A Suggestion for Keeping Classes Safe, and More Questions

I have spent a good deal of time in the last few days trying to figure out how to help my department (and anyone else that asks) buy masks that are safe enough for indoor use during this pandemic. It turns out that it is very difficult to ensure that one is buying KN95 or N95 masks that are not fake. This is why Professor Nathan Phillips thinks the university should be purchasing KN95 masks in bulk for all non-remote teachers at the university, with expert assistance. I would add that I think the university actually has a moral obligation to do this, given that they are imposing significant risks on their own employees by making them teach in classrooms, when, in most cases at least, there is a pedagogically preferable method available (remote teaching). In not providing crucial PPE, the university is diverging from the behavior of employers in other professions and industries.

Professor Phillips has also suggested to me that there is another thing that BU could do to help make classroom teaching safer, and I think that teachers and students should be insisting that they do it. Given the now well-known problems with ventilation in many classrooms in the university, the university should be providing to teachers machines that test for the extent of CO2 build up (wherever CO2 builds up, we can conclude that the airflow situation is dangerous). These devices are apparently not difficult to learn to use, and can be bought for about $200 each. Teachers might bring one to class, run a test, and then tell everyone to leave the class if the CO2 level is too high. Teaching for that class might then transition to being online until the airflow in the room can be improved, or an alternative classroom is located. The university is telling everybody not to worry about the ventilation issue, because the HVAC systems are being improved (even though it admits that a great many university buildings do not have HVAC systems). It should put its money where its mouth is, and provide enough of these devices to our university teachers to enable them to check their classrooms from time to time. Since I think it’s a safe bet that the university administration won’t do this, I recommend that individual departments now buy these devices and have their teachers ready to regularly check the CO2 levels in their classrooms when term starts.

Now for a few other items of interest. First, it’s worth noting that according to his statement yesterday, MA Governor Charlie Baker continues to require of all indoor meetings that there be no more than 25 people present. Although the university has said that social meetings on campus should follow this rule, they have not said that they will ensure that no classes in university rooms ever have more than 25 people in them at once. So far as I’m aware, the university will be violating Governor Baker’s orders if they allow more than 25 people to be in a classroom at once, and I know that presently there are classes that are scheduled to have more than 25 people in them at once. Will the university be accepting this ruling, so far as classes are concerned?

Here is another question: will the university be telling us what percentage of students have elected to return to campus, based on the student payments that came in this week? Harvard and MIT provided this information to the public, but BU has not done so as yet.

I have been meaning for a while now to provide an update concerning the BU graduate student housing problem that I previously reported on, concerning the policy that graduate students are to be housed alongside undergraduate students who may have contracted Covid-19. On July 29, the Provost’s Office sent an official communication to BU Real Estate graduate student tenants clarifying the situation. It indicates that no undergraduate students who have tested positive will be housed in graduate student apartment buildings, but it also says that students who have been identified by contact tracing methods as being at risk and have initially tested negative will be housed in quarantine in private rooms in the graduate student buildings, because private rooms are not available elsewhere. The communication further states that graduate students who who wish to be released from the relevant real estate contracts will not be financially penalized. It is left unclear why BU feels it needs to jeopardize the health of graduate students, rather than, say, use hotel accommodation to temporarily house students, as Northeastern, for instance, is planning to do.

BU’s Mask Policy is Inadequate

This is a guest post by Professor Nathan Phillips, Department of Earth and Environment, Boston University.

In light of national and Massachusetts trends in COVID cases, the wisdom of re-opening BU in three weeks is becoming increasingly questionable. But if BU is going to re-open this fall, among all the safety measures it is taking, it needs to address a big safety gap in its present approach: its mask policy.

To cut to the chase, BU should make a bulk purchase of properly-vetted KN95 masks for the university community, as a key part of a prudent strategy to reduce risk of airborne transmission. Institutionally-vetted KN95 masks are preferable to N95 masks for BU because of a shortage of N95 masks that is due to the need to prioritize the requirements of front-line healthcare workers and first responders.

Our current policy is inadequate because it takes a collective action problem, and views it simply as an individual matter. Choices regarding masks matter for indoor airborne transmission, and leaving this type of decision to tens of thousands of individuals will lead to highly uneven individual choices that will have bad effects on the whole community. Currently, for example, the use of bandanas would be allowed. Bandanas are effective at preventing ballistic transmission, but poor at blocking viral aerosols. Even those who might choose a KN95 mask could easily buy a faulty one by mistake, as this recent report makes clear. BU needs a community-level solution to a community-level problem. Masks must be considered not just PPE, but Community Protective Equipment, and part and parcel of the university’s ventilation strategy.

I appreciate that BU has begun to address concerns about building ventilation in light of mounting evidence of the potential for airborne COVID transmission. While this is laudable, these steps, which include increasing air exchange rates and installing HVAC filters, are missing both the very first and the last lines of ventilation defense: masks. Properly fitted and filtered masks inhibit aerosol transmission both at the source, and at the end point of potential infection. If we are investing time and expense in retrofitting rooms with improved HVAC filters, we should also be considering the quality of facial filters.

A recent Harvard-Illinois IT study of COVID transmission on the Diamond Princess Cruise Ship found that, despite good ventilation on this ship, airborne transmission was a likely major route of transmission. A NY Times review of this study states:

But good ventilation is not enough; the Diamond Princess was well ventilated and the air did not recirculate, the researchers noted. So wearing good-quality masks — standard surgical masks, or cloth masks with multiple layers rather than just one — will most likely be needed as well, even in well-ventilated spaces where people are keeping their distance.”

To be sure, the science is not settled and the cited study, a preprint, is one study, but the physical mechanisms posited as being involved make for a highly plausible causal account, and with the health and welfare of tens of thousands of people at BU on the line, as well as the lives of hundreds of thousands of people across greater Boston at risk, use of the precautionary principle is strongly warranted. If a bulk order can procure vetted KN95 at $2/mask, this is well worth an $80,000 university investment in community safety (supposing we need masks for 40,000 people). While there are risks with extended use of respirators like N95, they have been recommended for re-use under conditions of scarcity.  Compliance and enforcement is an important related issue, but due diligence would mean providing at least one properly-vetted KN95 mask to every member of the university community.  

The mask I wear affects you; the mask you wear affects me; the masks we all wear potentially affect everyone in the BU community. We need a community-level solution to this problem.

Quarantine Requirements and Compliance Issues

I recently reported that BU was planning to merely recommend that students arriving from out of state enter quarantine for fourteen days, rather than require that they do so. Fortunately, this insufficiently cautious plan has had to change because, on July 24, MA Governor Charlie Baker signed an executive order putting in place new quarantine regulations. Now, students arriving from overseas or any state that is not classified as one of the “lower-risk states” (presently only eight states are so qualified) must either quarantine for 14 days, or provide proof of a negative Covid-19 test that was taken no longer than 72 hours before arrival in the state. People who do not comply with this order may be fined $500 per day. The Mayor of Boston, Martin J. Walsh, responded to this news by indicating that although he takes it to be good news, he is still very concerned about the many students that will be descending on the greater Boston area (as many as 170,000, according to the Boston Globe), and that he thinks, ideally, students should quarantine for two weeks at home and then quarantine again for two weeks in Boston, before being tested.

On July 27, the BU President sent faculty and staff a statement regarding testing protocols and compliance issues. It contains a fair amount of information. I will comment on just one important piece of news contained in the statement. President Brown makes it clear that there is a requirement on everyone who returns to campus to follow protocols regarding quarantine, face covering rules, testing, etc. The protocols will be provided in a document that all students will be required to commit themselves to. It is said that they will do so through a “digital agreement.” I take it that such an agreement will involve scrolling to the end of a document and pressing a button that says something like “I agree to abide by these conditions” (much as one does when one installs computer software, although one might hope students will actually read this text more carefully than people usually do when they install software). Unsurprisingly, I am highly skeptical that this and the public campaigns also mentioned will ensure sufficient compliance with the necessary protocols (especially compliance outside of the classroom). Here is an additional concern. I express it with caution, lest I be accused of paranoia. Perhaps this digital agreement or contract, which all students will be required to accept if they wish to remain on campus, will also include text that amounts to a waiver, indemnifying the university from subsequent law suits. I do not say this will happen. As far as I am aware, BU has not so far indicated it will be joining other universities that are asking for waivers to be signed by students.

Comments regarding workplace adjustments have been coming in (please keep submitting them). Many people still haven’t heard whether or not they will be provided with a workplace adjustment. One troubling development on this front is that, for multiple faculty members, medical documentation provided by doctors to BU has gone missing (applicants are required to have doctors fax a form directly to HR). This may mean some people who are in CDC-recognized high-risk categories will have their requests to teach online denied.

In other news, BU Real Estate has declined to reverse course with respect to its plans to house regular graduate students alongside students suspected of being infected with Covid-19, despite the efforts of at least one dean and a representative from the Provost’s office. As a result, graduate students have set up a petition for all who are concerned about this development to sign, and are also undertaking a survey of graduate students.

Ventilation Issues and BU Classrooms

This is a guest post by Dr Sarabeth Buckley, a postdoctoral research fellow at Cambridge University. She recently received a PhD from BU’s Earth and Environment Department, where her research focused on ventilation and rooftop gardens.

Towards the beginning of the whole pandemic in early February, there was a story that came out of Hong Kong that was particularly frightening. In a large apartment building, one person on one floor initially tested positive for Covid-19. The virus was still primarily circulating in China at the time. What was scary was that someone ten floors away also then tested positive and that although they did not know each other and had not had any contact, their apartments did share some pipes and there was a leak in the second apartment. This was a very early indication that Covid-19 might be airborne.

WHO denied this, saying that the evidence overall suggested Covid-19 was not airborne. It took five whole months for this article, citing this paper to come out. The article says coronavirus is, in fact, airborne. We all need to take this fact seriously. When anyone coughs they release water droplets of different sizes. Some of these are large and they will fall right to the ground. Others are very tiny, around five μm, which is too tiny to see. Droplets of this size can travel tens of meters away from the person who exhaled them, which is a much longer distance than the length of a normal room, and definitely longer than the length of many of our small BU classrooms. Scientists had hoped that Covid-19 viral particles would not be able to survive in these tiny droplets and might only survive in the bigger droplets that people expel directly, next to themselves. If this had turned out to be the case, it would be enough to just stay out of spitting range of people while sitting inside.

The article states that Covid-19 can survive in these tiny droplets for three hours, which is longer than any of the classes I ever took at BU. This means that if you are in a room where someone who is infected with Covid-19 has been, even if you are on the other side of a large room, you could still catch the virus by breathing in air that someone, perhaps in an earlier class, breathed out a good couple of hours ago. I think about all the classes I took at BU and the little rows of desks a foot or two away. Even if half or more of those desks are removed and the ten people left coming to in-person classes all sit awkwardly, far apart, one person being infected means some portion of the air in the class is going to contain viral particles.

Before the July 4 article, the WHO’s official statement was still that the virus was only airborne in hospitals after medical procedures. It took 239 scientists in 32 countries writing an open letter, explaining the way in which Covid-19 is airborne, for this discovery to be taken seriously. 

Masks certainly help, but they can’t prevent you from breathing in particles. They’re not sealed. When you breathe in while wearing a mask, you can feel the slightly cooler air rushing in through the little areas on the sides of your nose where the mask isn’t quite flush with your skin, and this air hasn’t gone through the cloth. What masks do help with is preventing your own water droplets from being sent off to mingle in the air. Therefore, if everyone wears a mask the entire time they are around other people, then, hypothetically, all of the viral particles infected people breathe out should be caught on the inside of the mask fabric and stop their journey there.

There are a few other things that can be done. Classrooms can be cleaned very frequently with cleaning implements like ultraviolet lights, for example. But one of the most important things that can be done is ensuring that rooms have good ventilation. If potentially contaminated air is being continuously pulled out, recycled air is heavily filtered, and new fresh air without Covid-19 is pushed in at a fast enough rate, this should help get rid of the viral particles twirling about above our heads, threatening to infect us.

This is basically about trying to create a situation reminiscent of an outdoor environment, where the air is moving around so much that it fairly quickly whisks away any viral particles just hanging about (unless you are within direct firing range). This is where some of my work comes in. The recommended ventilation level for removing Covid-19 particles is thirty cubic feet per minute per person (Allen and Macomber, 2020), but how do you know what the current ventilation rate is?

A primary method for testing what ventilation rates actually are is measuring CO2 concentrations in rooms with multiple people in them. This is because, as everyone knows, people are constantly breathing out large amounts of CO2 that build up in confined spaces like classrooms; the more people, the more CO2 builds up. If CO2 concentrations get too high, this indicates that ventilation is not sufficient. Governing bodies set limits for CO2 concentrations in rooms. Generally these are:

5000 ppm – Upper limit of what should ever be found (ACGIH, 1999; OSHA, 1997)

1000 ppm – Suggested limit for classrooms, in particular (ASHRAE, 1989)

800 ppm – Suggested limit in Massachusetts (MADPH, 2020)

As part of my PhD research, I took CO2 measurements in BU classrooms to understand how well ventilation there is working. You can see for yourself how well some of the rooms in the College of Arts and Sciences building did on this test.

Macintosh HD:Users:Sarabeth:Desktop:MY DOCUMENTS:Personal:Activism:Covid19:BU:CAS Classroom CO2.png


Each color is CO2 measurements taken in a different classroom over the course of a week. They obviously go far above the 800 and 1000 ppm limits.

From one perspective, CO2 can affect how well you perform mentally, meaning high concentrations can make you a bit slow and sleepy, and you have probably experienced this first hand. High concentrations are also known to be associated with other pollutants, such as particulate matter, sulfur dioxide, or, as is critical in this case, biological contaminants. This is usually referred to as Sick Building Syndrome, but in the present context, you might as well just call it Covid-19.

What I found was a sign that current ventilation, at least in CAS classrooms, is far from efficient enough to deal with even normal contaminants, let alone something as contagious and virulent as Covid-19. This is good and bad. It means BU is not ready for normal classes at this point, but it highlights a clear step BU must take in order to make the campus safe in the fall. At this point, BU has said they will be doing “a comprehensive review of all HVAC systems, upgrading filters as needed.” This must include increasing ventilation rates and actively monitoring CO2 concentrations in these rooms, in order to keep tabs on whether or not ventilation is actually functioning at a high enough level. There are even third parties who BU could hire to help them test building ventilation and set up a system that will keep everyone safe. They just need to make this a priority and let us know what their plan is.

– ACGIH (American Conference of Governmental Industrial Hygienists). (2011). TLVs and BEIs. Cincinnati, OH: American Conference of Governmental Industrial Hygienists.
– Allen J. and J. Macomber. Healthy Building: How Indoor Spaces Drive Performance and Productivity. Cambridge, Massachusetts: Harvard University Press, 2020.
– ASHRAE. 1989. Ventilation for Acceptable Indoor Air Quality. American Society of Heating, Refrigeration and Air Conditioning Engineers. ANSI/ASHRAE 62-1989.
– MA EOHHS (Massachusetts Executive Office of Health and Human Services). (May 8th 2020). Massachusetts Environmental Public Health Tracking: Ventilation. https://matracking.ehs.state.ma.us/Environmental-Data/indoor-air-quality/ventilation.html
– OSHA. 1997. Limits for Air Contaminants. Occupational Safety and Health Administration. Code of Federal Regulations. 29 C.F.R 1910.1000 Table Z-1-A.

Workplace Adjustment Requests Update, with Invitation to Provide Comments

On Tuesday, July 21, department chairs at Boston University were sent a memo that made a number of them angry. The memo was accompanied by a list of their department members who had filed workplace adjustment requests, indicating whether the HR Work Adjustment Request Team (WART) had decided they met the CDC high-risk category guidelines for Covid-19, or had noted instead that the department member had filed a request that involved entering reasons for wanting an accommodation in the “Other” box provided on the workplace adjustment request form. A clear implication of the memo is that the remote learning option must remain the exception, rather than the rule. The university has said that approval of requests for courses to be taught wholly online, rather than in conformity with the hybrid Learn from Anywhere approach, should be kept to a minimum. The memo asked chairs to talk to all department members asking for workplace adjustments, including those that HR has now determined meet the CDC high-risk criteria, to see if they might be persuaded to teach their courses non-remotely, in conformity with the LfA model. It might be inferred from this memo that the university is concerned that they have received too many workplace adjustment requests (from their perspective). This request to go back to people who have already had their doctors provide medical notes, and who HR have determined are eligible for workplace adjustments, was thought by at least some chairs to be an outrageous request, and some CAS chairs said as much in an unscheduled meeting the next day.

In a subsequent email to chairs that might reasonably be interpreted as involving back-pedaling (sent after the CAS chairs meeting, on July 22), administrators indicated that faculty who HR has confirmed meet CDC guidelines will, in fact, be permitted to teach their courses online. However, it is still unclear what will happen to those applications where faculty provided their reasons for a request in the “Other” box. In the afternoon on July 22, faculty who had requested workplace adjustments received individual email messages from Faculty Actions indicating that WART had confirmed that the faculty member falls in a CDC high-risk category. It appears graduate student teachers have yet to receive any responses, and that their requests will be processed after faculty requests have been processed.

What types of good reasons might have been provided in the “Other” box? Two that are particularly important are concerns with respect to childcare and care of elderly family members, and concerns with respect to anxiety regarding teaching in the classroom during this pandemic. The second communication mentioned above indicates that decisions regarding applicants who cite childcare concerns are to be dealt with at some point down the road.

I am opening the comments here, and intend to leave them open for quite some time. They will be lightly moderated, and anonymous comments (submitted using pseudonyms) will be allowed. The primary reason I am providing this space for comments is to provide a public forum for people who have their requests turned down. If you are commenting for this reason, please indicate what the nature of your request was, and what you were told about why it was turned down. Other comments are also welcome.

Troubling Developments at BU (to be continued)

I’d like to be reporting right now on what appears to be an extremely troubling development at BU when it comes to the workplace adjustment application process and the exceptions to in-class teaching BU is meant to be providing to many BU teachers at this juncture. I’ve heard enough from four department chairs (indirectly in two cases) to know it is an extremely troubling development, but I have not yet seen the relevant internal communication to department chairs for myself. I feel I must wait to comment on this matter. If anyone has anything they’d like to share with me regarding this troubling development, please email me at allcaution@gmail.com.

There is no shortage of other troubling developments. For a start, a BU graduate student recently wrote to me (thank you!) regarding an extraordinary decision made by BU Real Estate, which is responsible for renting out many rooms to both undergraduate and graduate students. The student writes:

BU Real Estate is turning vacant rooms in some BU graduate housing into quarantine rooms for suspected cases of Covid-19. BU Real Estate wanted us to know that confirmed cases will be in a separate building. The [particular] graduate housing will be only used for quarantining of suspected cases. Although it is only for suspected cases… [there are] a myriad of health concerns and logistical uncertainties. … The plan [is] to turn vacant units into quarantine rooms … They essentially confirmed that, according to the current plan, most graduate students in this graduate housing in the fall will be exposed to a constant flow of suspected Covid-infected students. The most alarming of it all is that they currently have no plans to disclose this information to all of their current residents. I understand that it might be difficult to push them to change their whole plan but I strongly believe that BU Real Estate should at least disclose this information to current residents so that students can make informed decisions about their own living environments. BU Real Estate [has] compared themselves to other property managers around Boston and [has] argued for their lack of legal obligation to inform their residents. They [have] argued that if we lived in a random apartment building in Allston or Brighton, property managers/landlords would not notify us if our next door neighbor was suspected or confirmed of Covid-19. I believe this is a flawed comparison, as BU Real Estate is deliberately bringing suspected Covid cases into the building.”

Seriously, BU?

In other news, BU journalism and political science student Grace Ferguson has been doing some great work tracking recent developments, troubling and otherwise, at BU. After reporting on poor ventilation in BU classrooms and the heightened risks of infection that holding classes in these rooms will lead to (we will have more on this topic soon), Grace has in recent days been providing regular reports on Twitter regarding online town hall meetings BU has been organizing with students, in anticipation of students arriving on campus from the middle of August onwards. From Grace’s reporting of these meetings we have learnt, amongst other things, that the university will not be providing a quantitative threshold in advance (with respect to number of people infected, etc.) indicating when they will be prepared to close the campus. We have also learnt that students coming to Boston from elsewhere, including from virus hotspots, will not be required to enter quarantine; they will merely have it recommended to them that they enter quarantine.

A City Council Meeting and Critical Letters and Articles

Yesterday, the Boston City Council Committee on Public Health met to discuss university reopening plans. Jason Prentice, of BU’s College of Arts & Sciences Writing Program, presented live testimony, and submitted a letter corresponding to his testimony. I recommend that members of the Boston University community read this letter, as well as a letter and set of documents prepared by the Writing Program as part of an effort to have this program exempted from needing to conform with the Learn from Anywhere model. Jason and his colleagues present a compelling case against the university’s particular hybrid model, drawing on their expert knowledge concerning pedagogy, as well as safety concerns. The five hour meeting is available to watch on YouTube. Russell Powell and I also submitted this letter as testimony (previously posted here) to the City Council committee. We look forward to hearing more about the findings and recommendations of the committee.

In other news, BU Provost Jean Morrison and Vice President and Associate Provost Willis G. Wang yesterday labelled the proposed US Immigration and Customs Enforcement guidelines regarding international students “damaging… xenophobic, and malicious,” and announced that BU will join an amicus brief in support of Harvard and MIT’s lawsuit. Amongst other things, they interpret the news from ICE as meaning that international students will be able to take courses online from outside of the US, and that international students who come to Boston to attend classes will need to leave the US if the university finds it must move all courses online next semester (this is all on the assumption the legal challenges underway do not succeed). I have argued that this means we will, or at least should, see many more courses offered as online only courses, although clearly not beyond a point where the university would still count as following a hybrid model (again, this is all on the assumption, which I fervently hope is not correct, that legal challenges to ICE’s plans do not succeed). Of course, many of the reasons that we should see more courses offered in an online only mode are completely independent of these considerations regarding ICE’s plan regarding international students. In particular, this might also be a result of properly respecting BU teachers by allowing them genuine options.

Speaking of offering courses online, BU PhD candidate Emily Chua has published an excellent opinion piece in BU Today, BU Should Go Fully Online This Fall. BU Today deserves credit for publishing this piece, but, it must be said, it is peculiar that they seem to follow a policy of publishing pieces that are critical of BU policies only when they are written by students, and not when they are written by faculty. Our evidence for this is, in part, provided by my account of a broken promise, and also by the fact that they normally feature pieces fed to them by The Conversation (which is provided with funding from BU, as well as other universities), but they decided not to do so when Professor Neta C. Crawford, Chair of the Department of Political Science at BU, recently published Ethical Challenges Loom Over Decisions to Resume In-Person College Classes.

Also published today in BU Today is a piece summarizing BU’s policy regarding university staff and when they do and do not need to return to work. Like university teachers (including graduate student teachers), they will be able to apply for workplace adjustments. And all staff members who can do their work successfully at home will be permitted to work from home. Make no mistake: This is as it should be. Still, this rather gives the lie to criticisms I have received from some quarters that teachers are asking for something that is wholly unavailable to staff or that we are being elitist. The moral principle that the university is implicitly putting to work here is not being applied to teachers, for we too can effectively do our work from home (in fact we can do it more effectively at home than in the classroom, since teaching mask to mask is inferior to teaching online, pedagogically speaking). And, as we have argued repeatedly (see our Medium article), reducing the number of total employees and students on campus reduces the risks to all that remain on campus. We have also called for staff who are required to remain on campus to be provided with hazard pay. The BU Today story also reports that 84% of almost 3000 staff surveyed were concerned or very concerned about returning to campus. So they, and all of us, should be.

Finally, let me say why I think yesterday’s guest post here from Professor Otsuka is important. With respect to workplace adjustment requests at BU and elsewhere, employers claim that 65 and over is the crucial age-based risk group, but when the CDC recently revised its guidelines it removed the reference to 65 and over, and Otsuka demonstrates that the science now tells us that if you are 45 or over, you are more at risk than other groups that are properly recognized by the CDC and our employers as risk groups. This reveals a gross inconsistency in present university policy regarding workplace adjustments. There may be legal ramifications here.

Healthy people as young as 45 at greater risk from Covid-19 than people deemed “at increased risk” by the CDC

This is a guest post by Michael Otsuka, Professor of Philosophy at the London School of Economics

A study just published in Nature reveals the following: even for someone with no underlying health conditions, the increased risk associated with being 45 years of age, rather than 30, is greater than the increased risk associated with various health conditions the CDC deems sufficient to render a person “of any age” at “increased risk of severe illness from COVID-19”.

I. Quantifying the risks the CDC recognises

According to the CDC:

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

The aforementioned study in Nature — which is entitled “OpenSAFELY: factors associated with COVID-19 death in 17 million patients” — quantifies the risks associated with the above health conditions. It indicates that, when one adjusts to control for age, gender, level of income deprivation, and other health conditions, the CDC-listed conditions are associated with increases in one’s risk of death from Covid-19 by the following factors (see righthand column of Table 2 on p. 10):

  • Those who have kidney disease (GFR <30) are at 2.52 times greater risk of death than those without kidney disease
  • Those who have COPD are at 1.63 times greater risk of death than those without respiratory diseases
  • Those who have an organ transplant are at 3.55 times the risk of those without a transplant
  • Those who are obese (BMI of 30 or above) are at 1.05-1.92 times greater risk of death than those who are not obese
  • Those who have chronic heart disease are at 1.17 times greater risk of death than those without heart disease
  • Those who have Asplenia, including sickle cell disease, are at 1.34 times greater risk of death than those without this condition
  • Those who have uncontrolled diabetes are at 1.95 times greater risk of death than those without diabetes

Whatever one’s age — and therefore even if one is as young as 30 years old — having any of the above conditions is sufficient for classification as “at increased risk of severe illness from COVID-19”. The increased risks associated with these conditions range from 1.05 to 3.55 times the risks to those who lack these, as well as any other, health conditions.

Table 2 also indicates the following strikingly dramatically increasing risks associated with advancing age, even among those who are “healthy” insofar as they lack all of the above, as well as any other, health conditions. Compared with a healthy 30 year old:

  • a healthy 45 year old is at 5.00 times greater risk of death
  • a healthy 55 year old is at 16.67 times greater risk of death
  • a healthy 65 year old is at 40.00 times greater risk of death
  • a healthy 75 year old is at 101.33 times greater risk of death

II. Why are those who are older at such increasing risk?

The “OpenSAFELY” study does not address this question. Elsewhere, the hypothesis that Covid-19 involves impairment of the immune system has been offered as an explanation for why increasing age appears to be such a great risk factor:

Many T cells apparently die, and so the body’s reserves are depleted — particularly in those over age 40, in whom the thymus gland, the organ that generates new T cells, has become less efficient.

…The new research may help answer another pressing question: Why is it so rare for a child to get sick from the coronavirus?

Children have highly active thymus glands, the source of new T cells. That may allow them to stay ahead of the virus, making new T cells faster than the virus can destroy them. In older adults, [as mentioned above] the thymus does not function as well.

III. CDC has removed its age 65 threshold for increased Covid risk

In light of findings such as those reported in Nature, it is unsurprising that the CDC has recently “removed the specific age threshold” of 65 which it once affirmed. “CDC now warns that among adults, risk increases steadily as you age, and it’s not just those over the age of 65 who are at increased risk for severe illness” from Covid-19 infection. The CDC also maintains that “Age is an independent risk factor for severe illness, but risk in older adults is also in part related to the increased likelihood that older adults also have underlying medical conditions” (my emphasis added). Sensibly, and in line with the findings of the “OpenSAFELY” study, the CDC now says the following about “Older Adults” under the general heading of “People Who Are at Increased Risk for Severe Illness”:

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html

The data simply does not support an age threshold of 65. As I have shown in Section I above, even those who are 45 years old and healthy are at greater risk than 30 year olds whom the CDC classifies as “at increased risk of severe illness from COVID-19” because of underlying health conditions. If any employer attempts to adhere to the now-discarded age threshold of 65, there will be a glaring lack of consistency and parity in the protections it extends to their workers who are at higher risk.

International Undergraduate Students, ICE, and University Policies

I am going to comment on two significant news items from yesterday. First, Harvard University announced that a maximum of 40% of their undergraduate students in the Faculty of Arts and Sciences will be staying on their campus in the Fall, and confirmed that all courses there will be online courses (six of their graduate and professional schools have also announced they will be entirely online). I think it’s important for those of us working or studying at other universities not to take Harvard as a model. Harvard’s wealth and status puts it in a position to do things that other universities can rightly view as being too costly for them to do. That being said, there are at least three take home lessons here for all of us. The first is summed up nicely in a popular Tweet “If Harvard doesn’t have the resources to make in person education safe in the Fall, do you seriously think anyone else does?” Next, Harvard’s statement says that the 40% figure was based on reasoning by their public health experts concerning health risks, and I think it is sobering to compare that number to the much higher percentage (perhaps 100%, or close to it) many other colleges, such as my own, are trying to tell their university communities is a safe percentage to aim for. The third lesson, I would suggest, is that college students don’t come to campus simply, or even mainly, for in person classes. Amongst other things, they come to be with their peers and establish independence in relation to their families. I’ve been saying this for a month or so (as, I’m sure, have many other people), but Harvard’s policy represents an endorsement of this idea on the part of a leading university, since the students who come to Harvard will be taking all their classes online. We need to bear all these points in mind when considering the policies other universities are adopting or considering adopting.

The second piece of news concerns the US Immigration and Customs Enforcement announcement regarding student visas and online courses. Here, I must emphasize that what I will say at this point is speculative. I’m not a lawyer or immigration expert, and students should contact the International Students & Scholars Office (or equivalent) at their college regarding any specific concerns they might have. I am not writing this post to offer advice to students, but rather as part of my continuing efforts to think through university policies and policy options. The announcement begins by indicating, in effect, that the statement is not yet legally binding. This leaves a little room to think that petition signing and lobbying efforts now underfoot may possibly lead to some changes before the regulations become legally binding. On the assumption that no relevant policy changes occur, however, I am inclined to think the following. It appears that whenever colleges offer all courses online only, international students enrolled at these colleges will not be permitted to remain in the US. This means, first, that universities, such as Harvard, that are planning to only be offering courses online will have to either end up reversing their policies, or will be accepting that their international students will only be taking courses from outside of the US. Second, and closer to home, it also means that any college that has adopted a hybrid model* or is planning to hold classes in a face to face mode, and any international student that is contemplating attending such a college, will be very concerned that if the college needs to move online during semester, due to an outbreak of COVID-19, all international students at that college may need to promptly leave the US (unless they are able to go on medical leave, or meet some other excusing condition).

What are the likely implications of this last idea for the policies of colleges following either a hybrid model or holding all classes on campus? Here are two possibilities that are particularly salient to me, although they pull in different directions. First, if we suppose (hypothetically) that some colleges will succeed in attracting many of their overseas students back to campus to attend classes in person, then these colleges will have a new disincentive to provide information regarding infection and hospitalization rates and to declare an emergency of the kind that would require that all classes move online. They already have other disincentives to do this. Russell Powell and I have already called for our own university to set up a thorough, transparent, and independent process for the reporting of all relevant information to the university community and the city where the university resides. Such a move now seems more important than ever. In case any of this talk of disincentives to report information sounds paranoid or conspiratorial, let me be clear: I’m not saying that universities will engage in incomplete or biased reporting; I’m just saying we now need to hear what their information policies are going to be, and we need to think about them carefully.

Second, overseas students who are presently residing overseas will be considering their options now and they are more likely than ever to decide not to return to the US. They are looking at the option of attending college in a country where idiotic public policies and attitudes (let’s not mince words) are ensuring COVID-19 infections are not going to be reduced to small numbers any time soon, and are killing or ruining the lives of a great many people, and where their college may end up moving completely online part way during semester, because of an outbreak, meaning they will need to immediately leave the US. They are comparing this to the option of staying at home for a year, where risk of infection is probably quite a bit lower, and where they can take their courses online and not need to spend money on room and board in the US. Why would such students return to the US? These students are not going to be particularly satisfied with synchronous delivery of courses, such as is required by the Learn from Anywhere model, because of time zone differences. This suggests demand for online only courses will increase. Incidentally, I also expect demand for online only courses will significantly increase once those domestic and international students who do return to campus experience what it is really like to be taught in socially distanced classes by masked teachers (and often using a “platoon” based approach, at least at BU, that involves only some students being allowed to attend each class while other students attend online, due to a shortage of suitable lecture rooms).

There is one good piece of news in the otherwise terrible announcement from ICE that I should now also mention. In schools adopting a hybrid model, students “will be allowed to take more than one class or three credit hours online… [as long as] the student is not taking an entirely online course load.” As I understand it, this frees the relevant colleges up to offer more courses online, as long as they still offer enough face to face (or, let’s be frank, mask to mask) courses to count as following a hybrid model (this is good because the old rule, waived in the Spring, was that only 25% of a course load could be online). BU’s International Students & Scholars office today confirmed this interpretation, saying “Fortunately, this updated guidance appears to continue to allow students to take more online courses than normally allowed by regulation, provided that students continue to take courses in person.” Let us end on this positive note then: online only courses may be thought to be much better options for colleges following a hybrid model to offer from now onwards. Learn from Anywhere/HyFlex may end up dying a natural death.

*Surveys of student preferences generally fail to distinguish between two different hybrid models: (1) some courses are offered online, some are offered in class; (2) all or most courses are offered in class but students may take these classes wholly or partly online, watching and interacting with their teachers from home (the Learn from Anywhere or HyFlex approach). These models are very different in important respects, as teachers at institutions like BU, where the the second model is being forced on us, are only too aware.

[UPDATE, July 8: Legal challenges to the ICE plan have begun, with Harvard and MIT leading the way. Let’s hope they succeed.]

A Letter to the Boston City Council, for a Meeting on July 9

Dear Boston City Council members,

We are sending this open letter to you about Boston University’s plans for the Fall in anticipation of your upcoming meeting on July 9 to discuss these plans. We are two ethics professors at BU responsible for starting a petition, which presently contains over 1500 signatures, calling on BU to permit all of its university teachers (including not only tenure-line faculty, but also graduate student teachers, adjuncts, and lecturers) to be afforded the option of teaching their courses online, without needing to apply for and receive a work place adjustment, and without penalty. The complicated workplace adjustment procedure will have uncertain but necessarily limited outcomes and requires faculty to disclose personal medical information about themselves and their families. BU should meet the same standards of respecting teacher choice and privacy that UMass Boston, MIT, Harvard, and Northeastern are planning to meet

Offering a range of courses, some completely online and some classroom based, rather than requiring faculty to teach both online and in the class at the same time (as per the current policy) is crucial for protecting the health of BU’s teachers and their families, since many will not be eligible for workplace adjustments according to the narrow criteria being employed. Moreover, providing for faculty choice will help protect the health of all BU employees and students, as well as all people in the greater Boston area, by reducing the number of people both on campus and on public transportation traveling to and from campusThere is a serious risk that if BU does not change this policy, it will be responsible for the occurrence of major outbreaks in the Boston area due to its specific, and in our view reckless, policy choices. Such outbreaks would not only be bad in themselves, but could also significantly affect BU’s long-term financial viability.

We would also like to register a concern about transparency in how COVID-related information will be handled by the university. Very few public details have emerged thus far regarding BU’s pandemic information policy (we have only been told that there will be some kind of “dashboard”). We urge the university to establish a thorough, transparent, and independent public reporting process. In particular, the public must have constantly updated information about: (1) the testing and contact tracing protocols being used; (2) the false positive and false negative rates of the particular tests the university is producing or buying; (3) to what extent, if at all, the university is providing supportive quarantine so that infected individuals do not pose a risk to their families at home; (4) how many students and employees have tested positive, how many are in quarantine, how many are in the hospital (including in ICUs, as a separate data item), and how many have died. It is important that this information be collected at arm’s length from the university administration, given the financial incentives that universities have when it comes to controlling such information. The city and the BU community will then be in a good position to make decisions regarding whether or not to keep the campus open. We also recommend that the university be asked to specify publicly, ahead of time, their chosen threshold for the maximum level of known infections at which they would close the campus.

Yours sincerely,
Russell Powell
Daniel Star

Racism and BU, COVID-19 in Black and Latinx Communities, and Workplace Adjustments

Originally published June 25, 2020

Yesterday was BU’s Day of Collective Engagement. It’s a very good thing indeed that the university has been asking us all to reflect on issues concerning racism that involve BU, and this request couldn’t have come a moment too soon, given the incredible moral significance of efforts to combat racism in the US today. I have two issues concerning BU and racism that I wish to help add to the reflections on campus. In neither case did discussion of the issue start with me. I claim no originality at all here. 
 
First, I wish to link to a copy of an account of police acts and a closely related series of reflections by two BU PhD candidates which they have provided for all to read (it was earlier posted publicly on Facebook). I will let this powerful piece by these two students speak for itself.
 
Second, I’ve been talking to some concerned professors at BU about another important and relevant issue we should reflect upon. COVID-19 is hitting Black and Latinx communities particularly hard, because of the widespread effects of racism. This is one of the reasons UMass Boston states as a justification for moving their classes online in the Fall. BU has been saying that they will use CDC criteria for granting exemptions, but the risk groups that have been discussed and provided as examples by the university to date concern factors such as age, pregnancy and pre-existing health conditions. This is despite the fact that the CDC does recognize race as a crucial risk factor. It would seem that belonging to one of these communities should also allow for exemptions for faculty, lecturers, non-teaching staff, and graduate students. Will the university be providing exemptions of this kind? Hopefully our university leadership will consider this question carefully during this period in which they are inviting us all to reflect on issues concerning racism.

CDC Guidelines Change on Day that Workplace Adjustment Forms are Due

Originally published June 25, 2020

The CDC today released new guidelines regarding underlying medical conditions and COVID-19. There are important changes to the classifications of increased risk groups. For example, it was previously stated that a BMI of 40 or over puts you in an increased risk group, but it is now stated that a BMI of 30 or over puts you in an increased risk group. Today also happens to be the due date for workplace adjustment forms at Boston University (employees were given 5 working days to complete and submit the form). Will the university extend the deadline for submission of these forms so that employees who only now qualify for a health based accommodation might have an opportunity to ask for one? 

Faculty Council Meeting, Workplace Adjustment Forms, and Teaching Rooms

Originally published June 19, 2020

Four days after a snapshot of our petition was provided to our university leaders  (it remains open), I can report that a great many things have occurred at BU. Still, in the wake of emergency university meetings early in the week, one thing is very clear: the university has further hardened and further specified aspects of its policy that we must all teach on campus in the Fall, with exceptions to be kept to an absolute minimum.  At the Faculty Council meeting on Monday, faculty asked difficult questions, and our university leaders failed to adequately respond to faculty concerns (as the minutes demonstrate). One of many difficult questions asked of university leaders concerned the particulars of other comparable peer and “peer plus” universities’ plans (NYU was used as an example). The answer received was “we do not know the particulars of others’ plans and how they are deciding what classes to offer in-person and what to put online.” This is not encouraging, to put things mildly, because one might have hoped such momentous decisions were being made in consultation with other universities. If NYU and Duke can offer faculty the freedom to teach online,  and say to their students that there will be a mix of online and on campus classes, why can’t BU? I have subsequently had many Zoom meetings and email conversations with faculty who have been pooling ideas for things we can do to continue applying pressure on our university leaders in order to get them to take faculty preferences and perspectives seriously. There are many excellent ideas being shared. Russell Powell and I have a particular proposal that we’re developing, but we’re not quite ready to unveil it. 

For faculty who would like to seek teaching accommodations, this form became available on June 18. Faculty who are contemplating asking for special teaching accommodations have been provided with just 5 working days to submit the form. A day after this form became available, information about the rooms we will be teaching in during the Fall was also provided to chairs, in the form of a giant spreadsheet that at least some chairs have shared with their department members. As far as I understand, no new room assignments have been provided. We have been told we have until the beginning of July to request room changes. Note that this means that people considering whether or not to apply for a health or age based accommodation will not know, before the deadline for such requests, which room they will be teaching in if they don’t apply for an accommodation.  

​There is a great deal of information to be interpreted concerning the particular rooms we’ve been assigned for classes. I’d be very interested to hear what people have to say about room assignment matters (dnlstr@gmail.com) and what they reveal about whether or not the university is doing an adequate job of providing rooms that will be safe for classes. I have serious doubts on this score. In my own case,  my classes are still scheduled for two small rooms with poor ventilation (this happens to be my first teaching semester at BU where I haven’t been scheduled to teach at least one large freshman course). One room I’ve been assigned can fit 11 people in it if they are all 6 feet apart from each other, and the other room can fit 3 people in it if they are all 6 feet away from each other (a column in the scheduling spreadsheet provides this type of calculation for all rooms). Knowing the rooms in question, the calculations sounds like they might be right. But here is one really crucial question: why should we think that 6 feet distancing is sufficient in cases where multiple people are in one room for a long time, with many or all of these people talking (in many small courses, like mine, students must actively participate in discussions)? BU seems to be focusing only on ways to make the large classes safer, but small classes may be particularly dangerous. We have heard that some small classes may be cancelled altogether in the coming semester (teachers will need to make up for cancelled classes by teaching other classes either in the Fall or the Spring). In any case, graduate student teaching fellows will still, as far as I know, need to teach discussion classes, and they and faculty should be very concerned that many of these classes may be in small rooms. With respect to classes that are not cancelled, another important question can be asked: if all students in the class prefer to hold the class online, rather than on campus, may the class be held online? To answer ‘No’ to this question during this pandemic, when teaching in class means everyone must wear masks and take significant risks to their wellbeing, is absurdYet, so far as we are aware, BU leaders have not provided an answer to this question.

Finally, Russell Powell and I feature in an excellent new radio story by a BU student. We also have an Op Ed we hope to publish soon.

Where are you BU Today?

Open Letter

Open Letter to BU Leaders and the University Community of  June 2, 2020
Russell Powell and Daniel Star

BU’s plan for the fall of 2020 remains very much in flux. At the moment, however, the university appears wedded to the idea that not only should all students who are well and able take up residence on campus, but also that all or most courses be taught in person using a “Learn from Anywhere” approach that would allow students to attend classes either in person or remotely. Students would be permitted to make this decision based on their personal medical condition, family circumstances, travel burdens, and willingness to assume the health risks and potential anxieties that in-person attendance entails. We will not opine here on the practical or moral wisdom of bringing students to campus in the fall, a decision that many peer universities (for good or for ill) have also made. What is unusual about BU’s approach as compared to peer universities, and in our view raises serious moral misgivings, is that the university’s policy as it stands does not carve out a similar sphere of liberty for BU faculty. 

The Fall Plan

As of early June, BU faculty are being given no choice but to teach in person in the fall, even though this is a deeply personal decision—one that is no less than a matter of life and death—for faculty members and their families. Like the students they teach and mentor, faculty members find themselves in diverse medical, familial, and geographic circumstances and have very different tolerances for risk. A blanket requirement that faculty teach in person without regard to their medical and family situations would be an unconscionable breach of the university’s moral fiduciary duties to faculty members, one that places the overwhelming weight of the health burden of this once-in-a-century pandemic on important and vulnerable stakeholders.

The notion that faculty members could choose to take a paid sick leave in lieu of teaching, as suggested to us by some in the university administration, is woefully inadequate for any number of reasons, not the least of which is that a paid sick leave would not (as presently configured) cover situations wherein one’s family members are in high-risk categories, such as if one’s partner is pregnant or if one cares for elderly parents. Furthermore, many faculty members are parents of young children and cannot risk being quarantined from their family for 14 days at a time with each exposure (or worse, if they become infected with COVID-19), leaving them unable to properly care for their children. As it stands, the only recourse for a faculty member who finds themselves in such circumstances would be to take an unpaid leave, which for obvious reasons is not a satisfactory option. There is no doubt that a policy that allows professors, lecturers, and graduate students that fall into certain risk classes to teach online would be considerably better than a blanket policy that admits of no exceptions. If the university chooses to go in this direction, we would strongly urge them to also include faculty who are responsible for the care of young children or elderly family members. 

However, we strongly favor a policy that would give every faculty member the option of teaching their classes wholly online. This would allow all faculty members to exercise their autonomy over a fundamental life decision in light of their own personal circumstances and in consultation with their own values and priorities—just as the university has done for students. There are several reasons why this is the morally best policy. 

First, and most obviously, it is morally wrong to demand that professors risk their health and that of their family members, given the online teaching alternative. In the absence of a vaccine, the only way to open universities in an even remotely safe manner is to have robust testing, contact-tracing teams, supportive quarantine for those exposed, and full PPE gear for faculty in place by the time the fall semester begins. Given the dire national shortages of these things, to say this is a tall order would be an understatement. Creating a reasonably safe environment must go well beyond “security theatre” (such as temperature taking, hallway segregation, classroom spacing, etc.), which risks creating a false sense of security. There will also be major hurdles to adequately enforcing the required conditions, as some students will (e.g.) refuse to wear masks for any number of reasons, including political ones (and we have heard from the university administration that the campus police will not be in the enforcement business). Even if these conditions could be miraculously met and all protocols abided to, many students, faculty, staff, and people in the surrounding Boston community will inevitably get infected, some will be irreparably harmed, and some will die. It is far from clear that this would be a morally acceptable outcome even if the only alternative were to shut down the university for the fall; but it is patently immoral given the remote teaching alternative. 

We fear that despite assurances from the university and the good-faith efforts presently underway to physically reshape parts of the campus, the population density on campus will be too high at certain times to allow for adequate social distancing measures if all courses are taught in person. A mixed approach that allows some courses to be offered online only would considerably lower the population density on campus at critical times.

Ethical Tradeoffs

In defending the urgent need to bring students back to campus, universities have stressed the value of in-person teaching and the limits of teaching remotely, despite the advent of what only a decade ago would have seemed like miraculous communication technology. It is far from obvious that lecturing while dressed in full PPE gear, including masks, goggles, visors, gloves, and gowns, would be in any way optimal for anyone—as opposed, say, to carrying on these same activities from the safety and psychological comfort of one’s own home. Moreover, it is likely that many classes, if not the entire university, will be forced to switch to fully remote learning mid-semester as outbreaks flare up and students and faculty get exposed to the virus. In any case, it seems rather obvious to us that optimal pedagogy cannot conceivably justify significant risks to the health of faculty members, staff and their families, to say nothing of the wider Boston community. 

The only conceivable justification for in-person teaching under pandemic circumstances is that without it many students will choose not to enroll for the fall—and as a result, the economic impact on the university will be so devastating that many faculty members and staff will have to be furloughed or laid off. We are skeptical that this is the forced choice universities are confronted with, especially for institutions with vast real estate holdings and large endowments invested in a stock market that is booming irrespective of national unemployment rates. However, it is incumbent upon BU and any other universities to make this moral case explicitly and transparently, so that its stakeholders can meaningfully evaluate and contribute their voices to decisions that may have a profound effect on their health, their lives, and their livelihoods. 

Sending a Moral Message

What sort of a message are we sending to students if we encourage them to return to campus because their own health is not dramatically at risk, when they are likely to asymptomatically spread the virus to older and more vulnerable university populations? We are telling them that they should not care (or should not care very much) about taking risks that might seriously harm or kill other people. We are telling them that BU faculty do not deserve the same rights as students. We are saying that faculty are here to serve students at any cost—to provide supposedly optimal teaching environments at the expense of their own lives and the lives of those they love, rather than to work collaboratively with students in their development as responsible citizens of our community and stewards of our planet.

Crucially, universities should not take student preferences for how campus life should be conducted in the fall as a fixed point. Instead, they should make the moral case to students that we are all in this together and that we have an obligation to keep one another safe and to support the institution and community we have chosen to be part of. One of us (Powell) co-wrote an opinion piece on the science and ethics of reopening universities that was published in Inside Higher Ed. Since then, the article has been assigned in summer ethics classes, and it turns out that students embrace and appreciate the strength of the arguments therein. Many prospective and current students, who are not themselves at great medical risk, have yet to think through the moral ramifications of attending class in person (an obvious but important one of which is that teachers in the classroom will need to wear masks and screens, whereas online teaching requires no such impediments to teaching well). But they are receptive to reasons. The university must make the case that not only should these students join or continue with BU in the fall, but also that they should do so in ways that do not put others in grave danger. 

Are we, or these other ethicists, saying that it’s never permissible for the university to engineer an environment in which its members risk being harmed or harming others? No. We are simply asking that the seriousness of the policy being proposed be acknowledged and the costs and benefits transparently discussed. At the very least, professors and students should, where possible, have the option of teaching and learning online. If, knowing there are serious risks, professors choose to teach in the classroom, and students choose to return to the classroom, that is a decision they should be allowed to make in a way that respects their autonomy, weighing these considerations for themselves.

Faculty, not physical spaces, are the life blood of the university. Compelling faculty members, at the pain of their jobs, to risk their lives for putatively preferable pedagogy or unclear economic benefits is to cut off the university’s nose to spite its face.