Homeroom with Sal & Chancellor Robert J. Jones - Thursday, September 3

Hi everyone! Welcome to our homeroom live stream. We have a very exciting conversation coming up. Sal here from Khan Academy. In case you all don't know me, we're gonna have a conversation with Chancellor Robert Jones from the University of Illinois at Urbana-Champaign. It's going to be really interesting because the University of Illinois is really putting their best foot forward to do testing, contact tracing, and give as close to a normal experience as possible.

So, there's going to be some really interesting questions. The whole country is really looking at the University of Illinois at Urbana-Champaign to understand how this can be done well. But before we get to that, I will make my standard announcements.

First of all, a reminder that Khan Academy is a not-for-profit organization. We can only exist through philanthropic donations from folks like yourself. So, if you're in a position to do so, please think about going to khanacademy.org/donate. I also want to give a special shout-out to several organizations that have helped support Khan Academy. We were running at a deficit even before the COVID crisis, but then with the crisis, our deficit only grew because of increased server costs and we're trying to accelerate a bunch of content.

So, special thanks to Bank of America, Google.org, AT&T, Fastly, Novartis, and the many other supporters at all levels who've allowed Khan Academy to get to where it is today. But we need more help, so if you're in a position to do so, please think about doing that.

So with that, I'm excited to introduce Chancellor Robert Jones from the University of Illinois Urbana-Champaign. Thanks so much for joining us, Chancellor.

Chancellor Robert Jones: Thank you very much for the opportunity. Glad to be here!

Sal: So maybe a good place to start—you know, we're back to school. The big debate both in K-12 and in higher education is to have physical classes, not to have physical classes, to have hybrid classes. Tell us your thought process, the University of Illinois Urbana-Champaign's thought process, as you went into this back to school and how are you all approaching it?

Chancellor Robert Jones: Well, it became very clear to us as we transitioned very quickly over the course of about 12 days back in March from our traditional face-to-face education to more remote education. As soon as we got to graduation, our virtual graduation, we started to immediately pivot and start to focus very sincerely and rigorously on what the model should look like for the fall.

We quickly resolved that, based on our own analysis about the value of both the in-classroom and the learning that occurs outside of the classroom, that we should try to move towards some form of face-to-face education. We started to hear from our students who were anxious to come back to campus—the majority of them were pretty much insistent on being back on campus and maybe some blended form, but back on campus to have a chance to be among their friends and colleagues and really be part of that uniquely transformative and exciting environment that exists on university campuses.

So, the fundamental question became how could we do that in an effective way? My provost and chief academic officer, Andreas Canelaris, former dean of my engineering school, began to pose that question to several of our most outstanding innovative scientists. The first person he talked to was Marty Burke, who is the associate dean of our medical school.

He’s a biochemist as well as an MD. Marty put together, in a very short period of time, a multi-disciplinary team of more than 100 individuals across veterinary medicine with Paul Hergenrother and Tim Fenn, who were veterinary medicine cancer researchers. They all came together with their multi-disciplinary teams and pretty quickly came up with this testing protocol.

Because Provost Canelaris was very insistent that if we came back together in a hybrid form of education or completely face-to-face, we needed a test that was more rigorous than what was generally available because we had enough evidence to think that testing was going to be an absolutely critical prerequisite for us coming back.

So, I can fill in more detail, but that was our thinking—that some form of face-to-face education was the best model for this university but, more importantly, the best model for our students. We had to innovate to create this world-class and saliva-based testing that no one else has exactly been able to do this at the scale and in the way that we've gone about doing it.

Now this is what's really interesting about this. I think everyone would agree that the in-person experience in college is hard to replace. You can do something on distance learning, maybe get some of your academic learning, but the immersive experience you can't have. So, I think everyone's there. But what's really incredible is what y'all have done.

You know, some people have just kind of taken the leap of faith and said, "Let's cross our fingers and hope all that goes well," and those are a lot of the universities that are now having to send kids back home a couple of weeks in. But y'all said, "We can actually develop our own test, a high-quality sensitive test, and administer it." I believe y'all are administering it to every member of your community every three days?

Chancellor Robert Jones: Every member of our community every three to four days, so twice a week required mandatory testing of our students, our faculty, and our staff. We have the capability to do at least 10,000 tests per day in order to cover those cohorts. Several days this week and last week, we did 18,000 tests last Monday and the Monday before that.

So, at this juncture, we’re approaching probably 140,000 to 150,000 tests that we've done since July. The rigorous testing protocol and the fact that the saliva-based test is innovative in terms of that it really cuts out a lot of these supply chain issues that have become problematic with the nasopharyngeal test. A lot of the reagent steps have been cut out, and you basically dribble about a teaspoon full, a half a teaspoon full, into a test tube, and then that's heated to deactivate the virus, a buffer is added, and it goes directly onto this machine we call an RT-PCR.

So, it cuts out an enormous amount of time; it is cost-effective. It only costs a fraction of the cost of the nasopharyngeal test. It's scalable, and it gives us the capacity to test more than 100,000 tests every week. If we do this thing called pooling, we could actually do 20,000 tests per day if we have to.

And so the major difference as well is that it's scalable, it's cost-effective, and you don't need trained medical personnel to administer it. I haven't had the nasopharyngeal test, but I understand it's not the most pleasant thing to do in the world.

Sal: I really understand that there are other things y'all are doing as well, but this test that y'all developed, how quickly do y'all get the results?

Chancellor Robert Jones: You know, in an ideal situation, the results come back as quickly as five or six hours or so, but it shouldn't take any longer than 24 hours to get the test results, which are absolutely critical to be able to notify people to initiate our digital contact tracing, which I'd like to talk about a little bit later, as well as the physical contact tracers. This allows us to be able to notify people early, get those individuals in isolation, and those that they've been associated with in quarantine.

Quick turnaround is absolutely key because, as you know, with the nasopharyngeal test, in many cases, it's been days to get the results back, which creates an environment where you have no way of mitigating the spread of the disease. We were originally going to test once per week, but a lot of data coming out from other researchers and our own researchers clearly showed that our modeling worked by our biophysicists Nigel Goldenfeld and Sergey Maslov.

They clearly showed that if you want to be able to mitigate the spread, you need to be able to test those that are just showing or just accumulating virus in their saliva as well as those who have accumulated enough virus that they can spread it to others. So, the three to four-day testing protocol was the best way to do that and to mitigate it, and it's shown to be effective. It's allowed us to do broad-based surveillance testing.

Let me just mention that in the past week or so, we've been doing 20% of all the tests in the state of Illinois and 2% of all the testing in the entire country. This test is absolutely amazing; it actually has served as a canary in the coal mine for us too.

We do so much testing and get the results back so rapidly. A few days ago, we started to see signs of a potential rise in the number of positive cases. So, it's critically important—that another aspect of this test is that it actually has a canary-in-a-coal-mine effect to let you know well beforehand, before you get to that 5% or 8% or 7% or 10% positivity across your population. You have early warning enough to mitigate that rise. Those are some steps that were announced yesterday.

So, it is a game changer, we think, for this university and potentially a game changer for the state and for the nation. So, we're very, very excited about it!

Sal: I definitely want to get into the contact tracing because that's also another very important piece of y'all's approach to tackling this. But we're getting a bunch of questions off of Facebook and YouTube about just geeking out a little bit more on the test itself—on the accuracy. You know, Brian Sway is asking, “What is the accuracy? What's the false positive, false negative rate?” Maria K. Stumpf is asking essentially the same question from Facebook. So, what do you all know about the false positive and false negative rate of these tests?

Chancellor Robert Jones: We know that the false positive rate is extremely low. You know, there's no way to have a zero percent false positive, but I can tell you it is extremely low. We've done this by spiking saliva samples with the virus and with different viral loads, and it clearly shows—and then comparing them against other RT-PCR tests—and it clearly shows that our test has extraordinarily low false positive rates. That's one of the things that we are very, very excited about.

In order to get our emergency use authorization with our partnership with Yale University, we had to do what is called a bridging study to leverage off of their approval. They think they got their approval maybe on a Friday, and by partnering with them, we had our approval by the next Wednesday. The governor called a big news conference, etc., etc. And one of the things that the bridging study showed is that our test is able to detect a very, very low viral load—a fraction of what other tests or most other tests would not be able to detect at that number of viruses per milliliter sample that we're able to do.

So, it's very, very accurate, it's very sensitive. In fact, the comparison with the Yale test as a benchmark for our bridging study shows that it's about eight times more sensitive than the Yale test. We know it's much more accurate in terms of predicting positive cases. One of the concerns about the nasopharyngeal test is it's generally known that its percent accuracy is less than what we're experiencing.

There is the ongoing problem, say for example, if your viral load apparently is much higher in saliva because that is the predominant way that the disease is spread. Our studies and analysis would indicate that one of the reasons that some people are having a problem that even after they are no longer symptomatic, apparently have recovered from COVID-19, if they go back to get a subsequent nasopharyngeal test, it will still come back positive because we think the nasal cavity perhaps has some remnant virus that may not be active. Whereas saliva has predominantly an active viral load.

So, there are a lot of reasons that give this test a comparative advantage. It has allowed us, because of this predictive capabilities as well as scale and the number of people we can test, to do what no other university is doing, and that is wide-scale surveillance testing of everybody in the community. Hopefully, it will allow us to mitigate this rise in our positivity rate that was much higher than what we had predicted, but we think we can get our arms around it in the next few days, if not the next week.

Sal: The sensitivity, I think, matters a lot. The false negatives are the most dangerous because, obviously, then someone can go out and spread it without knowing it. So, that's really powerful. Tell us a little bit about the contact tracing because this is really, you know, there are two pillars to this—maybe a third on behavior—but the second one is contact tracing.

Chancellor Robert Jones: Yeah, you're absolutely right. We didn't just develop one of the most innovative saliva-based tests in the world; concurrent with that part of this, our whole strategy is an integrated system of saliva-based testing integrated with an app that we now call Safe or Safer Illinois.

This grew out of a conversation that I had with one of our alums who developed the whole integrated fan experience for the San Francisco 49ers, a guy named John Paul. He talked to myself and the provost about a year and a half ago when we were out visiting—about if we were interested in an app-based strategy to improve the student experience on campus, improve advising, improve the fan experience about ordering tickets and what to do over the weekend at any point in time.

So, we'd already built out the Illinois app, and as soon as COVID-19 hit, John Paul collaborated with Bill Sullivan, one of our professors over in engineering, and they created ultimately what is now called a Safer Illinois app that is built on a platform that we are calling Rockwire.

But the key part of it is that it allows a Bluetooth-enabled capability. Basically, when you sign up, you download this app. It allows the use of Bluetooth capability so that if ultimately you test positive or someone that you've been around for a short period of time, it can identify off of those signals and allow us to do kind of a digital Bluetooth-enabled contact tracing as well. We’ve had a pretty high level of people that have signed up for that.

Of course, you can turn it on and off if you want; you can set your sensitivity level. But most people—a significant number of folks in our community have higher enough participation in this to allow us to do both kind of quote-unquote digital contact tracing and to leverage that against the collaboration we have with the Illinois public health department that has allowed us to hire more than 100 physical contact tracers.

We just made a commitment to hire 35 more, so it is an integrated system that we've delivered. Once the test results come back from the lab, they go to our medical McKinley Health Services, and the positive cases are notified either by your cell phone because you're supposed to enter your cell phone number.

Then, this app basically has with it a critically important tool as well that's leveraged off of this app, and that is it gives your COVID status in terms of whether you're given permission to enter a building or not. It doesn't tell you or the person that's looking at it whether you're positive or negative, but it does enable our students and everybody—is required to do this, faculty, staff, and students—before you enter a building, before you can enter a classroom particularly, you have to display what we call your entry card and your boarding pass.

Either digitally on your smart device or we actually have a system you can print out hard copy that says access granted or access denied. And chancellors are not exempt! If you bear with me for just a moment, I can give you—if you're interested—a visualization of that. I just came back from giving my saliva test a few minutes ago, and hopefully, you can see that Robert Jones has been granted access to buildings on campus.

So, everybody in our community, if you're going to class, you have to show this in order to make this work. We had to invest in hiring between 300 and 400 individuals—mostly students, some folk from the community—that we call Wellness Associates. Their job is to be in front of classrooms to check these apps.

We absolutely require wearing masks inside of the classroom, so to be perfectly candid with you, being inside one of our classrooms, two things we know: as far as humanly possible, 99.9% of the folks in there are COVID-free; they're negative. We also require people—notwithstanding that, everybody has to wear a mask the full time that you're in the classroom, including the instructor and professors.

When they're speaking, in order to not disadvantage people that may have hearing issues, they can take their mask off and put on a text glass face shield. But we're creating as safe an environment as we can inside of the classroom. Even between classes, as I walked over to get my saliva test about an hour ago, you could see small groups of people sitting around on campus, and I’m very, very moved and touched by the fact of the large compliance that people use.

It's hard to see someone walking on campus and not have on their face covering. If they're walking along or walking with someone that lives in their roommate or someone, they’ll be chatting, but you can look down at their hands and you’ll see they have those face coverings in their hands. I can’t tell you how many times I've observed that as they are approaching others they don’t know, they put the face covering on; and that’s become part of the culture of keeping themselves safe but also protecting the health and safety of others.

Sal: There are so many questions. This is really impressive! You know, a couple of questions from Facebook: Jessica Fox is asking how are students quarantined after positive tests? Maybe, you know, I’d love your answer to that one because, you know, Fauci has talked about some colleges sending kids home—that's not a good idea because that just infects everyone else.

Chancellor Robert Jones: Well, let’s just start there. I have other questions.

Yeah, yeah, we're not sending young people home, but I agree that that's a bad idea. A key part of what we decided to do quite early was that we knew there were going to be students testing positive when the first week that they came back, as well as there would be positive cases as we began the first week of class.

What we have done about isolation is that, as soon as that test result is available—up until actually yesterday when we made another announcement—the results went to the local public health department. They were the first line of contact, calling up, trying to contact those individuals and let them know what they needed to do to isolate.

That went to the housing, and we created an environment where students would quarantine or isolate in place with very strict instructions about not violating isolation or quarantining. We set aside about 5% of our rooms in our housing residential hall for this purpose. We just decided to move that almost to 10%. We don't have a problem with expanding beyond that capacity.

The local public health department has rented hotel rooms within the community to also accommodate those, particularly the ones that may have difficulty isolating because they have a roommate or because of other kinds of circumstances. So, we've been very, very aggressive about the isolation and quarantining piece.

One of the things we have done to increase the rate at which we can contact those that have tested positive—we think we were putting a bit of burden on the public health folks to do this alone. So again, the same team that created what we call Shield T3—that's the formal name for our saliva-based test—will come up with the brilliant idea of something they're calling Shield 30, where we have 30 additional people to assist the public health department.

Within 30 minutes of one of our undergraduate students, in particular, receiving a positive test result, someone is trying to reach them either by phone or by text message. This is crucial because we need to make sure we identify and contact those folks as quickly as possible. Otherwise, they will be walking around the campus, in some cases unknowingly, potentially spreading COVID-19.

Sal: So, we've been very rigorous about this and keep innovating around it to make sure we have the most rigorous system of isolation and identifying those that are positive, using digital and physical contact tracing to quarantine those that they come in contact with.

Chancellor Robert Jones: I mean, this is incredible! I really have two questions—I have many, many more—but you know, the first one is I know you all have had, I mean, it's good that you're identifying these cases and you've had several hundred. At what point do you know that this is working or not? Is there a threshold that you're like if x percentage of the population starts testing positive, we might have to go to distance learning? How are you all thinking about that?

Chancellor Robert Jones: Well, the way that we're thinking about it is, and I try to remind people, it’s been a data-driven strategy that has gotten us to this point to make us feel comfortable with opening up in the fall. It will be a data-driven strategy that causes us to make a different decision.

A case in point: One of the things that we announced yesterday was that we were asking our students—all of our students, everybody in the community—to kind of limit their activity to essential activities only for the next 14 days. Why? Because, you know, we were very surprised and disappointed that a very, very small number of folks in our community were breaking isolation. They were leaving their isolation site to go get a burger or go do whatever they thought they could do. We had to send a very strong message that that's not acceptable.

Those that continue to do that are being suspended from the university. There was another small group of students who somehow had misinterpreted the CDC guidelines that in some states, in some communities, allows you to go back and get tested and test out of an isolation or a quarantine environment. We had to send a very strict and stern message that, no, remind you that the CDC also gave local governments the local jurisdiction to put in more rigorous criteria.

We have to remind people that you can't test out of a positive case, or you can't test out of isolation or quarantine here at the University of Illinois at Urbana-Champaign. You have to stay in isolation and quarantine for the designated period. When that is up, you will be notified about how to get an additional test to make sure that you're negative.

So, we have to really crack down on those two issues, as well as those repeat offenders of large parties that went beyond the guidelines that the city had put into Urbana and Champaign. They've been wonderful people to work with, and we have a deep and seamless relationship. They worked very hard with the bar owners to raise the legal drinking age to, for two weeks, to have outdoor dining only and to institute a significant fine for hosting parties that were more than the number of residents of a particular housing unit plus 10 individuals.

There were quite a number of folks that were violating that. We have suspended about four or five people so far—suspended one Greek letter organization—and have on notice a number of others. We have about roughly 100 cases that are currently being investigated for possible violations of our conduct code.

So, we're being as thorough and rigorous about this as we possibly can be, trying to send a very strong message that we can't have a small number of people that are essentially breaking the law in many cases and being non-compliant to put in jeopardy the health and safety of the rest of the community, as well as to undermine all of the hard work that a dedicated number of our scientists, scholars, and administrators have put into place, with the core primary goal of keeping our students and our faculty safe. I have zero tolerance for that.

Sal: You know, you had—you expect not everybody to be in compliance; we were not naive that there would be people that were non-compliant. In fact, our modelers had factored that into our expectations about what the number of cases were going to be. But I have to admit, we all acknowledged yesterday at a press conference that we were disappointed and very surprised that those folks who will knowingly come out of isolation to either test out or to do social gatherings—some of them were hosting parties and actually going to parties—and that is what we are trying to put an end to.

Chancellor Robert Jones: Well, and that makes all the sense in the world! I mean, my last question. You know, when you hear about the programs you have created, it's really incredible. It's actually the most impressive testing and contact tracing I've heard of—not just at a university, but anywhere I've heard of in this country.

It sounds comparable to what's been going on in places like Taiwan, which is really best in class in the world. Have other people been contacting y'all? I mean, not just universities; it seems, you know—not just K-12, cities, states, the federal government—to say, "Can we scale this?"

Chancellor Robert Jones: Absolutely! Because there's—some people have put it—this is a game changer, not only for the University of Illinois at Urbana-Champaign; it's a game changer for our other two institutions that we immediately made this testing capability available for—University of Illinois Chicago and our campus in Springfield.

Then, the next iteration of this, working with Tim Killeen, who's the system president and his staff, we are working on two paths. One is how do we expand this to the rest of public higher education across the state? Illinois has 12 or 13 public higher education systems.

We've been working to make this available very quickly, particularly in time for the next semester for the campuses in Bloomington and other public freestanding systems across the state. That was our second priority, as well as setting this up for cities and for other private and public entities, like nursing homes, K-12 education, city governments.

We're in conversation with the city of Chicago about standing something up there to particularly serve the underserved Latino, Latinx, and African American populations—populations that we know have a much higher rate of mortality related to COVID-19. So, we're trying to do the public good as well because we are the University of Illinois-Champaign at its core, and at its founding, it's a public land-grant university. I have an obligation to do the public good.

In addition to trying to stand it up across the state with other universities, we have another strategy where I'm trying to create this alliance of universities, leveraging my relationship and the fact I'm chairman of the board of the Association of Public and Land-grant Universities—242 of the finest public institutions across the country.

My colleagues in the AAU—the 64 world-class research universities, mainly across North America but two institutions in Canada—so you might not be surprised to know that the list of institutions outside of establishing the alliance, we've already gotten calls from almost every major university you can think of—from my colleague over at Indiana to Michigan, to Michigan State, Wisconsin, places in New York, across the globe.

So, this is a strategy that we’re working on to serve the public good. But then there is another piece of it: we start up as a formal university-related organization, who is vetting this for use with government agencies, other states, federal government agencies, as well as corporate entities. You can imagine large companies that have a large workforce—whether they are working remotely or not; it's kind of hard to do all of your manufacturing completely remotely.

They're interested in getting it into their management, their office headquarters, facilities, but as well as manufacturing as well. So, across the board, I can't name a sector that has not indicated interest in this in the last 12 to 45 days. Particularly, the interest really peaked once we got our emergency use authorization approved.

And let me just add one other thing to this that I failed to mention: another innovation that we're working on—because we can't serve all of these clients; some of them have different sets of uses. Some of them have the ability to set up their own CLIA-approved laboratories (many of our institutions do). But to serve an underserved community, for example, or to serve a small university, to serve K-12 education that won't have a CLIA-approved lab, we are in the process of a prototype that should be done in the next week or so of a mobile COVID-19 laboratory.

We envision at least a half dozen to a dozen to maybe two dozen of these being deployed.