Multiple COVID-19 Clusters on a University Campus

North Carolina, August 2020

Erica Wilson, MD; Catherine V. Donovan, PhD; Margaret Campbell, MSN; Thevy Chai, MD; Kenneth Pittman, MHA; Arlene C. Seña, MD; Audrey Pettifor, PhD; David J. Weber, MD; Aditi Mallick, MD; Anna Cope, PhD; Deborah S. Porterfield, MD; Erica Pettigrew, MD, JD; Zack Moore, MD


Morbidity and Mortality Weekly Report. 2020;69(39):1416-1418. 

In This Article


Rapid increases in COVID-19 cases occurred within 2 weeks of opening university A to students. Based on preliminary case investigations, student gatherings and congregate living settings, both on and off campus, likely contributed to the rapid spread of COVID-19 on campus. This suggests the need for robust and enhanced implementation of mitigation efforts and the need for additional mitigation measures specific to this setting.

The findings in this report are subject at least five limitations. First, the number of reported cases at university A is likely an underestimate. For example, some cases were reported to students' home jurisdictions, some students did not identify themselves as students to the county health department, some students did not report to the student health clinic, and not all students were tested. Second, the number of students possibly infected through affiliation with a fraternity or sorority is likely underestimated. Some students might not have disclosed their fraternity or sorority membership, and other students (who were not members of fraternities or sororities) might have participated in unofficial rush events and parties. Third, limited information was available on housing arrangements for students not identified to live on campus, as well as information about the extent of social gatherings and adherence to masking and other important mitigation efforts. Fourth, cases had limited clinical follow-up; thus, the extent of longer-term clinical complications is not known. Finally, because information available on cases in faculty and staff members was limited, the contribution of faculty or staff members to COVID-19 spread on campus cannot be estimated.

The rapid increase in COVID-19 cases among college-aged persons at university A underscores the urgent need to implement comprehensive mitigation strategies.[5,6] In addition to enforcement of mask requirements, measures needed to reduce transmission in college and university settings might include efforts to reduce the density of on-campus housing, increase testing for SARS-CoV-2, and discourage student gatherings. Emerging findings from ongoing monitoring and evaluation efforts at universities and colleges in North Carolina and nationwide are helping to update best practices, including optimal testing strategies, for preventing SARS-CoV-2 transmission on campus and in the adjacent communities.