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Bringing students to campuses

 If students are brought back to campus

Emerging concerns

  • Not enough PPE, testing, space on-campus to appropriately respond to COVID-19. Washington Post
  • The financial cost of COVID-19 testing. New York Times
  • On-campus congregate living buildings, dining halls, and other common spaces on-campus pose challenges for social distancing measures. CNBC
  • Some campus health services provide poor quality of care and lack infrastructure to respond to COVID-19 outbreaks. Washington Post
  • 70% of institutions lack at least one full-time physician or staff member.  12% of historically black colleges and universities have no campus clinic. Washington Post

Ethical principles

  • Preparedness plans should be flexible enough to allow timely adaptation as new evidence about the nature of the disease arises. WHO Ethics in Pandemic Flu
  • Costs and other practical constraints (e.g. logistics, distance, available workforce) may legitimately be taken into account to determine whether a less restrictive alternative is feasible under the circumstances, particularly in settings with severe resource constraints. WHO Ethics in an Outbreak

Recommendations and practices

Emerging concerns

  • Multiple outbreaks associated with universities’ reopening. New York Times
  • Nationwide COVID-19 outbreak clusters have emerged as athletes return to campus for summer training. New York Times, ESPN
  • Several colleges have cancelled athletic programs, citing an inability to safely play under current campus-wide policies. New York Times

Ethical principles

  • Preparedness plans should be flexible enough to allow timely adaptation as new evidence about the nature of the disease arises. WHO Ethics in Pandemic Flu
  • Information available will change continuously throughout the pandemic, requiring adjustments of response strategies based on ongoing assessments of the risks and potential benefits of interventions. These adjustments, and the justification for them, should be communicated to the public. WHO Ethics in Pandemic Flu
  • Decision-makers should be prepared to accept responsibility if errors or complications occur and be accountable for correcting such flaws. Indiana University

Recommendations and practices

  • The Open Smart Edu COVID-19 Planning Guide and Self-Assessment for Higher Education recommends that colleges develop models of the risks and metrics that trigger moves between alert levels and changes to the density of people on campus (Section 2.1).
  • Spelman College has reversed its decision to physically reopen campus to first-year students in the fall, citing high infection rates in Georgia, and a lack of intensive care unit beds and contact tracers in the state. Spelman College
  • After a local COVID-19 outbreak in a fraternity, UC Berkeley has reversed plans to bring students to campus in the fall. National Public Radio, UC Berkeley
  • University of Texas at Austin has created a public dashboard to display community testing and positive case data. University of Texas at Austin

Emerging concerns

  • Student athletes’ express concern that universities are prioritizing profit over safety. New York Times
  • Faculty express concerns that administrators are downplaying the personal and public health concerns. Philadelphia Inquirer
  • Professors are unwilling to return to campus but some universities are requiring them to do so. New York Times
  • Faculty are concerned that schools will not enforce face covering and social distancing guidelines on campus. National Public Radio
  • Faculties petition campuses to default to remote instruction, to enhance communication, and to ramp up public health measures. Raleigh News & Observer
  • Students are reluctant to return to campus in the fall. WRAL
  • Housekeepers and other university staff members file complaints over unsafe working conditions due to coronavirus. Washington Post
  • University concerns that local cities are not doing enough to ensure a safe environment. National Public Radio

Ethical principles

  • Avoid conflicts of interest that could interfere with the willingness to acknowledge public health threats. APHA Code of Ethics, 4.2.2.
  • Build relationships and partnerships based on mutual respect and reciprocity, recognizing the dignity and capability of individuals and the assets and strengths of the community. APHA Code of Ethics, 4.4.10.
  • All persons who could potentially be affected should have opportunities to make their voices heard in all stages of infectious disease outbreak planning and response, either directly or through legitimate representatives. WHO Ethics in an Outbreak
  • Decision-makers should be prepared to accept responsibility if errors or complications occur and be accountable for correcting such flaws. Indiana University

Recommendations and practices

  • The Open Smart Edu COVID-19 Planning Guide and Self-Assessment for Higher Education details communications processes and cycles that foster collaboration and support between the institution and the populations that it serves (Section 4).
  • Institutions may ethically continue athletic programs if students consent to participate and institutions guarantee students their athletic scholarships regardless of their decision to compete. Inside Higher Ed
  • The Ivy League has suspended all fall sports, citing an inability to “create and maintain an environment for intercollegiate athletic competition that meets our requirements for safety and acceptable levels of risk.” New York Times

Emerging concerns

  • The consequences of coming together may not be experienced equally by students, faculty, staff, and town residents. New York Times
  • Many campus staff that work in high-risk environments, such as housekeeping, sanitation, and food services do not feel fully protected or supported. The Chronicle of Higher Education

Ethical principles

  • Ensure that resulting interventions do not have a disproportionately negative impact on minority of otherwise vulnerable populations (including children and elders) and that there is an effort to enhance the resilience of populations and ecosystems to prevent future harm. APHA Code of Ethics, 4.2.9.

Recommendations and practices

Emerging concerns

  • Universities debate whether and how to enforce mask wearing and social distancing on campus. Texas Tribune, Philadelphia Inquirer
  • Some universities refuse to disclose testing and infection data for student athletes. New York Times
  • Some mandatory waivers exempt the university from liability if a student athlete contracts COVID-19. New York Times
  • Some mandatory university behavioral contracts prohibit students from social gatherings. University of Pennsylvania

Ethical principles

  • Guiding principles in determining these restrictions [on individual liberty] include: adopting the least restrictive practices that will allow the common good to be protected; ensuring that restrictions are necessary and proportional to the need for restriction; attempting to ensure that those impacted by restrictions receive support from the community (e.g., job security, financial support for individuals and their families, provision of food and other necessities to those who are isolated or placed under quarantine, and/or protection against stigmatization or unwarranted disclosure of private information). CDC Ethics in Pandemic Flu
  • The need to balance the interests of the community and the rights of the individual is of particular importance in the implementation of public health measures such as isolation, quarantine, social distancing and border control. WHO Ethics in Pandemic Flu
  • Empower community members and stakeholders to be active participants in the decision-making process. APHA Code of Ethics, 4.2.10.
  • Mechanisms should be in place to allow individuals whose liberty has been restricted to challenge the appropriateness of those restrictions, the way they are enforced, and the conditions under which the restrictions are carried out. WHO Ethics in an Outbreak

Recommendations and practices

  • The University of North Carolina at Chapel Hill will require all students to agree to abide by the University’s guidelines for physical distancing, health monitoring, and face masks. Carolina Together
  • Princeton University will impose significant student, staff, faculty travel restrictions for the duration of the school year. Princeton University
  • Emory has reversed course on fall reopening plan and will significantly reduce on-campus capacity for the upcoming school year, citing an inability to control people’s actions or local governmental regulations. The Emory Wheel
  • The University of Alabama will use a tracking app for anonymous contact tracing. AL

Emerging concerns

  • College-aged students make up an increasingly large number of COVID-19 cases nationwide. National Public Radio
  • Risk-taking behavior is highest among 20-24 year olds, and student behavior is unpredictable. New York Times, National Public Radio
  • At UNC, graduate students report being more likely to adhere to public health guidelines than undergraduate students; and students are less likely to adhere to public health guidelines off-campus. The Well

Ethical principles

  • Information available will change continuously throughout the pandemic, requiring adjustments of response strategies based on ongoing assessments of the risks and potential benefits of interventions. These adjustments, and the justification for them, should be communicated to the public. WHO Ethics in Pandemic Flu
  • Restrictions on freedom of movement should be applied in the same manner to all persons posing a comparable public health risk. WHO Ethics in an Outbreak
  • Requirements for mandatory liberty-limiting and social distancing interventions should be imposed only in cases where voluntary actions seem unlikely to be effective. CDC Ethics in Pandemic Flu

Recommendations and practices

  • CDC recommends ways to maintain healthy environments on campus to limit virus transmission. CDC
  • Harvard University will teach all undergraduate courses remotely, allowing no more than 40% of undergraduates to live on campus. Washington Post

If students are not brought back to campus

Emerging concerns

  • Clinical rotations, lab work, and some other courses and activities cannot be taught remotely. New York Times
  • 75% of students surveyed were unhappy with remote learning after colleges transitioned to virtual formats in the spring. OneClass
  • The proposed solutions to enhance the remote learning experience are time-consuming and costly. New York Times

Ethical principles

  • Costs and other practical constraints (e.g. logistics, distance, available workforce) may legitimately be taken into account to determine whether a less restrictive alternative is feasible under the circumstances, particularly in settings with severe resource constraints. WHO Ethics in an Outbreak
  • Ensure that reasonable alternative options are considered and evaluated and that final public health policies and plans are designed to most effectively accomplish stated goals while minimizing the potential for harm. APHA Code of Ethics, 4.5.9

Recommendations and practices

Emerging concerns

  • Remote-only decisions are unduly challenging for first-generation, low-income students. New York Times
  • Students have unequal access to resources to support remote learning. New York Times

Ethical principles

  • Provide adequate institutional and professional support to enable competent performance. APHA Code of Ethics, 4.8.4.
  • Even when public health measures are designed with the best of intentions, they can inadvertently place a disproportionate burden on particular populations. WHO Ethics in an Outbreak
  • Accommodating the needs of individuals whose situation makes them particularly vulnerable sometimes requires the use of additional resources. WHO Ethics in an Outbreak

Recommendations and practices

Emerging concerns

  • International students studying remotely may lose their visa status, unable to return to the United States. New York Times
  • Travel restrictions threaten students’ abilities to continue working university jobs and other university-related activities. New York Times
  • Harvard University will not allow newly admitted international students to travel to campus this fall. New York Times

Ethical principles

  • Ensure that resulting interventions do not have a disproportionately negative impact on minority of otherwise vulnerable populations (including children and elders) and that there is an effort to enhance the resilience of populations and ecosystems to prevent future harm. APHA Code of Ethics, 4.2.9.
  • Avoid unintentional stigmatization of specific groups within the community. APHA Code of Ethics, 4.5.5.

Recommendations and practices

Emerging concerns

  • Without a student population, college towns will suffer economically. New York Times
  • Colleges and universities face pressure to reduce tuition to compensate for the lack of physical presence and space. New York Times
  • Some athletic scholarships are uncertain for cancelled athletic seasons. New York Times
  • Faculty may experience layoffs and salary cuts offset financial losses from COVID-19. CNBC

Ethical principles

  • Costs and other practical constraints (e.g. logistics, distance, available workforce) may legitimately be taken into account to determine whether a less restrictive alternative is feasible under the circumstances, particularly in settings with severe resource constraints. WHO Ethics in an Outbreak
  • Governments and the health care sectors should institute measures and processes to guarantee provisions and support services to individuals and/or communities affected by restrictive measures, such as quarantine orders, implemented during a pandemic influenza emergency. University of Toronto

Recommendations and practices

What is Pandemic Ethics?

A pandemic is pervasive in scope and touches virtually every human-made system. In this dashboard, we focus on ethics in a government’s or an employer’s actions in a pandemic.

Public health ethics addresses the relationship between those governing or administrating and the population or employees they serve. They are best summarized by the Public Health Code of Ethics of the American Public Health Association.

Contact Jim Thomas