SummaryWhat is already known about this topic?SARS-CoV2 testing is a key component of a multi-layered mitigation strategy to enable safe return to in-person school for the K-12 population. However, costs, logistics, and uncertainty about effectiveness are potential barriers to implementation.What is added by this report?Over three months, 259,726 individual swabs were tested across 50,636 pools from 582 schools. Pool positivity rate was 0.8%; 98.1% of pools tested negative and 0.3% inconclusive, and 0.8% of pools submitted could not be tested. In reflex testing, 92.5% of fully deconvoluted pools with N1 or N2 target Ct ≤30 yielded a positive individual using the BinaxNOW antigen rapid diagnostic test (Ag RDT) performed 1-3 days later. With sufficient staffing support and low pool positivity rates, pooled sample collection and reflex testing were feasible for schools.What are the implications for public health practice?Screening testing for K-12 students and staff is achievable at scale and at low cost with a scheme that incorporates in-school pooling, RT-PCR primary testing, and Ag RDT reflex/deconvolution testing. Staffing support is a key factor for program success.
An inpatient rehabilitation program appears to positively impact optimal outcomes (functional recovery and discharge to home) for selected patients with HT and is comparable with regional and national FIM gain and efficiency for patients admitted to IRFs with other cardiac conditions.
SARS-CoV2 testing is one component of a multi-layered mitigation strategy to enable safe in-person school attendance for the K-12 school population. However, costs, logistics, and uncertainty about effectiveness are potential barriers to implementation. We assessed early data from the Massachusetts K-12 public school pooled SARS-CoV2 testing program, which incorporates two novel design elements: in-school “pod pooling” for assembling pools of dry anterior nasal swabs from 5-10 individuals, and positive pool deconvolution using the BinaxNOW antigen rapid diagnostic test (Ag RDT), to assess the operational and analytical feasibility of this approach.
Over three months, 187,597 individual swabs were tested across 39,297 pools from 738 schools. The pool positivity rate was 0.8%; 98.2% of pools tested negative and 0.2% inconclusive, and 0.8% of pools submitted could not be tested. Of 310 positive pools, 70.6% had an N1 or N2 Ct value ≤ 30. In reflex testing (performed on specimens newly collected from members of the positive pool), 92.5% of fully deconvoluted pools with N1 or N2 target Ct ≤30 yielded a positive individual using the BinaxNOW test performed 1-3 days later. However, of 124 positive pools with full reflex testing data available for analysis, 32 (25.8%) of BinaxNOW pool deconvolution testing attempts did not detect a positive individual, requiring additional reflex testing. With sufficient staffing support and low pool positivity rates, pooled sample collection and reflex testing were feasible for schools.
These early program findings confirm that screening testing for K-12 students and staff is achievable at scale with a scheme that incorporates in-school pooling, RT-PCR primary testing, and Ag RDT reflex/deconvolution testing.
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