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.