Editor’s note: Students’ names have been changed in order to protect their privacy.
Tufts Executive Vice President Mike Howard informed the Tufts community on March 12 that an undergraduate student had tested positive for COVID-19, the first known case at Tufts. Howard assured community members that the student was in isolation and receiving care.
Health Service had tested the student, Jack, for COVID-19 two days earlier — the same day that University President Anthony Monaco announced the suspension of in-person classes and asked students to leave campus.
However, university officials waited until the Massachusetts Department of Public Health (DPH) confirmed Jack’s positive case to begin conducting contact tracing. Though Howard told community members that Jack had been in isolation, Tufts Executive Director of Media Relations Patrick Collins wrote in an email to the Daily on April 19 that more than 140 people may have been exposed to this single case of the novel coronavirus.
By the time university officials began contact tracing, many students on the list were wishing their friends goodbye and planning their travel home. At least one had already left campus and returned to their family. Any of them could have been carrying COVID-19.
Meanwhile, two students who shared an off-campus apartment with Jack felt the university left them to fend for themselves. Jack’s housemates recounted a disorganized, “unhelpful” and “unprofessional” response from high-level administrators in the Office of the Dean of Student Affairs (DOSA) during their 14-day quarantine.
The Daily has not been able to determine whether any of the more than 140 contacts resulted in another case of COVID-19.Nonetheless, accounts from members of the Tufts community about the days surrounding Jack’s positive test reveal a lack of coordination among state, local and university officials over how to handle potential cases during the early days of the pandemic.
Research published in April by the Centers for Disease Control and Prevention (CDC) found that infected individuals may transmit the virus up to 72 hours before developing symptoms. The World Health Organization advises that patients may be most contagious around the time of the onset of symptoms.
Jack was tested for COVID-19 on March 10. In the three days before Jack’s visit to Health Service, he made a transatlantic flight, attended crowded social functions and otherwise lived a normal college life.
Dozens of people, including many members of the Tufts community, could have been infected in a worst-case scenario. Those people may have become contagious as soon as two days after exposure, according to the CDC.
Details about the virus’ transmission remain unclear, however. In early March, public health officials were working with even less definitive information.
“All of the actions the university took in response to this situation came during a time of great challenge,” Collins wrote in an email to the Daily. “Guidance from the CDC and the Massachusetts DPH was evolving daily, information about the novel coronavirus was incomplete and still emerging, and the immediate future was hard to predict or prepare for.”
According to Collins, it was impossible for Tufts to determine when or where Jack contracted COVID-19.
One week before Jack tested positive for COVID-19, however, he traveled to London for a high school reunion.
Jack estimates that 70 people attended the reunion on March 6, including students from at least five European countries. Two of those countries, Spain and France, reported several hundred cases at the time and had either implemented social distancing measures already or did so soon thereafter.
However, Jack does not recall that any of the attendees were sick and was not particularly concerned about contracting the virus.
“I’m more of a risk-tolerant person,” Jack told the Daily on March 14. “I guess the other thing was that the U.K. wasn’t remotely bad at that time — the figures were minimal, just like every other country.”
Jack returned to Boston on March 7 and attended a mixer at Arts Haus that evening with around 90 other people from five student organizations.
The following day, he spent about 30 minutes at Commons Marketplace in the Mayer Campus Center before meeting with four students at Tufts’ Collaborative Learning & Innovation Complex (CLIC) at 574 Boston Avenue to discuss their work for an extracurricular organization. Later that day, Jack attended a meeting for the same club at the Massachusetts Institute of Technology (MIT), along with a student from the CLIC meeting, two MIT students and a student from Northeastern University.
On March 9, Jack went to an economics class in Braker Hall and a physics class at the CLIC with 44 other students, according to Tufts’ Student Information System.
Jack developed a cough that evening. After waking up the next morning with a fever, he went to Health Service immediately.
Jack tested negative for influenza, and Health Service staff ruled out the common cold due to his fever. Based on Jack’s symptoms and travel history, they requested that the DPH authorize a test for COVID-19.
DPH Director of Media Relations Ann Scales could not comment on Jack’s case but explained that COVID-19 testing was much more limited in early March than it is now.
“At that time, there was guidance from the CDC about who should be tested and we were following their recommendations and approving which specimens should come into the State Public Health Laboratory for testing,” Scales wrote in an email to the Daily.
DPH eventually authorized the test after further requests from Health Service and recommended that Jack isolate at home. Health Service instead chose to quarantine Jack on campus “out of an abundance of caution” to prevent further community spread through his housemates, according to Collins.
Before being ushered to a designated ‘health suite’ in Hodgdon Hall, Jack gave Health Service staff a list of people with whom he’d been in contact in recent days. Of the students on that list, only Jack’s four housemates were contacted by the university before March 12.
On March 10, Jack’s housemates were told that he had been placed in quarantine after being tested for COVID-19. DPH did not require that Jack’s housemates quarantine themselves, and two, Danny and Wes, told the Daily they attended classes that afternoon.
The following morning, however, Health Service advised Jack’s housemates to isolate themselves in their apartment “out of an abundance of caution,” according to Collins.
Officials from Health Service also requested that they leave a bag with Jack’s belongings outside his quarantine room in Hodgdon on March 10.
This required entering Jack’s bedroom and handling his clothing and laptop, among other items. Health Service did not recommend that Jack’s housemates use protective equipment or take any measures to shield themselves from exposure to the virus, according to Danny.
Collins denies that Tufts put Jack’s housemates at risk.
“Any deliveries of belongings by friends of the student who tested positive for COVID-19 in isolation were made in a safe manner devised with input from health staff,” Collins said.
That evening, Monaco announced that Tufts would conduct courses online for the rest of the semester and asked students to leave campus. The decision was appropriate, despite its potential to disperse any asymptomatic cases around the country or overseas, according to Sen Pei, an associate research scientist at Columbia University’s Mailman School of Public Health.
“If there are some people getting infected and then moving to other places, like what happened in China … that is a situation we don't want to see here in the U.S.,” Pei said. “But it's necessary to close the school because if we let students stay in schools, there's much higher risk of transmission in school.”
On March 11, Howard informed the Tufts community in an email that a student had been tested for COVID-19.
“We are following all [DPH] recommendations pertaining to quarantine and isolation,” Howard wrote. “We are in close contact with public health authorities and will continue to follow their guidance on this matter.”
The following afternoon, around 4 p.m., Health Service told Jack that he had tested positive for COVID-19. Both the Medford Health Department and Health Service staff interviewed Jack that afternoon to identify people with whom he had been in contact, according to Collins.
Howard announced the positive case in an email to the Tufts community just after 6 p.m. and said that community members who may have had contact with the infected student would receive guidance on self-quarantine from the Medford Health Department.
Jack gave Health Service a student contact for the Arts Haus party earlier that afternoon as part of his list of contacts. However, representatives from one of the organizations present at the party already suspected the student tested on March 10 was in attendance.
When Jack’s positive case was announced on March 12, the club representatives sent DOSA a list of their members who attended the party and encouraged the other clubs present to do the same.
The good-faith effort turned into a disjointed attempt to identify party attendees. Some of the clubs gave DOSA the names of members who were at the party. Others told their members to reach out to DOSA if they had attended.
University officials ultimately pieced together a list using information provided by the clubs and by individual attendees, as well as a Facebook attendance list for the party.
DOSA staff worked late into the night on March 12 to contact more than 140 community members who may have been exposed.
In individual emails to the students, DOSA requested that they stay at home for two weeks and answer questions about their travel history and plans, contact with infected persons and whether they had attended the March 7 party at Arts Haus. Students living on campus who may have been exposed to the virus were given permission to stay in their residences until they completed their quarantine, according to Collins.
DOSA also told the students that they “likely [were] not contagious to others” if they did not have a fever, cough or shortness of breath. But public health experts were still learning about the virus’ transmission in early March and even now remain unsure to what extent this is true.
The current belief is that asymptomatic and presymptomatic people are less likely to transmit COVID-19 but can still do so, according to Pei.
“Based on our estimation, in China, the infectiousness of people [who] have no symptoms or have mild symptoms is about half as contagious as people [who] develop symptoms,” Pei said on April 1. “When they cough, the [viral] load in their droplets will be lower than the people who have symptoms.”
However, Elizabeth Lee, an epidemiologist at Johns Hopkins University, told the Daily in an email on April 9 that the “relative infectiousness” between people who experience symptoms and those who do not remains imprecise.
In addition to students who attended the Arts Haus party, DOSA contacted the students with whom Jack met on March 8 for an extracurricular project, students in his two classes on March 9 and Arts Haus residents.
Students in a different economics class, held on Tuesdays and Thursdays, in which Jack is enrolled received the same email from DOSA just after 10 p.m. Half an hour later, DOSA told them that the email was a mistake and that Jack did not attend the course that week.
The Medford Health Department informed MIT and Northeastern on March 12 that the students who attended the meeting at MIT on March 8 may have been exposed to COVID-19, according to Collins. The MIT health center provided its respective students with quarantine guidance that night. Northeastern officials did not respond to requests for confirmation that the university also alerted its student to the potential exposure.
Meanwhile, Tufts students flowed in and out of Arts Haus and the Campus Center, as well as classrooms in Braker Hall and the CLIC, in the days after Jack spent time there.
Based on CDC guidance, the novel coronavirus can remain on various surfaces for days. But Facilities Services only began disinfecting potentially contaminated spaces on March 13, after DOSA and the Medford Health Department completed their contact tracing, according to Collins.
That day, Tufts staff called every student on the list of more than 140 in order to discuss their individual circumstances, including housing details and health guidance, Collins said.
Students in quarantine were asked to complete a daily survey for Health Service to monitor their well-being, and those quarantined on-campus had meals delivered to them by Dining Services.
Jack said a call with staff at Tufts’ Counseling and Mental Health Services was particularly valuable.
“I think the administration has done pretty well,” Jack said on March 12. “They try to be helpful and supportive where they can. A lot of the things that make this feel really miserable, I feel like [are] out of their control and more circumstances of what solitary confinement or isolation is like.”
Jack’s four housemates in his off-campus apartment were among those asked to self-isolate. When Tufts tested Jack for COVID-19 on March 10, however, the housemates did not immediately receive guidance from Health Service on quarantine procedures.
Instead, when Jack told the group that afternoon that he may have contracted COVID-19, Danny took it upon himself to isolate as best he could. He asked a professor if he could take a midterm exam, which was held in Cohen Auditorium on March 10, in a separate room.
Collins affirmed that the administration adhered to guidance from state officials and the Medford Health Department when it contacted Jack’s housemates.
Danny and Wes said that when Tufts asked them to quarantine, they were running low on food in their apartment. According to both housemates, Tufts suggested that the group order food from UberEats or other delivery apps whose fees were on the rise at the time. Instead, the housemates relied on friends to deliver their groceries, according to Danny.
Students quarantined on campus were offered meal delivery from university dining centers.
On March 18, Health Service told Jack he was no longer contagious because he had displayed no significant symptoms for several days.
The same day, at approximately 6 p.m., Associate Dean of Student Affairs Kevin Kraft, who communicated with Jack’s housemates throughout their quarantine, informed them that Jack would be returning to the apartment the following day at noon, according to Danny and Wes.
Danny and Wes protested this decision, demanding confirmation that Jack was no longer contagious. They told Kraft that they did not wish for Jack to return until after their quarantine had ended or they could be sure he was no longer contagious.
According to the two housemates, Kraft became “antagonistic” in light of their requests.
Danny alleges that Kraft called him and Wes “selfish” and “unreasonable” for requesting proof that Jack was no longer contagious and refused to provide this documentation. Wes said that Kraft singled him out as a pre-med student, saying he should be governed by “facts” and questioned his judgment.
According to Wes, Kraft insinuated that the housing group were being bad friends by denying Jack a place to stay in their house, telling the students that Jack was struggling in quarantine.
“[Kraft] lost his cool before we did,” Wes said.
Wes admitted the dean was likely stressed due to difficulties created by the pandemic.
Kraft told the students that the Medford Health Department had confirmed that Jack could return home. Danny told the Daily that when he contacted the Medford Health Department, its staff could not definitively confirm or deny that Jack’s return would be safe but said documentation that he was no longer contagious should have been easy for Tufts to provide.
Collins, however, was unsure that Tufts would be able to provide such documentation.
“As a general rule, personal medical information is protected due to privacy considerations,” Collins said.
Meanwhile, when Danny and Wes asked Jack whether he would be willing to isolate longer, Jack agreed.
The housemates and DOSA eventually reached an agreement to allow Jack to return after their period of isolation was over, on March 24. Danny and Wes chose to stay with friends when Jack returned.
Collins declined to comment on the interactions between Kraft and Jack’s housemates, citing privacy concerns.
“At all times, staff acted in the spirit of helping community members understand and address the difficult circumstances created by the spread of COVID-19,” Collins said. “We appreciate the staff and the students who made sacrifices, showed flexibility and ingenuity, and worked together in a highly disruptive situation.”