COVID-19 Testing in Schools Why It Matters and How to Advocate for It

Why is screening testing important in schools?

Screening testing is a crucial tool for limiting transmission of the virus, especially in settings where large groups of individuals gather indoors. PK-12 school environments are especially vulnerable to asymptomatic transmission of the virus, not just because of number of people indoors in close proximity, and given varying degrees of mitigation measures in place, but also because of the characteristics of the population. School facilities are full of children under 12, who have not been approved for vaccination, and those age 12 to 17, who are vaccinated at lower rates than the adult population; they are also more likely to be asymptomatic or have mild symptoms when they are infected, although they can still transmit the disease.¹ 

Studies have shown that screening testing, in combination with other mitigation measures such as masking, distancing and increased ventilation, can allow schools to continue in-person learning by identifying infected individuals and stopping additional spread to others in the school.²

1. At this time, all elementary school-aged children (children under 12) are not eligible to be vaccinated. Vaccine-eligible children age 12-17 are vaccinated at a far lower rate than the adult population. https://covid.cdc.gov/covid-data-tracker/#vaccination-demographic

2. A large study of six K-12 testing pilots, conducted even prior to the rise in the Delta variant, found that weekly testing of all students, teachers and staff could reduce in-school infections by an estimated 50% (https://www.mathematica.org/news/research-supported-by-the-rockefeller-foundation-strengthens-the-evidence-base-for-reopening-k-12); the CDC highlighted a study of a high school COVID-19 testing program in Utah – Test-to-Play for extracurricular activities and Test-to-Stay for in-person learning – which facilitated completion of 95% of extracurricular competition events and saved an estimated 109,752 in-person instruction student-days (https://www.cdc.gov/mmwr/volumes/70/wr/mm7021e2.htm).

What resources are available for schools to provide testing?

Federally-funded programs for COVID-19 testing in schools are available through the Centers for Disease Control and Prevention (CDC)¹ and the U.S. Department of Health and Human Services (HHS)², including $10 Billion in funding, which the Biden Administration is calling on all schools to use to set up regular testing for students and staff in all K-12 schools.^3,4,5

1. Guidelines for the CDC’s program, Epidemiology and Laboratory Capacity (ELC) for Reopening Schools, can be found here: https://www.openandsafeschools.org/elc

2. HHS’s Operation Expanded Testing is divided up into geographic hubs. Information on free K-12 testing for 26 states in the Northeast and South can be found here: http://www.operationet.com/; information for the Midwestern hub here: https://www.testedandprotected.org/#/; and information for the Western hub here: https://letsendthistogether.com/.

3. A new White House fact sheet provides detail on the January 12 federal government expansion of school testing resources. Another White House fact sheet lays out the administration’s approach to promoting screening testing in schools.

4. The Rockefeller Foundation has additional resources, like a helpful startup guide for screening testing that includes links to additional resources and a frequently asked questions document for families.

5. Department of Education guidance for school districts on using American Rescue Plan funds to provide incentives to parents and guardians to participate in screening testing programs.

What are the best practices for screening testing in schools?

The CDC provides recommendations on screening testing in schools and detailed resources available from non-governmental organizations that have developed testing protocols.¹ The best practices for school-based testing include recommendations for:  

• Testing strategies for either pooled testing, which tests a larger number of samples and is recommended where positive cases are unlikely, or for testing a random sample of at least 10% of students
• Testing at least once a week, including weekly testing for all high-risk sports and extracurricular activities in all communities and twice weekly for these activities in areas with substantial to high community transmission
• Reporting results within 24 hours
• Ensuring informed consent of parents and students
• Conducting contact tracing while maintaining the confidentiality of test results, in accordance with requirements of the Health Insurance Portability and Accountability Act (HIPPA), Americans with Disabilities Act (ADA), and the Family Educational Rights and Privacy Act (FERPA)

NEA recommends opt-out testing of students, as opposed to requiring parents/guardians to affirmatively opt-in to testing programs. Removing barriers to participation in testing increases the population that is screened, which makes it a more effective tool for reducing transmission and reinforces the sense of collective responsibility of all members of the school community to the health and safety of the community.

1. https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-guidance.html#anchor_1625662107144

How do screening testing programs affect school labor-management relations?

It is important to keep in mind that screening testing that takes place in schools requires staff to oversee the testing process, potentially assist students and staff being tested, ensure that tests are appropriately handled and sent to a lab, and that results are processed and positive cases are addressed. For these reasons, it is very important to think through who will play these roles, and how the work can be accomplished with already-overburdened staff or with outside service providers.

Where collective bargaining takes place, the workforce implications of screening testing must be addressed within the context of existing agreements and requirements for negotiations. Even where collective bargaining does not take place, engaging association representatives to determine the process for a screening testing program and to discuss its implications is a fundamental part of making sure screening testing programs are effective.

Can Elementary and Secondary School Emergency Relief (ESSER) Fund and the Governor’s Emergency Education Relief (GEER) Fund be used to facilitate screening testing in schools?

Yes, American Rescue Plan Act (ARPA) funds can be used to help implement screening testing programs. The United States Department of Education has made that absolutely clear: “Because ESSER and GEER funds may be used for public health protocols including, to the greatest extent practicable, policies in line with guidance from the CDC for the reopening and operation of school facilities to effectively maintain the health and safety of students, educators, and other staff, providing COVID-19 testing is an allowable use of ESSER and GEER funds.” This means that funds may be used to hire staff and facilitate the administration of COVID-19 testing. Even where school district plans for the use of funds do not explicitly address screening testing, general provisions about implementing mitigation strategies or following CDC guidance is likely to be broad enough to incorporate such spending for screening testing. Also, keep in mind that a district plan on the use of funds is considered a living document that can be revisited and updated, and as tools like screening testing become more widely available, plans may be updated to include spending for these measures.

What about isolation and quarantine when there are positive cases?

One of the most frequently cited concerns about testing is that a positive test result is disruptive and inconvenient for the students and families and the staff members who must isolate if positive or quarantine if they are close contacts.¹ However, it is important to recognize that the individual inconveniences that arise as a result of screening testing are outweighed by the public health benefits for the entire school community and can help schools avoid outbreaks that may require broader and longer term shut-downs and can cause serious illness or death.

1. The CDC’s general definition of “close contact” is anyone who was within 6 feet of an infected individual for at least 15 minutes total over a 24-hour period; however, the CDC provides an exception for K-12 classroom – students who were within 3 to 6 feet of an infected student, if both were wearing well-fitting masks do not need to be considered “close contacts.” https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/appendix.html#contact. The CDC’s quarantine recommendations for close contacts also depend on vaccination status. Unvaccinated people are advised to quarantine for 10-14 days, or at least 7 days with a negative test after at least day 5 following exposure; whereas, vaccinated students, teachers and staff with no COVID-19 symptoms do not need to quarantine, but it is recommended that they be tested at least 3-5 days following exposure. https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html; https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/appendix.html#contact

What steps can school districts and educators take to reduce the burdens of quarantine requirements on students, families and staff?

Get Vaccinated!
Everyone who is eligible to be vaccinated – students, parents, and teachers and staff – should get vaccinated unless they are in the small minority of people for whom there is a medical reason not to. Increasing vaccination rates in the community will bring down the overall COVID-19 case rate and thereby reduce the number of positive cases in schools. In addition, vaccinated individuals who are exposed and do not develop any symptoms of COVID-19 are not required to quarantine (but should get tested 3-5 days after exposure and continue to wear a mask indoors).

Visit NEA's Vax To School to learn more

Plan for continued educational services 
It is crucial that schools have in place and communicate to families the plan for continued educational services when students and/or educators quarantine, including how students can continue learning from home when individuals students, a cohort or an entire class is required to quarantine. 

Provide quarantine and COVID-related sick leave 
Educators need to be able to stay home when they are ill, experiencing symptoms of COVID-19, or have been advised to isolate or quarantine, without loss of pay or fear of retaliation. “Quarantine” refers to remaining separate from others to determine whether or not someone is infected, while “isolation” refers to someone who is sick with a disease remaining separate from others until recuperated. With the expiration of the federal program that provided for COVID-related paid sick and family leave, many educators are concerned about exhausting their leave if they test positive for COVID-19. Local unions and school districts must bargain, where required, and collaborate where bargaining is not required, to address the unique challenges posed by quarantines, including providing additional leave.

CDC’s Take on Test to Stay
According to CDC:

“Test to Stay combines contact tracing and serial testing (testing that is repeated at least twice during a seven-day period post-exposure) to allow asymptomatic school-associated close contacts who are not fully vaccinated and do not test positive for SARS-CoV-2 to continue in-person learning. Because fully vaccinated close contacts are not required to quarantine following exposure, they would not be included in Test to Stay. Students who participate in Test to Stay should consistently and correctly wear masks while in school and should stay home and isolate if they develop symptoms or test positive for SARS-CoV-2. In the studies done in Illinois and California, both the person with COVID-19 and the close contact had to be properly masked at the time of exposure to qualify for Test to Stay. If schools are considering implementing Test to Stay, they should also have robust contact tracing in place and access to testing resources (for example, testing supplies and personnel to conduct testing, or access to an existing community testing site), among other layered prevention strategies. Testing frequency can vary (for example, from twice in a seven-day period to daily), but more frequent testing can more quickly identify students who become infected with SARS-CoV-2 and need to isolate.”

“Schools may consider Test to Stay as an option for keeping asymptomatic school-associated close contacts who are not fully vaccinated and do not test positive for SARS-CoV-2 in the classroom as an alternative to traditional quarantine at home. Because Test to Stay can be resource intensive, it may not be a viable option for every school. School district administrators and local public health agencies should make efforts to ensure that such strategies, if offered, are available in an equitable way among students and across schools and comply with all applicable laws, regulations, and policies, including those related to privacy and confidentiality. Administrators should ensure that students who are isolating or in quarantine at home have adequate access to remote learning options and that they and their families receive support and follow-up to promote learning and minimize disruption.”

“Some states and local jurisdictions offer publicly available plans and protocols that describe how they conduct Test to Stay. Their plans may include eligibility criteria for and duration of in-school monitoring, testing type, how often to test, and other relevant considerations. Contact your state or local health department or visit their website to learn more about whether Test to Stay is being implemented in your area.”