Rapid tests, lots of rapid tests: How US schools plan to reopen amid omicron-fueled COVID surge
- California, Connecticut and New York are among the states sending millions of rapid antigen tests to schools and families ahead of January reopening.
- Washington, D.C. and Baltimore schools are extending winter break by two days to test staff and students before reopening buildings.
- Some FedEx drop boxes in Chicago are overflowing with many of the 150,000 free tests sent to especially hard-hit neighborhoods.
Get ready for a lot more COVID-19 tests, kids.
In anticipation of steep challenges reopening schools amid an omicron-driven surge of infections, districts are planning to ramp up COVID-19 testing when classes resume in January. But leaders are still scrambling to work out the details – leaving big questions about safety and logistics.
The new testing strategies come as COVID-19 infections and pediatric hospitalizations have shot up in a handful of states, especially in the northeast.
With a record number of cases, even among fully vaccinated individuals, school leaders are worried not only the health of staff and students, but also about the ability to keep buildings open if too many employees fall prey to illness or quarantine.
With vaccination rates lagging, aggressive rapid testing can help swiftly detect and isolate cases and stave off outbreaks that could prompt school closures and a return to remote instruction that fails to meet the needs of many students.
"You hear this all the time, 'Oh my gosh, they have to shut the schools, there's all these cases,'" Daniel Griffin, chief of infectious diseases at ProHEALTH Care in New York City and a professor of medicine at Columbia University, said last week on the podcast, This Week in Virology.
"You can safely keep those schools open," Griffin added. "Part of the strategy to avoid the quarantine is testing."
Districts are taking different approaches. Washington, D.C. and Baltimore are extending winter break by two days to test staff and students before reopening buildings Jan. 5. Chicago is recommending parents administer rapid tests to their children before returning to school.
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And New York City is devising a rapid test strategy to stem the tide of cases while also keeping as many children in class as possible, city officials announced this week.
Meanwhile, state governments are deploying heaps of rapid tests to schools and families at a time when drug store shelves are often sold out.
New York and California are sending millions of rapid antigen tests to schools or families. Vermont will make 80,000 free rapid tests available to parents to conduct tests on students at home, its governor said Tuesday. Connecticut is sending 1 million tests to the community and 2 million to schools in January, its governor said.
The importance of returning to in-person learning has been pressed by doctors, health experts, politicians and educators, even amid the omicron surge.
"The kids will be going back to school," Mary Bassett, acting commissioner of health in New York state, said this week at a news conference.
But teachers' unions in Chicago and New York this week signaled they'd push for a delay in reopening if conditions aren't safe or if plans for more widespread testing aren't solidified.
"We are moving closer to a safe reopening of school next week," Michael Mulgrew, head of the United Federation of Teachers in New York City schools, said. "But we are not there yet."
'Quite the dance' for NYC schools
New York City, the largest U.S. district with about 1 million students, announced it will add a rapid-testing regime on top of the surveillance PCR testing it conducted last year.
The news comes as the number of New York City children in the hospital with COVID-19 quadrupled in December, health officials said.
Last semester, New York City tested a small sample of consenting, unvaccinated students in schools each week with PCR tests. Now PCR testing will be expanded to consenting vaccinated students. Outgoing Mayor Bill de Blasio said this week the numbers should increase to about 80,000 kids being tested each week, up from 40,000.
Under a new strategy for rapid testing, students with an exposure to a positive case will be isolated and sent home with an antigen test. Those with no symptoms who upload a negative result into the district's health screener app can return to school the next day, city and school leaders said this week.
Students will have to take another rapid test after seven days. If parents have not opted their child into testing, the child will have to stay at home learning online until the end of the quarantine period.
"We made sure that schools were literally the safest places in the city (last semester)," de Blasio said during a news conference. "We believe these additional measures will help continue that."
But details are still being worked out. Exact procedures for staff and families to follow haven't been solidified or communicated, Mulgrew told USA TODAY Tuesday.
Also, New York City schools still have a 10-day quarantine for positive students and staff, while the CDC recently shortened isolation guidelines to five days.
"It's been quite the dance," Mulgrew said.
Some New York City teachers see the new testing strategy weakening school safety measures. Arthur Goldstein, a teacher at Francis Lewis High School in Queens, said of 4,500 students in his school, about 800 are not vaccinated and around 37 opted into testing.
"This thing is exploding," Goldstein said. "Why don't people have to opt out of testing, instead of opting in? And why can't we mandate vaccines for eligible children?"
CDC rolls out 'test to stay' guidance
New York City's strategy takes a cue from an approach recently endorsed by the Centers for Disease Control and Prevention known as "test to stay." The strategy aims to reduce the numbers of healthy children sent home to isolate and miss class after exposure to a positive case.
Under the approach, unvaccinated students remain in school after an exposure under certain circumstances, including undergoing multiple rapid tests and staying symptom-free. Two negative tests within a week after exposure are required.
CDC guidance does not require vaccinated people to isolate after a possible exposure.
But it's not simple to quickly introduce the strategy. In New York, for example, the county has to approve "test to stay" before a district can adopt it, said Bob Lowry, deputy director for the New York State Council of School Superintendents. Many districts touch more than one county, he said.
Also, carrying out the procedures and properly monitoring the metrics often requires additional employees, at a time when schools are facing staffing challenges.
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Utah was one of the first states to implement "test to stay." The state passed guidelines for districts to carry out the strategy with help from local health departments. Depending on their size, schools that hit a 2% positivity rate or that have 30 infected students must host a test-to-stay event. Often, mobile units are deployed to help with rapid testing.
Students who test negative can stay in school; those who test positive or refuse to consent to testing must switch to remote learning for a designated period.
"We know that school is the best place for kids, and we want to make sure our schools stay open for students," said Lexi Cunningham, executive director of the Utah Schools Superintendents Association. "But it's hard, if you've never done a test to stay, to start it quickly."
A different 'test to stay' approach
On Wednesday, Duke University recommended a different "test to stay" approach that calls for fewer rapid tests. The approach kept transmission rates low and reduced by 90% missed days of school due to quarantine, according to a new study.
The CDC's approach calls for rapid testing after a positive exposure even if all students are masked. Especially with omicron, the logistics of administering that many tests would be "insurmountable" for many schools, Danny Benjamin, a pediatrics professor at Duke University School of Medicine, said Wednesday during a briefing.
Under a more focused approach studied for six weeks in five North Carolina districts and a charter school, a positive case triggered no additional testing as long as all students were masked, Benjamin said.
If at least one of the exposed students was unmasked, students would take a test at school, at the nurse's office or with another adult. If the rapid test was negative and the child had no symptoms, he or she stayed masked and stayed in school.
"The positive child goes home, the exposed child gets to stay for as long as their test at schools are negative and they remain asymptomatic," Benjamin said.
Over six weeks of the schools using the approach, the risk of COVID-19 transmission stayed at about 2%, schools administered 80% fewer rapid tests, and more than 1,600 days of in-person learning were preserved, the study showed.
FedEx drop boxes overflow in Chicago
Other beefed-up testing efforts have come with challenges.
Chicago Public Schools said distributed 150,000 free rapid tests to more than 300 schools located in neighborhoods hit hardest by the pandemic, and encouraged families to take the tests and return them to the district by Tuesday.
But after photos circulated online this week of test kits overflowing FedEx drop boxes. The district shifted the deadline to Thursday Dec. 30.
Teachers also said some of their families haven't received the tests because their classrooms had already pivoted to remote learning before winter break.
"Someone has to make a plan to get test kits to families," Keyonna Payton, a teacher at Park Manor Elementary in Chicago said Tuesday at a news conference. Seven out of 10 classrooms went remote before break, she said, as more than 25 students tested positive.
In a statement to USA TODAY, Chicago said district-wide, school-based testing will resume on January 3rd. But officials still said they expect "a higher than normal number of classrooms to convert to remote learning during this Omicron-driven surge."
Contact Erin Richards at (414) 207-3145 or firstname.lastname@example.org. Follow her on Twitter at @emrichards.