As we look ahead to the 2021-2022 session, it is clear that the Covid-19 pandemic will still affect our daily lives. The success of the vaccination campaign in the UK notwithstanding, it would be premature to declare the pandemic over. At the moment, there is a lot of discussion about whether government guidelines for Higher Education institutions at the national level are sufficient and about whether the decisions made by Senior Management of The University of Nottingham do enough to keep students and staff safe. One of the key issues here is whether these guidelines and decisions incorporate the latest scientific advice on Covid-19 and, in particular, on the now dominant Delta variant.
The current teaching blueprint at the University of Nottingham seeks to maximise face to face teaching, whilst recommending vaccination, the wearing of face covering indoors and weekly testing. However, these are mere recommendations which means that they cannot be enforced. In addition, staff have been asked to return to campus for face to face teaching.
During a recent interview, UoN UCU member Dr Rudolf Billeter-Clark, Associate Professor of Anatomy, School of Life Sciences (Rudi) has spoken out about his experience of f2f teaching in times of Covid and about what we know about the Delta variant. Indeed, he has a personal interest in the literature on COVID infections and their prevention. He spent 173 hours teaching Anatomy face to face this past year and is facing a somewhat reduced, but still very high number of hours in the coming year. He concludes that given how much we still do not know about the Delta variant: ‘It all seems to be in flux, many of the reports are quite recent, which probably renders the current Government guidelines (based on data before the newest wave) questionable.’
Regarding insights on the Delta variant, Rudi states: ‘The Delta variant is 2x or more infectious as the variants circulating last Autumn/Winter (CDC 2021a). Proposed mechanisms include higher virus load (Reardon, 2021) and faster cell entry (Callaway, 2021). The Delta variant’s infectivity has been compared to the infectivity of chicken pox, based on the data from Provincetown (USA) outbreak (Dyer, 2021).”
Continuing his summary of the scientific evidence, Rudi remarked: ‘Vaccines reduce the risk of infection by several fold, but not to the extent of preventing a significant number of fully vaccinated people getting infected again (“breakthroughs”, (for example Dyer, 2021; Hetemäki et al, 2021; Elliott et al., 2021). The UK REACT-1 round 13 final report indicates that 1 in 25 fully vaccinated persons with a COVID contact did get infected (Elliott et al, 2021).’
Rudi continued, stating ‘Vaccination strongly reduces the number of people getting severe COVID and requiring hospitalisation, the number of double vaccinated people who died and did not have underlying medical problems seems to be very small. But the risk is not zero.’
As with the variants of previous waves, age seems to be a risk factor. A recent CDC report on breakthrough infections had 74% of hospitalised people being over 65 years. ((CDC 2021b) This is a concern for those teaching anatomy because several of the people involved are 65 or older, some by quite a margin. Ethnic background seems also to be associated with higher risk of breakthrough (Elliot et al., 2021).
Relative to the risk of death and hospitalization, the risk of Long Covid has not been front and centre in devising policy, given that there does not seem to be enough data yet to make a judgement on long covid and breakthrough infections (Parker-Pope, 2021).
Indeed, a recently published modelling study, based on data from the University of Bristol (Brooks-Pollock et al.,2021), predicts an increasing number of infections during the forthcoming academic year, peaking at several thousand infected students in early to mid-winter, despite vaccination. Modelled measures to combat the spread reduce the infections to a variable extent. If several measures are combined, the reduction is more marked. Measures modelled included reducing student-student and student-teacher contacts, face masks and regular testing. The modelling indicates that we will likely have an increasing number of students infected during the Autumn term—a number that may well reach a four digit figure by Christmas, and possibly even more in the Winter, with many asymptomatic carriers spreading the virus to colleagues, staff and into the community.
Thus, while our University’s recommendations regarding vaccinations, wearing masks indoors and weekly testing will likely reduce infections, they will not do so dramatically, given the recent observations of relatively similar infectivity from Delta between vaccinated and unvaccinated breakthrough infections (Elliott, 2021).
We will likely experience disruption to teaching due to a considerable number of students and staff having to isolate after positive tests, and we can only hope that there will be no serious cases among them. There is a good chance that the isolating students will call for better on-line resources than we have, which we may not be able to provide at short notice.
Moreover, Rudi commented that the unintended behavioural effects of current procedures will be increased by the ‘risk of infected students not isolating. Their experience with isolation last year was not good, and many might see little benefit from sitting in their rooms for days on end if their symptoms are mild. Or they might abandon testing altogether until the period before the Christmas break when they need a negative test to go home.’
Asked what precautionary measures Rudi would advocate, he listed the following:
- ‘Better PPE against aerosols [Editor: particles, for instance of the virus, floating in the air for some duration of time]. It is now established that the vast majority of infections occur via this route. Students and staff should wear Visors and FFP2 or FFP3 masks during face to face teaching, 1m+ distancing should be followed.’
- ‘Good ventilation in the rooms where face to face teaching is taking place. Monitoring of virus load in the air of face to face teaching spaces (Stern et al., 2021).’
- ‘Check the antibody status of face to face teaching staff (and, if manageable, students), ideally for virus blocking antibodies (Mallapaty, 2021). If someone’s titre [Editor: refers to the concentration of antibodies against Covid-19 as measured in a standard test procedure] is low, enable a booster shot.’
- ‘Ensure that students test weekly, and positive students do isolate, with a support network that makes isolation bearable.’
- ‘Monitor virus load in the wastewater of buildings with face-to-face teaching activity, to get an idea of the amount of circulating virus. This could be important in case a significant number of students chooses to abstain from regular testing.’
- ‘Realistic contingency plans for those who have to step in for isolating staff. They [Editor: UoN management] have to take into account the workload as well as the background of the individuals affected, to prevent enhanced risk of serious COVID due to immune suppression as a consequence of exhaustion. This includes finding a way to protect those members of staff who have to step in at short notice from the fallout of negative student feedback.’
The branch committee is grateful to Rudi for compiling this evidence for us and allowing us to turn this into a website news item. We will continue to compile evidence and inform members so they can be as fully informed as possible. If you have any relevant expertise or knowledge and would like to contribute, please reach out to us at email@example.com or via your local rep.
For more information on the UCU response to Covid-19, please see https://www.ucu.org.uk/article/11665/Reopening-plans-put-students-education–health-at-risk and https://www.ucu.org.uk/covid19.
Edited by: Gertjan Lucas, Equality Officer & Lopa Leach, Branch Secretary
Brooks-Pollock E., et al. (2021) ‘High COVID-19 transmission potential associated with re-opening universities can be mitigated with layered interventions’, Nature Communications, 12: 5017. https://doi.org/10.1038/s41467-021-25169-3
Callaway, E. (2021) ‘The mutation that helps Delta spread like wildfire’, Nature 596, 472-473. https://doi-org.nottingham.idm.oclc.org/10.1038/d41586-021-02275-2
CDC (2021a) ‘Delta Variant: What We Know About the Science’, available at https://www.cdc.gov/coronavirus/2019-ncov/variants/delta-variant.html
CDC (2021b) ‘COVID-19 Vaccine Breakthrough Case Investigation and Reporting’, available at https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html
Dyer, Owen (2021) ‘ Covid-19: Delta infections threaten herd immunity vaccine strategy’, British Medical Journal, 374: n1933. http://dx.doi.org/10.1136/bmj.n1933.
Elliott, Paul, Haw, David, Wang, Haowei, et al. (2021) ‘REACT-1 round 13 final report: exponential growth, high prevalence of SARS-CoV-2 and vaccine effectiveness associated with Delta variant in England during May to July 2021’, Preprint medRxiv 2021.07.08.21260185; doi: https://doi.org/10.1101/2021.07.08.21260185.
Hetemäki, Iivo, Kääriäinen, Sohvi, Alho, Pirjo, Mikkola, Janne, Savolainen-Kopra, Carita, Ikonen, Niina, Nohynek, Hanna, and Lyytikäinen, Outi (2021) ‘An outbreak caused by the SARS-CoV-2 Delta variant (B.1.617.2) in a secondary care hospital in Finland, May 2021’, Euro Surveillance, 26(30): pii=2100636. https://doi.org/10.2807/1560-7917.ES.2021.26.30.2100636.
Mallapaty, Smriti (2021) ‘A blood marker predicts who gets ‘breakthrough’ COVID’, Nature, https://doi-org.ezproxy.nottingham.ac.uk/10.1038/d41586-021-02096-3
Parker-Pope, Tara (2021) ‘Explained: Can the vaccinated develop long Covid after a breakthrough infection?’ New York Times, available at https://indianexpress.com/article/explained/vaccination-breakthrough-infection-covid-long-explained-7457431/.
Reardon S. (2021) ‘How the Delta variant achieves its ultrafast spread’, Nature, available at https://doi-org.nottingham.idm.oclc.org/10.1038/d41586-021-01986-w
Stern et al. (2021) ‘Characterization of hospital airborne SARS-CoV-2’, Respiratory Resesearch 22: 73. https://doi.org/10.1186/s12931-021-01637-8