Amidst the whirlwind of COVID-19 news over the past few weeks, many students waited days on end for results from their random asymptomatic COVID-19 tests administered by the university.
After coronavirus cases began to creep up at the start of this semester, the university altered the asymptomatic testing policy and began to test the entire undergraduate population each week, rather than only a random sample, which amounted to roughly one-third of the population. Students normally receive their results in an email from BioReference Lab, the university’s lab partner, 36 to 48 hours after a test is administered.
“We noticed during the week of Feb. 15 and 16 that we hadn’t received results,” Dr. Cecil Price, Director of Student Health Services (SHS) said. “We called the lab and asked what was happening, and they said they hadn’t received any samples.”
Per Price, the samples had always arrived at the lab the next day without fail.
Dr. Price grew concerned, as samples must be tested within 72 hours of collection in order to be considered valid. Though he claims the university packed and refrigerated the samples correctly, they still had not arrived at the lab. He later learned that due to the winter storm, FedEx experienced problems getting the shipments to the lab in Gaithersburg, Md. The company was prioritizing shipments of the COVID-19 vaccine.
On Feb. 17, students who were administered COVID-19 tests on Feb. 15 and 16 received an email from the Office of Communications and External Relations saying that “weather issues” delayed the arrival of the test samples from BioReference Lab. The posting of the results would therefore be delayed as well.
In the meantime, Dr. Price and SHS made plans to get the test samples from Feb. 18 and Feb. 19 to the lab in a more timely fashion given the nature of the winter storm (for which the university decided to cancel classes on Feb. 18). According to Dr. Price, a university employee personally drove the samples to the lab to ensure their arrival.
The lab later notified Dr. Price that the samples from Feb. 15 and 16 still had not arrived. After consulting with Dr. Chris Ohl, an infectious disease specialist at Wake Forest Baptist Health, as well as the medical director of the Forsyth Health Department, Dr. Price and the lab agreed that the samples — whether positive or negative — should be invalidated. It could not be ensured the samples were kept in the proper condition or temperature while awaiting shipment with FedEx, and the time gap between collection and lab testing would be too large. However, Dr. Price took comfort in the knowledge that each of the students whose samples were rejected would be tested again in a matter of days as part of the asymptomatic testing cycle. He did not immediately see a need to bring everyone back in for testing.
Yet, on Tuesday, Feb. 23, senior Kit Burroughs woke up with an email from BioReference Lab, notifying her that her test from Feb. 15 had come back positive, eight days later.
“Once I received my positive test eight days late from Student Health, that’s when the frustration started,” Burroughs said. “I called Student Health, not the other way around, to tell them I was positive and they told me that there was confusion with our samples, so I needed to come in for re-testing.”
SHS was unaware that the results had been released until Burroughs and other students who tested positive contacted SHS. The Old Gold & Black spoke with 16 students who also received their results from the 15 and 16 on the 22 or 23, though others have yet to receive any results.
“We immediately said, what on earth is going on? We had to get answers as quickly as possible,” Dr. Price said. “We were frustrated and confused by that because the lab didn’t do what they said they would do. The lab should not have run them.”
SHS was not expecting to receive any results from that testing sample, since the lab had told them the results would be rejected. Therefore, they had not been on the lookout for these results. Burroughs, who visited SHS that morning, said that from her perspective, SHS “generally did not really understand what was happening.” Dr. Price also said, “we were scrambling and wanted to provide a clear message”.
According to Dr. Price, roughly 30 tests from a sample of around 200 were positive. While waiting for results, five or six of those students had developed symptoms and were confirmed to be positive for COVID-19. That left just over 20 students who could potentially be positive. Under Dr. Ohl’s guidance, SHS contacted the rest of those impacted directly, rather than sending another mass email, and invited them to take another COVID-19 test to confirm which were “real positives versus fake positives”.
This prompted the university to issue a statement to Resident Advisers, which was posted on Our Way Forward several days later. However, it was never sent to the impacted students.
“Our partners in the Student Health Service are in active consultation with both our lab partner and with public health experts about the validity of these tests and how we move forward,” the email stated. “We believe the risk to our communities to be low from this situation.”
After re-testing the impacted students, it was determined by Dr. Price that students who tested negative and did not have symptoms must have received false positives. For those who tested positive, it could be assumed that their first test was accurate. Roughly three-fourths of the tests came back positive again, while the remainder came back negative.
Burroughs claims she was led to believe by a nurse and a doctor that her test could very well have been a false positive. Still, she was instructed to isolate until she received results from her second test. However, Burroughs notes that her friend was told not to quarantine while she waited for her second results and was cleared to attend an in-person class that same day. She suspects this might have been because she was experiencing symptoms while her friend was not.
But both Burroughs and her friend tested positive again on Feb. 23. Panic ensued as they realized the possibility that they had unknowingly been spreading the virus over the course of the eight days while waiting for their results. Though she is not currently enrolled in any in-person classes, Burroughs had gone to friends’ houses and out to dinner throughout that week.
“Finally, I get a call two days later. Not only am I definitely positive, but based on my viral load, I had had COVID-19 for the last ten days,” Burroughs said. “Imagine knowing that in the midst of this pandemic, you were a super-spreader despite how careful you had been and multiple reassurances from Wake that you were negative!”
Burroughs was not alone. A sophomore who requested to remain anonymous out of fear of retribution, but whose identity is known to the Old Gold & Black, witnessed a suitemate receive a positive result Feb. 22, seven days after their initial test on Feb. 15. The individual will be referred to as “Charlie,” a gender-neutral pseudonym.
According to Charlie, the suitemate was “roaming around campus” for seven days before being notified that the COVID-19 test had come back positive. The suitemate was not experiencing symptoms.
“[The suitemate] ended up infecting over five people that I personally know of, and however many more I don’t,” Charlie said.
Charlie expressed frustration surrounding the university’s handling of the situation.
“What is the purpose of testing the student body if COVID positive people are not being removed from the equation as soon as possible? Seven days is outrageous and ‘weather delays’ is an inexcusable answer. Look at every northeast school that deals with snowstorms or weather-related issues very frequently,” Charlie said. “I think the school has an obligation to the student body to be efficient in their testing. Otherwise testing is fairly pointless.”
Dr. Price admits he was worried that students had been positive for days without knowing, and shared in students’ concerns.
“That was very frustrating for students and I understand that, I understand that completely,” Dr. Price said. “We would have much rather known this earlier than later and I thought, ‘Oh my word, the numbers could increase’.”
However, Dr. Price insists that they did not, and that there is “no evidence of a mini-surge” related to this mishap.
“We would have seen a big difference already, and we haven’t,” he said. “Our overall numbers are excellent.”
To add to the miscommunication, the Forsyth Health Department received information about these tests as reported by BioReference Lab, but was not aware of the situation. According to Dr. Price, all labs that process COVID-19 tests are required to report data to the state as well. The department independently began reaching out to students for contact tracing, which added to students’ confusion.
“I told her [a representative from the health department] the situation with my potential false positive test,” Burroughs said. Though Burroughs was told by Student Health that she did not need to quarantine after Feb. 25 since it had already been ten days after her initial positive test, Forsyth Health Department told Burroughs that based on when her symptoms ended, she was advised to quarantine until Feb. 28.
Dr. Price regrets not asking students about their symptom onset and basing their isolation off of that timeline. He also wishes SHS was able to better and more quickly communicate with the health department so as not to confuse students.
“It was a timing issue, and we were trying to stay on top of this for these students,” he said. “We should obviously have filled them in with the testing and what Dr. Ohl said.”
In addition to students who tested positive, this situation has impacted countless other students like Charlie, who have been required by the school to quarantine due to exposure. For each of these students, their 14-day quarantine began not when the initial tests were administered on Feb. 15 or 16, but instead when the results were released roughly one week later. According to Dr. Price, quarantine begins on the most recent day of exposure, rather than when an initial test was administered. Had the samples not been delayed and had students learned earlier of their exposure to other positive students, they would have been able to begin quarantining earlier.
Charlie began quarantining due to exposure Feb. 23 and is expected to quarantine until March 9, even though her suitemate first tested positive on Feb. 15.
“From a student’s perspective, it feels that every week there are new made up rules that have not been verified or have been proven to be wrong, such as the 14-day quarantine policy,” Charlie said.
The CDC proposes that individuals can stop quarantining after day ten or even after day seven if they don’t test positive after day five, though “local public health authorities make the final decisions.” The university has changed its quarantine guidelines several times over the course of the year.
As a result of the 14-day quarantine mandated by the university, Charlie spent their 20th birthday quarantine alone in a room.
“So I’m definitely pretty upset about the situation,” Charlie said. “It’s pretty [expletive] up, frankly.”
Senior Lizzy Herbst, one of Burroughs’ suitemates, was told to begin quarantining on Feb. 25 despite the fact that Burroughs first tested positive on Feb. 15. She expressed concerns about the dates of her quarantine to an individual at the Wake Forest call center after calling SHS, but was not given the explanation she sought.
“The dates made no sense because I could have potentially been spreading COVID-19 for the previous two weeks if I had it, and they are making me quarantine when I wouldn’t even be contagious or have it anymore,” Herbst said.
After Herbst said she would keep calling until “the university listened,” she received a call from Dean of Students Adam Goldstein.
“In a very aggressive and threatening tone, he said that if I kept calling he would ‘have to ask and tell me to stop’,” Herbst said. “He called back later and was super nice because he probably realized or was told that he can’t talk to students like that.” Herbst does not recall Dean Goldstein apologizing to her. Dean Goldstein did not immediately respond to a request for comment.
“The confusion amidst this whole thing was aggravating and disappointing,” Burroughs said. They should have retested us immediately after the mixup.”
“It was really frustrating for them and for us,” Price said. “I can’t be as frustrated as the students, but I was right there next to them.”
SHS has now switched from using FedEx to a more reliable courier service that the lab provided at a discount due to the error. The lab also apologized to Dr. Price. Fortunately, the courier service has been delivering samples to the lab at a faster rate than FedEx had, so students are now receiving results one day earlier. Price describes this as a “great advantage,” enabling all parties to learn even sooner if an individual is positive.
“We didn’t want this to happen,” Price said. “It had not happened before and we made changes so it won’t happen again.”