Many universities across the nation opened in the Fall of 2020, while others vacillated between opening, partially opening, and closing.7 The Spring of 2021 will require clearer decision making. On average, our sample of students who are knowledgeable about COVID-19-associated risks would be willing to risk a 23% chance of infection in exchange for in-person classes and would be willing to pay only 48% of the cost of in-person classes if were classes held exclusively online. None of the 46 students surveyed were willing to pay full price for online-only courses even assuming they received full academic credit.
However, university and local elected officials alike should be cognizant that this risk tolerance, even when measured among public health students, extends to with more attending large gatherings and to travelling off campus. About 40% of students of students were willing to attend a party, including over 25% who would attend even if the community prevalence of COVID-19 were moderate or high, and students planned to dine out off-campus an average of 3.6 times per week.
Our study was limited in that it was a sample of 46 recent public health graduates at one school. Moreover, some students reached out to other students to ask them to take the survey. Since no identifiers were collected, it is possible that these additional students had similar risk preferences as the primary respondent. However, the means for the final 16 responses were not statistically significantly different than the initial 30 responses, suggesting that these additional 16 responses produced little influence on the results.
Although our respondents have the requisite knowledge of Covid-19 and had first-hand experience with both online and in-person instruction, our risk assessment should be interpreted with caution. Students who are younger and less knowledgeable may be even more inclined to attend large gatherings. In addition, the perception of risk may be different between well-trained public health students with a deep understanding of infectious diseases epidemiology and other student populations. Another factor is the socioeconomic characteristics of the students in our survey and the institution’s location in Upper Manhattan that should be considered by university authorities and decision-makers. While the Mailman School of Public Health student population is socio-economically and demographically similar to the general student population in the US than Columbia University as a whole, the students may be more altruistic and health contentious than other students. Therefore, the generalizability of our findings to other populations with a different composition of risk-aversion, risk-neutral, and risk-seeking individuals should be interpreted with caution.
Finally, we based willingness-to-pay on a round valuation number ($20,000) that was less than the tuition charged by the university ($60,000). We instead used the lower number because it reflects what the average student pays after scholarships and grants.
It is also unclear how students’ risk of infection might differ were classes offered exclusively online and were students to remain off-campus. When classes are held on-campus, students may live in an environment with significantly more infection controls in place than they might have were they to remain in their hometown and take classes online. For example, one work-around for students’ willingness to take on risk is to place students in “cohorts.” In this model, they have opportunities to socialize, but those opportunities are limited to smaller numbers of students who live together and take the same classes together.8
University life likely offers more opportunities for socializing than, for example, living with one’s parents. Therefore, it may be that holding classes online-only comes at a lower risk of infection with COVID-19 than holding classes in person.
However, it may be that the “worst-case” scenario for many universities is a situation in which students are invited back to campus only then to switch to online-only instruction. In such cases, students are removed from their hometown, placed in proximity to other students near campus, and then removed from the protective environment of on-campus instruction. In such situations, both student dissatisfaction and the risk of infection may be maximized. For this reason alone, universities with large numbers of students off-campus may wish to: 1) re-consider re-opening or 2) commit to remaining open in the face of surging COVID-19 cases in the Spring of 2021; should they have to close campus, then the “worst-case” situation is likely to be realized.
It is unclear whether the guidelines from the Centers for Disease Control and Prevention (CDC) for re-opening universities will be sufficient to reduce risk on campus.9 Our findings suggest that, irrespective of whether they do reduce infection on campus, students appear willing to accept a about a 25% risk of infection in exchange for the opportunity to attend in-person classes, socialize, and dine out. Furthermore, none of the 46 students in our sample was willing to pay full price for online-only instruction, and on average they were willing to pay less than 50% of standard tuition.
This combination of students’ risk tolerance proclivities and their unwillingness to pay tuition places universities in a true conundrum. Some have been willing to assume, the infectious risks, only to shut down because of infectious spread. Others may decide to remain open despite the infectious hazards, perhaps by attempting a variety of “cohort” approaches to reduce risks. Still others are attempting to enrich online-only instruction and to collect most or all of their tuition revenue. Unfortunately, no single instructional model can conclusively balance the desires of students, the usual priorities of universities, and the public’s health.