Why COVID testing is declining in many schools across the US

National

“A lot of schools are testing parts of their population once a week, or are not using tests strategically, or confusing surveillance with testing to suppress outbreaks.”

Holly Amos, a special education teacher, gives her son a COVID-19 test at a testing site at Garda High School in Garda, California. Allison Zoucha / The New York Times

In California, storms over the winter break destroyed 1 million coronavirus test kits meant to help students returning to schools screen. In schools in Seattle, children waited for hours for virus tests, some in the rain. This month in Florida, an effort to supply test supplies to teachers in Broward County ended.

And in Chicago, a labor dispute, partly over the test, kept students out of school for a week.

As millions of American students go back to their desks – Los Angeles, the nation’s second largest school district, begins classes on Tuesday – tests itself the coronavirus test that was supposed to help keep classrooms open safely He is going. Things are not going well in most parts of the country.

From the ultra-contagious Omicron version, under pressure by political factions, baffled by conflicting federal guidance and stymied by national shortages of rapid-test kits, many districts struggle to establish or effectively set up testing programs. has done. In many areas, schools have already had to be closed in recent weeks because flawed testing allowed infected children and teachers to return to the classroom, putting others at risk.

Most schools have managed to continue with in-person instruction, and in many areas transmission in classrooms has been lower than in the wider community. But parental concerns and clashes with teacher unions are jeopardizing the Biden administration’s efforts to halt the return of distance learning. And even for districts where testing programs are working, the high cost is raising questions about their sustainability.

Burbio. data from, a company that audits how schools have operated through the pandemic, shows that more than 5,400 schools have returned to virtual learning since January 3. Public health researchers say the issue is not that the test doesn’t work – especially in combination with vaccinations, face masks and other precautions. Rather, he says, many districts are floundering in execution or failing to mobilize the resources needed to test properly.

Former Harvard University public health researcher and Dr. Michael J. “A lot of schools are testing parts of their population once a week, or are not using tests strategically, or confusing surveillance with testing,” Meena said. Leading expert in rapid testing, now chief science officer for eMed, which certifies test results at home.

The result, he said, has been comparable to an army going to war without knowing how to use its weapons or understanding its objectives.

“You can throw all the guns and military personnel into the war zone, but if you don’t go with strategy, you’re never going to win,” Meena said.

During the pandemic, testing – subsidized with billions of dollars in federal funding – has been seen as an important way to keep children in classes and reduce the toll of distance learning. on emotional health and academic progress. But public health experts say some districts are testing enough or strategically enough – especially in the wake of Omicron.

Screening to detect and isolate outbreaks requires widespread participation, but many districts have resisted requiring students to participate, fearing a political backlash. Many schools also screen with PCR tests, which are useful in diagnosing cases but could open schools to the risk of outbreaks as they wait for results from processing laboratories.

New test-to-stay programs – which let exposed students stay in class until they test negative and have no symptoms – also require intensive testing, but they rely on rapid antigen tests. which are in short supply nationally due to rising omicron infections. Demand has increased.

“The lack of clear federal guidance on rapid testing has also been an issue,” Meena said, “forcing every school system to reinvent the wheel.”

Health experts say the results of many schools have been half-hearted.

“Asking whether the school test works is like asking if the dishwasher works—yes, it works, but only when you load the dishes,” says Megan Fitzpatrick, MD, an assistant professor at the Maryland School of Medicine. Said, who specializes in infectious disease modeling.

In Seattle, schools canceled classes and held optional pop-up testing programs for staff and students early last week, hoping to curb distance learning by preventing infectious people from entering schools after the holiday. But only 14,000 of the district’s 50,000 students and 7,800 staff showed up – almost 1 in 25 tested positive.

By Monday, two schools remain closed Due to staff shortages and infections, and the district was considering returning to remote classes. David Giugliani, a parent of two children, said he was grateful for the district’s efforts to protect schools and the community, but also worried about individual learning and the uncertainty of it all. Among other issues, he said, there was a four-hour wait for the test that he and his children had to endure.

“I want more confidence in what’s going to happen next, but who has it?” They said.

In Portland, Oregon, where COVID-related staff shortages previously closed two out of 12 high schools by the end of the week, only 27% of students opted for regular screening, said Brenda Martinek, chief of student support. Said services. Vaccinated teachers were not offered school-based testing until last week, when staff from staff secretaries in the district office to people in the IT department were trained to conduct PCR tests.

“I was there too, with my face shield and my mask and gloves on, like, ‘Okay, swab five times in one nostril, now swab five times in the other,'” she said. “I never thought I was a health care provider, but apparently I am.”

Some Republican-led states have insisted on school testing or have lagged behind distributing stockpiles. In Florida, Governor Ron DeSantis said last week that children “don’t need to do any crazy mitigation like wearing a mask or getting tested” unless their parents want it to. In Broward County, school staff, who took advantage of a gift of 75,000 tests given by the school district, found that some of them had passed their expiration date.

Even in heavily democratic parts of the country, in some large urban districts, where leaders have vowed to keep schools open, effective testing has been halted. Schools in New York announced last week that they were doubling their participation in routine surveillance testing. But union officials said that even at the expanded level, elective screening covers 20% of the students in the district.

In Chicago schools, less than a third of the 150,000 reentry home-test kits mailed over the winter break were returned by families, and most of those returned were invalid. The district, which serves more than 300,000 students, closed last week as teachers unions demanded more aggressive testing.

And in California, the weather disrupted Gavin Newsom’s effort to test 1,000-plus districts fast enough during the winter break, so that all more than 6 million K-12 students are eligible for re-admission. to be screened. State health officials said that of the 10 million rapid tests sent to the districts, one million were destroyed in the rains.

Still, some districts are bowing out.

In Washington, D.C., which serves about 50,000 students, school officials are requiring a negative coronavirus test for every person returning to campus. On Monday, district officials said they would also provide weekly rapid tests to very young students to be vaccinated and added unspecified “test-to-stay” provisions. Most of the district school this week was in-person.

And in Los Angeles, which has had one of the nation’s most ambitious testing programs since 2020, masked parents lined up for blocks at school sites last week to undergo another free test, along with unaccompanied children , it was necessary for every student and teacher to return to campus.

Matthew Prado, 9, standing with his mother and younger brother outside a school testing clinic in Wilmington’s working-class community, said: “I do the swabs by myself now – it’s like something is tickling my nose with a feather Is.” Near the port of Los Angeles. “It’s just normal.”

But the Los Angeles program also underscores the resource intensiveness of effective testing. The Los Angeles Unified School District was the first district in the country to introduce comprehensive school-based testing. The initiative – which includes more than 600,000 students and staff – relies on PCR tests provided to the district by SummerBio, a Bay Area startup, for about $12. The company, which has designed an automated system to cut costs and speed processing, is contractually bound to provide results overnight.

As classes reopened in the fall, the district required all returning students and staff to take baseline tests, then to re-test weekly regardless of vaccination status as a condition of in-person instruction. The strategy caught thousands of potential outbreaks and eased labor concerns over workplace safety.

But even at its relatively low cost — about half the cost per testing district that the state has negotiated with another vendor for its tests — Los Angeles Unified is spending about $5 million per week on coronavirus testing, says Nick Melvoin. , said the vice-chairman of the school board.

“We were getting ready in November to pull back on testing because of cost — then the omicron hit,” Melvoin said, noting that the advent of vaccines had significantly reduced the number of cases and the risk of serious disease.

With more than 400,000 tests in Los Angeles schools as of Monday, the Omicron challenge, at least for the short term, was clear: About 15% were positive.

This article originally appeared in the new York Times,