SARS-CoV-2 Screening Testing Programs for Safe In-person Learning in K–12 Schools

Abstract

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening testing is a recommended mitigation strategy for schools, although few descriptions of program implementation are available. Methods Kindergarten through 12th grade (K–12) students and staff practicing universal masking during the delta and omicron variant waves from 5 schools in Durham, North Carolina and 8 in Kansas City, Missouri participated; Durham’s program was structured as a public health initiative facilitated by school staff, and Kansas City’s as a research study facilitated by a research team. Tests included school-based rapid antigen or polymerase chain reaction testing, at-home rapid antigen testing, and off-site nucleic acid amplification testing. Results We performed nearly 5,700 screening tests on more than 1,600 K–12 school students and staff members. The total cost for the Durham testing program in 5 public charter K–12 schools, each with 500–1000 students, was $246,587 and approximately 752 hours per semester; cost per test was $70 and cost per positive result was $7,076. The total cost for the Kansas City program in 8 public K–12 schools was $292,591 and required approximately 537 hours in personnel time for school-based testing; cost per test was $132 and cost per positive result was $4,818. SARS-CoV-2 positivity rates were generally lower (0–16.16%) than rates in the community (2.7–36.47%) throughout all testing weeks. Conclusions and Relevance Voluntary screening testing programs in K–12 schools are costly and rarely detect asymptomatic positive persons, particularly in universally masked settings.

Summarizing Implementation Support for School-Based COVID-19 Testing Programs in Southwest American Indian Communities

“…A systematic review of school-based testing programs reported that cumulative school-based transmission rates among students from December 2019 to September 2020 were low (ie, 0.15%) 21. This review and others suggested that while school transmission is related to community transmission, schools are no riskier for COVID infection than at home or out in the community 16,19,21,22…”

“…21 This review and others suggested that while school transmission is related to community transmission, schools are no riskier for COVID infection than at home or out in the community. 16,19,21,22 Recognizing the utility of school-based testing, the National Institutes of Health's Rapid Acceleration of Diagnostics Underserved Populations (RADx-UP) program awarded $33 million to COVID testing projects in underserved communities. This article describes developing and implementing an approach to support COVID surveillance and reflex testing strategies in partner schools funded under the RADx-UP initiative (OT2HD107543) to facilitate a return to in-person learning.…”

Notes from the Field: Multipathogen Respiratory Virus Testing Among Primary and Secondary School Students and Staff Members in a Large Metropolitan School District — Missouri, November 2, 2022–April 19, 2023

“…Although children spend most of their awake hours in the school setting, few data are available on the prevalence of respiratory viruses in schools. Surveillance for respiratory viruses other than SARS-CoV-2 has not been widely conducted in primary and secondary schools (2).…”