How Many Students Are Hospitalized with COVID-19? NC Colleges Don’t Know

For college campuses across North Carolina, the fall ushered in a less-than-ideal reality. The coronavirus, although under greater control than in the spring, was—and is—widely circulating.

Within the first few weeks of the semester, hundreds of students tested positive at UNC campuses including UNC-Chapel Hill, North Carolina State University, and East Carolina University. Since then, all UNC campuses now report the number of confirmed positive cases on publicly available dashboards.

Yet, despite the sharp rise in student cases, few young North Carolinians seem to require serious medical attention. A UNC Health viral disease specialist, Dr. William Fisher, noted that “[in North Carolina,] we’re seeing a younger group becoming infected, and those younger individuals tend not to require hospitalization.”

What about UNC system students specifically? How many of them require hospitalization? And faculty and staff? Given that universities are making consequential policy changes based on the perceived threat of the coronavirus—with some going completely remote—it would seem reasonable for them to consider how sick it is actually making people on campus.

However, based on information requests made by the Martin Center, most schools don’t know the number of hospitalizations. The Martin Center contacted media relations at each of the 16 UNC system universities and asked how many students, faculty, and staff had been hospitalized due to COVID-19.

UNC-Chapel Hill reported two known hospitalizations. Both cases involved students who were hospitalized in June and July. The cases were “noncritical:”

Campus Health is aware of two students who were tested at Campus Health and then treated and released from a nearby hospital in June and July. Both were noncritical. These are the only instances we’re aware of.

Seven schools said they had no reported hospitalizations:

• UNC Pembroke: “Of the cases the university has reported, we have not had anyone hospitalized due to COVID-19. All reported symptoms are mild to moderate or asymptomatic.”
• UNC School of the Arts: “We have not had any hospitalizations due to COVID-19.”
• UNC Wilmington: “There have been no hospitalizations to our knowledge.”
• Western Carolina University: “I am told that there have been no COVID-related hospitalizations through Student Health Services.”
• Elizabeth City State University: “ECSU has not received any reports of students, faculty or staff who were hospitalized due to COVID-19 since mid-May when one staff was in the hospital, but has since recovered and returned to work.”
• North Carolina A&T University: “We don’t have record of any student, faculty or staff member who have been hospitalized due to COVID-19… While I am aware of some who have had COVID-19 symptoms/illness, I’m not aware of any hospitalizations.”
• UNC Charlotte: “To our knowledge, we have no UNC Charlotte students, faculty or staff that have been hospitalized due to COVID-19.”

Six schools do not appear to track hospitalizations:

• East Carolina University: “ECU is not specifically tracking numbers related to the hospitalizations of students, faculty, and staff associated which may be related to the coronavirus.”
• Fayetteville State University: “The university does not track hospitalizations. We only keep track of the number of cases.”
• North Carolina State University: “The large majority of students who have tested positive have either had mild symptoms or been asymptomatic and tested through our contact tracing program. Hospitals do not report whether our students have been admitted.”
• UNC Asheville: “We have no records that are responsive to this request.”
• Winston-Salem State University: “Unfortunately, this data set is too granular and could violate HIPPA and FERPA. More than likely, in the event of hospitalizations, faculty, staff, and students would have engaged with their private doctors, and that data wouldn’t be available to us unless it was self-reported.”
• North Carolina Central University: “The information provided [on the public data dashboard] is what the university is currently sharing.”

Two universities declined to report, citing privacy concerns:

• Appalachian State University: “We regret that we are not able to provide you with the documents you are seeking because the information you have requested is both protected from disclosure in conformity with the definition of section (f) of “Personally Identifiable Information” in 34 CFR 99.3 of the Family Educational Right and Privacy Act (FERPA), as well as N.C.G.S. § 126-24. Therefore, Appalachian does not have any public records responsive to your request.”
• UNC Greensboro: “We do not collect or report hospitalization data for a variety of reasons— particularly the inability to ensure thorough/accurate data (people use their own doctors, we would only know if something was self reported, etc.) and potential HIPPA/FERPA privacy implications.”

The two privacy laws cited are FERPA (the Family Educational Rights and Privacy Act) and HIPPA (Health Insurance Portability and Accountability Act). FERPA is a federal law that protects the privacy of student education records and HIPAA is a federal law that protects patients’ health information. It’s unclear, however, whether universities disclosing the number of hospitalizations would violate either law.

Three legal experts told The Washington Post that the federal laws “do not apply to withholding overall coronavirus data.” In the FERPA guidelines released in March, the Department of Education stated that schools could share coronavirus data as long as students’ personal information isn’t revealed. “Coronavirus data can be shared without pointing to individuals if the school shares blanket numbers,” the Post reported.

Frank LoMonte, director of the Brechner Center for Freedom of Information at the University of Florida, told the Post that “the reason universities are so confused about this is that their lawyers have been misusing FERPA for decades to block public records requests for things that FERPA doesn’t cover.”

Unlike UNC schools, federal, state, and local governments—as well as healthcare systems— are tracking and reporting COVID-related hospitalizations. And the data point to two key realities that university leaders should take into account:

1. The coronavirus does not pose serious threats to most college-aged people, and
2. A high number of positive cases does not necessarily translate into a high number of gravely ill people.

According to Dr. Scott Solomon, a professor of medicine at Harvard Medical School and one of the authors of “Clinical Outcomes in Young US Adults Hospitalized With COVID-19,” the “vast majority of young adults who get Covid are not going to require hospitalization.” However, he added that those who do require hospitalization “have [a] really high risk for these adverse outcomes.”

As Solomon noted, there are exceptions: Some young people are severely affected by the virus. Tragically, on September 29, Appalachian State University announced that a student passed away from complications related to COVID-19. The student, Chad Dorrill, had the “rarest” of COVID-19 cases, according to his doctors. The New York Times reported that Dorrill may have had an undetected rare neurological disorder called Guillain-Barré syndrome, which viruses can trigger.

Cases such as Dorrill’s underscore the need for schools to provide ample testing, require those who test positive to self-quarantine, and allow students who are high-risk to opt out of in-person classes and activities.

Apart from rare cases of hospitalizations and deaths among young people, some might point out that large numbers of infected students could place other, more vulnerable community members in harm’s way. Dr. Fisher from UNC Health emphasized this point: “That’s great for them [students] because they’re not as sick. But the more that we have positive people interacting with others, the greater chance we have of community transmission.”

Nevertheless, although the number of positive cases has risen among students, they don’t seem to be causing more people to get seriously sick. According to data from the North Carolina Department of Health and Human Services, on August 10, the first day of college classes, the number of statewide hospitalizations was 1,104. Since then, the number of hospitalizations has not risen above 1,104, despite the ongoing rise in positive cases.

Orange County, where UNC-Chapel Hill resides, has seen a gradual decrease in hospitalizations. Ever since the county started reporting hospitalization data in early July, the number of hospitalizations has been, for the most part, on a slight downward trajectory— even during students’ momentary return on campus in mid-August.

Notably, the number of Orange County emergency room visits for COVID-like illnesses also slightly fell during the same period.

In the end, it’s odd that most UNC system institutions do not track hospitalizations. It shouldn’t be that difficult for them to do: Universities often rely on self-reporting to track the number of positive cases on campus. Why can’t they ask students, faculty, and staff to self-report COVID-related hospitalizations?

But more importantly, the institutions’ lack of hospitalization tracking is irresponsible because it could help policymakers make more prudent and measured decisions. If many students are contracting the virus, but most are asymptomatic or develop “mild symptoms,” should campuses stay shut down, forcing students to take online classes? Even with routine testing, contact tracing, and enforced self-quarantine?

Many would answer “no.”

Shannon Watkins is senior writer at the James G. Martin Center for Academic Renewal.