By signing this petition, I support the following letter as written below:

June 19, 2020

Open letter to the School of Graduate Studies and Research regarding mandatory SARS-CoV-2 (COVID-19) testing

To Drs. Motley-Johnson and Stewart:

We hope this email finds you both well and healthy. We are emailing to express our concerns regarding the mandatory testing for all graduate students and faculty in the School of Graduate Studies and Research (SOGSR). As graduate students, we understand the importance in reducing the spread of COVID-19 and feel that it is our duty as current and future scientists/healthcare providers to assist in these endeavors as much as possible. However, several issues were identified regarding this mandate, and they are as follows:

1. Utilizing essential, precious resources

As an institution whose vision is to serve underserved populations (which includes providing COVID-19 testing), we would be consuming necessary resources from those who need testing more [1] by mandating that all graduate students and faculty get tested for COVID-19 on Meharry’s campus. Although tests have become more readily available, there are still some places in which tests are scarce. Recent reports show a 30% increase in COVID-19 hospitalizations in Tennessee since early June [2], and the latest Institute for Health Metrics and Evaluation (IHME) model predicts that Tennessee could experience 2,396 total COVID-19 infections by October 1st, doubling the current daily estimated infection rate (as of June 18, 2020) [3]. That said, as a major testing site in Tennessee, we should be prepared to deal with a second wave of COVID-19 by conserving valuable resources.

2. Sensitivity of nasopharyngeal swab

Although limited reports are available for all COVID-19 testing (oral, nasal, blood, sputum, etc.), reports of nasopharyngeal sensitivity have been moderate (between 63–78%) [1]. In addition, relying solely on negative test results may be perilous for the following reasons:

• A negative RT-PCR nasopharyngeal swab test is not sufficient to rule out COVID-19 [1]
• Individuals with negative results may relax physical distancing measures designed to reduce viral transmission [4]
• Negative test results should not be used to determine when individuals return to work [1]

Based on the two concerns outlined above, mandatory testing for all graduate students and faculty is not ideal nor is it sufficient to prevent COVID-19 spread within the institution. However, if the college as a whole and the SOGSR think this is best, then we would like to highlight three additional concerns:

3. One-time testing is insufficient

According to the most updated CDC guidelines for testing asymptomatic individuals without known or suspected exposure to SARS-CoV-2 for early detection, the following steps should be followed:

• Initial testing of everyone residing and/or working in the setting,
• Regular (e.g., weekly) testing of everyone residing and/or working in the setting, and
• Testing of new entrants into the setting and/or those re-entering after a prolonged absence (e.g., one or more days) [5]

By following all of the aforementioned steps, this ensures spread of the virus is decreased, specifically from asymptomatic individuals. Does the college or the SOGSR have a continuous plan for early identification of COVID-19 beyond one-time testing?

4. No clear school-wide or SOGSR-specific policy for mandatory testing or college/lab reopening

Administration has not provided an institutional policy that outlines mandatory testing for students. Additionally, a rationale for retesting on June 29th has not been provided for students who have recently (within the past months) been tested for COVID-19 at alternate testing sites and are actively practicing social distancing guidelines. Most importantly, administration has not detailed any clear plan for labs operations upon reopening, e.g., how PIs will ensure social distancing in the lab environment, use of shared lab equipment, use of core equipment, etc. Does the college or the SOGSR have a school-wide or SOGSR-specific policy in place for mandatory testing or college/lab reopening?

5. No clear guidelines for management of test results

According to the most updated CDC guidelines on COVID-19 testing:

“Before testing large numbers of asymptomatic individuals without known or suspected exposure, the facility should have a plan in place for how it will modify operations based on test results.” [5]

To date, graduate students have not been made aware of Meharry’s nor the SOGSR’s plan for handling negative test results, positive test results, or suspected/positive exposures. Does the college or the SOGSR have a plan in place for management of various test results and exposures?

Lastly, communication concerning the COVID-19 crisis (college shutdown, Meharry being a testing site, etc.) from the college and SOGSR has been subpar at best. Specifically, graduate students were not informed of a clear plan to end experiments and leave lab nor resume experiments and return to lab. Even information surrounding mandated testing was unclear and disseminated last minute. In summary, we urge the School of Graduate Studies and Research to reconsider SARS-CoV-2 mandatory testing for all graduate students and faculty.