Candice Lockett from the South East Toronto, Family Health Team administers a COVID-19 vaccine on April 22, 2021.Fred Lum/the Globe and Mail
Lauren Cipriano is an associate professor at the Ivey Business School. Gregory Gloor is a professor of biochemistry at Western University. Wael Haddara is the chief of critical care and Michael Silverman is the chief of infectious diseases at London Health Sciences Centre.
Staying one step ahead of COVID-19, rather than always reacting to its impact, has proven elusive over the past year and a half. With a very successful vaccination campaign under way, Canada has an opportunity to get our lives back on track. The key lies in understanding the nature of the coming phase of the pandemic, rather than being stuck in the moment, or worse, in last year’s frame. To get ahead of future outbreaks, we need to act now and make vaccinations mandatory for students, staff and faculty on postsecondary campuses.
On Sept. 7, more than a million postsecondary students will return to university and college campuses across the country. This mass relocation represents both an opportunity and a threat. Vaccine mandates for returning students will help control further spread of COVID-19 and achieve our primary goals of minimizing interruptions in health care delivery, maintaining in-person education and limiting disruptions to communities.
Postsecondary educational institutions combine many of the factors that facilitate and accelerate the spread of COVID-19. They introduce many people into high-density situations such as classrooms and laboratories. Classes that exceed 500 people in one lecture hall are common. The time between classes is short, resulting in crowding as one group of students leaves and another enters. Between classes, students engage in numerous informal gatherings, including clubs and study groups.
It’s not just the student population that is at risk. Students are often crowded into cafeterias and other public spaces with staff and faculty. Students live, work part-time and shop in our communities. Postsecondary students have many close contacts on and off campus.
The Delta variant’s infectiousness is such that every infection will lead to seven more if unchecked. With vaccines that provide about 75 per cent to 90 per cent protection, vaccinating nearly 100 per cent of the eligible population is necessary to give our communities a fighting chance of preventing further outbreaks. In high-density settings such as universities and colleges, we will also need to improve ventilation systems, continue masking in high-density indoor environments, and perform contact tracing and quarantine upon exposure.
Mandatory vaccination can be the key to keeping our schools and businesses open. Specifically targeting college and university communities, where transmission is expected to be the highest, is the best way to stop the spread in mid-sized communities with relatively large postsecondary populations. Unfortunately, the vaccination rate is currently lowest and the infection rate is highest among young adults, and uptake of first dose vaccination has plateaued. Many of the vaccine hesitant simply need a nudge to get vaccinated.
Outbreaks will not stay on campus. They will spread to the community through restaurants, shops and schools. Unrestricted operation of colleges and universities without vaccine mandates will put access to elementary education and hospital care at risk again. In U.S. counties with similar vaccination rates to Canada (e.g., Los Angeles County and the San Francisco Bay area), relaxing all public-health controls has led to increasing cases and, already, a reinstatement of mask regulations.
A number of institutions such as Western University and McMaster University require proof of COVID-19 vaccination to be able to live in residence. Toronto’s Seneca College demonstrated courageous leadership by mandating proof of vaccination to be on campus. Individual public-health units are now on record saying colleges and universities should have vaccine mandates.
What is the barrier to mandating vaccination on campus? Political will. Everyone can see the problem, everyone is worried about the problem, but there is no political will to provide the postsecondary institutions with the legislative tools to mandate vaccination as a condition of being on campus. Provincial governments need to do the right thing and make it a requirement to be vaccinated on campus.
Without a vaccine mandate for colleges and universities, we will be guaranteeing a return to online education. A vaccine mandate, which includes proper proof of vaccination documentation, with appropriate exemptions and privacy protections, would allow us all to get back to the business of learning, to get back to the important research that has been put on hold and protect our communities. Those who wish to remain unvaccinated could be accommodated by remote learning or by mandatory frequent testing. This is an opportunity to be pro-active and get ahead of the pandemic. We should not squander it.
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