campus stayed low from the end of August through now, here we are in mid-December. Even as of yesterday, although the rates were double what they had been a few weeks before, that was doubling from 0.2 to 0.4 on campus or levels like that, so they were really with one exception below 1 percent. So I’m really pleased and proud of how well our students and our faculty and our staff worked to live under these new circumstances and keep themselves safe.

The place actually where it was more than 1 percent, was a place where we have relatively few students. There were a couple of outbreaks. People had gone home and come back and infected the people that were around them. So a half a dozen students would take us over the 1 or 2 percent level, but still a small and manageable number of people. That turned out as well as I could have imagined, honestly.

SHANOOR SEERVAI: On the other hand, if you look back over this time, what is one thing, if you could have done it differently that you would?

MICHAEL DRAKE: I don’t want to be weird about that. We worked really hard to have it all work as well as we could. I don’t know that we would’ve done anything much differently. I’ll tell you actually what we would have done differently, but I don’t know that we would have. I’ve said that in two ways. Knowing what we know, some of the campuses would have done better to have more students living on campus than they did. The ones that had a thousand students on campus, what we see is, “Gosh, it was just as safe with 2,000 or 3,000.” We think that’s better for students. They’re safer, the data are that they’re safer on campus, but then also that the support services for them are there, and we think that things work better for their education. Even socially distancing, are in pods where they have a bit of human interaction.

I think there are a couple of places where we would have had more students on campus, knowing what we know, but there was no way for us to know that. No one had done it. I didn’t know week to week what was going to happen, and we’re really just looking at the data now. It looked like we could have had more students on campus and managed those, but I don’t know that I would have suggested that we do anything differently if you asked me in August.

SHANOOR SEERVAI: Right. That’s a very valuable lesson. Does it inform how you’re thinking about the spring semester?

MICHAEL DRAKE: Yes, it does. I think for the most part the campuses that had fewer students are saying, “Gosh, we can do more.” The physical environment at the campus in some cases limits the number of single rooms that we can have with low utilization of bathrooms, et cetera. So the places that have more suites can have more students. I would say that everyone is looking to see how many students they can bring back. There are cases where we were relatively conservative, where we believe we can bring back more students safely.

I think that the experience with the tents and the outdoor classrooms worked well. We have not had any cases that have derived from that enterprise. The winter a little bit, but by the time we get to the spring, I think many more people will be thinking of having in-person classes in limited and very specialized circumstances.

SHANOOR SEERVAI: Listeners, it’s an understatement to say that 2020 has been a really rough year. Here at The Dose, we’ve had to figure out how to do all our recordings remotely from our small apartments in Brooklyn, shipping mics to our guests in their homes.

This is our last episode of the year. So if you’re looking for something to listen to over the holidays, we recommend episode 44 from June about why more black Americans are dying from COVID. It’s a very sobering reminder of how racism permeates our lives in the U.S. and how important it is to work for change. We also have episodes on how other countries are fighting the pandemic. There’s number 40 on Germany and number 50 on Canada. And if you’re wondering exactly how President Biden is going to get us out of this mess, then check out episode number 55. We’ll be back with a brand-new episode in January. Thank you for listening this year and stay safe over the holidays.

The Dose is hosted by me, Shanoor Seervai. I produce this show along with Joshua Tallman for the Commonwealth Fund. Special thanks to Barry Scholl for editorial support, Jen Wilson and Rose Wong for our art and design, Oona Palumbo for mixing and editing, and Paul Frame for web support. Our theme music is “Arizona Moon” by Blue Dot Sessions, with additional music from Podington Bear. Our website is thedose.show. There you’ll find show notes and other resources. That’s it for The Dose. Thanks for listening.

Show Notes

Bio: Michael V. Drake, M.D.