University of Illinois Urbana-Champaign response to the COVID-19 pandemic

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UIUC COVID-19 response
UIUC COVID-SHIELD logo.jpg
FormationMarch 2020; 1 year ago (2020-03)
Location
Parent organization
UIUC
Website

On March 11, 2020, as the impact of the COVID-19 pandemic became clear, the UIUC announced that face-to-face classes would end at Spring Break, as did most universities. Almost immediately, the university started developing a strategy to reopen the university during the Fall semester, with these elements:

  • in-house development of a new rapid, reliable, low-cost saliva test for the SARS-CoV-2 virus, with faster turnaround and safer handling than existing tests
  • adaptation of the UIUC-developed Rokwire open-source smart-phone app to provide results from testing so that individuals could quickly demonstrate building-entry permission for classes and other campus activities
  • use of UIUC mathematical models of disease spread to plan facilities for isolation and quarantine of students during and after re-entry in mid-August, and to inform crucial decisions about which groups should test once, twice or more times per week.

The three elements came together, barely in time -- with some glitches early in the semester, followed by smoother operations. By late August, RT-qPCR tests run at UIUC accounted for 1-2% of total testing in the United States.[1] The University of Illinois system quickly expanded the program to its universities in Springfield and Chicago. However, expansion to businesses and to other schools and universities, within and outside Illinois, was slowed because of the need to obtain authorization under the FDA's EUA process. Meanwhile, universities with CLIA-certified labs started testing programs based on the UIUC saliva test well before FDA authorization on February 24, 2021. After FDA's EUA authorization, testing expanded to over 20 private universities, public universites and community colleges within Illinois and to about 30 colleges and universities outside Illinois.

Preparations for COVID-19 management[edit]

The saliva test[edit]

In April 2020 a team was formed to develop and deploy large-scale COVID-19 testing for use on the UIUC campus. The possibilities of using a saliva test were explored; such a test may be a good indicator of how contagious a person is: it tests the fluid which is likely responsible for much of the transmission between people.[2] The team, headed by Paul Hergenrother of the UIUC School of Chemical Sciences,[3] included people in the university's Institute for Genomic Biology, the Carle Illinois College of Medicine, the Beckman Institute for Advanced Science and Technology, the Department of Microbiology, and the College of Veterinary Medicine where a veterinary diagnostic lab was repurposed for handling the demands of analyzing thousands of samples per day.

As this team began its work, reports of methods to detect the virus in swabs, without the time-consuming RNA-extraction step, were appearing,[4] and on April 10, 2020 Rutgers University received FDA emergency use authorization (EUA) for a saliva test (which included RNA extraction).[5] Within two months of the UIUC team's formation, a scientific paper documented the team's research on a rapid saliva test which replaces RNA extraction by heat inactivation, with no need for laboratory personnel to open the vial after an individual provides a saliva sample.[6] Meanwhile Yale University developed a test which uses proteinase K treatment during a heat inactivation step.[7]

As a CLIA-certified lab, the campus's veterinary diagnostic lab was able to satisfy the Food and Drug Administration's test requirements within the FDA's LDT regulations.[8] By early July, 2020 this lab was running the saliva procedure on samples provided by UIUC employees and students.[1]

The Safer Illinois app[edit]

Starting in mid-March the university developed a smart-phone app to play an important role in the UIUC campus response to the COVID-19 pandemic.[9] The "Safer Illinois App," which had a soft launch on June 8,[10] was built on the ROKWIRE open-source smart-phone platform, established at UIUC in 2018. This was a natural platform to use, since ROKWIRE was already serving the campus with its first product, the "Illinois App."

On August 13, 2020, days before students arrived for the fall semester, the Safer Illinois App was announced as operational.[11] Two days later the saliva test lab started analyzing increasing numbers of samples 7 days per week.[12]

Modeling[edit]

A mathematical model was used to estimate the number of people who would test positive in entry screening during August 15–23.[13] An estimate, made on July 24 using an existing UIUC model of COVID-19 dynamics in Illinois,[14] projected forward to mid-August to estimate of the percentage of infected people within the state of Illinois in mid-August: 0.44%. Based on this, the detection of roughly 200 positive infections was anticipated during entrance screening, with 95% confidence interval of 72 to 414 infections. For students in University Housing, about 5% of the campus room inventory was reserved for isolation or quarantine.[15]

The 2020-2021 academic year[edit]

The return to campus and an early spike[edit]

55,034 tests were performed during the August 15 through 23 return to campus, with 288 people testing positive.[12] This number falls within the "entry screening" model's 95% confidence interval of 72 to 414 positives. This 0.5% positivity continued during the first week of classes, August 24 through 28. The next four days, August 29 through September 1, saw 588 positive tests, almost equaling the number of positives during the previous 14 days. This was deemed to reflect risky behavior, particularly among undergraduates.[16][17] On September 2 a campus massmail announced a university-wide two-week "essential activities only" period and announced increased efforts to identify and remove individuals who were creating risk for the campus and the community.[18]

At this time, New York Times writer Kenneth Chang credited the overall UIUC COVID-19 response as "one of the most comprehensive plans by a major college to keep the virus under control."[19] During the second week of "essential activities" there was a sizable decrease in the number of cases observed, and, on September 16 a campus massmail[20] ended the two-week period.

Ongoing campus COVID-19 management[edit]

Initially the UIUC plan was to test each individual once per week. However, based on modeling studies this was changed to twice per week before large numbers of students arrived on campus in August. This rate was characterized by Nick Anderson of the Washington Post as "a staggering pace for a large public school".[21]

Soon, this rate of testing strained the laboratory's ability to produce rapid results, which weakened the ability of the testing program to quickly identify people who should go into quarantine.[22] At the same time, it became clear that fewer than 5% of positive tests were from among faculty, staff and graduate students. So, on September 7, 2020 testing of these groups was reduced to once per week.[20] This, combined with an expansion of laboratory capacity, caused laboratory turnaround times to reduce from as high as 48 hours early in the semester to a little over 8 hours by early October.[23]

The number of positive tests reached a semester-low of 85 new COVID-19 detections during the week of October 10 through 16, then increased steadily during the following three weeks.[24] On November 10, the university announced that faculty, staff and graduate student positivity was increasing rapidly, so these groups were required to resume twice-per-week testing.

Extended usage of the saliva test[edit]

In August, 2020 the University of Illinois had a strategy for expanding use of the test outside of CLIA-certified labs,[2] based on an understanding that the UIUC test could receive, via a "bridging" study, FDA's Emergency Use Authorization (EUA) under the umbrella of Yale University's SalivaDirect test.[25] However, because the UIUC saliva test differed significantly from the Yale test, this strategy was found to be insufficient[26] and a study was undertaken to directly qualify the test for use under the FDA's EUA process.The test was authorized by FDA's EUA process on February 24, 2021.[27][28]

Meanwhile the University of Illinois developed a system, named SHIELD T3, for extending the saliva test to a wider range of users. By Spring 2021, a number of universities adopted this for use, even before FDA authorization, by using their own CLIA-certified labs; these included the University of Notre Dame,[29] the University of Wisconsin–Madison,[30][31] the University of Maine[32] and the University of Wyoming.[33] In addition, it was adopted by Bloom Energy to implement COVID-19 testing for businesses and individuals in the San Francisco South Bay area.[34]

Following the February 24, 2021 FDA authorization, the university cooperated with OSF HealthCare to begin offering the test to employees of Champaign County and to students in local schools, both elementary and high school.[35] In addition, members of UIUC student and staff households could receive saliva testing, for payment of $10 per test.[36] At greater distance, four Washington, D.C.-area universities, Gallaudet, American, Catholic and Marymount, as well Baltimore high schools have begun SHIELD testing,[37][38] and testing began at a variety of private and public universities[39] and Community Colleges[40][41] in Illinois.

References[edit]

  1. ^ a b Peplow, Mark (November 1, 2020). "How one university built a COVID-19 screening system". 98 (42). Chemical & Engineering News. Retrieved 2020-11-07. Cite journal requires |journal= (help)
  2. ^ a b Munks, Jamie; Leventis Lourgos, Angie (August 19, 2020). "FDA approves U. of I.'s 'potentially game-changing' COVID-19 saliva test ...". Chicago Tribune. Retrieved 2020-10-06.
  3. ^ Service, Robert F. (August 28, 2020). "Spit shines for easier coronavirus testing". Science. 369 (6507): 1041–1042. Bibcode:2020Sci...369.1041S. doi:10.1126/science.369.6507.1041. PMID 32855317. S2CID 221358939. Retrieved 2020-10-12.
  4. ^ Bruce, Emily A.; et al. (2 October 2020). "Direct RT-qPCR detection of SARS-CoV-2 RNA from patient nasopharyngeal swabs without an RNA extraction step". PLOS Biology. 18 (10): e3000896. bioRxiv 10.1101/2020.03.20.001008. doi:10.1371/journal.pbio.3000896. PMC 7556528. PMID 33006983.
  5. ^ Garcia de Jesus, Erin (April 17, 2020). "Here's where things stand on COVID-19 tests in the U.S.". Science News. Retrieved 2020-10-12.
  6. ^ Ranoa, Diana Rose E.; Holland, Robin L.; Alnaji, Fadi G.; Green, Kelsie J.; Wang, Leyi; Brooke, Christopher B.; Burke, Martin D.; Fan, Timothy M.; Hergenrother, Paul J. (June 18, 2020). "Saliva-Based Molecular Testing for SARS-CoV-2 that Bypasses RNA Extraction". bioRxiv 10.1101/2020.06.18.159434.
  7. ^ Vogels, Chantal B.F.; et al. (August 3, 2020). "SalivaDirect: A simplified and flexible platform to enhance SARS-CoV-2 testing capacity". medRxiv.org. Retrieved 2021-04-30.
  8. ^ "Laboratory Developed Tests". www.fda.gov. U. S.Food & Drug Administration. September 27, 2018. Retrieved 2020-11-14.
  9. ^ "The human element: How the need for voluntary adoption changed every aspect of the Illinois reopening plan". rokwire.org. UIUC. August 17, 2020. Retrieved 2020-10-22.
  10. ^ Deckert, Taylor (May 28, 2020). "U of I adds new platform to prepare for on-campus activities". foxillinois.com. WICS/WCCU. Retrieved 2020-10-22.
  11. ^ Cauguiran, Cate (August 20, 2020). "University of Illinois 'Safer Illinois' app could notify users of COVID-19 exposure in minutes". ABC7 Chicago. Retrieved 2020-10-22.
  12. ^ a b "Shield Testing Data". UIUC. Retrieved 2020-10-15.
  13. ^ Elbanna, Ahmed; Wong, George N.; Weiner, Zach J.; Wang, Tong; Zhang, Hantao; Liu, Zhiru; Tkachenko, Alexei; Maslov, Sergei; Goldenfeld, Nigel (September 2, 2020). "Entry screening and multi-layer mitigation of COVID-19 cases for a safe university reopening". medRxiv. doi:10.1101/2020.08.29.20184473. S2CID 221399269. Retrieved 2020-10-24.
  14. ^ Wong, George N; Weiner, Zachary J; Tkachenko, Alexei; Elbanna, Ahmed; Maslov, Sergei; Goldenfeld, Nigel (June 17, 2020). "Modeling COVID-19 dynamics in Illinois under non-pharmaceutical interventions". Phys. Rev. X. 10 (4): 041033. arXiv:2006.02036. Bibcode:2020PhRvX..10d1033W. doi:10.1103/PhysRevX.10.041033. S2CID 219260667.
  15. ^ Zigterman, Ben (August 5, 2020). "UI students begin dropping off belongings ahead of move-in". The News-Gazette. Retrieved 2020-11-02.
  16. ^ Simmons, Ethan; Robinson, Heather (September 2, 2020). "University attributes spike in COVID-19 cases to illegal student behavior". The Daily Illini. Retrieved 2020-10-15.
  17. ^ Cherney, Elyssa (September 2, 2020). "'Irresponsible and dangerous' partying by some students leads University of Illinois to crack down on social activity and warn of suspensions as campus COVID-19 cases near 800". Chicago Tribune. Retrieved 2020-10-21.
  18. ^ Jones, Robert J.; Cangellaris, Andreas C.; Young, Danita M. B.; Mirza, Ali; Perezchica, Alexis (September 2, 2020). "Increased enforcement of COVID-19 safety guidelines". UIUC. Retrieved 2020-10-15.
  19. ^ Chang, Kenneth (September 10, 2020). "A University Had a Great Coronavirus Plan, but Students Partied On". New York Times. Retrieved 2020-09-12.
  20. ^ a b "Massmail Announcements (COVID-19)". UIUC. Retrieved 2021-03-26.
  21. ^ Anderson, Nick (September 4, 2020). "Welcome to college. Now get tested for the coronavirus — again and again". The Washington Post. Retrieved 2020-09-07.
  22. ^ Cui, Willie (October 12, 2020). "University COVID-19 testing capacity far lower than advertised". The Daily Illini. Retrieved 2020-10-15.
  23. ^ Cui, Willie (October 5, 2020). "Average campus test result sent within 8 hours, SHIELD says". The Daily Illini. Retrieved 2020-10-21.
  24. ^ Simmons, Ethan (November 9, 2020). "COVID-19 continues surge in Illinois, campus". The Daily Illini. Retrieved 2020-11-09.
  25. ^ Gallagher, Grant M. (August 15, 2020). "FDA Grants Emergency COVID-19 Authorization to Yale's Open Source Method of Saliva Testing". Contagion Live. Retrieved 2020-10-12.
  26. ^ Zigterman, Ben (Oct 13, 2020). "UI plan: Start semester late, cancel spring break". The News-Gazette. Retrieved 2020-10-14.
  27. ^ Cherney, Elyssa (March 1, 2021). "University of Illinois wins FDA approval for saliva COVID-19 test: 'We're wasting no time in deploying this,' Gov. Pritzker vows". Chicago Tribune. Retrieved 2021-03-01.
  28. ^ Griffin, Jake (March 1, 2021). "U of I's COVID-19 saliva test finally receives FDA approval". Daily Herald. Retrieved 2021-03-02.
  29. ^ Paul, Maria Luisa (October 19, 2020). "Notre Dame adopts saliva-based testing as part of its surveillance testing strategy". The Observer. Retrieved 2021-04-23.
  30. ^ Musso, Gina (November 6, 2020). "UW-Madison will expand COVID-19 testing for Spring semester". The Daily Cardinal. Retrieved 2021-04-18.
  31. ^ Schinderle, Abby (January 17, 2021). "UW-Madison begins new Covid-19 testing plan inspired by the University of Illinois Urbana-Champaign". channel3000.com. WISC-TV. Retrieved 2021-04-18.
  32. ^ Mundry, Jackie (January 15, 2021). "U Maine System announces mandatory weekly COVID-19 testing for spring semester". News Center Maine. Retrieved 2021-04-18.
  33. ^ "UW Offers Free COVID-19 Tests to Public". University of Wyoming News. January 28, 2021. Retrieved 2021-04-18.
  34. ^ Louie, David (December 12, 2020). "Bloom Energy in San Jose builds new lab to expand COVID-19 testing". abc7news-SF. Retrieved 2021-04-19.
  35. ^ "Saliva based Covid tests coming to schools". wcia.com. WCIA. March 23, 2021. Retrieved 2021-04-20.
  36. ^ Pressey, Debra (March 23, 2021). "UI working with OSF to expand saliva testing to local community". The News-Gazette. Retrieved 2021-04-20.
  37. ^ Lumpkin, Lauren (February 24, 2021). "New coronavirus testing lab will produce faster, cheaper results for D.C.-area universities". The Washington Post. Retrieved 2021-04-24.
  38. ^ Isaacs, Abby (February 24, 2021). "City Schools offering asymptomatic COVID-19 testing for students and staff in-person". WMAR-TV. Retrieved 2021-04-18.
  39. ^ Majid, Aliza (February 18, 2021). "UI saliva-based COVID-19 test expands nationwide". The Daily Illini. Retrieved 2021-04-19.
  40. ^ Sobota, Lenore (March 16, 2021). "Heartland Community College to have Shield Illinois COVID-19 testing". The Pantagraph. Retrieved 2021-04-17.
  41. ^ "About SHIELD testing". richland.edu. Richland Community College. April 5, 2021. Retrieved 2021-04-17.

External links[edit]

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