BOONE, N.C. — Since last Monday, when a sophomore at his school died from suspected Covid-19 complications, Chase Sturgis says he has been thinking about his own bout with the coronavirus — and his own mortality.
Mr. Sturgis, 21, had been avoiding socializing over the summer, but as students at his school, Appalachian State University, began returning to campus in August, he yielded to temptation. “We went out to a bar,” he said. Within days he felt ill, and then tested positive for coronavirus: “To this day I have no sense of taste or smell.”
But even more unnerving is the “really, honestly scary” realization that he and the student who died, 19-year-old Chad Dorrill, were sick at about the same time, with similar symptoms and no known pre-existing conditions. “He died a week or two after he got the virus,” Mr. Sturgis said. “It has been about two weeks for me.”
Young people have generally been at lower risk of developing severe cases of Covid-19, and there have been only a few student deaths linked to the virus. But while that statistical advantage may have led to apathy about the pandemic at some institutions, Mr. Dorrill’s death has shaken the rural Appalachian State campus in the Blue Ridge Mountains, sparking questions about whether the college is doing enough to keep its students and faculty safe.
“It’s not a hoax, that this virus really does exist,” said a classmate of Mr. Sturgis, Emma Crider. “Before this, the overall mentality was ‘out of sight, out of mind.’”
As if to underscore that point, cases at Appalachian State, part of North Carolina’s state university system, spiked sharply last week. On Thursday, the school canceled an upcoming football game and announced outbreaks in four residence halls, two fraternity houses, the volleyball team and the football program. The school’s dashboard shows more than 700 confirmed Covid-19 cases at the 20,000-student campus since early June.
Aside from athletes, who must be tested under N.C.A.A. rules, Appalachian State has not conducted the kind of costly, widespread mandatory testing and tracing of people with and without symptoms that has helped control the virus at some campuses. Rather, the school has offered voluntary testing at its student health center and at “pop-up” test sites where students can walk up and be tested twice weekly.
That approach, the school’s website says, is based on C.D.C. guidance, which has advised against testing all students upon arrival to campus. Health experts have criticized the C.D.C.’s guidance as weak and confusing, but many large public colleges have based their coronavirus health regimens on it.
Surrounding Watauga County also experienced its worst 7-day period in the pandemic this past week, according to data collected by The New York Times. Coronavirus cases in the county have more than doubled since Sept. 1, to more than 1,300, and an update last week found “the largest percentage of cases in the 18-24 old age group.”
Despite efforts by most colleges and universities to contain the virus by banning large gatherings, mandating face masks and expanding remote instruction, many have nevertheless become some of the nation’s most virulent hot spots.
A C.D.C. report released last week said cases among people ages 18 to 22 rose 55 percent in the month from early August to early September, as students were returning to campuses. A New York Times survey has documented more than 130,000 cases on campuses since the pandemic began.
Tensions around reopening have already run high in the 16-campus University of North Carolina system, where the push to maintain sports and dorm occupancy has met with intense opposition from worried faculty members. Days after the semester began, the flagship campus in Chapel Hill pivoted to all remote instruction amid spiking infections.
At Appalachian State, which continued to allow students to live in dorms and take classes in person, the faculty senate voted in August to hold the system responsible for any illness or death as a result of reopening.
Mr. Dorrill, a seemingly fit basketball player, was among some 5,000 students on campus and thousands more off-campus attending a blend of in-person and remote classes. He went home to Wallburg, N.C., feeling under the weather, in early September. He tested positive for the virus there. His family said he remained isolated at home for two weeks and then returned to Boone, but fell ill again less than a day later, calling to say he couldn’t remember how he had gotten back to college.
His neurological condition swiftly deteriorated; three weeks after his positive test, Mr. Dorrill died at Forsyth Medical Center in Winston-Salem. An autopsy is pending.
Relatives said that though he had recovered from the respiratory symptoms of Covid-19, the virus had also attacked his brain, possibly triggering a previously undetected case of Guillain-Barré syndrome, a rare disorder in which the body’s nerves are attacked by its immune system.
“Any loss of life is a tragedy, but the grief cuts especially deep as we mourn a young man who had so much life ahead,” the university system’s president, Peter Hans, said in a statement after Mr. Dorrill’s death.
The events of the past week have caused mounting alarm among both staff and students, and some tensions over whether the school needs to take stronger measures to contain the virus.
“There has been polarization between those who say, ‘Just wear a mask, we’ll be OK,’ and the faculty who just don’t want to be in the room,” said Rick Rheingans, chairman of Appalachian State’s department of sustainable development, who has been tracking the school’s health measures. “My argument has been that we need rigorous testing and active tracing, quarantining and isolation. We can’t reopen if we’re not safe.”
One graduate teaching assistant, Chloe Dorin, called on the university to cancel athletics, shut down the dorms, disband Greek life and return to online instruction, in a letter to university leaders that was posted on Facebook Saturday. “Our lives,” she wrote, “are in your hands.”
In a letter to students, Chancellor Sheri Everts said the school had added an extra pop-up testing event, expanded contact tracing resources and suspended football practice.
“Should we need to, we are ready to pivot to all-remote learning,” Dr. Everts wrote, urging students to wear masks and “hold one another accountable.”
As students absorbed the latest blows from the pandemic, the campus was quiet on Friday, bereft of the usual student crowds shuffling in and out of academic buildings. Signs posted in flower beds and around buildings warned students to wear masks. Most seemed to be complying.
Emma Metzger, a senior and communications major, said the death was “a big wake-up call for a lot of people,” though many students “still only wear masks because they don’t want people to think badly of them in public.”
Ms. Metzger said she had her own Covid scare about two weeks ago when her roommate’s boyfriend learned he had been with infected students. With her parents planning to visit that weekend, she said, she tried to get a rapid test on campus, only to be told she would have to wait four days. The closest CVS pharmacy offering rapid results was in Tennessee, so she called her family physician, who sent her to a health facility 90 minutes away.
She tested negative, she said, but the experience left her impatient with those who shrug off precautions. A friend texted her on Thursday, saying that he had tested positive, she said, “and then literally, two hours later, a girl in our sorority posted a picture, and he was in the picture!”
Ms. Metzger laughed, shaking her head at the scene: “No one is wearing masks. And they’re all over each other.”
On their patio at an apartment complex in Boone, Kathryn Behmer, 19, Makenzie Thompson, 20, and Anna Goebelbecker, 20, said they weren’t sure they would even come back to Appalachian State next semester.
Just last weekend, hundreds of students had swarmed the streets on football game day. Now each new development, they said — Mr. Dorrill’s death, the canceled game with Louisiana, the spikes in new cases — amplified the seriousness of the situation. Friday was Ms. Goebelbecker’s 20th birthday, but having a party felt “disrespectful.”
“I think when someone our age actually passes away, it’s harder,” Ms. Behmer said. “We thought it wouldn’t affect us. We’re young, we’re healthy.”
Austin Nykamp, 21, a junior majoring in computer information systems, said he was even wondering whether the local 25-person cap on gatherings was sufficient. “Paying full tuition for this is kind of a rip-off, if you ask me,” he said.
That unease resonated with students in a Zoom class on health development and the coronavirus, where Mr. Sturgis shared his health scare with about 15 classmates last week. Some students blamed their peers for not following health rules; some questioned whether the university, having invited them back for the semester, was doing enough to protect them.
“All of us must remain vigilant with our safety behaviors,” Chancellor Everts reminded in her email on the death of Mr. Dorrill, noting that “I wear my mask for Chad” had become a catchphrase on campus.
But that wasn’t what stuck with Hannah Mitchell.
“I didn’t have much reaction to Chad’s death until I read the email,” she said. “Now, all I can think is, ‘What if this had been me?’”
Cristina Bolling reported from Boone, and Shawn Hubler from Sacramento.