Abstract and Introduction
Abstract
University settings have demonstrated potential for coronavirus disease (COVID-19) outbreaks; they combine congregate living, substantial social activity, and a young population predisposed to mild illness. Using genomic and epidemiologic data, we describe a COVID-19 outbreak at the University of Wisconsin–Madison, Madison, Wisconsin, USA. During August–October 2020, a total of 3,485 students, including 856/6,162 students living in dormitories, tested positive. Case counts began rising during move-in week, August 25–31, 2020, then rose rapidly during September 1–11, 2020. The university initiated multiple prevention efforts, including quarantining 2 dormitories; a subsequent decline in cases was observed. Genomic surveillance of cases from Dane County, in which the university is located, did not find evidence of transmission from a large cluster of cases in the 2 quarantined dorms during the outbreak. Coordinated implementation of prevention measures can reduce COVID-19 spread in university settings and may limit spillover to the surrounding community.
Introduction
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease (COVID-19), can spread rapidly within congregate settings, including institutions of higher education (IHEs).[1,2] During August–December 2020, as IHEs around the United States resumed in-person instruction, IHE-associated SARS-CoV-2 cases began to rise.[3] By February 2021, >530,000 COVID-19 cases linked to US IHEs had been identified.[4] In many IHE settings populated substantially by young adults 18–24 years of age,[5] susceptibility to severe COVID-19 is lower than for older populations (≥65 years of age).[6] Adhering to physical distancing is also challenging for young adults, for whom interaction with peers and social networks is important.[7]
As students returned to in-person learning, high-density clustering within on-campus housing may have increased transmission and resulted in community outbreaks (;[8–10] M.S. Andersen, et al., unpub. data, https://doi.org/10.1101/2020.09.22.20196048; C.S. Richmond, et al., unpub. data, https://doi.org/10.1101/2020.10.12.20210294). One study using whole-genome sequencing (WGS) data, which can be used to track specific SARS-CoV-2 lineages through space and time (;[11–16] M. Zeller et al., unpub. data, https://doi.org/10.1101/2021.02.05.21251235), suggested that SARS-CoV-2 transmission chains beginning or proliferating on IHE campuses may lead to spread within the surrounding community, including to populations at higher risk for severe disease (C.S. Richmond, et al., unpub. data). Therefore, strategies to prevent SARS-CoV-2 spread on IHE campuses and between IHEs and the community are needed.
We used epidemiologic and genomic data to describe an outbreak of SARS-CoV-2 infection at the University of Wisconsin–Madison (UW-Madison; Madison, WI, USA) shortly after its reopening for the fall 2020 semester. We report the trajectory of the outbreak and describe measures taken to reduce transmission. In addition, using genomic data, we investigated whether SARS-CoV-2 lineages associated with outbreaks at dormitories may have spread into the community surrounding UW-Madison.
The Western Institutional Review Board obtained a waiver of Health Insurance Portability and Accountability Act authorization (WIRB #1-1290953-1) to obtain the clinical specimens for whole-genome sequencing. Our analysis was reviewed by Centers for Disease Control and Prevention (CDC) and was conducted consistent with applicable federal law and CDC policy (45 C.F.R. part 46.102(l)(2), 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d); 5 U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq.). The Institutional Review Board at UW-Madison determined these activities were nonresearch public health surveillance.