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'Light at the end of the tunnel': Spring brings improvements to UNC's COVID-19 testing

A student puts her COVID-19 test in the tube at the Rams Head Recreation CTTP testing site on Jan. 19, 2021.

The first week of move-in for the fall semester – and the first week students returned to campus after the pandemic began — the University conducted 354 tests for COVID-19. Over the spring semester's first week of class, it did over 13,000. 

Here’s how UNC-Chapel Hill pulled off an over 3,000 percent increase in testing for a semester that has by-and-large avoided the COVID-19 crisis of the fall.

After sending students home only seven days into the fall semester, the University set out to completely revamp its testing program for the spring. Dr. Amir Barzin, a professor in UNC’s Department of Family Medicine, was tapped to lead the effort.  

“My goal going into it was to make a fast, easy, reliable experience for students that would allow us quick turnaround time for tests (and) limit, as much as possible, any kind of human error or manual labor,” Barzin said. 

His team developed the Carolina Together Testing Program, which requires students taking classes on-campus or living in dorms to get tested twice a week, while students with remote classes who live off-campus get tested once weekly. 

The process is organized through the UNC Hall Pass web-based app, which gives students a unique bar code for each test they take at one of three testing locations on campus. Results are typically returned within two days. 

Since the spring semester began, the percent positivity rate of COVID-19 testing has rested at about 0.5 percent, a far cry from the 13.6 percent positivity rate that prompted the University to move classes online in August. 

“It definitely does make me feel safer,” said Gabriela Duncan, a student volunteer for the testing program. “I just think that if we implemented this program last semester, it would have made a huge difference.”

When the fall semester began, testing on campus was only available at Campus Health. These tests could also take a while to return results which, as Rachel Graham, an epidemiologist at the UNC Gillings School of Global Public Health pointed out, is not sufficient to limit spread. 

“It was up to a week in some cases,” Graham said. “Which is a kind of pathetic snapshot of what your health was like a week ago, but doesn't tell you anything about what your life is like right now.”

Barzin said that back in August, there simply was not a testing infrastructure well-developed enough to supply a mandatory testing program. 

 “If we were to try to have done what we're doing right now in the fall, I don't think that we would have had the technology there to be able to even think about doing it, let alone the supply chain,” Barzin said. 

In September, the University began offering optional saliva tests for students who remained in the Chapel Hill area. This program gave Barzin’s team essential insight into how to develop an effective testing infrastructure. After this voluntary testing option was introduced in September, the University conducted about 2,300 tests every week, on average. 

“That was a really great way for students to segue into what it would feel like to do regular cadence testing,” Barzin said. “And I think that what we saw was, you know, if you do larger-scale testing in asymptomatic people, this is what we expect the positivity rate to be — and that was helpful science for us.” 

The percent positivity rate from this initial voluntary program rested at about 0.9 percent, on average. Now, with approximately 3,500 students eligible to live on campus and a mandatory testing program established, the percent positivity has lowered to 0.5 percent.

Graham said a robust testing program such as this one is the largest factor in having a successful semester.

“There also is a likelihood, particularly in the University community, that there has already been a significant amount of exposure and that there is some immunity showing up that actually influences the ability to spread virus and spread disease,” Graham said. 

For Barzin, the semester’s success would not have been possible without compliance from students.  

“I think the testing is a large part to do with it,” he said. “But I think you're selling yourself short if you're not giving credit to your student classmates. I think the job that you guys have done to abide by the community standards and take them seriously is absolutely tremendous.”

Although vaccines are now available for some members of the University community, Graham said regular testing will likely continue to be a part of life for students until nationwide herd immunity is reached — a milestone Barzin is optimistic about.

“We talk about seeing the light at the end of the tunnel,” he said. “And that light is bright right now. We're poised to set ourselves up to succeed if we continue to do the things that we're doing.” 

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