Pharma Focus Asia

SARS-CoV-2 Variant Introduction Following Spring Break Travel and Transmission Mitigation Strategies

Justin M. Napolitano, Sujata Srikanth, Rooksana E. Noorai, Stevin Wilson, Kaitlyn E. Williams, Ramses A. Rosales-Garcia, Brian Krueger, Chloe Emerson, Scott Parker, John Pruitt, Rachel Dango, Lax Iyer, Adib Shafi, Iromi Jayawardena, Christopher L. Parkinson, Christopher McMahan, Lior Rennert, Congyue Annie Peng, Delphine Dean.


University spring break carries a two-pronged SARS-CoV-2 variant transmission risk. Circulating variants from universities can spread to spring break destinations, and variants from spring break destinations can spread to universities and surrounding communities. Therefore, it is critical to implement SARS-CoV-2 variant surveillance and testing strategies to limit community spread before and after spring break to mitigate virus transmission and facilitate universities safely returning to in-person teaching.


In the spring of 2021, surging SARS-CoV-2 cases kept most universities from in-person education and adversely impacted the learning experience of college students. Implementation of a saliva-based RT-qPCR testing strategy has enabled several universities to retain in-person classes. The high-complexity testing strategy allows surveillance testing of the entire university population with rapid turnaround time.

Materials and Methods:

The Clemson University Research and Education in Disease Diagnosis and Intervention (REDDI) Lab (CLIA ID: 42D2193465) performed COVID-19 diagnostic tests from saliva samples from college students, employees and neighboring community members. The SalivaDirect™: RNA extraction-free SARS-CoV-2 diagnostics protocol Workflow 2 (Yale) was modified, with only one heat treatment step at 95°C for thirty minutes instead of three.


University campuses are conducive to disease transmission due to close living quarters and high-density social interactions among the adolescent population. While the risk of severe illness from SARS-CoV-2 infection in the adolescent population is low, this population may disproportionately contribute to the spread of the disease compared to other age groups. Ideally, during times of high infectious disease rates with public health concerns, such as a dangerous epidemic or pandemic, institutions should implement high-frequency repeated testing or alternative surveillance-based testing strategies for disease mitigation during the semester, though such strategies face increasingly obstructive barriers as they become more comprehensive.


Clemson University is acknowledged for providing computing time on their high-performance computing resource, the Palmetto cluster. The Clemson University Social Media Listening Center is acknowledged for collecting and curating social media data. The authors would like to thank Rachel Ham and Kylie King of the REDDI Lab for technical support

Citation: Napolitano JM, Srikanth S, Noorai RE, Wilson S, Williams KE, Rosales-Garcia RA, et al. (2024) SARS-CoV-2 variant introduction following spring break travel and transmission mitigation strategies. PLoS ONE 19(5): e0301225.

Editor: Vittorio Sambri, University of Bologna / Romagna Local Health Authority, ITALY

Received: November 1, 2023; Accepted: March 12, 2024; Published: May 9, 2024.

Copyright: © 2024 Napolitano et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The sequence data underlying this article are available in the GenBank Nucleotide Database at and in the Global Initiative on Sharing Avian Influenza Data (GISAID) Resources at Accession numbers are provided in Supplementary Data Set 1.

Funding: This research received funding from multiple sources. SW, REN, CLP received support from Clemson University's College of Science. DD, CAP received support from Clemson University's Vice President for Research, Clemson University's Creative Inquiry, and the South Carolina Governor & Joint Bond Review Committee. SW, REN, CLP, LR, CAP, DD received funding through the National Institute of General Medical Sciences of the National Institutes of Health (; grant number: P20GM121342). SW, REN, CLP also received funding from the National Institute of General Medical Sciences of the NIH (under grant number P20GM109094). Additionally, CAP received support from NIGMS under grant P20GM139769. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: SW is currently employed by Illumina. BK, SP, JP, RD, LI, and AS are employed by Labcorp. The other authors declare no competing interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.


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