LAUREN GILGER: Last week, the University of Arizona and Pima County responded to growing concerns on the number of COVID-19 cases among students by issuing a voluntary shelter-in-place recommendation to students who live on or near the campus. The recommendations asked these students to limit their outings to in-person classes, work, doctor's appointments and getting food. This, in addition to local and county ordinances on face coverings and large gatherings. The numbers do seem to be improving, but that doesn't yet mean the university will let up on precautions. So what's next for the university and for Pima County more broadly? I spoke more about that with Dr. Theresa Cullen, the county's health director.

THERESA CULLEN: I think we are seeing improvements. What we're seeing is increased, at least anecdotal reports of people not being on the mall and that my personal experience walking through the U of A would support that. We also know that there appear to be less parties, less gatherings of students outside. Our CHEFs people — our Consumer Food Safety people — did double checks over the weekend about the pools because remember, part of our recommendations were to close the pools because we knew that they were gathering places in certain residences and in certain off-campus housing, and they had 100% compliance.

GILGER: So is it good enough? What kind of progress have we seen?

CULLEN: So I think that that's the real question, right? So we didn't expect to see progress within five to seven days. Obviously, the metric we're going to use is new positive cases because of the period where you can be asymptomatic prior to being diagnosed, we normally give ourselves four to six days to see if we're going to see any intervention. We do know the numbers that came in [Sept. 21], which would have been seven days for the university, appeared to be lower than they were in the previous week.

GILGER: What is the goal here in terms of what is good enough? Like, are you aiming for zero cases? Is that possible?

CULLEN: Yeah. You know, it's a great question, right? What we're aiming for is a positivity rate of less than 5%. So you may be aware in the recommendation we made, we gave a specific positivity rate, especially for the Greek houses of greater than 10%, at which time we would recommend quarantine. And that's what we had been doing prior to even initiating the shelter in place. So what we look for is this less than 5%. If you go back to what the state put together for monitoring minimal and moderate transmission, the difference happens at 5%. So our goal would be to get a total positivity rate of 5%. Now, the reason why that works with the university is, you may recall they have a Test All Test Smart strategy, which means anybody can walk in and get tested. And they do fairly routine testing in their dorms, so in a sense, we're getting a random sample through the Test All Test Smart program.

GILGER: Was this unsurprising to you? I guess, given the fact that you're bringing a large number of people back to a small space and it's young people who are, you know, maybe not as concerned about this, we often hear. Are you surprised it wasn't worse? Were you expecting this kind of outbreak?

CULLEN: I think all of us were anticipating that this might happen and hoping that it wouldn't. However, as we entered into the decision last weekend about whether to recommend a shelter in place situation, it was based on what we were seeing not only at the University of Arizona, but what we were seeing by monitoring other college campuses. And what we saw was that college campuses and the communities around them, that initiated an intervention — in our case, shelter in place — were seeing the positivity rates go back down. In the places where they hadn't done that, what you saw was the positivity rates and number of cases continue to increase. And at that point, the universities totally shut down. Our goal was to work in tandem with the University of Arizona and the city of Tucson. We have a great relationship with them. And the decisions that we made last weekend were made in concert with everybody getting a review and a comment and the ability to edit prior to going forward with the decisions.

GILGER: So what does this mean more broadly for the county? Like, why is it so important that you keep a handle on the university? Is that where the majority of the cases are going to be coming from?

CULLEN: Yeah, that's a great question. There's this concept called "leakage" in disease. It's kind of an odd concept, right? But that the disease leaks out into the surrounding areas. And when you look at the area that we put the shelter-in-place recommendation in, that graphic distribution was based on an evaluation of where we were seeing cases. So you know it includes some off-campus areas. And that was not random, it was based a on data-driven scientific approach to where we were seeing a higher number of cases than we would normally have anticipated, going back to what the incidence was before we had this, in a sense, mini outbreak at the university. So our real concern is that leakage. And one reason we wanted to clamp down was to try to limit that exposure into the general community. What that means is that we're very, very closely monitoring where our, our other new cases are coming up. Most of them, in fact, are not being tested through the university program, obviously, right? They're not on campus. They're being tested through community-based testing facilities.

GILGER: That was my conversation with Pima County health director Dr. Theresa Cullen about the progress made at the University of Arizona in curbing the spread of COVID-19 on campus.

STEVE GOLDSTEIN: Now let's turn to KJZZ's Rocio Hernandez for more on the outlook at the University of Arizona and how the situation there compares to other college campuses in the state. Rocio, good morning.

ROCIO HERNANDEZ: Good morning.

GOLDSTEIN: So as we just heard from Dr. Cullen, U of A is seeing positive results from the shelter-in-place recommendation. And University President Robert Robbins held a briefing [Sept. 21]. Is he satisfied with these results?

HERNANDEZ: So he says that for the most part, a majority of the students are complying with the recommendation and with the COVID-19 public health rules that have been set in place. But he's still seeing a group of students that are continuing to gather in parties. He said [Sept. 21] that over the weekend there was a party of over 300 attendees that was discovered and ordered to disperse. In addition, university and Tucson police have also had to respond to 17 other properties from Thursday until Saturday. And Robbins promised that there'll be consequences for anyone who disregards these public health guidelines from here on.

ROBERT ROBBINS: So we've gone from begging, encouraging, now moving into the action phase of where your choices will have consequences. And there will be individuals who will be asked to leave the university. It's that simple.

GOLDSTEIN: And Rocio, Robbins himself has had to deal with exposure, right?

HERNANDEZ: Yeah. Yesterday, he told us that he had dinner with two students. And after this dinner meeting, one of the students told him that she had tested positive. So after he got the news, he did as you know, public health officials have been recommending, he quarantined. And he took two antigen tests, which came back negative. And he also did his first ever PCR test, which he's still waiting for results from. But, you know, getting those two other negative results makes him confident that this one will come back negative, too. So he personally knows how important it is to keep a handle on the spread. And the university will continue to offer that same testing for its students and employees, whether they're asymptomatic or symptomatic, to monitor the situation. And they're going to be continuing that wastewater testing around some areas of campus.

GOLDSTEIN: And please give us some context on this. How does the U of A mitigation effort compare to other universities?

HERNANDEZ: So there are obviously cases that all three of our state's public universities. But the U of A's the only university in the state where things have gotten serious enough to ask students to shelter in place, even if it's just a voluntary recommendation and not an order. But there has been a limiting of in-person classes to only those that are deemed essential, such as performing arts and sciences. And, you know, that's not, that's at every university. And ASU President Michael Crow has also been coming down hard on these kind of reckless behaviors. So he recently alleged there's been several bars around the Tempe campus that have been violating safety protocols and potentially contributing to the cases here locally. And ASU has also suspended multiple students for violating COVID-related rules, both on and off campus. And Robbins said that looking ahead to the end of the year, U of A students won't be returning to campus [after] the Thanksgiving break. NAU is doing the same. And ASU made a similar call recently. And all instruction at ASU will be virtual after Thanksgiving, and finals week has been canceled. So maybe that's a little bit of good news, giving a little break for students?

GOLDSTEIN: I guess so. KJZZ's Rocio Hernandez. Rocio, thanks.

HERNANDEZ: Thanks.

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