Background
Colleges and universities across the country have worked aggressively to suppress SARS-CoV-2 transmission and safely bring students back to campus and in-person classes. These efforts have generally relied on extensive testing, contact tracing, and appropriate isolation or quarantine for students, faculty, and staff using on-campus protocols that start and stop within campus boundaries. While these approaches are critical to identify and prevent the spread particularly among asymptomatic individuals, even the best testing efforts can be thwarted by a single event such as a large social gathering without social distancing and the use of face masks.
College towns are highly complex, with local businesses and economies dependent on the student population, and student life that extends beyond campus into the community. There are unique safety challenges associated with the rapid influx of students from various parts of the U.S. and internationally where COVID-19 occurrence may be elevated, as well as students’ living situations on and off campus. Students moving into university towns often live in highly dense and communal living situations, from dorms to off-campus apartment buildings and houses. To be successful, campus and community plans to mitigate the spread need to consider the interconnected nature of city and student life.
Creating a Model for Community Control of COVID-19
Healthy Davis Together is a joint project between the City of Davis and UC Davis, with the goals of preventing the spread of COVID-19 and facilitating a coordinated and gradual return to regular city activities and reintegration of UC Davis students back into the Davis community. The project combines the best elements of epidemiologic infectious disease control with behavior change interventions to synergistically improve health and well-being for the entire community. By taking a community-centric approach, Healthy Davis Together seeks to create a proven, replicable model that colleges and other communities can successfully use to reopen.
The Healthy Davis Together program design and implementation were developed in collaboration with UC Davis scientists, city administrators, county health and local business leaders, and community representatives. HDT is grounded in public health principles with epidemiology and health behavior change as focused strategies such as free and regular COVID-19 testing, enhanced case finding and contact tracing, support for individuals in need of quarantine or isolation, assistance to help businesses adapt to new public health guidelines and operate safely, citywide environmental monitoring of wastewater, and health education, mass communications and incentives. Since its launch in November 2020, Healthy Davis Together has administered more than 224,000 tests and identified more than 950 individuals who tested positive, contributing to lower transmission in the community. Core components of the program include:
- Screening and Diagnostic Testing. Free, regular SARS-CoV-2 testing for everyone who lives or works in Davis, and their immediate households, is a key strategy. Healthy Davis Together has built capacity to conduct 8,000 rapid and convenient saliva-based PCR tests per day across multiple community screening facilities for both symptomatic and asymptomatic individuals and employs mobile vans to reach targeted under-resourced areas. Its low cost, high throughput testing enables timely, accurate, and affordable identification of new cases with contact tracing, and quick triage to isolation and quarantine services to reduce spread of the virus.
- Environmental Monitoring. Regularly testing wastewater, indoor air, and certain contact surfaces for presence of the virus can serve as an early warning system, with relevant updates to the community shared on HealthyDavisTogether.org. Knowing whether, where, and how virus is present can indicate where spikes may occur and helps target parts of the community where stepped-up individual testing should occur.
- Mass Communications. Communications campaigns promote healthy behaviors, drive registrations for regular testing, promote the business partner program, and share information about safe opening plans and vaccine availability. Integrated paid media, social media, and text campaigns ensure the community receives the latest information. Regular public opinion surveys inform content and targeting by regularly tracking shifts in awareness, attitudes, and behaviors.
- Business Partnerships. Healthy Davis Together engages 260+ Davis businesses through grants, PPE distribution, free testing for employees, patron incentives, marketing, and education. From helping businesses adjust their physical operations to allow for social distancing, to offering gift cards to local businesses as incentives for testing, these partnerships encourage healthy practices while supporting the local economy.
- Student Partnerships. Trained UC Davis undergraduate and graduate students – Aggie Public Health Ambassadors – help scale Healthy Davis Together’ efforts by modeling healthy behavior and encouraging campus and community members to make healthy choices that reduce COVID-19 transmission.
- Isolation and Quarantine Assistance. Recognizing that financial barriers and the reality of living in multi-person households can make isolation and quarantine difficult, Healthy Davis Together provides assistance to anyone who needs it. Healthy Davis Together offers isolation kits for all positive cases and provides support for housing, transportation, food, or salary needs to those who need to safely quarantine or isolate.
- Contact Tracing. Healthy Davis Together investigates positive cases to understand potential exposures. Our contact team includes full-time staff and parttime public health graduate students. In addition, we have helped to leverage smart phone exposure notification technology to further control the spread of the virus.
- Epidemic Modeling and Forecasting. Healthy Davis Together links epidemiological data at multiple levels (state, county, city, zip code, and institution) to evaluate the effectiveness of targeted interventions. This is the basis for employing precision public health approaches to identify and target where more support is needed.
- COVID-19 Vaccination. Healthy Davis Together has brought together and partnered with multiple healthcare provider organizations, retail pharmacy companies, Federally Qualified Health Clinics, and Yolo County Health to optimize vaccinations in the county. This includes setting up and operating vaccination sites, providing personnel, running communications campaigns, supporting mobile vaccination services, and even targeting certain hard-to-reach individuals such as migrant farmworkers and individuals who cannot leave their homes.
- Population Health Informatics. HDT’s patient privacy-first, community-centered digital platform and ecosystem manage individual health information, support a broad range of health services, and identify trends using data analytics. The effort addresses long-standing barriers to public health that have historically discouraged engagement among diverse populations, ensures sensitive patient data is protected, and facilitates meaningful data sharing between researchers, providers, and government entities.
- Knowledge Sharing. Communities need real-time, digestible learnings at a speed faster than traditional and much-valued peer-reviewed journal articles. A foundational goal of HDT is helping to write a playbook with effective approaches that can be used in other communities. HDT regularly shares learnings through forums, commentaries, and media updates so that key learnings and leading practices can inform program activities in other U.S. communities and college towns.
