How has coronavirus (COVID-19) spread among students in England?

The number of coronavirus (COVID-19) cases among the student population rose following the start of the autumn term at both the University of Exeter and Loughborough University.

Data from these universities shows cases rising steeply in September and October 2020, particularly in halls of residence, but falling again during November.

Bringing together information gathered at a number of English universities, we found the risk of transmission to be greater in residential settings such as halls and student houses, with minimal evidence found of the virus being spread in face-to-face teaching settings such as classrooms and lecture theatres. The largest outbreaks occurred in halls of residences.

COVID-19 infections peak at the start of term among students at Exeter and Loughborough before tailing off in November

The number of coronavirus (COVID-19) infections increased rapidly in the general population throughout September and October 2020.

From early August through to mid-November, the Coronavirus (COVID-19) Infection Survey (CIS) consistently showed that positivity rates were highest among teenagers and young adults. In early September, the Scientific Advisory Group for Emergencies (SAGE) warned that large numbers of students travelling for study presented a “critical risk” of seeding coronavirus outbreaks across the UK, and said universities were highly likely to experience significant outbreaks.

However, capturing information on the prevalence and transmission of COVID-19 among higher education (HE) students in England is difficult. The CIS does not cover those living in university halls of residence, the NHS Track and Trace programme only tests those with COVID-19 symptoms, and testing programmes run by individual universities vary in their size and scope.

We have worked with the University of Exeter and Loughborough University to produce case studies that provide insights into what happened when their students returned to university in September. While these findings cannot be applied to all institutions, they do provide initial information that could inform the wider higher education sector.

Cases of COVID-19 among Exeter students rose fastest the week following the start of term

The number of positive test cases for students attending the University of Exeter by test date between 2 September and 16 November

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Notes

1. This includes data from students tested via the University’s commercially-provided PCR testing and from students tested via NHS Test and Trace.
2. Students attending the University of Exeter had wider access to COVID-19 tests than at universities without access to their own testing. This could affect the volume of cases seen on campus.
3. A smaller number of students are typically housed in university halls, meaning the numbers of cases in this accommodation type likely represent a larger proportion of the residents

The number of cases at Exeter rose rapidly from roughly a week after the start of term (which commenced on 21 September, with students arriving in halls of residence between September 10 and 20) to a peak of 196 cases on 30 September. From that point, total cases fell to less than 25 per day from 15 October for the rest of the period. This increase was sharper in halls of residence than in private residences.

COVID-19 spread among private student households before halls of residence

The number of cases in Exeter University students by date and place of residence

Notes

1. Data presented and permission for its publication was provided by the University of Exeter
2. This includes data from students tested via the University’s commercially- provided PCR testing and from students tested via NHS Test and Trace.
3. Students attending the University of Exeter had wider access to COVID-19 tests than at universities without access to their own testing. This could affect the volume of cases seen on campus.
4. Case counts have been suppressed where the number of daily cases in an area is lower than five
5. There may be some double counting for students aged 21 and over who could appear in both the NHS testing data and in the positive cases seen in private residences.

The map shows that COVID-19 cases among Exeter students initially spread in private student households (in blue), before high numbers of cases appeared in halls of residence (in green) from late September.

Typically, students living in halls of residence at the University of Exeter are first year undergraduates, while all other students reside in private housing. As a smaller proportion of students are housed in halls, the high number of cases in this accommodation type likely represents a higher percentage of residents tested positive here compared with in private housing.

It is likely that students living in halls share spaces with a larger number of students than those in private housing, increasing the likelihood for the virus to spread quickly. Flats in halls of residence at the University of Exeter usually accommodate between six and nine students.

The map also shows NHS testing data for those aged 21 years and over in the general population in Exeter (in grey). Overall, cases were spread across the city between September and November and were not confined to areas of student residences. However, Exeter students make up the majority of recorded cases in the area during late September and early October.

The peak in cases among students is not seen in the wider population of Exeter

All cases among students by day, and NHS testing cases by day for those aged over 21 in Exeter, 2 September 2020 to 16 November 2020

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As cases among students began to settle down again in November, cases in the wider population remained at a consistent level slightly higher than was seen in September.

There is not enough evidence in these data to be certain whether infections spread from the wider population into the student population, or whether the arrival of students in Exeter had an impact on the rising levels of COVID-19 in the wider community. As infections were increasing across the country during the autumn, we would expect the number of infections to be higher in the wider population in these months compared with earlier in September too.

At Loughborough University, cases among students generally rose in October before falling in November

We also worked with Loughborough University to understand patterns seen throughout the autumn term. Although these data are not directly comparable with that of Exeter University because of differences in testing programmes, we can use this information to understand what happened at each university.

COVID-19 saw a higher spike among student in halls than students in private housing

Covid-19 cases in Loughborough University students by result date, by housing type, 7 October 2020 to 2 December 2020

Download the data

.csv

Notes

1. A smaller number of students are typically housed in university halls, meaning the numbers of cases in this accommodation type likely represent a larger proportion of the residents

COVID-19 cases among Loughborough University students rose during October 2020, with the cases in halls of residence rising sharply in late October. While cases peaked multiple times throughout October, they then decreased to a lower level during November.

At Loughborough, like at Exeter, most students live in private housing, with around a third housed in halls. Therefore, the number of cases recorded in halls likely represents a higher proportion of the total population in this accommodation type compared with private housing.

Halls of residence tend to house more students in closer proximity to one another. This, coupled with the university’s ability to monitor cases more readily in this setting, are likely contributing factors to the high peak of COVID-19 cases in Loughborough halls.

Coronavirus cases among Loughborough students peaked later in October

The number of cases in Loughborough University students by date and place of residence

Notes

1. Data presented and permission for its publication was provided by the Loughborough University
2. Case counts have been suppressed where the number of daily cases in an area is lower than five

This map, showing positive COVID-19 cases among students at Loughborough University by location, shows multiple clusters of cases in the area throughout the autumn.

Data from these case studies alone cannot give us a definitive picture of the transmission and prevalence of COVID-19 among students across England.

Universities introduced different preventative measures at different points in time to curb the spread of the virus. We do not yet have sufficient evidence to assess the effectiveness of these different measures.

However, this information does show that comprehensive monitoring of infections in halls of residence is vital in fully capturing how the virus is affecting students. No comprehensive programme is yet in place to do this, but pilots by the Joint Biosecurity Centre into waste water sampling and mass testing may provide further evidence into the best way to tackling this.

Most COVID-19 transmission could be traced back to students living together

These case studies demonstrate the potential for rapid spread of the coronavirus (COVID-19) among university students in residential settings. We also worked with a selection of universities to understand more about transmission among HE students more generally.

Information about the transmission of COVID-19 was collected by universities through a range of methods, including telephone calls with students who have tested positive and analysis of student timetables and residential information.

Most COVID-19 transmission could be traced back to students living together. Patterns often show one positive case followed by further positive cases within the same university block with quick succession (usually within a couple of days of the first case).

We found minimal evidence of transmission happening in face-to-face learning environments, such as lecture theatres. In instances when transmission was traced back to a face-to-face learning environment, further investigation showed specific reasons for it happening, usually through appropriate guidance not being followed, such as the removal of a face mask. One university described the results of their investigations of non-domestic transmission as “human compliance failures rather than systemic failures”.

Assessments into transmission of positive COVID-19 cases at the University of Reading and York St John University concluded that the majority of transmission was through domestic or social interactions (82% and 76% respectively). Neither university had evidence of direct transmission through a face-to-face learning environment.

The evidence presented here does not yet provide a comprehensive national picture about the nature and level of transmission among HE students, but provides some insights into where and how COVID-19 transmission happens for ongoing research.

Student wellbeing has worsened as a result of the pandemic

The coronavirus pandemic and the various measures introduced to slow its spread have significantly affected the day-to-day lifestyle and mental well-being of the general public. However, many HE students have found themselves in a unique situation, perhaps isolating in a household with others they do not know well.

Students responding to the Student Covid Insights Survey (SCIS) in October and November 2020 reported lower levels of life satisfaction, life worthwhile and happiness, and higher levels of anxiety, compared with the general population responding to the Opinion and Lifestyles Survey (OPN).

Further, results from three different surveys conducted during November 2020 conclude that more than half of students report that their wellbeing and mental health have worsened as a result of the pandemic.

Findings from these and other studies are summarised in Coronavirus and the impact on students in higher education in England: September to December 2020.