HIGHLAND HEIGHTS, KY — No one was within 100 yards of her, but Lexi Salamon still wore a mask over her mouth and nose last Thursday as she quietly pushed a supply cart filled with books down a long sidewalk on the Northern Kentucky University campus.
If Salamon, a 19-year-old second-year elementary education student from Anderson Township, had removed the mask, she would have violated NKU's updated student code of conduct, which now requires everyone on campus to wear face masks to reduce the spread of the virus that causes COVID-19.
"I think a lot of the students on campus are doing a great job of social distancing and keeping our masks on," Salamon told the WCPO 9 I-Team during our visit to the NKU campus.
Students who live on the NKU campus are also required to fill out daily questionnaires assessing their risk of being exposed to COVID-19, according to Valerie Hardcastle, the executive director of the NKU St. Elizabeth Healthcare Institute for Health Innovation and the leader of NKU's COVID-19 prevention and response efforts.
"We decided to take a different approach and just assume everyone is always infectious at all times," Hardcastle said. "We need to shape our behavior accordingly."
Salamon said NKU's COVID-19 policy is too restrictive.
"There's a reason that I don't live on campus this year," Salamon said. "And it's because they were being so strict about certain rules."
There is no national plan for how higher education should respond to the pandemic, so colleges and universities have created their own.
Ohio Governor Mike DeWine announced on Thursday that the state's guidelines for higher education now include a recommendation that all residential colleges and universities should test at least 3% of their students for COVID.
The I-Team examined the COVID-19 response plans of nine public and private universities; Northern KentuckyUniversity, the University of Cincinnati, Xavier University, Miami University, the University of Dayton, The Ohio State University, Ohio University in Athens, Indiana University in Bloomington, and the University of Kentucky in Lexington.
Those plans vary dramatically in some key areas, including testing students for COVID-19.
Some universities mandate testing for all students.
Others don't require it.
Despite widespread efforts to slow the spread of the virus, the United States reached a grim milestone this week: 200,000 Americans have died from COVID-19, according to the Johns Hopkins Coronavirus Resource Center, which has created a network designed to track all confirmed COVID-19 cases worldwide.
COVID-19 has killed 957,938 people worldwide, according to the JHCRC.
But some students have ignored the risks.
Over the Labor Day weekend, Oxford police cited six Miami University students for violating the city’s ordinance against mass gatherings, according to a police report.
An officer's body camera recorded a Miami student admitting that he and other students were hosting an off-campus party, even though they had tested positive for COVID-19.
Miami offered only online courses for the first month of the fall semester, an approach criticized by Dr. Deborah Birx, the White House COVID-19 Response Coordinator.
"It's actually more dangerous to both students and the communities to have universities close or create the perception of closure by going exclusively online," said Dr. Birx during a September 14 news conference at the University of Kentucky. "These infections are brought on campus due to what happens off campus in communities."
This week, with COVID-19 cases among Miami students trending down and new widespread testing, the university started in-person classes.
"In the end, our defense against this virus is strictly our behaviors," Dr. Birx said.
Dr. Birx said there is a "secret sauce" for success in fighting the virus on college and university campuses.
"It's a combination of having a plan and the flexibility to modify the plan based on the information that's coming in," Dr. Birx said.
"Universities that worked over the summer to prepare have been successful."
Taking Precautions
Each of the nine university COVID-19 plans examined by the I-Team describe in detail how the universities have increased cleaning and disinfecting of campus buildings, especially student housing and public bathrooms.
Each university requires face masks and social distancing in buildings on campus, according to their policies posted on the websites of those universities.
Ohio University, Miami University and the University of Indiana don't require people on campus to wear face masks outside if they are at least six feet from someone else, according to their websites.
Xavier, the University of Cincinnati, Northern Kentucky University, the University of Kentucky, The Ohio State University and the University of Dayton require people to wear masks outdoors on campus even if they are practicing social distancing.
"I think they're doing as much as they can," said UC graduate student Brahma Chintalapudi, who is studying aerospace engineering.
Chintalapudi, 24, said he works in an office on the UC campus.
"My work environment is really good," Chintalapudi told the I-Team. "I'm comfortable. We all have masks, practice social distancing and everything is sanitized."
The universities have also canceled or restructured events that traditionally attracted large crowds and increased online courses to reduce the number of students on campus.
Each of the nine universities emphasize the individual responsibility of students, and faculty and staff to follow COVID-19 policies and the potential consequences if they don't.
The Ohio State University requires students, faculty and staff to take a Buckeye Pledge to "be an active participant in maintaining my own health, well-being and safety, as well as the safety of others, by following all the guidelines and expectations outlined by the university."
According to the OSU website, students who refuse to sign the pledge "will only be permitted to take courses virtually, may not schedule a move-in time (if intending to live on-campus), may not physically enter any campus or university facility, and may not physically participate in any university activity on or off campus."
If faculty and staff refuse to take the same pledge, their supervisors take note of it and place that in their personnel file, according to the OSU website.
Beginning September 16, the University of Dayton lowered its COVID-19 threat level from RED - WARNING to YELLOW - CAUTION based on COVID-19 positive seven-day averages trending lower.
Even at the reduced threat level, Dayton students are not allowed indoor dining on campus and can't have visitors in their rooms.
COVID-19 surveys
Every day before she arrives on the NKU campus, Merlyn Mabrey said she completes her required COVID-19 self-assessment questionnaire.
Mabrey, a 49-year-old administrative assistant in the Dean of Students office, said the questions focus on if you've tested positive for COVID-19, been exposed to someone who tested positive and your symptoms in order to assess your risk of having the disease and spreading it.
NKU policy requires all students, faculty and staff to fill out the questionnaire each day they are scheduled to be on campus.
"I love that idea," Mabrey said.
Mabrey said she also works from home four out of five days a week as part of NKU's plan to reduce the number of people on-campus.
"We're taking it very, very seriously," Mabrey said.
In order to complete NKU's self-assessment, university staff, faculty and students are required to enter their university ID and password.
Miami University and OSU also require a university ID and password to begin taking daily COVID-19 surveys.
UC Vice Provost for Academic Programs Dr. Chris Lewis said 11,000 UC students signed up to use an app that enables them to do a self-assessment and find resources.
Students living on campus or coming to campus are required to use the app.
According to the UC website, students log in, then answer health-related questions.
The answers are evaluated and users either receive a "Green Pass" enabling them to go on campus and into certain buildings or a "Red Pass."
If they receive a Red Pass, the user is contacted within a day by a UC health professional to discuss next steps, according to the university's website.
"It's a huge part of our strategy," said Dr. Lewis, who is also on the university's COVID-19 response team.
OU's website provides a link for an online survey that doesn't require a university ID and password.
UK emails a daily COVID-19 screening at 6 a.m. to all faculty, staff and students who are on campus, according to the UK website.
If the self-assessment isn't completed within two hours, UK sends a text message as a reminder.
Students who fail to complete these COVID-19 screenings are considered in violation of the student code of conduct, according to the UK website.
COVID-19 testing
COVID-19 testing programs vary greatly at the universities we examined.
Although no national testing guidelines exist, a recent study by researchers at Harvard and Yale determined that in order to safely re-open, colleges and universities should require students to get tested at least twice a week.
NKU, Xavier and UC encourage students to get tested and offer it on campus, but don't require it.
"So far, we haven't seen the need to make it mandatory," said UC's Dr. Lewis, who is also a professor of family and community medicine.
Dr. Lewis said the university conducts random voluntary student tests every week.
"For our random testing program, students are invited and they have the opportunity to opt out for right now, but we are always staying elastic with our approach," said Dr. Lewis.
Each of the nine universities we reviewed provide testing, keep a record of that data and share it with their local health departments, according to the websites of those universities.
On September 10, Miami University announced that all students needed to get a COVID-19 test before moving into university dorms and on-campus apartments.
Test results would be provided to the students within 24 hours, according to a news release on the MU website.
It's the latest major update to a university testing program revised on August 29 following a surge in students who tested positive for COVID-19.
"Miami University has taken a different and more comprehensive approach to COVID-19 testing," wrote MU spokeswoman Carole Johnson in her email response to the I-Team's questions.
The university also regularly requires students who live off-campus to get tested, according to Johnson.
"We are reporting those numbers publicly on our website," Johnson wrote in her email to the I-Team. "That is why our numbers appear to be higher than other universities."
Data published September 17 on MU's website shows that 1,361 students have tested positive for COVID-19 since August 17.
"We have painted a clear picture of the impact COVID-19 has had on our community because of our extensive testing," wrote Johnson.
About 20,000 students are enrolled for classes on MU's Oxford campus.
On its website MU does not reveal the total number of COVID-19 tests taken by its students and employees.
Ohio State and the University of Kentucky have also conducted extensive testing.
OSU reported on September 17 that it has conducted 73,865 COVID-19 tests with 2,587 positive results.
UK reported it had a total of 30,539 COVID-19 tests with 1,205 positive results, according to a September 17 update published on UK's website.
UK's testing program relies heavily on data that was shared with Dr. Birx on September 14 during a series of private round-table discussions with public health experts from the university and the region.
"I saw this incredibly sophisticated system where they grade each of the contacts for severity to determine which ones have to go into quarantine," Dr. Birx told reporters after the private meetings.
UK required COVID-19 tests for every student enrolled for classes on the Lexington campus.
Those test results indicated members of UK's sororities and fraternities have a higher rate of positive tests, so UK tested the students in those organizations again, according to Lance Poston, a co-leader of COVID-19 response efforts by UK's Health Corps.
The amount of COVID-19 test data universities share on their public websites also differs significantly.
Indiana University doesn't provide COVID-19 testing result data on its website.
The University of Dayton website has updated data on total cases, positive tests, new cases, seven-day moving averages and the rate of positive cases.
Xavier provides updated data for total daily positive active cases for employees and students isolated on and off campus.
Ohio University provides updated data on total COVID-19 cases, total positive tests and the number of students currently quarantined and isolated.
NKU provides one small graph on its primary COVID-19 web page that shows the university's seven-day rolling total for new COVID-19 cases.
On September 19, NKU reported it had 9 new COVID-19 cases during the previous seven days.
NKU's Valerie Hardcastle said the university presented its data that way because "the numbers are relatively low."
Last week, Miami University released another round of COVID-19 test results for students.
The university tested 2,276 students prior to their move into campus housing.
Twenty-one of them tested positive.
Resources for COVID-19 positive students
Each of the 9 universities addresses in detail how and where students will be isolated following a positive test.
Xavier students who live on campus are asked to move from their housing assignment to the quarantine facility as soon as possible, preferably within 30 minutes.
UK transfers COVID-19 positive students by "sterile taxi" to their "dedicated isolation hall," according to UK's Lance Poston.
Poston said UK has teams that focus on helping students with COVID-19 get what they need, whether it's food delivered to their housing unit, better WiFi or health-related issues.
"We're following the best advice of our experts here," Poston said.
Based on the data provided by the nine universities the I-Team reviewed, there are currently at least 1,500 students in quarantine and isolation as a result of either testing positive for COVID-19 or being exposed to someone who tested positive.
Miami University reported on September 17 that 831 students – 61% of those who tested positive – are assumed to have "recovered."
The remaining 528 positive cases are still "active."
The 9 universities documented thousands of COVID-19 cases, but they have not reported a single death.
But the biggest challenge may be coming soon.
CDC Director Robert Redfield predicted last month that COVID-19 will make this fall "the worst ever for public health."
