We read both Stephanie McKay’s “Send the students home” and Dr. Joanna Fava’s “Let the students stay” this week with great interest. As recent alumni and as medical professionals with experience in front-line care of patients with COVID-19, we felt compelled to respond to Dr. Fava’s viewpoint.First, to be clear, we do not envy the current students and staff who must live and work in the midst of this crisis, nor do we envy the administrators who are faced with a difficult decision on how to address the evolving situation. These are impossible times. Nonetheless, the decisions made now must be as evidenced-based as possible and re-evaluated constantly to ensure the University is doing what is best for all parties.We agree that mental health is absolutely an important factor to consider when deciding whether to keep students on campus. But the claim that we will improve mental health by keeping students on campus is unsubstantiated. There is no clear data on how to balance the mental health impact of keeping students on campus versus sending them home. It would be wonderful to teach the students resilience and grit, but is that really the most likely outcome? Indeed, the development of fear and anxiety in students may be more likely.Further, keeping students on campus is not teaching them to “approach their fears, not run from them.” Rather, it teaches close-mindedness by demonstrating a refusal to reassess one’s decisions in the face of evolving information. When Notre Dame started the semester with so few cases, there was a chance, albeit small, of preventing a worsening outbreak. If each infected person only spread the infection to one other person, the disease would remain under control with a persistent but very low number of infections. Such a rate of spread (an R of 1) is eminently obtainable with the “scientifically proven practices on campus” that Dr. Fava notes. However, now that hundreds of students (>2% of the student body) are infected, controlling the outbreak would require significantly lowering the frequency of spread (R <<< 1) to a degree that is, frankly, not likely attainable with students housed in close-quarters in dormitories.To put it simply, the situation has changed, and our policies should too. Dr. Fava asked, “Wasn’t this anticipated and planned for accordingly?” We certainly hope this was not anticipated. More than 2% of the student body contracting COVID in about two weeks should be alarming no matter how it occurred. More importantly, it should give cause to re-evaluate the University’s entire plan.We join Dr. Fava in her call to “urge the University to fight for both the physical and mental well-being of the students.” We also urge the University to show humility by learning and adapting to new information. We had hoped that an on-campus education would be feasible this semester, but two weeks in, Notre Dame is faced with an uncomfortable and dangerous reality. We caution the University against the notion that they can somehow strengthen mental health by keeping students on campus in the midst of a worsening pandemic. Instead, we implore they consider the very real physical toll this virus can take not only on the students but also on the staff and the broader community.
J. Henry Brems, M.D.
class of 2014
Michael Kraft, M.D.
class of 2014
Aug. 21
