Students’ Views towards Sars-Cov-2 Mass Asymptomatic Testing, Social Distancing and Self-Isolation in a University Setting during the COVID-19 Pandemic: A Qualitative Study
2.1. Study Design
2.2. Study Context
2.3. Participants, Sampling, and Recruitment
2.4. Online Focus Groups
2.5. Data Analysis
4.1. Impacts on University Life during a Pandemic
4.2. Risk Perceptions, Adherence and Social Behaviours
4.2.1. Communications and Social Behaviours
4.2.2. Communication Approaches
4.3. Students and COVID Testing
4.4. General Wellbeing and Mental Health
4.5. Diversity and Inclusion
4.6. Study Strengths
4.7. Study Limitations and Considerations
4.8. Summary and Future Recommendations
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Sample n = 25|
|Age (median, range)||23 (18–51)|
|Male n (%)||9 (36)|
|Female n (%)||16 (64)|
|Student status †|
|Home students n (%)||19 (76)|
|International students n (%)||6 (24)|
|On-campus n (%)||8 (32)|
|Off-campus n (%)||17 (68)|
|Testing status a|
|Not tested n (%)||13 (52)|
|Symptomatic testing n (%)||11 (44)|
|Asymptomatic testing n (%)||1 (4)|
|Previously self-isolated b|
|Yes n (%)||18 (72)|
|No n (%)||7 (28)|
|Themes||Subthemes||Frequency n (%) *||Representative Quotes|
|Term-time experiences||Logistical difficulties||7 (28)||‘For me, it was very much a case I was supposed to be going abroad this year for like a study year abroad and that was cancelled quite late notice with the Covid stuff, it was cancelled in about June/July. And so I didn’t really have much time to think about it before I had to start thinking about, you know, planning for next year and getting the practicalities sorted. So it was kind of almost a rush because I had in my head that I was going to go abroad and sorting my accommodation out there and everything like that, transport—and then suddenly everything changed and I knew I only had a couple of months to get everything together’; Participant 12|
‘A lot of the flats that have been in quarantine, the students have actually been forced to come out of quarantine just to get their food, because we don’t get meals or anything with our accommodation’; Participant 15
‘As an international student we wouldn’t have to isolate in a usual time but during this time when we arrived at the UK we needed to isolate for two weeks first from certain countries and that happened with everyone. It’s very difficult because when you just move into a new country and you cannot do anything and you’re wondering ‘how am I going to get groceries?’; Participant 1
|Adjustment to online learning||11 (44)||‘All our limited lectures can be done online and it’s quite nice to be able to relax and get myself into a rhythm. It isn’t as pre-determined as it used to be’; Participant 8|
‘I think the university’s done well to kind of quickly get it all online actually because, you know, it’s still running and that’s the most important thing and there’s nothing—I can’t think of anything more that they could be doing’; Participant 23
‘I thought that I would have really interesting experiences and networking opportunities and potentially job opportunities at the end of my matriculation and I feel very frustrated by the fact that I don’t have those opportunities anymore’; Participant 2
‘I’m a new student, an international student in my Master’s degree and for me it was quite difficult to get used to all the different platforms that we use for online teaching’; Participant 11
|Safeguarding||10 (40)||‘On campus I actually feel relatively safe because of the social distancing. I don’t know about in halls but like in teaching, especially when we have like our labs and in-person teaching, people are actually sat away from each other and we wipe down our area’; Participant 22|
‘Because we all have to wear masks and visors in the labs anyway, we’re quite—and we have to social distance, 1 metre plus is the closest we’re allowed to get in the labs, so in terms of actual risk of transmission we’re lower risk than halls and social areas basically’; Participant 13
‘I’m primarily lab-based and my lab was shut for 5 months due to Covid, so that’s affected my studies quite a lot’; Participant 4
‘Because of the fact that my hall has a courtyard and there was a security guard watching us, it felt a bit prison-y’; Participant 19
|Connectedness through communication||4 (16)||‘I was actually really humbled to have an email from [my School] just to check up on me as they heard I was isolating, and that was really nice. It made me feel less forgotten’; Participant 18|
‘Also as a postgrad I also feel a bit forgotten about because like we were here the whole time when our labs were closed and just like a lot of the emphasis—I know we’re like a minority obviously and you can’t sort out everything at once, but it felt like a lot of the emphasis was on like majority groups that were probably less affected’; Participant 4
‘I feel like they need to be in constant contact with people that are isolating or even just anyone that could make themselves known to the uni. Or just something to, I dunno, I think the uni needs to be really, really proactive in offering lots and lots of online things, constantly like daily or every evening, because I think the main thing is making sure people don’t feel alone at all’; Participant 6
|Risk perception and worry||Previous experience with COVID-19||14 (56)||‘A guy who lives, who I share a bathroom with, tested positive but he didn’t have any symptoms so it’s been like something happening but not really anything to do with me’; Participant 19|
‘My mum was super bedbound for the whole ten days, but we were both very lucky, we didn’t have to go to hospital or anything. So at the beginning I wasn’t very worried about it until I kind of got it’; Participant 6
|Perception of health||9 (36)||‘I had no real worry for myself because, I mean, I’ve had it now so hopefully it means I’ve got some sort of immunity. I’m more worried for my older relatives’; Participant 14|
‘Covid terrifies me—Until recently I was considered vulnerable to the virus because of previous serious illness. So being in a shared house, still going to work in order to pay rent and also having to go onto campus for some lessons has made my anxiety go crazy’; Participant 18
‘I was actually pretty excited to come back to uni, just because I know young people at the moment are having loads of cases and everything, but it kind of separates me from my parents. I know I wouldn’t put them at risk because I wouldn’t be living with them so even if I contracted the virus on campus or whether in the city of Nottingham, I would just self-isolate by myself or with my friends. I wouldn’t be putting my parents at risk. So in that sense I was kind of excited to come back and like kind of separate myself from parents’; Participant 22
|Engagement in protective behaviours||Format of communication and guidance||12 (48)||‘I know we’ve been receiving lots of emails about what the rules are, what we need to do—but they are very text heavy—and I wouldn’t have thought of this if it weren’t for my housemates—but they’re all international students and they struggle with the large blocks of text because there are a lot of words in there that are just unfamiliar to them’; Participant 15|
‘There was no guidance from the government or the university that we could find about what to do when someone did test positive, so we didn’t know if we should make them stay in their room or wear a mask. We weren’t really sure’; Participant 9
‘We didn’t get told that we weren’t allowed to use our communal space until after we finished self-isolating so, for us, there was no communication and then they emailed us to say ‘oh, even if you’ve all tested positive, you’re not allowed to use your communal space, or you are but one at a time’—we didn’t realise this—so that seems like really weird because, to be fair, if you’ve tested positive it’s probably too late and you’ve probably given it to all your flatmates anyway’; Participant 14
‘And the only place it said what the mealtimes were initially for the first couple of weeks was on this email that we got and there’s now a poster once you’re at the food counter telling you what times you should be there. I think at that point it’s a bit too late if you’ve turned up at the wrong time’; Participant 5
|Environmental and structural factors||9 (36)||‘There were just like large crowds of them in the corridor over both sides of the system and then we would all get like stuck in crowds of students’; Participant 4|
‘I feel like the majority of people are self-isolating, at least here, and it got a lot better now they’ve got the categories in, because before they were trying to deliver to everyone who was isolating, which there were way too many people for that to work, so now that if you don’t have symptoms but are isolating you’re allowed to go to the dining room, it works so much better. And also you get to actually see people, which makes it feel a bit better, even if you’re in different households you’re not allowed to sit near them, you still get out your room’; Participant 16
|Desire for social contact||12 (48)||‘It’s the fact that people want to socialise more than they’re worried about the rules’; Participant 19|
‘I think also people will social distance with strangers or people they don’t know, but they feel it’s fine with friends, even if they’re not in the same household, which can be hard because literally some people, like the only friends they have are not in their household and now it’s dark, it’s getting cold and it’s like sit in your room alone or, like, break the rules, and especially now you’re not allowed people in your household even if you’re social distancing with them, I reckon lots of people are going to not follow that’; Participant 16
|Openness to testing||Control of the virus||6 (24)||‘There clearly are people who are asymptomatic but carrying the virus and being able to get on top of that is going to play a massive role in being able to control the virus’; Participant 13|
‘I think it’s a good idea in terms of—because obviously the whole point of wider testing means you’ve got a better ability to potentially control the virus and that’s, like, in all other countries that have done good control and lots of testing is seen as a good thing’; Participant 25
‘I fully agree with halls being prioritised because you’re kind of mixing without PPE and stuff—but I know from the amount of work that’s going in to trying to get postgrad researcher back in labs, I can imagine the asymptomatic screening would be really useful if there were capacity to do it’; Participant 13
‘My only sort of slight issue with the asymptomatic testing is it does—it kind of puts, like, it makes [City] seem a lot worse than potentially it actually is in comparison to other areas of the country and other universities’; Participant 5
|Access and experience||8 (32)||‘I think it’s quite a good thing because otherwise you can’t really have a test unless you’ve got symptoms’; Participant 19|
‘I think it’s pretty much impossible to get an NHS test unless you’ve got really loads of symptoms and even if you do it’s still really a long wait and you have to like drive somewhere. Like we see it on BBC news every single day how they’re all backed up. So I think in a way it’s quite nice to see. I know it’s not everyone that gets the best but at least some halls and like quite a lot of people are getting tested, which is quite good, that otherwise wouldn’t have been tested’; Participant 22
‘Like it’s not terrible but it’s just a bit uncomfortable but it was quite easy to do, just like setting up that appointment online and then just going to the walk-in and it was a bit weird because it was that big white tent and it felt very much like a big Hollywood film or something. It wasn’t too bad because everyone was really friendly and really helpful. I found it quite—even though it wasn’t a massively fun experience, it was kind of a positive experience’; Participant 6
‘I was impressed, I had my NHS results back within 2 days. The test was easy and quick’; Participant 18
|Perceived immunity||6 (24)||‘I’ve had a few friends who’ve mentioned that they do want to get tested positive because they’re quite confident on their immunity and so they’re just like ‘I want to get tested positive so that I can feel free about social distancing and not really have to feel so restricted’; Participant 11|
‘I’d be quite wary around some of the people that I know. I sort of fear that once they’ve got it they’re going to feel like they’re immune and they can do whatever now. I’ve certainly seen like parties of households as soon as they come out of isolation, they sort of celebrate and go a bit mad’; Participant 10
|Barriers to testing||Guilt about impact of test result on others||6 (24)||‘I feel people feel guilty if they have it and then that means everyone in the household has to isolate and then, like, the prospect of having to isolate in a pretty small room for like two weeks is quite daunting as well’; Participant 16|
‘I think once you’re living in a bigger household, the guilt of knowing you’re going to make everyone have to isolate with you, would be a very strong detractor’; Participant 10
‘In our house—we’re kind of getting it sorted now—but unfortunately we had some tensions over, like, to what extent the regulations hold specifically—and I’ve asked a few people their opinions of this—it’s like there’s one person that tests positive, should they be, like, literally allowed to leave their room’; Participant 24
|Mental health impact of testing||8 (32)||‘Some of my friends don’t want to get tested because if they are positive they have to isolate and they’re really scared of the loneliness, kind of thing’; Participant 4|
‘I think it’s that point about lockdown that really got me because, again, over the summer, especially that sort of first half of the summer, my mental health just completely deteriorated and went like really, really badly and I’m in the position now and sort of getting a positive test is I don’t want to go back to what that was like, being locked down’; Participant 24
|General wellbeing||Social impact of the pandemic||10 (40)||‘I think that’s going to be the tough thing for students, is that sort of emotional wellness boost that we all get from being around other people’; Participant 15|
‘I’d say I feel very strongly about the first years and sort of hearing, like, about, like, where they get like a positive test in a hall, they’ve got security guards on the door and they’re sort of, like, breaking the law because they want to go and see their mates and I remember how difficult it was in first year, like, to meet people, to make friends—and when you don’t have those obvious, like, big social weeks to meet people and the university is, like, encouraging them to not go out and meet people—I can’t imagine how difficult that is for some people’; Participant 25
‘I would say as a fresher starting, it’s been really hard to actually meet people and I think what a lot of people are worried about is the fact that, you know, in the next couple of months we’re going to have to choose who we want to live with next year and maybe even for like the rest of our course and we’ve really not had an opportunity to meet people outside of an academic setting’; Participant 5
|Mental health impact of the pandemic||8 (32)||‘I’m getting quite down about it, because it’s literally your work’s on your screen, like, and then all you can do is like looking at your screen, like, if you socialise you have to do it over on your screen and it’s just really, just making me a bit down really, because I can’t even eat lunch with people’; Participant 16|
‘Nationally if we went into another lockdown I would be scared about how I coped because I coped pretty badly in the last one with my mental health and stuff and I’d just be scared I’d go straight back into that again if that were to happen’; Participant 23
|Practical impacts during Autumn return to campus|
|Emotional impacts during Autumn return to campus|
|Engagement in protective behaviours (social distancing, self-isolation)|
|Mass asymptomatic testing on campus|
|Broader and longer-term impacts of COVID-19|
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Blake, H.; Knight, H.; Jia, R.; Corner, J.; Morling, J.R.; Denning, C.; Ball, J.K.; Bolton, K.; Figueredo, G.; Morris, D.E.; Tighe, P.; Villalon, A.M.; Ayling, K.; Vedhara, K. Students’ Views towards Sars-Cov-2 Mass Asymptomatic Testing, Social Distancing and Self-Isolation in a University Setting during the COVID-19 Pandemic: A Qualitative Study. Int. J. Environ. Res. Public Health 2021, 18, 4182. https://doi.org/10.3390/ijerph18084182
Blake H, Knight H, Jia R, Corner J, Morling JR, Denning C, Ball JK, Bolton K, Figueredo G, Morris DE, Tighe P, Villalon AM, Ayling K, Vedhara K. Students’ Views towards Sars-Cov-2 Mass Asymptomatic Testing, Social Distancing and Self-Isolation in a University Setting during the COVID-19 Pandemic: A Qualitative Study. International Journal of Environmental Research and Public Health. 2021; 18(8):4182. https://doi.org/10.3390/ijerph18084182Chicago/Turabian Style
Blake, Holly, Holly Knight, Ru Jia, Jessica Corner, Joanne R. Morling, Chris Denning, Jonathan K. Ball, Kirsty Bolton, Grazziela Figueredo, David E. Morris, Patrick Tighe, Armando Mendez Villalon, Kieran Ayling, and Kavita Vedhara. 2021. "Students’ Views towards Sars-Cov-2 Mass Asymptomatic Testing, Social Distancing and Self-Isolation in a University Setting during the COVID-19 Pandemic: A Qualitative Study" International Journal of Environmental Research and Public Health 18, no. 8: 4182. https://doi.org/10.3390/ijerph18084182