Pooled Surveillance Testing Program for Asymptomatic SARS-CoV-2 Infections in K-12 Schools and Universities

Abstract

The negative impact of continued school closures during the height of the COVID-19 pandemic warrants the establishment of new cost-effective strategies for surveillance and screening to safely reopen and monitor for potential in-school transmission. Here, we present a novel approach to increase the availability of repetitive and routine Covid-19 testing that may ultimately reduce the overall viral burden in the community. We describe implementation of a testing program that included students, faculty and staff from K-12 schools and universities participating in the SalivaClear™ pooled surveillance method (Mirimus Clinical Labs, Brooklyn, NY). Over 400,000 saliva specimens were self-collected from students, faculty and staff from 93 K-12 schools and 18 universities and tested in pools of up to 24 samples over a 20-week period during this pandemic. Peaks of positive cases were seen in the days following the Halloween, Thanksgiving and New Year holidays. Pooled testing did not significantly alter the sensitivity of the molecular assay in terms of both qualitative (100% detection rate on both pooled and individual samples) and quantitative (comparable cycle threshold (CT) values between pooled and individual samples) measures. Pooling samples substantially reduced the costs associated with PCR testing and allowed schools to rapidly assess transmission and adjust prevention protocols as necessary. By establishing low-cost, weekly testing of students and faculty, pooled saliva analysis enabled schools to determine whether transmission had occurred, make data-driven decisions, and adjust safety protocols. Pooled testing is a fundamental component to the reopening of schools, minimizing transmission among students and faculty.

Resources Required for Implementation of SARS-CoV-2 Screening in Massachusetts K-12 Public Schools in Winter/Spring 2021

“…At all COVID-19 incidence levels, screening provides local, real-time information about SARS-CoV-2 prevalence in schools and may be reassuring to students, educators/staff, and their families. 5,[10][11][12][13][14][15] For the 2021-22 school year, CDC recommends screening of unvaccinated students and staff in communities where COVID-19 incidence is at least 10/100,000 people/week. 5 Many K-12 schools are using substantially fewer mitigation measures than in 2020-21, including cohorting, universal masking, and physical distancing; at the same time, vaccination of al K-12 students is now available.…”

Resources Required for Implementation of SARS‐CoV‐2 Screening in Massachusetts K‐12 Public Schools in Winter/Spring 2021

“…Where COVID‐19 incidence is high, screening serves as an additional mitigation measure by identifying people with SARS‐CoV‐2 infection and isolating them before in‐school transmission can occur. At all COVID‐19 incidence levels, screening provides local, real‐time information about SARS‐CoV‐2 prevalence in schools and may be reassuring to students, educators/staff, and their families 5,10‐15 …”

“…At all COVID-19 incidence levels, screening provides local, real-time information about SARS-CoV-2 prevalence in schools and may be reassuring to students, educators/staff, and their families. 5,[10][11][12][13][14][15] For the 2021 to 2022 school year, the CDC recommends screening of unvaccinated students and staff in communities where COVID-19 incidence is at least 10/100,000 people/week. 5 Many K-12 schools are using substantially fewer mitigation measures than in 2020 to 2021, including cohorts, universal masking, and physical distancing; at the same time, vaccination of all K-12 students is now available.…”

“…At all COVID‐19 incidence levels, screening provides local, real‐time information about SARS‐CoV‐2 prevalence in schools and may be reassuring to students, educators/staff, and their families. 5 , 10 , 11 , 12 , 13 , 14 , 15…”