COVID-19 testing in schools works. So why aren’t more doing it?

Asymptomatic screening dramatically increases case detection among students and staff in the K through 12 setting,

In August 2020, the school superintendent in Omaha, Neb., approached a microbiology lab at the local university’s medical center. School districts across the country were starting to design pilot programs for routine COVID-19 testing in the coming fall semester, and Omaha Public Schools wanted to join the trend.

The result? During Omaha’s pilot of frequent, asymptomatic testing, the rate of cases detected in the school testing program was six times as high as the case rate reported by traditional testing for symptomatic students only. The pilot program detected 70 cases per 1,000 students, compared with 12 per 1,000 in the official tally reported by the local public health department, researchers report September 22 in JAMA Network Open.

“Asymptomatic screening dramatically increases case detection among students and staff in the K through 12 setting,” says M. Jana Broadhurst, a microbiologist at the University of Nebraska Medical Center who led the team that designed and implemented pilot programs for the school district. In other words, regular testing of all students and staff will catch far more COVID-19 cases than simply testing those who demonstrate COVID-19 symptoms or have a known exposure to the virus. Catching those cases is crucial to nipping outbreaks in the bud and keeping kids in school and healthy.

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But this fall, Omaha Public Schools does not have a COVID-19 testing program at all. Why? “The absence of public health guidance on how to utilize and act upon those test results,” Broadhurst says.

Omaha isn’t alone. Throughout the United States, numerous K–12 schools have struggled to implement routine COVID-19 testing, despite expansive funding from the federal government and a recent surge in cases, fueled by the delta variant (SN: 7/30/21). This surge has taken a huge toll on children, demonstrating for many experts the need for deploying testing as a safety measure (SN: 9/20/21). Many school districts have seen more cases among students — and more shut-down classrooms — in fall of 2021 than they did last fall, before vaccines were widely available.

But major hurdles to testing include a lack of clear guidance on how testing programs should work, obtaining tests, gaining consent from parents and communicating the value of testing to families and staff in increasingly polarized environments.

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