With the fall semester approaching, college and university leadership are weighing the risks and benefits of reopening schools.
Without a cure or viable vaccine for COVID-19, universities are exploring a range of options, each bearing a hefty price tag and set of compromises.
Of 780 colleges tracked by the Chronicle of Higher Education, 67% are planning for in-person classes, 6% online, 7% are proposing a hybrid model, 9% are waiting to decide and the other 11% are considering a range of scenarios.
The Centers for Disease Control and Prevention weighed in on this issue. According to the agency's guidance, it's risky for colleges and universities to host full-sized, in-person classes and events.
That means going virtual is the safest option, with the entire California State University system announcing it will be entirely virtual for the fall semester. But among those that have announced in-person classes in the fall, there is a range of proposed strategies for keeping students and staff safe, including social distancing in classrooms and dorms, frequent testing, face coverings and alternative scheduling options.
However, because of the high density of college campuses and the unprecedented nature of the global pandemic, experts say there's no guarantee that any of these strategies will protect against outbreaks.
"A secondary factor is trying to deliver a high-quality educational product," he said, especially when weighing "the difference between in-person and true distance learning."
Frederick also serves as the chair of the Consortium of Universities of the Washington Metropolitan Area, which represents 17 member colleges and universities representing nearly 290,000 students,
He's working across several schools to ensure there's as much consistency as possible with various reopening strategies.
"We all have different populations, so our individual plans would be different, but the broad umbrella of what we all are trying to do is going to take a similar shape," he said.
The University of South Carolina, has asked that employees and students wear face coverings at all times, in addition to adhering to CDC social distancing and frequent hand washing.
And many schools will stagger students returning to campus. For Boston University, one approach is a phased reopening that involves bringing medical and dental students back in late summer ahead of the undergraduate students.
Johns Hopkins University, meanwhile, will open research labs before opening the rest of campus. At the University of Notre Dame, school administrators are already thinking ahead to the second wave of infections in the fall, hoping that shifting the semester forward by two weeks to start in August and end before Thanksgiving might help.
Others are considering mass testing their students and staff. In a "Return to Learn" pilot program, UC San Diego began broadly testing its students for COVID-19 with intentions to expand when they reopen the campus in the fall.
Last month, Assistant Secretary for Health Admiral Brett Giroir, MD, proposed testing wastewater on campus for traces of the virus as an early warning system.
But mass testing and wastewater testing may be too expensive and logistically complex for some universities.
And what happens if students and staff get sick? Some universities are considering separate quarantine housing, and many are working in conjunction with local and state health departments to contact trace other potential people at risk.
Some schools are even considering controversial apps to trace staff and students' movement so anyone who may be exposed gets a notification.
All of these efforts are expensive, but perhaps less of a financial hit than the lost revenue from students who decide that virtual learning is not worth the hefty tuition price tag.
"I think it's likely many places will be thinking about virtual options for the appropriate settings," said Dr. Joshua M. Sharfstein, physician at the Johns Hopkins Bloomberg School of Public Health and director of the Bloomberg American Health Initiative.
For most, the pandemic will mean a mix of virtual and in-person learning. Sharfstein said this will likely include, "the ability to switch quickly if there is a lot of community spread to virtual."
University leaders will need to be flexible as they move forward with their plans to reopen. The pandemic has proven to be unpredictable and ever-evolving. Potential surges over the summer months may change what needs to be done without much notice.
"I think nobody really knows what the virus is going to do this fall, and so having all your eggs in one basket may not be the smartest strategy," said Sharfstein.
"Maybe some of our thinking for how we're going to do those things will evolve, as it has evolved over the last 90 days," said Frederick.
Delaram J. Taghipour, MD, MPH, MBA is a preventive medicine resident at Johns Hopkins Bloomberg School of Public Health and is a contributor to ABC News.