A Q&A about COVID-19 testing at Yale
COVID-19 testing is an integral part of Yale’s strategy for supporting the health and well-being of students, faculty, and staff.
As the fall semester gets under way, Dr. Madeline Wilson, chief quality officer at Yale Health and chair of Yale’s COVID-19 Testing and Tracing Committee, spoke with YaleNews about the university’s testing program. A primary care physician and past chief of internal medicine, she has been with Yale Health — the primary health care provider for Yale University students, faculty, staff, and their families — for 15 years.
Why is COVID-19 testing important?
Our main goal in building Yale’s testing program is to reduce the risk of outbreaks on campus. Protecting the Yale and greater New Haven community is the underlying rationale for the design of the testing program. While safer behaviors are the cornerstone of prevention, testing plays a critical role in identifying positive cases early and isolating those individuals to reduce risk to others.
We have two testing approaches, one for individuals with COVID-19 symptoms, and one for testing of people without symptoms. In both cases, the test performed is a viral PCR test. We’re confident that the tests we’re using are highly sensitive and specific.
Can you describe the two testing approaches?
The test for symptomatic individuals is performed with a nasopharyngeal swab obtained by a healthcare provider. We are asking those individuals in the Yale community with COVID-19 symptoms to get tested as soon as possible, either through Yale or through their private health care provider. We also ask these individuals to isolate themselves immediately. Students or staff with symptoms should not come to campus and should call Yale Health first for guidance.
Asymptomatic testing is for a much larger testing group, and is the approach we’ll use to test students, for example. The test is a self-administered, front-of-the-nose swab. The tests are processed by the Broad Institute in Cambridge, and we expect to get the results 24-36 hours after the sample is obtained.
We expect to be handling more than 2,000 tests a day during the semester. Given that volume of tests and the fact that students will be arriving from all over the country, we do expect to see some positive tests.
If a test result is positive, that individual will get a call from Yale Health and will be notified directly through their MyChart account. The individual will have a prompt interview with a nurse who will go over the results and explain what will happen next. Yale will initiate contact tracing, and if the individual is an undergraduate, we would move that person to isolation housing on Old Campus. Students living off campus would be asked to isolate in their residence.
How is Yale going about testing for different campus populations?
We’re requiring that students be tested before they arrive and then be tested again upon arrival. We’re focusing on on-campus undergraduates as the highest-risk community because they will be living in a communal housing environment. So, we’ll be testing them twice each week, as well as the undergraduates who are enrolled in residence but living in off-campus housing. We’ll also have twice-a-week testing for graduate students living on campus in certain high-density, dormitory-style housing. For graduate students living off campus or in lower density Yale housing, we will provide optional testing up to once a week.
We’ve also identified about 800 faculty and staff members who are expected to have daily, non-incidental contact with students. We’ve asked them to get tested on a weekly basis. Testing for all other faculty and staff is voluntary up to once a week.
Why not test more people more often?
For people who are not on campus or who aren’t having extended close contact with others on campus, the value of frequent testing in order to prevent an outbreak on campus is low. What reduces risk is behavior, such as wearing a face covering, frequent handwashing, and practicing social distancing.
How does Yale’s testing protocol compare with testing at other universities?
I’m in touch with a number of folks in charge of testing programs at other Ivy League institutions, and we are all facing the same challenges. Some schools will test students only on arrival, others will offer testing once, twice, or even three times weekly. We feel good about our testing frequency to minimize transmission in our community.
What are the data telling us now?
All of the information about the Yale community, as well as the Connecticut community, is reassuring. Our asymptomatic testing shows our positivity rate at about 0.17%. It is low. Connecticut has been very stable, at about a 1% positivity rate. We feel good about the baseline numbers we’re starting from, but we’re being extremely careful as we start the semester.