Here's how one college system kept Covid-19 cases down as they surged throughout the state

(CNN)Students began flocking back to the six campuses of the University of Maine this fall hoping for a more normal college experience, one without shutdowns or Zoom classes.

As those tens of thousands of students returned to residence halls and full classrooms, university leaders hoped the measures they put in place would keep Covid-19 cases down and avoid widespread cases that shut down many campuses nationwide last spring.

University of Maine President Joan Ferrini-Mundy, who chairs the system's Science Advisory Board, told CNN they prepared a science-based, multifaceted approach with the help of a team that included an epidemiologist, a statistician, microbiologists and virologists.

As the semester began at the end of August, university officials were about to find out if it would work.

In September, cases in the heavily vaccinated state began to rise. According to the state's Center for Disease Control Prevention, hospitals began to fill up with patients not seen since January. The number of people needing ventilators reached all-time highs and intensive care units reached record numbers, according to state health data. All counties began to be classified as having high levels of transmission.

The University of Maine has seen cases remain low, and it seems that the state is avoiding a crush. At the start of October, the campus system of more than 30,000 students and employees had a 1.5% positivity rate, compared to the state's rising 4.5% positivity rate.

CNN was informed by the university that 52 Covid-19 cases had been reported to it by students and employees as of Wednesday. Forty-five of those were on the flagship campus in Orono. Zero cases were reported at the University of Maine, University of Maine Farmington, and University of Maine Presque Isle campuses.

So how did they do it?

Ferrini–Mundy credit this multifront system, which is also known as the “Swiss cheddar” model, for helping to defend against Covid-19. Each layer of cheese, or prevention measure, has holes. However, when they are stacked together, they provide an effective defense.

Ferrini–Mundy recognizes that the biggest part of it isn’t just the campus’ measures but the willingness and ability to stick with them -- a situation that does not always exist in other settings.

Ferrini-Mundy stated that "we've been able control this through excellent behaviour and compliance from our students."

Lucia Mullen (a senior analyst at Johns Hopkins Center for Health Security) said that the university’s success is evidence of two things. This "Swiss-cheese" model is the strongest to increase activities and social interactions while keeping transmission low.

Mullen said that it also showed the difference compliance and willingness could make in bringing down certain cases.

While there is always going to be exceptions and settings where the university model couldn't work, Mullen says it's a good example of success in a time of Covid-19 fatigue.

Vaccination efforts

One of the big reasons for the university system success is the rate of vaccination on campus compared with the rest of the state. Maine has a high full dose vaccination rate at 74.4% compared to the university’s 88.3%.

State health officials said that the Delta variant requires a very small window of time to cause havoc. According to Dr. Nirav D. Shah, Maine CDC Director. That's primarily what happened in the unvaccinated. Some pockets, especially rural areas, don't have vaccination rates on par with the state's average.

Shah responded to the increase in cases by saying that "people are getting it in everyday life." "Maybe because they had coffee together with a friend, or had dinner with friends at the house. The virus can travel easily between people in smaller settings." Most cases of Covid-19 currently being reported are among unvaccinated persons.

The University of Maine campus seems to have had a mandate for vaccinations that helped students protect themselves against community transmission. According to the university, more students were vaccinated earlier in the semester. This provided protection for the campus.

Tuesday's compliance rate was 97.2%. Ferrini-Mundy reports that the compliance rate across the entire system (faculty, staff, students off-campus) is 88.3%. Officially, the mandate is effective October 15.

A 'robust-testing regime'

Ferrini-Mundy describes weekly testing for students who have not been fully vaccinated. These tests are processed in a laboratory located on campus by the university.

"We get quick turnarounds and then have a solid contact tracing system that that follows-up," she states.

The University of Maine is one of many campuses that has begun to use wastewater testing to detect potential cases early. Researchers say they are optimistic about this testing. It can alert public officials to trends in infection and doesn't require that individuals get tested. It can also be used as an early warning system in the event of outbreaks, since people often excrete virus from their feces long before they experience symptoms.

Ferrini - Mundy spoke of the wastewater testing, saying that they want to make sure there are no asymptomatic cases in people who have been vaccinated but are not being tested on campus.

Mullen stated that such testing was an important component in testing unvaccinated students to help stop the spread of the virus.

Mullen stated, “We can identify (the disease) much quicker." "So, we stopped any potential chain of transmission. Instead of waiting until others have infected themselves, we identify the virus at the source."

Indoor masking

Ferrini-Mundy also touts their indoor masking policy for all facilities, including classrooms.

Some state colleges that have vaccine mandates do not require indoor masking or only in residence rooms. Some colleges have said their state's board of regents have not allowed them to enact mask or vaccine mandates.

Mullen stated that "It sounds to this university has such strict compliance with mask use indoors. That's an important factor as we're just creating less chances for the virus and people to get exposed."

Ferrini–Mundy cites the message throughout the system as well as the assistance of faculty in ensuring that mask wearing isn't just happening but actually happening.

She stated, "I just left a faculty meeting where some of the people there were saying, ‘I need to remind the students every now and again the mask must go above their nose, and they're actually doing that, but the students comply."

Ferrini Murray even mentioned that students sometimes hide outdoors in places where it's not permitted.

Doubling down

Ferrini - Mundy said that the university system doesn't rest on its success. However, there are some new measures.

Concerns about conferences, sports, and other events moving indoors in Maine's winter mean that there will be a requirement for proof of vaccinations to be presented at gatherings with more than 250 participants. Some campuses have already been doing that, but it will become a requirement next week, Ferrini-Mundy says.

As the vaccine mandate is implemented, the university reaches out to the small number of people who have not yet submitted proof or requested an exception. Ferrini-Mundy said Tuesday that there were 708 people in the entire university system.

To try to get them all in compliance, the university has been making phone calls, sending text message emails, app reminders, and holding Zoom support sessions.

Then, it will be dropped.

"They won't be able to register for spring semester if they don't do this and come October 31, we actually will be withdrawing them from their courses," Ferrini-Mundy says.

A bubble that promotes good health is possible

Ferrini–Mundy can't help but to praise all their partners, even students, for creating a climate that seems like it has protected them from the onset of widespread cases.

Maine's Center for Disease Control Prevention called the university an "excellent partnership throughout Maine's response to pandemics."

"Its leaders have consistently placed public health before politics and taken proactive measures to limit virus transmission at campuses and in the wider university community," the agency stated in a statement.

Ferrini-Mundy believes that the university's success is due to student support during the pandemic.

"We had an extremely disruptive year last school year. Our students were not able to make it all. They took part in many hybrid courses that were remote, and we are grateful they did," she stated.

"But, the feeling I get here when I talk with students out on the campus is that they really want back. They want to do the work.