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Brian Lehrer: Brian Lehrer on WNYC. Having talked about the slow return of audiences to live performances in New York largely because of COVID fears, we're actually going to stay on the COVID beat but add monkeypox in the final segment of the show today, but talk about a whole other realm of life and that is life on campus.

As the new term begins at colleges and universities, a study by PLOS One, the peer review journal from the Public Library of Science, which analyzed COVID data from the fall of 2020, so the first fall semester of the pandemic, found the college re-openings across the country caused us 37% increase in COVID cases at that time. That doesn't come as a huge surprise as college seems to be kind of a Petri dish, a bunch of students living in close quarters plus all the socializing and partying that tends to ensue.

This new academic year is starting for America's colleges and universities. It's the third year of the COVID-19 pandemic, but now there's monkeypox thrown in the mix. While some areas are reporting a stagnation or decline in monkeypox cases, we've seen more reports of children testing positive for it. Just yesterday, Texas, of all places, reported the nation's first known death due to the disease.

How are universities approaching these health issues and how do students, their parents, and faculty feel about their schools' policies right now? You tell us, college students, professors, parents, faculty, staff, give us a call and tell us what your college or university is doing this year very much in terms of monkeypox protocols because that's really what's new here but also COVID school year three. 212-433-WNYC, 212-433-9692, or tweet @BrianLehrer.

With me now is Caroline Lewis, health and science reporter for WNYC and Gothamist who published an article earlier this month titled Why New York Colleges Should Start Preparing for Monkeypox Now. Hey, Caroline, thanks for coming on.

Caroline Lewis: Hi, Brian. Good morning.

Brian Lehrer: I see that so far at least Georgetown American University, UT Austin, Bucknell, and West Chester University that's outside Philadelphia, that West Chester, have reported at least one case of monkeypox each over the summer. Now the colleges and universities are recovering, reconvening, I should say, for full-time on-campus life. How much of a risk is there that monkeypox will spread on college campuses if anyone knows?

Caroline Lewis: Even though we've seen those individual cases reported, I think it's still unclear whether colleges will be a significant site of monkeypox transmission. Certainly, city health officials have said they're not particularly worried about monkeypox spreading in classrooms, in general, but, of course, as you mentioned, colleges or college dorms, I should say, are congregate settings where people are living in close quarters and really any congregate setting can create a higher risk of viruses spreading.

I think it's important to recognize that monkeypox doesn't spread as easily as COVID which ran through some campuses like wildfire. It often spreads through skin-to-skin contact with someone who has sores from the virus or prolonged face-to-face contact such as when people are kissing. I'm sure as people have heard most of the cases reported in the current outbreak in New York have been linked to sex or other intimate contact among men who have sex with men as well as people who are trans and non-binary. Of course, it could break out of that community, though, and there are people in that high-risk group in colleges as well.

Brian Lehrer: As your article points out, it's kind of a fluke that it landed in the gay male community as much as it did. That just happens to be where it landed and so those people and the sex that they were having started to spread it first, but we know there's a lot of skin to skin contact among college populations. In many dorms, one of my producers was thinking about this, especially underclass dorms, not graduate school, you don't usually have any furniture except your bed. It's such a college thing to just sit on someone's bed when you're hanging out. I don't know if that'll lead to monkeypox cases but it's a question.

Caroline Lewis: Yes, colleges are trying to make sure that students know all of the ways that monkeypox spreads which includes contact with bedding or clothing from someone who's been infected. I don't think students have to avoid all beds but maybe if someone has sores or feels sick, they shouldn't be sitting on their friend's bed. I think one of the other key things colleges are trying to do is make sure that students are aware of the symptoms of monkeypox, not just visible sores but also early symptoms like fever or chills or respiratory symptoms that they might mistake for something else if they didn't know that that could be a sign of monkeypox.

Brian Lehrer: Again, listeners, if you are returning to campus or know someone who is, how worried are you? Are you concerned about monkeypox and COVID or are you just happy that school is starting? Parents, maybe you're just happy that they're going back to college away from home, or college students, maybe you're just happy to get out of your parents' house. This, of course, assumes you're going away to college. Obviously, there's commuting too when living at home while you're going to college, but this is largely about people who are going away, living in the dorms, living away from home off campus.

How about monkeypox as a new risk this year and how about COVID year 3? 212-433-WNYC, 212-433-9692, or tweet @BrianLehrer, and tell us what your college or university is doing this year in terms of COVID or monkeypox protocols or what you've heard. Wonder if signs are going up in the dorms about monkeypox protocols like they've gone up in dorms over the years about other things that have been in the news healthwise, 212-433-WNYC, 212-433-9692 or tweet @BrianLehrer for health reporter Caroline Lewis.

Caroline, what are some of the public health guidelines and protocols you're seeing from colleges when it comes to monkeypox?

Caroline Lewis: I think that they are largely following what the city health department is saying. For instance, I saw that NYU's page on monkeypox online said a student only has to isolate if they have fever, chills, or respiratory symptoms, whereas if they're positive but don't have those symptoms, they're just directed to take other precautions like covering up their sores when they're in public or wearing a mask.

In general, these city guidelines have faced some criticism from advocates who say that people should be supported to stay home during the full course of the disease to make sure that it doesn't spread. I think for now colleges are taking their cues from the city and also saying that students should isolate if they're sick, come to college healthcare providers and get tested if they think they have it. Notably, you can only get tested if you actually do have sores.

Brian Lehrer: Here's a report from one college via a listener on Twitter who writes, "Tulane University is recommending that students who live on campus and are diagnosed with monkeypox travel home to isolate there." Apparently, there are 174 cases in Louisiana as of August 29th, most located in Orleans. That's where Tulane is. That's consistent with what you just said about going home for a while if you get monkeypox.

Caroline Lewis: I don't know about traveling home. I've seen it said that people should isolate in their rooms.

Brian Lehrer: Oh, in their rooms.

Caroline Lewis: I'm not sure if I've seen colleges at least just-- I've only looked at a few websites, but I haven't seen people being told to go all the way home. It's an interesting--

Brian Lehrer: We can't confirm that. Of course, this is just somebody's tweet but that's something that we can look up and confirm one way that they say Tulane University is handling it, but if they're isolating in their room, let's say it's a dorm room and they have a roommate, what does a roommate do?

Caroline Lewis: I think that's a good question. To be honest, I haven't seen colleges really giving specific guidelines around those types of considerations. Certainly, when I was reaching out to public health experts at some colleges like Columbia, NYU, and CUNY earlier this month, they were still figuring out what their protocols would be. I know that the city said it was talking to colleges about what they should be doing last week. Maybe they're figuring it out, but I think maybe there is some concern that they haven't really hashed out exactly how to make sure that people can completely isolate.

Brian Lehrer: Sheila in Connecticut, you're on WNYC. Hi, Sheila.

Sheila: Hi. What about the showers and the toilets and all of that? There's three toilets for my daughter's dorm room and two showers. Are they supposed to be disinfecting everything every single time they touch a handle of a faucet and everything?

Brian Lehrer: Is that more a COVID risk or a monkeypox risk as far as you are concerned as a parent, Sheila?

Sheila: Both, I have to say, but we just had COVID in May, so she's not that worried about that anymore at this very moment, but it's more the monkeypox and if it's skin-to-skin and somebody has a sore and they sit on a toilet, how long is it going to-- and somebody else goes in, are they supposed to be cleaning?

Brian Lehrer: Thank you, Sheila. What's the science on that? Do we know if it can get transmitted on hard surfaces like shower handles?

Caroline Lewis: Well, I've seen public health experts say that it's not a big risk. I know, for instance, the City Health Commissioner was asked about city bikes, like should you be wiping down your city bike handles or seat if you're sharing it? I think that's a little different because it's, obviously, not bare-skin touching. Well, it could be if it's your hands, but basically, they said it's not a big risk.

I think that, obviously, it can be on a surface if infected clothing is capable of spreading it, but it's not a big risk that public health experts have identified, and I haven't seen anything around specific cleaning protocols.

Brian Lehrer: Desiree in Park Slope, you're on WNYC. Hi, Desiree?

Desiree: Hi. Nice to speak to you again. What I said to the screener is that I lived through the AIDS pandemic as a teenager, [unintelligible 00:11:34] as a first and second-year college student, well, all of my college years, but the height of it was at the beginning of my college years.

The thing that I found frustrating at the time was the inability of adults to be really clear in their language when they talk to young people about how to spread and contract AIDS at the time, HIV, et cetera. I find the same thing is happening with monkeypox.

The discussions around gay men and the preponderance of the virus being in gay male sexual networks failed to talk about the actual activities that were making it more prevalent in gay male sexual networks.

I think that that is a problem because some of those activities or the kinds of activities that young people engage in when they're in a college setting, particularly if they're living on campus in a dorm or in apartments with eight people, et cetera, the kinds of things you usually do when you're in college, touching, sharing towels, sitting on each other's beds. Yes, but also young people just touch each other more than people do as they get older. They hug, they do each other's nails, they share makeup.

You know what I'm saying? They're always rubbing and touching each other, not in a bad way. That's not a bad thing, but you get what I'm saying, it's not necessarily how adults are interacting with their friends and other people on a daily basis, the way that you do when you're in college. That's above and beyond the sexual activity. I would've liked to have more discussions about the specific things that people are doing not just say intimate touching. What do you mean by intimate touching? Because when you say intimate, some people think you're only talking about sex.

Brian Lehrer: You're right on every single one of those points and, Caroline, some of that is reflected in your article. Some of that also implies the complexities for settings like colleges and universities, where there's a lot of this kind of touching, a lot of touching common things as well that aren't just about sex.

Caroline Lewis: Yes. I think it's tough, for one thing, because there are studies that linked a lot of like the early cases in this outbreak in the US to specifically sexual contact, sex or oral sex, things like that, but it was unclear whether it's because people are making out or because they're touching someone's skin and they have a sore or because it's spreading through sexual fluids.

I think there's still a little bit of uncertainty, but I think you're also right. The city health department does say things like cuddling, you should be careful as opposed to just having sex. Certainly, if we only link it to sex, then people might think that, "Oh, if I didn't have sex, then I'm safe," or if that person has it, then they're being promiscuous, which creates stigma.

I think it's difficult, partly because public health experts are still figuring out how to talk about this, but I think you're absolutely right that we should be talking about specifically what is leading to this transmission.

Brian Lehrer: Desiree, thank you. Kevin in Manhattan, you're on WNYC. Hi, Kevin?

Kevin: Hi. I'm a student but I don't live on campus. I live off campus, and I strongly suspect I have monkeypox and I have no idea what to do about it. I've gone online, and unlike with COVID where there's just a lot of information about what to do should you have COVID, with monkeypox, you go online and it's just "contact your healthcare provider". Being a student, I don't have one, so what do I do and I've got these red welts all over my body from my feet up to my neck?

Brian Lehrer: Well, you do need to see a doctor, I would say. Caroline, you're not a doctor but you are a health reporter, can you give any advice to Kevin?

Caroline Lewis: Yes. I don't know what school you go to, but I have seen schools saying like if you have symptoms like that, then you should go to the school healthcare provider and get tested there, but you could also go to a city health clinic. You could go to Callen-Lorde, which is an LGBT clinic that has centers in Brooklyn, Manhattan, and the Bronx where they're very familiar with it. You could go to a city hospital.

I would actually say that it might make more sense to go to a city hospital or a place like Callen-Lorde, where they're very familiar with the virus because if you have a severe case, they might also be able to give you treatment, and not everywhere can offer treatment because it's still considered experimental. Going to a city hospital, for instance, I think that's a place where you would be able to get treatment if you need it.

Brian Lehrer: Has your school-- [crosstalk]

Kevin: Can you expand on what you said about Callen-Lorde, I don't know what that is?

Caroline Lewis: Sure. That's a community health center that specifically serves the LGBT population. Because of that, they're very familiar with the monkeypox virus and I know that they have been diagnosing people, but also prescribing this sort of like experimental treatment TPOXX which can help people alleviate symptoms. I know they're just very well versed in it and so I just thought that would be a good option to look up if you don't want to go to a city provider.

Brian Lehrer: Kevin, I hope that's helpful. Thank you for calling in. Good luck. In our last minute, Caroline, to go back to COVID, we're in the third year, third full school year starting, let's say, of the pandemic, and whether for the right or wrong reasons, the CDC's latest guidance seems to treat COVID cases as an inevitable part of the new normal, greatly reducing the isolation period and no longer recommending quarantine for those who are merely exposed to the virus. Are colleges and universities largely following suit?

Caroline Lewis: Yes. I have seen that protocols such as mask-wearing are definitely being relaxed, although schools are still taking some precautions. I saw Columbia, for instance, is encouraging students to get tested for COVID in the 72 hours before they arrive on campus. Schools are also still emphasizing vaccination. CUNY, NYU, SUNY, Columbia, all of them are requiring students and faculty to be vaccinated, and all except for CUNY-- Sorry. All except for SUNY are making it mandatory to have a booster as well.

Brian Lehrer: There we leave it with Caroline Lewis, health and science reporter for WNYC and Gothamist. She has reported on college campuses preparing for monkeypox in addition to all her great COVID coverage over the whole pandemic. Caroline, thanks for coming on with us for this.

Caroline Lewis: Awesome. Thanks, Brian.

Brian Lehrer: Brian Lehrer on WNYC.

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