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COVID-19 Testing Recommendations for Colleges and Universities

Overview

To prevent and reduce COVID-19 transmission, the Department of Health (DOH) and the Department of Education (PDE) strongly encourage Institutions of Higher Education (IHEs), including colleges and universities, to develop and implement a testing strategy. DOH and PDE recommend any IHE testing strategy include entry screening testing (testing students at the beginning of each term and when returning to campus after a break) and regular screening testing throughout the term depending on available resources and local conditions.

The following recommendations and guidance are provided to assist IHEs with developing a COVID-19 testing strategy that facilitates frequent, targeted testing and effective contact tracing. The guidance addresses when to test, who to test, and what tests are available, as well as quarantine and isolation strategies to support mitigation efforts.

To be effective, any IHE testing strategy should combine testing with case investigation, contact tracing, isolation and quarantine as well as measures to mitigate disease spread, including physical distancing, mask usage, hand hygiene, and enhanced cleaning and disinfection practices. Testing strategies also should align to the Centers for Disease Control and Prevention (CDC) guidance Testing, Screening, and Outbreak Response for Institutions of Higher Education (IHEs).

IHEs should prioritize the following when developing a testing strategy:

  • Communicate through a health equity lens, that resonates with all students, faculty and staff in the IHE community to address health disparities, including racial, ethnic, minorities, and other disparate populations.
  • Protect vulnerable students with underlying health conditions.
  • Protect faculty and staff, especially those with underlying health conditions.
  • Limit transmission to families (visits home and family visits to campus) and the public, especially older populations.
  • Consider levels of community transmission of COVID-19 where the IHE is located and where students and staff live.

A comprehensive testing and contact tracing communication plan should be developed and implemented to keep all students, faculty, staff, and the surrounding community safe and updated with the latest information. The following should be included in the communication plan:

  • Testing strategy overview and testing locations on and off campus.
  • Contact information for IHE Health Center or designated IHE staff in charge of plan operations.
  • Designated information on locations for isolation and quarantine, if applicable.
  • Overview of isolation and quarantine process, including what to expect for students during those times (both residential and off-campus).

IHE Testing Strategy Considerations

An IHE testing strategy should include plans to use available testing resources in an efficient and effective manner. The strategy should consider including both entry and regular screening testing, depending on available resources and local conditions. An example of an IHE testing strategy may include the following:

  • Entry screening testing. Test all students upon return to campus from an extended break, such as Thanksgiving or Winter break. Test each student twice with four days between tests.
  • Regular screening testing. Perform ongoing testing of a random or targeted selection of 10 percent of students, faculty, and staff (up to 10,000 individuals) per day. Test each individual twice with four days between tests.
  • Consider implementing daily wellness checks by students and staff, and use of the COVID Alert PA app.
  • Students and staff should stay home if sick.

As recommended by the CDC, before implementing a testing strategy, an IHE should consider:

  • Availability of dedicated resources and the logistics needed to conduct broad testing among students, faculty, and staff in IHE settings. Examples of resources include trained staff to collect specimens and conduct tests, personal protective equipment, physical space for conducting testing safely and ensuring privacy, and capacity to consistently report results in a timely manner to health departments as required.
  • Capacity within the IHE or public health department for follow-up and contact tracing with those who test positive.
  • Availability of facilities to isolate those who test positive and quarantine their close contacts.
  • Levels of local community transmission.
  • Likelihood of future exposures. Transmission risk is two-way: students can be exposed to the virus in the surrounding community and bring it to campus, but students can also bring the virus to the surrounding community from campus.
  • Cost.
  • Number of tests needed and testing capacity in a CLIA-certified laboratory or facilities operating under a CLIA Certificate of Waiver.
  • Acceptability of the testing approach among students, their families, faculty, and staff.

When to Test?

IHEs may want to consider testing students, faculty, or staff for purposes of surveillance, diagnosis, or screening. Individuals should be considered for and offered testing if they:

  • Show signs or symptoms consistent with COVID-19;
  • Have recent known or suspected exposure to a case of COVID-19;
  • Have been asked or referred to get testing by their health care provider or DOH or local county or municipal health department (CMHD) staff;
  • Are part of a cohort for whom testing is recommended;
  • Are returning from an extended break as part of the IHE entry screening testing;
  • Are in a community where public health officials are recommending expanded testing on a voluntary basis, including testing of a sample of asymptomatic individuals, especially in areas of moderate to high community transmission; or
  • Volunteer to be tested to monitor occurrence of cases and positivity rate.

If an IHE has limited testing resources and capacity, the following hierarchy should be considered when selecting individuals and populations for testing, starting with the highest priority populations:

  1. Individuals with symptoms of COVID-19.
  2. Individuals who have had close contact with someone with COVID-19.
  3. All students, faculty, and staff with possible exposure in the context of outbreak settings.
  4. Random sample of asymptomatic students, faculty, and staff to more rapidly detect increasing SARS-CoV-2 (the virus that causes COVID-19) incidence, with consideration for incentivizing voluntary testing.
  5. All students, faculty, staff and members of their place of residence as part of a community-based testing strategy by health departments outside of outbreak settings.

The following distinguishes between surveillance, diagnosis, and screening testing. See the U.S. Food and Drug Administration (FDA) FAQs on Testing for SARS-CoV-2 for more comprehensive definitions and examples of COVID-19 testing.

  • Surveillance for COVID-19 includes ongoing systematic activities, including collection, analysis, and interpretation of health-related data that are essential to planning, implementing, and evaluating public health practice. Surveillance testing may sample a certain percentage of a specific population to monitor for increasing or decreasing prevalence and to determine the population effect from community interventions, such as physical distancing1.
  • Diagnostic tests are intended to diagnose an infection in patients suspected of COVID-19 by their healthcare provider such as in symptomatic individuals, individuals who have had a recent exposure, individuals who are in a high-risk group such as healthcare providers with known exposure, or testing to determine resolution of infection.
  • Screening tests are intended to identify occurrence at the individual level even if there is no reason to suspect infection—e.g., there is no known exposure. This includes, but is not limited to, screening of non-symptomatic individuals without known exposure with the intent of making decisions based on the test results.

What Test to Use?

As the field of diagnostic testing evolves and antigen tests become more readily available, the type of test most suitable for each situation may vary. For example, Polymerase Chain Reaction (PCR) testing should be made available to individuals who are symptomatic and close contacts of confirmed cases, whereas antigen testing may be more appropriate for some individuals when a point of care rapid result is most important. DOH Health Alert Network (HAN) 532 provides considerations on point of care antigen test use and interpretation. The IHE should partner with health care providers to ensure the individual being tested is referred for the clinically indicated type of test. Refer to the DOH Coronavirus Symptoms & Testing for more information on types of COVID-19 testing and other testing resources.

All tests must be reported to Pennsylvania's National Electronic Disease Surveillance System (PA-NEDSS) as outlined in Pennsylvania law, DOH Health Alert Network (HAN) 534, and the Secretary of Health Order on reporting test results. It is also recommended that test results be reported to health care providers' Electronic Health Records (EHRs).

Testing of Asymptomatic Individuals with Recent Known or Suspected Exposure to COVID-19

Areas of campus where students might be crowded together (e.g., residence halls or other congregate living spaces, dining halls, locker rooms, laboratory facilities, libraries, student centers, and lecture rooms) may be settings with the potential for rapid and broad spread of COVID-19. IHEs should limit crowding in these settings, even with the establishment of a widespread testing protocol.

Diagnostic tests may be appropriate in areas of substantial community spread, at the discretion of the ordering provider. Substantial community spread is defined as a case incidence rate of > 100 per 100,000 or percent positivity > 10%. If necessary, broader testing beyond close contacts may be done simultaneously with other strategies to control transmission of COVID-19 on campus. This can include expanded or widespread testing as described below:

  • Expanded testing includes testing of all people who were in proximity of an individual confirmed to have COVID-19 (e.g., those who shared communal spaces or bathrooms) or testing all individuals within a shared setting (e.g., testing all residents on a floor or an entire residence hall). Testing in these situations can be helpful because in high density settings it can be particularly challenging to accurately identify everyone who had close contact with an individual confirmed to have COVID-19. For example, students who do not know each other could potentially be close contacts if they are in a shared communal space. Expanded testing could be prompted by other surveillance efforts, such as wastewater (sewage) surveillance. Wastewater surveillance involves testing water from household/building use (i.e., toilets, showers, sinks) that can contain human fecal waste, as well as water from non-household sources (e.g., rainwater and industrial use.) for RNA from SARS-CoV-2.
  • Widespread testing includes testing of individuals who have been potentially exposed at some point. This might also include testing across campus building(s). Widespread testing may also be considered based on the preliminary results from initial, targeted, or expanded testing or repeat periodic campus testing such as testing across residence halls. The implementation of widespread testing may also take into consideration local infrastructure factors like capacity and availability of testing locally, mitigation strategies, current academic instruction plan (percentage of classes meeting in person), status of residence halls (open or closed, students per room), access to dining halls and recreation areas, access to laboratory facilities, status of sports facilities like weight rooms (open or closed), status of other extracurricular activities related to campus including those with large gatherings or congregate living spaces (e.g., interest groups, communities of faith, sororities, fraternities) and occurrence of athletic events with spectators and other mass gatherings.

Contact Tracing

Efficient contact tracing is vital to slowing the transmission of COVID-19. DOH and local CMHDs are responsible for initiating and leading case investigation and contact tracing. DOH has partnered with some universities to assist with the state's contact tracing efforts. More information about Contact Tracing is available on the DOH website.

All IHEs can assist DOH or CMHD staff in completing contact tracing as quickly as possible by helping to identify close contacts of cases of COVID-19 in the IHE community.

A close contact is defined as someone who was within six feet of an infected person for cumulative total of  15 minutes or more over a 24-hour period. See PA HAN 533 for more information on determining a close contact.

Upon notification of a case of COVID-19, IHE Health Services personnel or designated IHE staff should identify close contacts of the case and provide the information to local DOH or CMHD staff if the IHE is not conducting its own contact tracing. The status of an employee's or student's health is protected health information and may not be shared with the community in a manner that would violate the right to privacy of that employee or student.

IHEs can take measures to more easily trace exposed individuals:

  • Use assigned seating for each class when feasible.
  • Take attendance for every class to include all individuals, including staff, who were in the classroom.
  • Use sign-in sheets for in-person meetings to document all attendees.
  • Keep accurate records of any persons that enter the building, their reason for being there, the locations in the building they visit, and the names of close contacts they visit in the building, if possible.
  • Encourage students and staff to use the COVID Alert PA app. COVID Alert PA is a free mobile app offered by DOH that is designed to help reduce the spread of COVID-19. The app uses Bluetooth Low Energy (BLE) technology and the Exposure Notification System developed by Apple and Google to help notify and give public health guidance to anyone who may have been in close contact with a person who has tested positive for COVID-19.

IHEs that choose to conduct their own contact tracing efforts also may benefit from forming a contact tracing or mitigation team to assist with internal efforts. More information about Contact Tracing is available on the PA Department of Health website.

  • Recruit contact tracing workers from the student body.
  • Recruit volunteers.
  • Provide training on their roles.
  • Create support networks for those students isolated or quarantined on or off campus.

Isolation and Quarantine

Robust surveillance, case investigation, contact tracing and isolation of individuals with COVID 19 and quarantine of close contacts can slow and stop the transmission of COVID-19. State and local public health authorities may contact the IHE if there are unusual or alarming levels of disease requiring more intensive investigations and accompanying interventions.

An individual will be in isolation if they are diagnosed with COVID-19 and are asked to stay home, in a hospital, or healthcare facility to avoid exposing others. Isolation is for people who have tested positive for COVID-19 and requires people to stay in their homes (including apartments or dormitory rooms) for at least 10 days while monitoring symptoms.

An individual should quarantine if they are at-risk for contracting the virus. Quarantine is for people who have been determined to be in close contact with someone who has COVID-19 during the infectious period and requires staying at home for at least 14 days while monitoring symptoms.

IHE Health Services or other designated IHE staff should implement a daily wellness check during isolation and quarantine of a positive case or close contact.

If a person is tested because they are symptomatic, they need to isolate until test results are known. If a person is tested because they were a close contact of a known COVID-19 case, they need to continue the quarantine for 14 days, regardless of the result of the test.

Prior to moving onto campus, residential students should know campus quarantine and isolation plans through the IHE Communications Plan.

Recommended Quarantine Plan for Students

Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick. If directed by the local DOH or CMHD to quarantine, students should report that information to the IHE Health Center or designated IHE staff member. The Health Center or designated staff member then should register that information in the student's health record and follow up with the student during the quarantine period. Individuals must quarantine even if they feel healthy and do not have contact with a person with COVID-19.

Students in quarantine should be contacted daily to conduct a wellness check and symptom review by IHE Health Services personnel, designated IHE staff, or public health staff. Follow up, such as referral to a health care provider, will be implemented as necessary. The process will be documented in the individual's existing health record and treated as all other protected health information would be in a medical record.

Students in quarantine also should check their temperature twice a day and watch for symptoms of COVID-19. Students should notify their health care provider and the IHE Health Center or designated IHE staff member if symptoms emerge.

Students living in the residence halls should quarantine in their current residence hall assignment (dorm room) or another location assigned by the IHE (other dorm room, hotel room).

  • Individuals should stay in their room and have limited in-person contact, including roommates, until 14 days after their last exposure.
  • Individuals should only leave their room to get food or use the bathroom and should wear a mask whenever leaving their room.
  • Residence Life/Food Services should coordinate with the student to use their meal plan to order food and have it delivered to a designated pick up location.
  • Students should have access to a 24/7 IHE hotline for any questions, issues, or other needs.

Students living off campus should quarantine at that location.

  • Individuals should stay in their room and have limited in-person contact, including roommates, until 14 days after their last exposure.
  • Individuals should only leave their room to get food or use the bathroom and should wear a mask whenever leaving their room.
  • Students should have access to a 24/7 IHE hotline for any questions, issues, or other needs.

It is important to note that in addition to normal stressors, quarantine and isolation may further affect the mental health and well-being of students and staff at IHEs. IHEs should make comprehensive mental health services available to students and staff who are in quarantine or isolation.

Recommended Isolation Plan for Students

Isolation separates sick people with a contagious disease from people who are not sick. If directed by the local DOH or CMHD to isolate, students must physically isolate themselves from others. Students must isolate if they have been diagnosed with COVID-19, are waiting for test results, or have a cough, fever, shortness of breath, or other symptoms of COVID-19.

If a student contracts COVID-19, the student should be instructed to go to their designated isolation location. In the event a student does not have a designated isolation location, assist the student with isolating in a room on campus or securing another location.

Students living in the residence halls should isolate at the IHE's pre-identified location (dorm, hotel, home, or other area).

  • Residence Life/Food Services should coordinate with the student to use their meal plan to order food and have it delivered to a designated pick up location.
  • All isolated students should stay in their room and have limited in-person contact, including roommates, until discontinuing isolation period as outlined below.
  • Individuals in isolation should only leave their room to pick up food and use the bathroom and must wear a mask whenever leaving their room.
  • Students should have access to a 24/7 IHE hotline for any questions, issues, or other needs.

Students living off campus should isolate at that location.

  • All isolated students should stay in their room and have limited in-person contact, including roommates, until discontinuing isolation period as outlined below.
  • Individuals in isolation should only leave their room to pick up food and use the bathroom and must wear a mask whenever leaving their room.
  • Students should have access to a 24/7 IHE hotline for any questions, issues, or other needs.

All isolated students should monitor their symptoms daily and notify their health care provider and the IHE Health Center or designated IHE staff member if symptoms worsen.

Students in isolation should be contacted daily to conduct a wellness check and symptom review by IHE Health Services personnel, designated IHE staff, or public health staff. Follow up, such as referral to a health care provider, will be implemented as necessary. The process will be documented in the individual's existing health record and treated as all other protected health information would be in a medical record.

Students may discontinue isolation after ten days and if they are fever-free without the use of fever reducing medications for 24 hours. In other words, if a student had a positive test and 10 days have elapsed, symptoms are improving and they have not had a fever for the last 24 hours, the student may discontinue isolation.

It is important to note that in addition to normal stressors, quarantine and isolation may further affect the mental health and wellbeing of students and staff at IHEs. IHEs should make comprehensive mental health services available to students and staff who are in quarantine or isolation.

Most Important Rule: Stay Home

When it comes to the rules governing what is allowed in isolation and quarantine, it is actually quite simple. In either isolation or quarantine, people always need to stay home. The safest situation is to not be in contact with others.


1“Physical distancing” means the practice of staying at least six feet away from others. Social distancing is the term that was used earlier in the pandemic as many people stayed home to help prevent the spread of COVID-19. Now, the term physical distancing is used to stress the importance of maintaining physical space when in public areas.

This page was created on November 17, 2020.