Most colleges and universities have started classes and brought students from the campus across the country. Several of these institutions, especially large ones, are now seeing outbreaks of COVID-19 among students.

Many of the most visible and severe outbreaks are in the southeastern United States.

The University of Alabama has had more than 500 cases in Tuscaloosa campus, for example, and Auburn University has seen more than 200 cases this week alone. University of Miami reported 141 after the first week of school, and the University of Kentucky has seen 250 cases so far.

In some instances, the impact of such cases count is tempered by considering high numbers of enrollment and a low rate of positivity. University of Kentucky, for example, enrolls more than 30,000 students, and their positive results as part of the evidence reach only 1.1 percent.

In other cases, which is high is high. University of North Carolina at Chapel Hill, for example, has reported 635 cumulative cases among students since the first week of August. For the most recent period of testing, the positivity rate was over 30 percent. The university announced last week that it would be sending students home, a step that none of the others mentioned have been taken.

While the case counts and spread in the community are worse, in general, in the southeast, the high numbers of cases among some universities also may be related to the start of classes. Schools in the South are more likely than those elsewhere to start the academic year in early August, in line with K-12 schools in the region. Some of these schools have been holding classes for three weeks now, allowing more time for an outbreak develops. Chapel Hill, for example, classes began more than two weeks.

However, geography can not account for everything. Outbreaks have also occurred in other regions of the country. University of Notre Dame, for example, has had 471 cases in August and last week put students on lockdown, teaching online. University of Missouri in Columbia reported 159 cases Tuesday, the first day of class. Iowa State University has seen 130 cases of this semester.

Most universities are great. State of Iowa, Mizzou, Auburn, Alabama, Kentucky and Chapel Hill all enroll more than 30,000 students each. In contrast, Fayetteville State University in North Carolina, fewer than 7,000 students enroll, has only seen 16 cases.

Tests prior to arrival at some of these universities was not as robust as it has been in other institutions. Alabama and Auburn only requires students to be tested within 14 days prior to arrival on campus. Mizzou and Chapel Hill made no prior screening on arrival, an approach that is in line with the recommendations of the Centers for Disease Control and Disease Prevention.

Universities have also seen the most attention for their case counts precisely because they have chosen to release them. In some universities, like the University of the State of Arizona, it is possible that outbreaks occur without public knowledge because the administration will not release any information, citing privacy concerns.

But amid questions about what colleges with outbreaks can and should be done differently, it is clear that at least one university, while maintaining most online classes, closing residences and encourage students to stay home was not enough to keep cases zero. University of Southern California did all those things and his health chief the student sits on COVID-19 working group of the American College Health Association, which has been providing guidance for institutions.

The university still reported 43 cases among students outside the school on Monday.

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