University of Iowa health expert latest to raise concerns over in-person classes

IOWA CITY - Even though COVID-19 numbers for Johnson County and the University of Iowa are imperfect and should be seen as an indication of trends, what those trends show is that face-to-face learning at this time is unwise, a UI Health Care expert said Wednesday evening.

'Given the way our numbers look, I don't think there should be any in-person instruction at any level of education,” Michael Edmond, UIHC chief quality officer and associate chief medical officer, said during a special UI Faculty Senate meeting.

Edmond, a clinical professor of internal medicine and infectious diseases, was among a handful of UIHC experts - including UI Vice President for Medical Affairs Brooks Jackson and UIHC hospital epidemiologist Jorge Salinas - to speak to the faculty.

Acknowledging that the daily tally of new COVID-19 cases has dropped in Johnson County and on the UI campus in recent days, Salinas aired concern the dips don't paint an accurate picture of the community's coronavirus prevalence. The rate of testing could be low or students could have gone home over the Labor Day holiday weekend and been tested elsewhere, he noted.

He also pointed to data glitches at the state, which Salinas said has been 'impaired by technological problems.”

'They have had difficulties with their data management,” he said. 'They've been trying to fix those. But every week, you can hear reports of an issue.”

The UI, meanwhile, implemented a 'passive surveillance” system that hopes individuals self-report positive cases.

'The problem with such type of surveillance is that if there are any incentives or disincentives to report, it may not be a true reflection of reality,” he said. 'So all of the numbers that are reported are indicators of trends. But don't believe that we've only had the exact number that is being published. You need to be aware of the biases and based on that you adjust your estimate.”

UI faculty members asked a range of questions about the university's handling of COVID-19 - including why students have struggled to get tested; why some classrooms aren't properly distancing students; and why the UI isn't conducting more random and proactive sampling to prevent outbreaks.

UI Campus Health Director Daniel Fick said such testing hasn't proved beneficial when other campuses have tried it, noting the UI is following federal and state guidance.

'I think, at this point, we've not been able to see a campus that tests everybody that then ultimately can show total numbers of virus and an outbreak are significantly better,” Fick said. 'So, again, we don't know. We're making no promise on campus that we're 100 percent right, and we know how to do this better than anyone else.”

But, Fick said, testing too many could result in false positives.

'And, at this point, the campuses that have done a lot of testing don't actually show decreased virus numbers,” he said.

Although the UI has recorded 1,642 cases of COVID-19 on campus among students and employees since Aug. 18 - among the highest totals across the country's higher education system - UI officials have rejected calls from some students, faculty and staff to shift all learning to online only.

Fick defended that decision Wednesday, noting three-quarters of undergraduate learning already is virtual.

'At this point going totally online most likely - given our small spread to faculty and staff - isn't going to make a significant difference in the spread at this point,” he said. 'Students need to stay here; the (Centers for Disease Control and Prevention) is not recommending students leave. Our residence halls would be open, and the majority of our students would still be on campus. So it wouldn't dramatically affect our numbers here in the community.”

When asked whether UIHC has enough testing supplies - and whether there is capacity to ramp it up - UIHC Vice President Jackson said the hospital campus does have enough to test symptomatic patients and those they've had close contact with.

'But obviously if you were wanting to test everybody every day, no, we don't,” he said.

Vaccine news

Jackson told the faculty that the university's portion of a Pfizer vaccine trial is expected to be fully enrolled by next week. He re-upped recent reports of potential results by the end of October, but he said that is 'no guarantee.”

Earlier in the day, Dr. Francis Collins, director of the National Institutes of Health, told a U.S. Senate panel he had 'cautious optimism” an effective vaccine would be ready by the end of the year - maybe, the Associated Press reported.

'We've got to show efficacy and safety,” Jackson told the faculty. 'But the phase one-two data looks really quite good in terms of being able to generate neutralizing antibody.”

And, he said, 'side effects have been pretty minor with this vaccine.”

'I feel pretty confident that it will work - but you never know until you see the data.”

Jackson said the state has asked UIHC to 'prepare to be able to distribute vaccine by Nov. 1.”

'We have been ordering the ultra-freezers for the vaccine, so we are getting prepared just in case that this vaccine really is efficacious and meets the safety parameters,” Jackson said.

In the meantime, he said, UIHC has done a 'very good job” in keeping infection rates low and treating those who are infected or even hospitalized.

He reported about a dozen medical students have been infected, but no university students have been hospitalized.

'And we probably had close to a couple thousand students who have been infected over the last couple of weeks.”

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