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Told to self-isolate, they were four to a room

Told to self-isolate, they were four to a room

Over the weekend of Jan. 31, 108 students who had visited China in the preceding 14 days were asked to self-quarantine in response to the global 2019 Novel Coronavirus (2019-nCoV) outbreak.

As of Monday the approximately 125 students who had been assessed were all declared low-risk and no longer required to self-quarantine. Even so, a “small number of students” have still elected to remain self-isolated.

Some students affected by the initial self-isolation policies felt the University’s decision was poorly implemented and incompetently executed. In an anonymous letter to the Daily Princetonian last Tuesday, graduate students expressed frustration regarding “the University’s conduct toward the returned members during [the] implementation” of its isolation policy.

“Each one of us has taken tremendous precaution to protect ourselves while staying in mainland China, while experiencing fear, pressure, and anxiety,” they wrote. “Upon our return, instead of finding ourselves protected and safe, these policies and conduct nullified all prior efforts and put us in an unsafe environment.”

Addressing students’ concerns, Deputy University spokesperson Mike Hotchkiss wrote to the ‘Prince’ that the individuals in self-isolation were receiving “housing, dining and academic support.”

“Our priority at all times has been to protect the health and wellbeing of all members of the University Community,” Hotchkiss wrote. “By its nature, emergency response is an imperfect process that requires responding in real time to changes in information and guidance. The University responded ... by working with officials with infectious disease and public health expertise at the campus, local, and state levels to ensure that our response was appropriate and informed by the latest science and pertinent guidance.”

Previously, Aly Kassam-Remtulla, Vice Provost for International Affairs and Operations, Irini Daskalaki, an Infectious Disease Physician at University Health Services, and Robin Izzo, Executive Director of Environmental Health and Safety, published a letter in the ‘Prince’ affirming their commitment to the “health and safety of every member of the University community.”

Four students who agreed to be interviewed by the ‘Prince’ on the condition of anonymity described the fear, anger, and frustration they experienced, specifically pertaining to the alternative accommodations the University had provided them.

They commended the University’s quick implementation of the self-isolation policy — put in place before most peer institutions in the United States — but criticized the lack of timely and appropriate response to inquiries via phone calls and emails, which they said exacerbated their emotional stress.

According to students asked to self-quarantine, they were communally isolated — in several cases up to four in a room in campus housing, with shared bathrooms and kitchens — which, in their view, defeated the very purpose of isolation. Furthermore, student accounts indicate that University officials either were delayed in addressing concerns from students or simply did not respond.

A third-year graduate student (G3) who had visited family in China for a month described their experience with self-isolation.

Having been assigned with other students to “an Annex room” for self-isolation, G3 panicked. The Graduate College Annexes are three-story houses on Dickinson Street, Edwards Place, and University Place, with single bedrooms, but shared bathrooms and common rooms, including a community kitchen and laundry facilities.

The student reached out immediately to Environmental Health and Safety (EHS) regarding the high risk for cross-infection.

“I did not expect [them to respond],” they wrote in a statement to the ‘Prince,’ “and indeed they did not, given they already made such a decision ignoring risks to our personal safety.”

The student then proceeded to draft an email with “around 30 students and scholars” in a collectively signed request to Community Health, EHS, the Office of the Provost, the Graduate School, and University Health Services (UHS) on Feb. 2.

“By that time, I was fully exhausted due to drafting and organizing, jetlag, and emotional stresses,” the G3 explained. It wasn’t until the next day at noon that Community Health and EHS responded, but only after a follow-up email was sent by the students.

“They refused to provide hotel rooms or studios,” the G3 said. “We also asked for masks and disinfection materials and got ignored. They only provided food.”

Indeed, the University did “displace guests staying at the University-owned Palmer House (which has hotel-style rooms) to create space for some students, but area hotels were not amenable to housing self-quarantined students,” according to Hotchkiss.

Even then, only some students received food — in some cases, up to three hours after “normal meal time” — according to G3. Other graduate students were never contacted by the University about food delivery nor received any, leading many to resort to instant meals or skip meals entirely.

Many Chinese students volunteered to buy groceries or meals for those in self-isolation — even individuals they did not know personally — coordinating their schedules according to the needs of students in self-isolation, G3 told the ‘Prince.’

Another student who self-isolated, a senior undergraduate who also asked to remain anonymous, had a more positive perception of the University food-delivery service.

They opted-in to the offer, “which appeared to be a variety of food from Frist three times a day.”

“I was very happy with the meal delivery plan and was happy the university was trying to reduce the risk of say, a student going to the dining halls,” they said.

However, all the students interviewed, including the senior, found the level of support and lack of administrative transparency to be troubling.

The G3 expressed outrage over Hotchkiss’s remarks in the ‘Prince’ article published on Monday, Feb. 3.

“How could [the University] say that they were ‘working to fully support’ us, when they actually put some of us in danger, pushed us to move, and [refused] our request for hotel-room self-isolation, a solution we actively proposed out of our sense of responsibility to public health?” the G3 said.

The senior, who was in China for the Lunar New Year, also described their initial surprise upon learning of the self-isolation requirement. The senior noted that, the call to self-isolate may have suggested that the situation was more serious than it was. Because they had not seen the State Department’s announcement, they were “shocked and confused” to receive the notification.

“Peer institutions (Harvard, JHU, and MIT) had not made similar announcements at the time,” they added. “It seems like everyone is just doing the best they can, but it's confusing when peer institutions' policies do not match.”

Still, several institutions including Harvard, Massachusetts Institute of Technology, New York University, University of Pennsylvania, University of Chicago, and Columbia University announced different recommendations and requirements for registration and self isolation.

Upon their return to campus, the senior was assigned to a room in upperclass housing with three other individuals. None of them knew each other. The specific room appeared to be a two-room triple with a private bathroom in floor plans reviewed by the ‘Prince,’ even though four students were assigned to it.

The University explained the decision to house students together was based on the lack of  symptoms exhibited.

“We utilized all immediately available housing to address the requirements of self-quarantine,” Hotchkiss wrote, in a statement to the ‘Prince.’ “In some cases, this meant placing self-quarantining students together in the same room, which is a common and acceptable practice as long as those with symptoms are separated from those without.”

However, students did not feel comfortable living in the rooms due to the possibility of cross contamination.

“It seemed to be a risky choice,” the senior said. “For example, if I was sick, I would very easily get others sick. Even if everyone was healthy and not carrying the coronavirus, living with four people in a triple could still lend itself to easy transmission of the common cold or flu.”

“The University seems to have tried to put those who returned from China into a riskier environment,” they added.

A junior undergraduate who was in China for Lunar New Year was also communally isolated with other individuals.

“Obviously, [the initial email] was personally jarring, but I knew it was the right thing to do in terms of epidemic containment,” they said in an interview. “The University had to react to and follow a poorly worded and unsubstantiated federal travel directive.”

Even so, they also described their assigned living accommodations as “ridiculous.”

“It was quite an emotional experience for me and maybe I’m being overdramatic, but just from a common sense perspective, self-isolation doesn’t seem to be a group activity,” they remarked. “For the amount of time it took the University to get back to me about my housing assignment, I was surprised their ultimate solution was a quad.”

Additionally, affected undergraduates were expected to coordinate with their professors and directors of studies regarding accommodations and potential extensions on their own.

“The University asked us to reach out to professors ourselves. It seemed to be a play-it-by-ear thing — we were just dealing with things as they happened,” they said. “Thankfully, as only one day of the semester had passed, no large accommodations needed to be made.”

A fourth-year graduate student (G4) interviewed by the ‘Prince’ was in China for three weeks during the Lunar New Year. However, living off campus, the G4 decided to self-isolate at home instead of in University housing.

Even so, the G4 criticized the University for its emails and preparation, saying that it could have been “more timely,” given the school’s intersession break.

When the G3 revealed their self-isolating practices to their housemates, some asked G3 to move out into a hotel.

“Scared and offended, [I] explained that I would need food delivery and reimbursement from the University,” they explained. “I showed them the screenshots of University instructions for self-isolating students and proved [to exceed the University’s] requirements.”

“Dealing [with my] housemates at this sensitive moment was emotionally challenging. I was actually very fearful that they would protest to the University and ask me to move to the assigned Annex,” they added.

However, when G3’s housemates became aware of the situation, they brought water and food and offered to provide any assistance or support they needed. Despite the challenges, G3 remarked, “It is all worth it. I’m grateful to have them as my housemates.”

The G3 also anecdotally conveyed the struggles of other graduate students.

“One grad student, who works in a lab and chose to continue voluntary self-isolation, was required by her boss to go back to work,” they explained. “But her lab mates were very unhappy. They did not dare to challenge the boss directly but rather pushed her to continue self-isolation. So now she is under [opposing] pressure from both her boss and her lab mates.”

In their Feb. 5 letter to the ‘Prince,’  Kassam-Remtulla, Daskalaki, Izzo — the University administrators — acknowledged the challenges of self-quarantine for students, while thanking the campus community for their efforts “to be supportive, respectful, and inclusive” of those affected.

Addressing the concerns regarding housing arrangements, the authors wrote that asking self-quarantined individuals to share bathrooms and kitchens was an approach that is “a common practice in public health emergencies and necessary given the limited housing availability on campus.”

The G3 expressed their disappointment with the letter, accusing the University of intentionally “avoiding their mistake[s]” regarding the risk of cross infection in the assigned housing with shared bathrooms.

“They are either not professionally qualified for their positions — namely not [being] aware that the virus spreads through droplet, touch, and stool — or not responsible, or both,” G3 rebuked. “‘Common practice does not justify anything. It's out of luck that the cross infection did not happen earlier. It only shows that the University has been risking some of its members' personal safety for [a long time].”

In a phone interview with the ‘Prince,’ Michael Levy, Associate Professor of Epidemiology at the University of Pennsylvania’s Center for Clinical Epidemiology and Biostatistics, corroborated this statement, saying, “The issue is, ‘common practice’ … doesn’t mean it’s a good practice.”

“If you’re going to isolate people, isolate them,” he added.

Levy further stated that, in his opinion, the University’s implementation of self-isolation was “done very poorly” and the housing arrangements were “problematic, to say the least.”

In a subsequent email statement, he explained that because 2019-nCoV has a basic reproduction number (R0) of at least 2.2 — that is, the number of additional cases one infected individual would on average cause — “true isolation is a powerful tool.”

Although Levy acknowledged that the University’s overarching intent to isolate was “a rational thing to do,” he added, “‘dorm-room’ isolation is troubling. Putting four people together in a dorm room seems like feeding the Minotaur.”

The junior had a final message to the University community at large.

“In the same way that people from China are the most likely to transmit the disease, they are also the most affected by it. Please remember that at the center of all your rightful fears and wariness are real people,” they wrote in a statement to the ‘Prince.’ “If there's one thing I hope readers take away from this, it’s not any of the issues I had with Princeton's response ... but how infinitely better it is to be here than the real center of the epidemic. People who have friends and family trapped in cities in lockdown.”

The University recognized the unique challenges of returning to campus from China at the start of the semester and thanked the students for their assistance in protecting the campus community.

“We acknowledge and empathize with their situation navigating housing on campus while also worrying about family and friends in China,” wrote Hotchkiss. “Our response efforts could not have been implemented successfully without the students’ diligence in self-reporting, self-observation and commitment to protect our community…. We plan to invite these students to meet next week to discuss their concerns.”

The G4 offered that the University community can remain cautious without holding grudges.

“Given that this tragedy has happened, we are all in this together. It is during times like this that one should remember that we are vulnerable individually, only stronger in solidarity.”

This article has been updated to reflect more detailed comments from the University.

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