US colleges and universities face tough Covid decisions at the start of the spring semester, with financial pressures looking likely to complicate responses to the fast-spreading Omicron variant, a chief health advisory group is warning.

Just a few weeks since its discovery, Omicron already is driving a wide split, with some leading universities declaring plans to resume classes next month in online formats, while other institutions cope with state government pressure to keep operating in-person classes with neither mask nor vaccination requirements.

Alongside those overtly political constraints, a less visible reality confronts US higher education: many campuses, with little public awareness, are understood to have cut back the attention and funding they promised their health teams for such initiatives as testing and tracing.

Surveys this autumn semester of thousands of health professionals at hundreds of US campuses, by the 900-institution American College Health Association, have shown that a dangerous ¡°business as usual attitude¡± among campus leaders who had been hoping that the pandemic threat was in retreat and began feeling that extraordinary measures could be set aside.

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While the responses were compiled ahead of the Omicron breakout, campus health professionals describe that basic leadership approach as persisting, said Anita Barkin, co-chair of the Covid-19 Task Force at the American College Health Association.

¡°Certainly we're not hearing reports of schools saying: ¡®We can¡¯t do any of this for the health and well-being of our campus because of the bottom line,¡¯¡± Dr Barkin said. ¡°But we know that this has had an incredible financial impact on institutions, there¡¯s no question about that,¡± she said of various mitigation strategies ¨C testing, mask requirements, limits on the size of social activities and academic activities ¨C that have been gradually eased, in some cases to save money.

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¡°And to those in college health who are dealing with the onslaught of illness, a business as usual attitude is very troubling,¡± Dr Barkin said.

The immediate exceptions include some of the nation¡¯s best-resourced institutions. Harvard and Stanford universities are among those their students they will begin January in . They, along with many other elite institutions ¨C including Yale, Brown, Princeton, Columbia, Cornell and Duke universities ¨C are imposing Covid booster shot requirements as a condition for returning to campus.

The situation is less clear elsewhere. The University of Georgia has led a legal challenge to vaccine mandates in academia ¨C reflecting the opposition?to health-oriented requirements in many conservative state governments. Such institutions have been pleading with their students to get their immunisations regardless of any requirement, but the lack of mandates is understood to be leaving significant coverage gaps, and some states won¡¯t even allow their institutions to ask their communities about vaccination status, Dr Barkin said.

Between those relative extremes, she said, the vast majority of US institutions are the fast spread of the Omicron variant and what reaction makes most sense.

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For that, the American College Health Association has been a leading source of medical guidance. Yet it recognises that campus-specific circumstances are so unique ¨C in areas that include institution size, staff and housing resources and community spread ¨C that it cannot offer any overall guidance on whether US higher education should resume the online formats that were seen almost universally in early 2020.

Other autumn?semester survey data from the American Council on Education, the main US higher education association, affirms that many campus presidents are concerned about their finances but overwhelmingly rate political considerations as the chief complication in their pandemic responses.

The survey of 113 campus presidents found 63 per cent agreed that politics hindered their use of Covid protections such as vaccine mandates. Another 63 per cent cited maintaining enrolment for the coming academic term as a leading concern. Only student mental health topped enrolment as the top overall concern for the campus presidents. Those two issues were followed by their concern for staff mental health, and then by their concern over their institution¡¯s long-term financial viability.

paul.basken@timeshighereducation.com