Seven key questions and answers about how Boston University will test students, faculty, and staff for coronavirus
7 Key Questions and Answers about BU’s Coronavirus Testing Plans
From frequency to categories to testing sites and nostril swabs, what you need to know
A demonstration of one of BU’s-COVID-19 sample stations and the test collection process at the Kilachand Center for Life Sciences & Engineering. Photo by Janice Checchio
What protocols and precautions for coronavirus testing will greet Boston University students, faculty, and staff come mid-August, as the campus gradually repopulates after five months of unprecedented quiet brought on by the pandemic?
Yes, masks and social distancing will be required and expected; building ventilation and air filtering will be improved; and contact tracing of close contacts of anyone who has been identified with the virus will be in place.
But at the heart of BU’s return-to-campus plan is one very basic step: frequent COVID-19 testing through self-administered nostril swabs, with the aim of swiftly identifying and isolating those infected to limit further spread and keep the campus as safe as possible for the uninfected.
In a series of letters going out this week to students, faculty, and staff, University leaders are reminding the BU community that the new health and safety measures are considered mandatory and the University, which is covering all costs of testing, will enforce them. With so much uncertainty around testing for a community that includes 35,000 students and 10,000 faculty and staff, these seven questions seem to be the most critical:
How frequently will I be tested?
Why do some people have to get tested more often than others?
Where will the test collection be administered?
What should I do if I feel possible symptoms of coronavirus?
How will the test collection be administered?
How quickly will I get my results, and what happens if I test positive for COVID-19?
How did BU choose, or arrive at, these protocols, and was this system modeled after something?
With a flood of new information coming out weekly, BU Today set out to boil down some of the key points around testing to these essential questions and answers. One other important step is coming soon, when BU launches an internal website for people to complete a daily form stating that they have no symptoms, and then to schedule testing, check results, and show their status.
On to the questions:
How frequently will I be tested?
It all depends on how frequently you will be on campus, how much interaction with others, especially students, you will have, and other factors.
All faculty, students, and staff are being placed into four different categories that determine their testing frequency (find the details about which category applies to you at the bottom of this story).
Undergraduates will be tested for the coronavirus immediately upon returning to campus. They will swab their own nostrils at designated collection sites on the Charles River Campus and receive results within 24 hours. After that, undergraduate students, whether living on campus or off campus, will be tested every three days. Graduate students—living on and off campus—will also be tested immediately upon returning to campus, and then once a week
Testing for faculty and staff is a little different.
All faculty and staff in categories 1, 2, and 3 must be tested upon return to campus and that testing will begin August 15, unless otherwise notified. Faculty and staff in category 4 (largely those who are working from home) will not be tested.
Additionally, faculty and staff in categories 1 and 2 will be tested weekly. Those in category 3 will be tested only at the beginning of the semester.
Why do some people have to get tested more often than others?
People will be categorized depending on a variety of factors, such as how they will get to campus, how frequently they intend to be on campus, how much interaction they expect to have with people on campus, and other factors. Categories 1 and 2 will constitute the bulk of all tests. (Undergraduates on campus, as well as RA staff and people who rely on mass transit, are category 1, for example, while category 2 would be people commuting to campus using personal vehicles and who expect to have infrequent interactions with residential students).
Those in category 3 (for example, commuting staff whose on-campus interactions are primarily with other employees in nonstudent settings) will be tested only once, at the beginning of the semester, while those in category 4 (anyone who is learning or working remotely and will not be commuting to campus) will not be required to get tested.
It all depends on the frequency of interactions with others on campus.
Where will the test collection be administered?
Convenience is key: to avoid people having to travel too far for test collection, there will be testing stations up and down the Charles River Campus, in addition to one site on the Medical Campus.
- Kilachand Center for Integrated Life Sciences & Engineering, 610 Commonwealth Avenue
- 808 Gallery, 808 Commonwealth Avenue
- Agganis Arena Lobby, 925 Commonwealth Avenue
- BU Medical Campus, 72 East Concord Street
- 925 Comm Ave Rear, in the back of Agganis Arena, which will be exclusively for those who report feeling symptoms of coronavirus.
The main collection sites will be open daily from 7 am to 9 pm and will be able to process 50 to 250 tests per hour, or about 500 per hour across all sites.
What should I do if I experience possible symptoms of coronavirus?
Important question. First of all, any member of the BU community who is coming to campus will be required to do a self-assessment in the morning before arriving, and will have to submit their self-assessment through a web portal that is still being set up. That includes monitoring their symptoms for fever, chills, cough, aches, sore throat, sudden loss of taste or smell, or other signs of possible coronavirus infection.
If a student feels possible symptoms, they should contact Student Health Services, and they will be directed to the collection site for those feeling symptoms. If a faculty or staff member feels symptoms, they can use that same collection site, or they can go through their own primary care physician for testing options.
How will the test collection be administered?
Students, faculty, and staff will be able to choose the time and location of their test, based on availability. Before arriving at a collection site for their appointment, each person will fill out a form attesting that they don’t have any symptoms of coronavirus and have not been exposed to anyone confirmed to have coronavirus. People who do have symptoms, or who have been exposed to someone with coronavirus, will be tested at a designated sampling site, separate from sites testing asymptomatic people.
It will take a person approximately three to six minutes to check in, perform their nasal swab, and complete the screening. The nostril test requires a person to rub a swab around the inside edges of their nostrils for several seconds.
Fortunately, for those who might be squeamish about pushing a swab up their own nose, BU’s test will be easier, and more comfortable, than the deep nasal swabs (called nasopharyngeal swabs) that state labs, hospitals, and medical clinics have largely been using. The reason BU is using this easier and more comfortable type of swab (anterior nares swab) is that research shows that coronavirus is being spread mainly by droplets containing virus that are exhaled from the mouth and nose—making the deep swab less important. Another reason for using this anterior nares swab is that it can be done frequently and is less likely to lead people to avoid getting tested.
Observers will make sure each person swabs correctly and adequately before placing their swab inside a sterile test tube container filled with liquid saline and marked with a barcode associated with their unique student ID or other identification number. Sealed test tubes containing completed nasal swabs will then be placed in collection boxes, which will be packaged up and stored until they are taken to the BU Clinical Testing Lab.
“We know it’s in our spit and in the mucus of our noses, that’s how droplets are getting suspended in the air and infecting the next person, such as if you’re talking to someone face to face [without a mask],” says Catherine Klapperich, director of BU’s Precision Diagnostics Center, whose team set up the lab that will perform BU’s COVID-19 tests. “People who are spreading the virus will have high viral load in their mouth and nostrils.” The nostril swab will collect mucus from the nose to be screened for the coronavirus.
More fun with nostril swabbing! pic.twitter.com/3TyKUbqogu
— Cathie Klapperich (@DrKlapperich) July 25, 2020
Observers at the collection sites will be stationed behind plexiglass barriers; each collection station will provide six feet of space, and plexiglass barriers, between adjacent stations.
How quickly will I get my results, and what happens if I test positive for COVID-19?
BU’s testing laboratory will be able to process thousands of tests daily and the goal is to get results back to people within 24 hours, through an online portal, or in the case of a positive result, by phone. That turnaround speed was the driving force behind the University’s decision to set up its own lab, because if a person is tested on Monday but does not learn until Thursday that they are positive, they could have infected dozens or hundreds of people unknowingly during that window. A 24-hour result dramatically reduces that likelihood of spread.
If a student tests positive and they live in residential housing, Student Health Services will work with Residence Life to arrange for the student to move into special isolation housing that will be located on the Fenway Campus. Nonresidential students will be advised to self-isolate in their off-campus home and will be monitored by Student Health Services. Per CDC guidelines, they would be isolated for at least 10 days after the onset of the illness and at least 3 days after recovery.
If a staff or faculty member tests positive, their first call should be to their primary care physician. And they should avoid coming to campus and follow CDC guidelines.
In the event a faculty, staff member, or student tests positive, BU will initiate its contact tracing plan to identify and notify other individuals who have come into close contact with the person who tested positive.
People who get inconclusive test results will be asked to return to one of the general collection sites to complete another nasal swab.
The testing data will be collected in a digital dashboard, which will be made available to the BU community and be scrutinized by the BU administration in search of any indicators of community spread.
If there are infections in a dorm, the BU Clinical Testing Lab has left a buffer of bandwidth so that coronavirus screening efforts can rapidly home in on specific spaces that could contain a cluster. Close contacts of anyone infected would be tested, which could mean an entire floor, or a section of a dorm.
How did BU choose, or arrive at, these protocols, and was this system modeled after something?
The frequency of testing has been based on detailed models of transmission that have been developed by BU scientists as well as colleagues at other universities, says Davidson Hamer, a School of Public Health professor of global health. These are based on known characteristics of SARS-CoV-2 (the virus that causes COVID-19), including the incubation period (time between exposure and onset of infection), estimates of the transmissibility of the virus, and other factors. Those could be the likelihood of introduction of new infections from outside the campus, the duration of quarantine, and characteristics of the test that will be used to diagnose infections.
Testing category details
Testing Category 1
- Residential undergraduate students and RA staff
- Commuting students, staff, and faculty who interact with residential students for significant periods of time either in classes or other activities or who otherwise spend many hours on campus in close contact activities like athletics, performing arts, or in some research and off-campus educational environments
- Students who live off campus and employees who, due to age or medical condition, have disclosed (through a confidential process) that they fall within a CDC high-risk category (or who have disclosed that they have household members in these categories)
- Students and employees who use public transportation to travel to or from campus
- BU healthcare providers (including, for example, faculty, staff, and students providing healthcare services to members of the BU community or the public, but excluding Boston University Medical Group faculty who do not have classroom or laboratory contact with students and other BU faculty and staff members) and first responders, like the BUPD, who have high contact hours with each other or must interact frequently with individuals outside the University who may not have taken basic CDC protective measures (face covering, distancing, self-diagnosis).
Testing Category 2
- Commuting students residing off campus attending in-person classes, but with little contact with residential students
- Commuting employees, including certain faculty, who are student-facing, but have little contact with residential students and have limited contact hours in venues such as classrooms. Although at risk for infections from outside the Boston University community, individuals in this category will work within protocols established for entry into the BU work environment.
Testing Category 3
- Commuting employees whose job duties require very limited contact with students and who can control their contact with other employees so as to limit interactions to small groups of individuals with appropriate work environment protocols in place and minimal contact hours.
Testing Category 4
- Students, faculty, and staff who engage only in virtual learning, working, and other activities and events and who do not commute to campus.
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