And this unprecedented experience has left many first-year students coming right out of high school less prepared academically and emotionally for the college experience, the report warns.

But there are challenges within higher ed, as well. The entire sector is grappling with heavy turnover—higher ed job postings, for example, spiked by 280% in spring 2022. Student success and support leaders may now be operating with less experienced teams to meet growing needs as mental health replaces academic achievement as the top priority on many campuses, EAB’s report says.

“We should not panic,” Ed Venit, EAB’s managing director writes in the report. “Instead, we should view the challenges ahead as an opportunity to finally address student success barriers that have existed for years.”

Building on recent innovations, EAB’s analysis offers several student success solutions to help campus leaders meet the challenges of the coming years:

1. Rebalance support and free capacity: One-size-fits-all support underserves students who need intensive assistance while overserving those who are more smoothly transitioning to higher. Campus leaders should develop systems to separate students into these three tiers: baseline support, active monitoring and intensive care.

2. Fully implement early-alert systems: Many colleges and universities have early-warning platforms to identify students who are struggling but not all institutions are getting the most out of their investments. Administrators should recommit to a multi-semester process of fully activating their early-alert system. EAB’s report provides a checklist administrators can use to assess this alert process.

3. Embrace mass communication: Institutions looking to broaden the reach of their communications should consider an “SSMS system” that can mass-message groups of students. This technology allows administrators to pre-coordinate messages, better focus on onboarding and orientation for first-year students, automate outreach and provide students with self-service tools.

4. Develop a mental well-being strategy: Mental health services have often been siloed in Student Affairs counseling centers. To meet rapidly increasing demand and avoid staff burnout, counseling services must be supplemented with nonclinical supports developed through an equity lens. Students of color often have greater mental health needs but white students are more likely to seek out counseling, EAB advises. Campus leaders can use their communications systems to nudge students who need help or conduct well-being surveys. 

More from UB: Why Stanford President Marc Tessier-Lavigne is under investigation

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However, it’s important for everyone to stay COVID-cautious this year, despite the recent loosening of restrictions this school year. And several colleges are making sure students and faculty are playing it safe this holiday season.

In October, President Joe Biden called on colleges and universities to do their part in keeping their campuses protected by hosting at least one vaccination clinic by Thanksgiving.

Williams College in Massachusetts, for instance, has announced stricter COVID-19 policies for students once they return from Thanksgiving break, according to the student-run paper The Williams Record. Students will be required to wear masks almost everywhere on campus from Nov. 27 to Dec. 6, according to a campus-wide email sent by Chief Communications Officer Jim Reische. Additionally, students must receive a COVID test once before they return to campus and twice after they arrive.

The requirements are similar to those set forth at the beginning of the Fall semester.

“Our goal with these rules is to help get everyone through the last weeks of the semester COVID-free, with the ability to fully enjoy the winter break and the holidays if you celebrate them,” Reische wrote.

Similarly, some Boston-area colleges are requiring boosters for their students in order for them to return for the spring semester. Tufts University and Harvard University, although they’re in the minority, have asked students to get the bivalent booster by the end of the year.

“Students must be compliant with all vaccine requirements in order to register for the spring term,” according to Harvard’s Health Services website. “It is highly recommended that students receive the required vaccinations during the fall term while on campus.”

“The COVID-19 pandemic is not over,” wrote Tufts’ Infections Control Health Director Michael R. Jordan. “Indeed, SARS-CoV-2, the cause of COVID-19, is becoming an endemic infectious disease, and we continue to see new cases on our campuses. Therefore, in accordance with the university’s current COVID-19 vaccine policies, we are requiring all eligible faculty, staff, and students to receive the updated (bivalent) COVID-19 booster.”

What’s also top of mind for many education leaders is the possibility of a “tripledemic,” the combination of COVID, influenza and the respiratory syncytial virus (RSV). Cases of each virus are surging after flying under the radar during the pandemic, according to Columbia University’s Irving Medical Center.

What’s most troubling is the timing of these viruses, as they’re ramping up much earlier than usual.

“The Southern Hemisphere has had a pretty bad flu season, and it came on early,” Director of the National Institutes of Allergy and Infectious Diseases Dr. Anthony Fauci told Bloomberg News. “Influenza—as we all have experienced over many years—can be a serious disease, particularly when you have a bad season.”

“This could very well be the year in which we see a ‘twindemic,’” Infectious Disease Professor at Vanderbilt University Dr. William Schaffner told NPR. “That is, we have a surge in COVID and simultaneously an increase in influenza. We could have them both affecting our population at the same time.”

More from UB: U.S. News: Law school rankings will continue, even as more schools opt-out

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However, the dramatic shift in instruction also created a demand for certain services that had gone unnoticed for years.

220 million students were directly affected globally by the pandemic in April of 2020, according to the Boston College Center for International Higher report. Yet, throughout the year as colleges provided remoted instruction, the unprecedented reliance on technology caused a significant surge in the education technology market.

According to an August 2021 report from Fortune Business Insights, the market size grew by 9.9% to nearly $78 billion in 2020. By 2028, that number will more than double and is projected to reach $169 billion by 2028 as the demand and reliance on education technology increases.

“Online learning has started to gain much pace in the higher education sector,” the report reads. “The availability of high-speed internet, increasing usage of personal computing devices, and governments’ initiatives toward digital learning are the key factors for driving the popularity of online learning platforms.”

More from UB: 5 cooperation tools leaders can use to manage change successfully

This projected growth lines up with student perceptions of online learning as per a 2021 report from Sykes Enterprises as the majority of students highly favored remote instruction. According to the report, 95% of students felt their professors were addressing their personal needs while allowing for understanding in submitting coursework on time. Additionally, 85% of them felt as if they were part of a “classroom community,” and 84% said remote learning was effective.

“The rippling effects from COVID-19 have dramatically transformed higher education systems for good—and with students indicating that virtual learning can offer an effective learning environment, now is the time to further invest in elevating the virtual student learning experience,” Steve Davis, Higher Education Business Development Executive at Sykes, told University Business.

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For higher education, the pivot back from fully remote to fully reopen has been welcoming this fall. Campus leaders have expressed confidence that even with reductions in protocols and mandates that they will be able to handle potential outbreaks, hardened by 30 straight months of planning, team-building, reacting and finding solutions.

Still, where there’s coronavirus and flu and monkeypox–and a winter ahead–disruption likely will occur. New subvariants continue to emerge, though none yet have stormed in to unseat the prevalent BA.5 and BA.4.6. There is one more on the way, BA.7, though it is unclear whether it will be any more severe than its omicron predecessors. Colleges should continue to keep a watchful eye on developments and heed the guidance of public health officials, especially if a new variant does break through to oust omicron.

Over the past few years, the American College Health Association’s COVID Task Force has been meeting with college health leaders across the country and providing advice to institutions. They’ve leaned largely on the Centers for Disease Control and Prevention guidance in creating their own roadmap for safe reopenings.

With so much change happening in the past few months and with populations seemingly reluctant to get new bivalent boosters, University Business asked Task Force co-chair Dr. Anita Barkin, a nurse practitioner and former head of health services at Carnegie Mellon University, to discuss the latest on COVID and the flu and how colleges should be navigating this very unusual and surprisingly quiet period this fall.

What are you hearing from college health leaders about uptake of vaccines and boosters on campuses with COVID numbers waning?

There is a lack of real enthusiasm for embracing mitigation strategies like masking, vaccine requirements and booster requirements. Most schools we’ve talked to have said we’re going to encourage it and educate people about the availability of the booster, but we’re not going to require it. They are turning it back to individuals to be responsible. One of the drivers I used to hear most consistently is that students are motivated to get vaccines if they feel that they’re going to lose footing academically and if they’re going to miss classes. That may be a hook for them to get the booster and flu shot.

More from UB: Yes, 82% of college students are fully vaccinated but is that enough?

If I were still in my role as executive director of health services, I would be including the opportunity to get the bivalent booster with flu shots. Some schools are doing that. Some other schools are outsourcing their flu clinics and asking if the company can include boosters. One school said if we can’t get it, we’re going to talk with a local Walgreens [to get students appointments] or are asking Walgreens if they’ll do on-campus clinics.

Short of mandates, why should colleges be encouraging students to get boosters now?

If I’ve already gotten the initial series and gotten boosted and haven’t been ill, why wouldn’t I take advantage of a vaccine that now has the two variants that are circulating included? [A new study from the University of Minnesota shows both the efficacy and safety of the new boosters]. But it’s hard to make a case with college students who, by and large, are not having any significant illness. Certainly, there are some reports of long COVID, and you don’t know how it’s going to affect you. COVID has been tricky. I’ve been a nurse practitioner for over 40 years, and I have never seen anything like this, where there’s one unpredictable scenario after another.

One the strongest protections implemented by colleges was robust testing. So why have colleges opted to reduce it?

It’s really about resources. It has been very expensive to do heavy-duty testing and surveillance. Colleges are saying, why should we have robust surveillance if we have people who can test at home? The level of concern, given the severity of illness or lack thereof, is disincentivizing schools from spending a lot of money. And there are ways to do surveillance that are pretty typical of the way that we’ve done it in the past: How many people are showing up in the health service with COVID? How many people showing up are testing positive? Are we seeing a lot of absenteeism? Are local health officials seeing an increase in the severity of disease? What the CDC said, is look at what’s happening in your local hospital. Talk to your local public health people. I have talked to enough schools to know that they are not inclined to start up surveillance testing again.

Another great development were COVID dashboards. Some have remained, but many disappeared. Without them and testing, what should college leaders do if outbreaks occur?

If the school doesn’t have a dashboard or took it down, campus leaders should be communicating to the campus that we are seeing an uptick in cases, and this is how we know that is happening: there have been positive tests, health services are overwhelmed, there is class absenteeism. It’s important that they say, here are our recommendations to decrease your risk–mask wearing, getting the vaccine or booster, remembering to wash your hands and avoiding large gatherings. And they should say, we’ll communicate with you again and give you an update in a week, or five days.

Positive cases have gone down dramatically since the beginning of the year, and the U.S. did well in stretches during the pandemic, but delta and omicron surfaced to change that. How attuned should campus leaders be to emerging variants?

As the chief medical person on campus, I had to understand what public health threats look like. I needed to understand how to develop a response plan, and how to roll out a response to a public health threat. This is not the last novel virus we’re going to see. And this is not the last pandemic. We need to learn from the past so we don’t make the same mistakes going forward. We weren’t prepared for this pandemic. And I wonder if we’ll be prepared for the next one. Should college health professionals be aware of emerging public health threats? Absolutely.

Most colleges developed thorough plans over the past few years, led by COVID teams, some of which have been disbanded. We’ve heard some leaders tout their ability to pivot during crises, with the knowledge that their campus can react because they’ve done it before. However, many institutions have seen sea change in leadership over the past two years. What is the key to responding to new health developments?

You need continuity. Emergency response structures have to be reviewed periodically. They have to be tweaked accordingly, and there have to be tabletop exercises going forward. Because it could happen at any point in time, like meningitis, or H1N1 or COVID. We learned from each one of those experiences, and you need to go back and ask what really went well and what didn’t.

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That same percentage–from a random national sample of 948 students surveyed in early September–also said they felt safer because their colleges had installed requirements. Still, in some parts the country, especially the South, uptake and mandates have not been as robust. There remain steep challenges that colleges must overcome to deliver critical information and avoid confusion when encouraging vaccines to campus populations. They likely will not reach the unreachable but can still try.

“Among the one in seven college students who are unvaccinated, few are likely to get a vaccine, with majorities unconvinced of the vaccines’ safety or effectiveness,” the ACHA’s COVID-19 Task Force noted in the report. “About six in 10 of those who are fully vaccinated but have not received a booster dose say they’re unlikely to get one, with perceived lack of necessity topping the list of reasons.”

However, ACHA points out that 53% of students believe colleges are not providing enough COVID-related information to them, especially on vaccines. That is notable given the timing of the survey as the fall semester opened and many institutions had lowered their levels of concern, removed dashboards, said they were not requiring boosters and lessened some safety protocols. Perhaps it was too soon? Around 45% of students said they’re still worried about getting COVID, and that includes nearly one-fifth who are unvaccinated.

More from UB: New vaccines get green light as Illinois deals with outbreak

While case counts continue to fall, test positivity remains high in many states, and there has been at least one major outbreak on a U.S. campus at the University of Illinois. From the survey, around 55% of students believe they have already gotten COVID, although only 40% said they actually tested positive. That doesn’t mean they can’t get COVID again, but could be protected further against current strains circulating in the United States. That includes the omicron BA.5 subvariant, which is still dominant.

At the moment, at least 43% of students are mandated to be vaccinated this fall. One third said they were not required, while around 20% didn’t know. The majority of college and university mandates land in the Northeast, where 75% of students need vaccines to be enrolled. It is much lower in other parts – West (50%), Midwest (36%) and South (24%).

Without requirements, how are students getting their information on COVID and whom do they trust? News organizations top the list at 68%, followed by health care providers at 66% and family at 62%. But college leaders, both in administration and in health care centers, can play a significant role in continuing strong messaging around the safety and efficacy of vaccines … and debunking some myths.

For example, 71% say they are not convinced COVID vaccines are safe, even though 99% of those surveyed (and the vast majority across the world who have gotten them) have not had severe reactions. Nearly half of those in the unvaccinated pool said they don’t think they are effective, and around 40% said they don’t think they need them, given the good outcomes so far among college-age students. Another one-third said they’ve already gotten COVID, so they don’t need them.

“Campus leadership should clearly and consistently convey the safety of the COVID-19 vaccines and the importance of vaccination to the health and wellbeing of the campus and community, to students and their families,” ACHA leaders noted in the report while acknowledging the role campus health centers can play. “Students who use college health center services rate them positively on giving clear health information, reinforcing the importance of including college health professionals in developing and delivering COVID-19 messaging.”

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Despite consistent guidance from the CDC and public health officials that vaccine boosters do prevent more severe outcomes from the disease and its variants, interest has been low because few individuals between ages 17 and 24 have experienced hospitalizations or deaths. Some colleges and universities that required vaccines from the start have even abandoned mandates on boosters or haven’t adopted them. But is that ambivalence about to change?

On Thursday, the CDC gave approval to what could be one of the biggest breakthroughs in COVID vaccine developments since December 2020, greenlighting a potentially more effective bivalent booster that targets both the original strain of COVID and the omicron subvariants, BA.4 and BA.5. Officials are hoping this shot, unlike the others, will offer much more protection than the originals, though trials have not yet been conducted on humans.

Millions of those Pfizer boosters are set to be available in pharmacies nationwide by Tuesday, with Moderna to follow shortly thereafter. Anyone 12 and over can get them, and health officials are again urging populations to roll up their sleeves, if not to protect themselves then to protect others who are in potentially vulnerable populations.

“If you are eligible, there is no bad time to get your Covid-19 booster, and I strongly encourage you to receive it,” Dr. Rochelle Walensky, director of the CDC, said in a statement.

More from UB: Monkeypox, COVID and masks: Most colleges tell students, it’s on you this fall

That message has been echoed by most college leaders throughout the pandemic, although many of their institutions have relaxed requirements and protocols since the start of the year. That seemed a safe strategy, but COVID is still lingering, punctuated by the developing situation at the University of Illinois, which is experiencing one of its largest outbreaks of COVID since the pandemic began. In the seven days leading up to Sept. 2, it registered a whopping 1,194 cases at a more than 20% positivity rate, easily the highest in more than two years. Only 1,100 tests are being conducted now of undergrads on its campuses, a massive decline from the 10,000 or so it had in the fall two years ago.

The university, once staunch on its mandates, is not requiring masks or boosters, though it did mandate the initial vaccines and got 92% compliance. But with this outbreak and with the new bivalent vaccines, will Illinois adjust its policies, or will it follow the lead of Gov. J.B. Pritzker, who has said colleges and universities no longer need to require them? Expect to hear more in the coming days on updated guidance from Illinois and other institutions, as well as the availability of boosters on campuses.

Isolated incidents or not?

Over the past month, many universities not only eliminated masking requirements for the fall but also told students who test positive for COVID to isolate in their residence halls, a popular decision from 2021-22 that saves precious housing space and puts less strain on colleges to care for them. But one institution, West Virginia University, surprised its students this week by telling those who test positive they must enter separate isolation housing.

“We know this is difficult news. However, please be assured the WVU family is here to support you through this time,” the university said in a release to students. “We ask you to stay calm. As a member of the community, it is critical that you take necessary measures to keep everyone safe.”

The cost of noncompliance at West Virginia includes the possibility of being removed from classes and/or housing and even being expelled. Those who continue to be symptomatic after six days must remain in isolation until they are released by the university. Even after the release, students must wear masks for five days. The university, which does not require vaccines but has seen more than 80% of its students get doses (20% more than the rest of the state), did exceptionally well keeping positive cases down throughout the fall of 2021 and spring of 2022.

Though positive cases have fallen since last winter, there also has been far less testing being conducted. And 15 states are showing positivity rates at 20% or more, including Missouri at 33% and South Dakota at 29%. Only seven states and Washington D.C. have positivity rates lower than 10%.

As institutions navigate the start to the fall and the potential for COVID cases to rise, the American College Health Association has recommended looking at policies related to boosters and leaning on guidance from the CDC:

“At this point in the pandemic, the primary COVID-19 vaccine series should be routinely recommended and made available on campus, if possible,” the ACHA wrote in its August update. “Boosters should also be made available on campus for all eligible students, faculty, and staff. Because boosters are necessary to maintain sufficient immunity, healthcare providers must be well versed in the booster eligibility categories to make appropriate vaccine recommendations to include timing, dosage, contraindications, and risks. Ideally, campus community members should be up to date on COVID-19 vaccines and boosters. If the campus does not have the resources to provide immunizations and boosters, arrangements should be made with local health resources to ensure easy access for the campus community.”

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As we slog through the pandemic, we will surely continue to learn many lessons about leadership, change management, and ongoing cautions and threats to higher education. What we may miss is the opportunity to be more transparent about processes and decisions made during the pandemic.

Of all the mysteries of higher education administration—typically brought on by personnel and other privacy issues—some of the more visible decisions are made at such a pace and amidst such complexity that the impetus behind those decisions remains opaque.

But the pandemic affected everyone in one way or another, giving us a shared foundation for demystifying those processes and decisions, even if they are revealed largely after the fact. For instance, grounding our decisions in the available research and data was helpful but even as new information emerged (e.g., whether the virus was primarily surface- or air-transmissible) required us to rapidly change our protocols and standards.

One of the most obvious questions regarding the pandemic is ‘who is making the decision(s) and why them?’ Whether the president or her cabinet is driving the decisions, subject matter experts are always needed. In the case of the pandemic, that means physicians and mental health professionals to help interpret medical guidance, data and safest practices as delivered by the CDC, the state’s health department, WHO and other experts.

For instructional changes, our IT and faculty development teams are the key drivers. For student wellbeing and behavior, Student Life and Campus Security, instructional support staff, and advisors for clubs/organizations/athletics play a critical role in decision making. In short, everyone on campus has a role—albeit one that looks and feels different from non-pandemic operations even as it includes those routine operations.

Making and remaking decisions

Some of the more interesting nuances of decision-making during the pandemic help demonstrate why simple answers and procedures typically defy value in a crisis—in other words, the easy answer is almost always wrong. The clichÁ© of building the car as it speeds downhill is more than apt for this situation as new information and data comes in daily and, occasionally, even hourly. Whether it’s about new numbers, new strategies, new guidance or new solutions—just when we are ready to hit “send” on a communication to the campus—new information has us scuttling to revise and amend that message.

To provide more transparency in this ongoing battle, a few key groundings are significant. First, we had to set a tone of seriousness about the pandemic that, in its earliest days was oftentimes portrayed as “just the flu” and then a “hoax.” Those who offered cautions were labeled hysterical, even as horror stories of overcrowded hospitals and morgues, escalating death tolls, shortages of ventilators, restrictions on family visitors, and symptoms of long COVID emerged.

In this early context, we had to decide whether to send students home or keep them in congregant living. Depending on each student’s circumstances (personal health, the health of those at home, resources, access to technology, and more), the matter of safety and health and educational progress could make answering that question dramatically different for each student.

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As time went by, other decisions had to be made and remade. These decisions provide some insight on the difference between individuals making personal choices or parents deciding for their students versus making decisions for the health and well-being of an entire campus community.

Early questions focused on response to the illness itself, including the conditions under which the illness spreads—surface, airborne, physical contact—and the best means to respond. Should we focus on cleaners? air filters? gloves? masks? wipe-downs? Subsequent decisions revealed the cascading effects of the pandemic:

• Do we require masks? If so, where? (inside, outside, dining halls, athletic events, transportation, classrooms, labs, libraries?) And what kind of mask (Cloth? Disposables? N95s? KN95s? Gators? Scarves?) Do we make these available or hope people can find their own?
• Do we require testing? If so, what kind? (Antigen? PCR? Wastewater?) and with what frequency? (Daily, weekly, after exposure After symptoms emerge? Surveillance?) How available are the tests? And who pays for the testing?
• Do we contact trace? If so, with what personnel? With what instructions for contact? With what confidence in accuracy? Or privacy? And at what cost?
• How do we measure proper social distancing? (6 feet? 3 feet? Front to back? Circular perimeter?)
• How do we secure entry/exit from buildings (One-way? Two-way? Automatic or human door openers?) And do we lay out directional arrows to keep building traffic going in a consistent flow with less chance for airborne spread?
• Should we confront someone who is not following the community standards? How? Are there penalties? Fines? Honor code violations? Send-homes? For how much or how long? Is there an appeal process?
• Do we require vaccinations? Boosters? Do we allow medical or religious waivers? Who determines which waivers are acceptable? What are the consequences or penalties for not following college policy?
• How do we care for students/employees who become ill? How much space do we set aside for isolation/quarantine? How will we check on someone’s physical and mental condition? Do we deliver food? Communicate with family? Protect privacy?
• Do we allow visitors on campus? Trustees? Guest speakers? Parents? Visiting athletic teams? Contractors? Vendors? Can we insist they follow our community standards and if so, how do we communicate those standards to visitors and what are the penalties for violations?
• How do we encourage potential students to come to campus if we are not allowing visitors? How do we show one of our best features—our campus—to potential employees, new partners, and parents?
• How do we graciously cancel event contracts? Weddings? Speakers? Performances? Competitions? And when can we reschedule them? Or start accepting new events? With what rules or guidelines in place?
• How do we redefine traditions such as study abroad, research, internships, community service, and other options that embody the character of so much of what we do?
• How does campus safety secure a once-open campus from a pandemic and these concurrent elements?
• How does our food provider contract for quality and quantity of meals with uncertain fluctuations of students on campus using meal plans?
• How can we project an accurate budget for the upcoming cycle? What financial scenarios are we testing, depending on a 3-month versus 3-year-plus duration of the pandemic? Do we increase or decrease our drawdown from the endowment? The quasi-endowment? Do we initiate a special appeal to donors? To legislators? Do we increase/decrease tuition, room & board?
• Do we continue our building projects? Hiring? Partnerships? Other strategic initiatives?
• How do we recognize and support front-line workers who cannot work from home? How do we ensure fairness for those working from home whose hours dramatically increased or decreased during the pandemic?
• How do we respond to critics who wonder why we aren’t doing what XYZ University is doing down the street or in another state altogether?

When will it be really over?

These questions, of course, are just a glimpse of the questions and decisions that have swirled during the pandemic, and we remain with one of the most stubborn of all: When will it be really over, if ever, or will we have to go back into pandemic-decision mode at any moment? What will we have learned about our institutions, our students, our community, and ourselves?

At the very least, we should learn that crises are not one-size-fits-all events and that they have immediate and cascading effects, and they require careful consideration of data and options even when time is of the essence. They require the trust, even among skeptics, of leaders and colleagues and community. And they require the gracious support and suspension of judgment in the face of unknown variables. Worst case scenario planning is exhausting, but when the consequence is human lives and not just budgets, missions, and wishful thinking, the need for even greater clarity emerges.

For those of us blessed with collaborative teams, gracious communities and their expressions of confidence and gratitude, the pandemic has offered an insight into humanity that far overshadows the awfulness of the illness and divisiveness that has also ensued. As the pandemic continues to change, we realize more than ever that we, too, have the power to change. And being more transparent about those changes—especially when we have some moments to reflect and share that candor with our colleagues—is a critical component of battling the collateral damage of the pandemic: the loss of community.

Jo Allen is president of Meredith College in Raleigh, North Carolina.

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“To be clear, there is no COVID-19 testing, vaccination, social distancing, or masking requirement to visit, live, work, or study on campus,” Renisha Gibbs, Associate Vice President for Human Resources, told the FSU community. “In addition, faculty and staff will no longer be required to report positive COVID-19 test results to the university or complete the daily COVID wellness check.”

FSU is in a state where mandates cannot be enforced but it is hardly an outlier this year. Even those in Democratic-leaning states are opening up. UCLA, the University of Vermont, St. Lawrence College and the University of Michigan are among the hundreds that have maintained the easing of, or reduced significantly, safety protocols to start 2022-23. At the same time, they are all telling students to be updated on vaccinations, to remain vigilant when gathering and to watch close contact with individuals as they navigate campuses with the novel monkeypox circulating.

There are still a few universities that have taken a more reflective and conservative approach to opening by again instituting mask policies, at least temporarily as they acclimate students again to the college scene. The University is Delaware is requiring masks from Aug. 30 through Sept. 9 in classrooms, labs and transportation, citing the potential for spread of the BA.5 omicron variant, which is still fueling a 16% positivity rate across the state.

“We know from campus experience over the past two and a half years that COVID-19 cases tend to surge at the beginning of each semester, largely due to the sharp increase in campus density as students arrive at UD from various locations around the United States and the world,” UD officials said in a statement. “These surges are fairly short lived (1-2 weeks) and are typically not replicated until the next semester.”

More from UB: Will monkeypox cases at two universities be harbinger for fall?

One potential benefit of continued masking, at least in terms of COVID, is that the Food and Drug Administration is aiming to approve long-term boosters for omicron just after Labor Day. Campuses that can keep outbreaks down to start the fall and limit the potential for faculty to get coronavirus – most institutions are allowing instructors to remove masks even if students can’t – may feel more at ease reopening if they can assure populations to get the new booster doses.

That guarded approach is also being taken by Georgetown University, Columbia University and Rutgers University, which have indefinite policies that again will keep face coverings on. They were among the first during the start of the COVID-19 pandemic to institute further safety measures and have not eased them much.

“It is clear that the COVID-19 virus, in some form, is now a permanent part of our daily lives,” Antonio Calcado, Executive Vice President and Chief Operating Officer at Rutgers, said in a statement. “As the virus moves from pandemic to endemic, Rutgers continues to maintain safety protocols on face coverings, vaccines and boosters, testing, and quarantining and isolation.”

Regardless of stances on COVID, all institutions are keeping a watch on developments around monkeypox. Calcado offered a warning to his community ahead of the campus’ Sept. 6 opening, saying “the university does not have access to monkeypox vaccine and will not be offering treatment.”

There are approximately 17,000 cases of monkeypox now in the United States, and that number is growing, primarily among gay men. The University of Delaware and Texas State University have reported individual cases among their campus populations this week. Supply remains extremely limited, as the lone drugmaker in the world, Bavarian Nordic, struggles to meet demand. U.S. healthcare workers have been asked to try to get five injections out of every one dose to maximize the amount of patients that need them.

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The University of Maryland announced on Thursday it has a presumptive case of a staff member who is taking “all necessary medical steps,” and the Pennsylvania State University also reported earlier this week that an off-campus student had been deemed positive. They are among the first to show up as colleges open for the fall semester, with leaders watching closely the potential for a trifecta of viruses–monkeypox, COVID-19 and the flu–to impact the 2022-23 academic year.

Maryland and Pennsylvania are among the top 10 in cases nationally for monkeypox, a disease that can present symptoms such as fever and swollen lymph nodes, but has been recognizable by painful sores and rashes in some patients. New York, Texas, California, Florida and Illinois–no surprise given their populations–lead the way in cases, with Georgia also in the top five with more than 1,000. Though there is debate over how it spreads, sex among gay men has resulted in most positive cases, according to health experts. With limited vaccinations (an additional 1.8 million doses are on the way) only being available to those with the most severe symptoms, there are concerns about spread and its potential to hit college populations.

“As this disease continues to be present across the country and the world, it is likely we will experience MPX cases on campus,” Dr. Spyridon Marinopoulos, director of the University Health Center and chief medical officer at Maryland, said in a statement to the community. “We are continuing to monitor the situation. We appreciate everyone’s heightened awareness as we work together to prevent the spread of this emerging illness.”

In a recent webinar with the University of Arizona community and in an article published by its student newspaper, The Daily Wildcat, President Robert Robbins pressed the need for students to be conscious of their hygiene because he said monkeypox can transmit “through everyday activities such as sharing utensils, linens and being in close proximity to respiratory droplets.” But he also noted that the disease is not as dangerous as COVID-19 and its ever-evolving variants, where outcomes can be much more severe. “If you have not received a [COVID-19] vaccine, I implore you, I beg you to make an appointment today.”

More from UB: Monkeypox is going to college: Here’s now to prevent campus outbreaks

At least for now, the numbers of COVID cases nationwide have dropped 18% over the past two weeks, though underreporting could be a factor. Test positivity is up in every state, as low as 4% in Vermont but as much as 33% in Missouri. In 18 states, positivity is sky high, at more than 20%. But monkeypox is grabbing most of the headlines because it is new. Colleges and universities, many of which just opened or will be in the coming weeks, are planning as they did for COVID, with increased sanitation measures in place and with strong messaging to students.

The University of Maryland is advising students to “avoid close, skin-to-skin contact with people who have a rash that looks like MPX. Do not kiss, hug, cuddle or have sex with someone with MPX” and also to “avoid contact with objects and materials that a person with MPX has used. Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face.”

Penn State has told its students that if they believe they are symptomatic to get an appointment with its university health system immediately or call its 24/7 health hotline. They also should self-isolate and avoid contact with others. More severe cases that require vaccination will be addressed by the state department of health. As for faculty and staff members, officials said they should not come to campus and instead work remotely if they can or use sick time. Most of the cases there have not come from rural areas of the state but from Philadelphia, which has struggled to get enough vaccines to those who need it. The city is expected to get more help soon under the new wave of doses coming from the Biden Administration, but colleges in big urban areas should be watching case counts closely.

One institution trying to get in front of potential outbreaks is the University of Minnesota system, whose team is testing wastewater, similar to the COVID response. According to the Duluth News Tribune, researchers are not only looking at the potential for monkeypox (they haven’t found any yet) but also polio, which has resurfaced in New York in one confirmed case, with the presumption there could be more. The CDC has alerted individuals to ensure they are up to date on the polio vaccine, though most adults got them as children, and colleges should be conduits to spread that message, as well.

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They represent just a small fraction of the millions that are converging on residence halls and apartments at colleges and universities for the 2022-23 academic year, snarling roads and jockeying for position in hallways as they haul their items up the stairs and into dorms and other spaces, including makeshift hotel rooms.

They are being greeted by more than just fellow students this fall. They will contend with COVID-19 and its variants again, new outbreaks of the highly contagious monkeypox, political footballs such as Roe v Wade and inflation and affordability. How will they respond, and how will their institutions respond in kind?

Many admissions offices and other stakeholders across higher ed—from Georgia Tech in Atlanta and Elon University in North Carolina to the University of Nevada at Reno—have sent out guidance on expectations and handy resources prior to arrival. UNR put out a blog post from alumni to share their tips and tricks for incoming freshmen to survive the first semester. One alum said: “Don’t procrastinate. Write down test dates a week early in your planner so you start studying sooner. Talk to your professors, they have so much knowledge about the things you are interested in.” She also advised students to explore several clubs and “don’t be afraid to try new things.”

They will arrive, in many ways, at traditional-looking campuses, though that will mean traditional challenges, too. A welcome back message to students at Penn State includes this very long list of parking changes that is sure to be problematic for parents dropping off kids and for those distracted by friends they haven’t seen maskless since 2020. There already have been obstacles involving housing, including a few dorm delays at Flagler College, dirty apartments reported at the University of South Carolina, mold in some residences at Augusta College and low water pressure at Jackson State University.

Those institutions are all finding solutions, but perhaps the best came from Western Kentucky University, which allowed students to arrive on campus early because of the historic flooding in the state. The University of Kentucky also went above and beyond for the community and families in early August to help. “Our Office for Student Success mobilized quickly to reach out directly to more than 1,100 students who may have been affected by the flooding, connecting them with resources such as our Counseling Center, housing and other information regarding basic needs,” Kentucky President Eli Capilouto said, noting that its human resources and risk management teams also offered assistance to other colleges as well as employees who lost homes.

More from UB: Housing crunch sends colleges scrambling to find room for students

As for those coming to campus, some will be in residence halls while others will be forced to commute as an explosion of applicants and admitted students pushes space to their limits. There will be others who will arrive at off-campus apartments, paying exorbitant rent. While some institutions are planning a couple of days for move-ins, the big ones will be inviting students in for more than a week. Ohio State University got started last Friday and the process will continue through next Tuesday, as 14,000 strong bring their gear to campus. The university has asked that only one or two guests per student provide help. They will have to do so with masks but without moving trucks. More than 6,000 students will descend on the University of Tennessee in Knoxville starting today, but some of them will be staying at a nearby Holiday Inn run by university staff.

Move-in week, of course, is about more than just moving in, as new students get familiarized with campuses and the long lists of events they have planned. At Montana State University, its Debut lasts for more than a month with a rodeo, block party, in-service day, football game, concert and traditional painting of rocks.

“We are so excited to welcome all students back to campus,” Chris Pruden, student engagement and leadership adviser, said. “At MSU, we want to give our students the opportunity to achieve academically, but we also want to give them opportunities to engage with the local and campus community. Events like these keep our students connected.”

One of the institutions where residences are being watched closely this fall is Howard University, whose students staged a monthlong sit-in over conditions at its dorms last year. Rashad Young, senior vice president and chief strategy officer, told Howard’s news service The Dig that they “worked hard over the summer to prepare the campus, and students will continue to see ongoing maintenance throughout the buildings. We have contractors, plumbing, HVAC and electrical on-site, even after students move in, to ensure any concerns are immediately resolved. Students will see us very active in the building for weeks and probably even a couple of months after they move in.” They also set up a hotline for housing concerns that they say will be addressed within 24-48 hours.

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