COVID-19: consequences for higher education.

The COVID-19 pandemic has already cost UK universities an estimated £790 million. The shutdown has meant that accommodation, catering, and conference income has evaporated. A similar situation is evolving in the USA. In the 2017 fiscal year, the US higher education sector earned about US$44·6 billion in so-called auxiliary revenues, such as bookstores, halls of residence, and summer camps. The figure for this year is likely to be nearer $30 billion. Meanwhile, Australia expects its higher education sector to lose somewhere in the region of AUS$3–4·6 billion for the 2019–20 academic year.

Universities worldwide have been forced rapidly to scale up online teaching, which has typically entailed unexpected expenditure. They have had to find money to continue paying their staff, as well as deep-cleaning facilities and mothballing research projects. Yet, sizeable as the losses are for the current academic year, they could easily be dwarfed by those expected next year.

The economic downturn will force thousands of youngsters to defer entering university. More than 20 million Americans lost their jobs in April 2020 alone. Students from outside the UK and EU contribute about £6·9 billion in yearly fees to British universities. Encouraged by successive governments, who wished to bolster commercial education, institutions have come to rely on this money, which represents about a third of the total income from tuition fees. A collapse in the international student market, which seems inevitable, would have serious consequences. Australia is similarly exposed. Its higher education sector hosts more 300 000 students from overseas. Terry Hartle (Vice-President of the American Council on Education, Washington, DC, USA) expects international enrolments in US universities and colleges to fall by at least a quarter in 2020–21.

Prospective students might also be put off by the physical distancing requirements that are likely to prevail on university campuses for the foreseeable future. Much will depend on the dynamics of the pandemic. “We really do not have a handle on what will happen when it comes to September”, said Hartle. “Very few schools in the USA are certain that they will be able to open on time.”

The shift to online learning looks set to continue at least until the advent of a successful vaccine for COVID-19. This situation raises questions about whether institutions can justify a fee structure predicated on a model of face-to-face contact. “Students generally report that university is much more than just tuition—place is also really important”, said Simon Marginson (Professor of Higher Education at the University of Oxford, Oxford, UK). “If students are going to miss half of what usually constitutes the student experience, are they really receiving the same value for money?” Furthermore, online learning is no substitute for laboratory work.

Moreover, recessions diminish the prospects for graduate employment. “You have a downgrading of the student experience and a downgrading of the value of the degree; I think it is going to be difficult for universities to sustain the same level of fees that they have been”, said Marginson. It could easily add up to a perfect storm: weakening of domestic and international demand coupled with pressure to decrease fees. “Without any action, universities will be forced to make huge cuts, jobs will be lost, and vital research will be halted”, a spokesperson for Universities UK, an umbrella group representing 137 institutions, told The Lancet Oncology.

“Pretty much every university in the country is looking at voluntary redundancies”, added Malcolm Reed (Dean of Brighton and Sussex Medical School, Brighton, UK, and Co-Chair of the Medical Schools Council, London, UK). “A lot of staff on short-term contracts are likely to go, and funding for PhDs is looking very precarious because of the impact on charities; our pool of future researchers is going to be shallower.”

Prestigious research institutions, such as Harvard (Cambridge, MA, USA) or Oxford (UK) universities, are well placed to weather the coming storm. But places that fall lower down the league tables are vulnerable, especially if international student fees form a big part of their income. “For the most part, medical schools and high-quality research will be ring-fenced from changes”, said Marginson. “Medicine and life sciences are very strong in the UK system; I am confident that they will survive when other things go down”. Much will depend on the depth of the downturn. Reed points out that medical schools are integrated within the university's wider economy. “If the university is under threat, so is the medical school”, he said.

Clinical placements for UK medical students in their penultimate year have been suspended since March. Reed hopes that if they are able to restart by September, the lost ground can be recovered. But any further delay would be problematic. “There is no simple answer as to how to deal with students who have missed 6 months of their clinical experience”, said Reed. “It would be a real threat to graduating on time next year”.

As The Lancet Oncology went to press, the number of confirmed cases of COVID-19 worldwide was approaching 5 million. In the absence of substantial financial support, many of the world's colleges and universities are unlikely to survive the pandemic. Others will have to shut down large projects or sell property. “This is an epochal event”, said Hartle. “It is going to leave a huge impression on the education sector.”