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When schools in Marietta, Ga. Opened on August 3, the highly contagious Delta variant swept south and children were not spared.
As of August 20, 51 students in the city’s small school district had tested positive for the coronavirus. Almost 1,000 others were reported as close contacts and had to self-quarantine at home for seven to 10 days.
“It’s a lot of school, especially for kids who are recovering from 18 months in a pandemic where they missed a lot of school or had to go virtual,” said Grant Rivera, superintendent of Marietta City schools. .
Last week, the neighborhood changed course. Students identified as close contacts can now continue to attend school as long as they have no symptoms and are negative for the virus every day for seven days.
A growing number of school districts are turning to testing to keep more children in the classroom and avoid disrupting their parents’ working lives. The resource-intensive approach – sometimes referred to as a ‘test-to-stay’ or modified quarantine – allows students who have been exposed to the virus to stay in school as long as they take frequent Covid tests, which are usually provided by the school, and adhere to other precautions.
Experts agree that children infected with the virus should self-isolate at home, but the question of what to do with their classmates poses a dilemma.
Allowing children who have been exposed to the virus to stay in school poses a potential risk of transmission, and the Centers for Disease Control and Prevention says it “does not have enough evidence” to support the approach. Instead, he recommends that close contacts who have not been fully vaccinated be quarantined for 14 days. (Close contacts vaccinated can stay in the classroom as long as they are asymptomatic and wear a mask, according to agency school guidelines.)
“At this time, we do not recommend or endorse a test program to stay,” the CDC said in a statement to the New York Times. The agency added, “However, we are working with several jurisdictions that have chosen to use these approaches to gather more information.”
The CDC guidelines mean that a single case of Covid in an elementary school, where students are usually too young to be vaccinated, can force an entire class of children out of school. New York City school guidelines also state that all unvaccinated students must self-quarantine for seven to 10 days if a classmate contracts the virus.
As the academic year has barely begun, some districts in Florida, Louisiana, Missouri and other Covid hotspots have already had to quarantine hundreds or even thousands of students. As of mid-August, Mississippi had nearly 30,000 students in quarantine, according to data released to the state.
A new study, published last week in The Lancet, suggests that the test-to-stay approach may be safe. The randomized controlled trial included over 150 schools in Britain and found that case rates were not significantly higher in schools that allowed close contact of infected students or staff to remain in class with daily testing than in those that required home quarantines.
About 2% of close school contacts eventually tested positive for the virus, the researchers found, meaning schools kept 49 uninfected students out of the classroom whenever a student tested positive.
“When you put that in the larger context of what we do in society, it penalizes young people quite heavily, I think,” said Dr Bernadette Young, an infectious disease expert at the University of Oxford and chief in line. author of the paper.
This summer, the UK announced that children identified as close contacts no longer need to be quarantined, although it encouraged them to be tested for the virus.
As school officials embark on a pandemic third school year, many say now is the time for a new approach.
“The philosophy of this is how can we keep healthy children in school and sick children at home? Said Isaac Seevers, the superintendent of schools for the city of Lebanon in Ohio, who is preparing to start a test program to stay. “I think there is real optimism that this is a game changer in how we learn to live with Covid. “
Test trials
Melissa True Gibbs, a mother of two in Sandy, Utah, would rather not think about last fall. “It was hell,” she said.
In August, her soccer-playing daughter Lydia and acting-loving son Brody attended Alta High School.
At the end of September, with the increase in Covid cases, the school closed its doors and switched to online learning. Two weeks later, he switched to a hybrid schedule – in which students came to school on certain days and learned from home on others – then again in person, then again in hybrid, then again fully online. as the number of cases increased again. .
“My kids are pretty tough,” Ms. True Gibbs said. “But man, that first semester of that year, I saw things going on with my kids that scared me. They weren’t well emotionally, they weren’t well mentally, they were struggling. .
Many other Utah schools have had similar experiences. So, with winter approaching, officials worked out a testing protocol to stay. Small schools that had 15 cases, or larger ones that had a 1% infection rate, could either switch to online learning or host a mass testing event. Students who tested negative could return to class, while those who were infected or whose families had not consented to the test would stay at home.
Thirteen schools, including Alta High, have held test events to stay at the start of this year. Only 0.7% of 13,809 students tested positive, researchers reported in May.
“It really convinced us that pursuing in-person learning at these schools was the right choice,” said Dr. Adam Hersh, pediatric infectious disease expert at the University of Utah and co-author of the ‘article.
The program saved more than 100,000 in-person student days last winter, the researchers found.
Ms True Gibbs said the testing program allowed her children, who tested negative, to continue going to class, training and rehearsing. “For my children, it made them feel safer because they knew the students who were in school were not sick,” she said.
In March, the state passed a law requiring schools to hold test events to stay when they hit certain epidemic thresholds.
Other schools and districts adopted similar solutions, focusing on testing only students who had been identified as close contacts.
Some states, including Illinois, Kansas, California, and Massachusetts, have now set their own modified stay or quarantine testing protocols, as have some local districts elsewhere. More than 2,000 Massachusetts schools use the state’s procedure, which allows close contacts to stay in school as long as they are asymptomatic, wear a mask, and test for the virus daily for seven days after exposure .
Many parents across the country are excited about the new approach. For Monica Fambrough, who has twin daughters in grade two and a son in grade five at Marietta’s school, the first six weeks of school were trying.
“We kind of got a little bit of joy every Friday – we got through the week without being quarantined,” she said. “I just feel like every day that I send them to school, we kind of throw the dice that we’re going to get a close contact notice. And so having the option to keep them in school, even though they’re close contact, is a really big deal for my family. “
Attending classes in person is not only a better educational experience for her children, she said, but also a godsend. for her and her husband, who both work from home.
But Jennifer Shotwell, who has children and grandchildren at school in Missouri, was concerned that allowing close contacts to stay in school could put vulnerable children – like her granddaughter, at risk. , who suffers from an autoimmune disease. “If I could do whatever I wanted, the modified quarantine would not be used at all in her classroom until the students could be vaccinated,” she said.
And some places have more stringent guidelines than others. While Massachusetts and Marietta require daily testing for close contact, Illinois requires testing every other day, and California guidelines say testing twice a week.
Some districts have solved the problem of disruptive quarantines by abandoning the practice altogether. “If you’re a close contact, we don’t require that you stay home during a quarantine period,” said Joe Koch, assistant superintendent of the Waukesha, Wisconsin school district. The school board has taken the approach that “basically it’s up to you how you want to manage Covid for yourself,” he said.
Make it work
For the test-to-stay approach to work, tests must be readily available and easily accessible. So far, relatively few families have opted for Marietta’s program, possibly because they don’t have transportation to the district’s central testing site, Dr Rivera said. (The district hopes to increase the number of testing sites soon.)
In Bay County, Michigan, more than 300 students have already been identified as close contacts, said Joel Strasz, county health official.
“We require that the test be done on site before entering school,” Strasbourg said of the test-to-stay protocol. “It’s pretty manageable if you only have to test five or ten kids. But when you have to test close to 100, it can be difficult, and we had to rush to provide resources to schools. “
Test-to-stay programs are more achievable when paired with other security measures, including masking, experts said. Utah, which required masks in schools last year, banned such warrants this year, and some districts have decided not to do any testing unless they reach the epidemic threshold, said Kendra Babitz, state director of Covid testing.
Robust testing is a “really important” strategy to support in-person learning, said Dr Hersh. “But it’s an operational challenge. So to the extent that we can reduce how often we have to worry about close contact exposures, and everything that goes with that, we’re going to create much more sustainable learning environments.
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