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- Epidemiologist and health economist
WASHINGTON — In hopes of keeping schools functioning normally as a new surge fueled by the Omicron variant appears to be on its way, the Biden administration has endorsed a new strategy called “Test to Stay,” intended to prevent students from having to undergo lengthy quarantines at home if they’ve been exposed to the coronavirus in the classroom.
Instead, students can keep going to school, provided that they are tested for COVID-19 regularly and don’t show any signs of illness.
“Test to Stay is an encouraging public health practice to help keep our children in school,” Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said during a Friday briefing of the White House pandemic response team, which came as infection rates are rising in many parts of the country.
“That testing needs to be at least twice during the seven-day period after exposure,” Walensky said on Friday, and reiterated the need to keep masking in schools.
The new approach, abbreviated as TTS, relies on the availability of rapid antigen tests, which remain expensive and difficult to obtain in many parts of the country. Nor does the CDC endorsement mean that state and local officials will move to implement the new guidance.
Still, the move amounted to “a huge improvement over the previous regimen, which resulted in long quarantines for kids that served no public health purpose,” Dr. Jay Bhattacharya, a Stanford professor of medicine who has frequently been critical of the Biden administration’s pandemic response, told Yahoo News in a text message.
Keeping schools open will be a critical test for the White House in the coming weeks, which will present a complex combination of challenges: cold weather, the spread of the Omicron variant and the increased personal interactions that the holiday season brings.
A winter surge is imminent, health authorities agree, but how much that surge will disrupt everyday life is debatable. Few disruptions have been as pronounced as school closures, which the Biden administration has promised to avoid.
“All students should be able to access their classrooms five days a week,” Education Secretary Michael Cardona said in a statement that followed Walensky’s description and endorsement of the Test to Stay approach, which some states have in fact been using for months.
To make the case for TTS, the CDC on Friday released two studies — one conducted in Los Angeles and the other in suburban Chicago — that showed that the approach was safe and effective. “A school-based TTS strategy does not increase school transmission of SARS-CoV-2, and might greatly reduce loss of in-person school days,” one of those studies said, using the scientific name for the coronavirus pathogen.
The study conducted in Los Angeles found that quarantines led students to lose 92,455 school days during a five-week period earlier this fall.
The new testing protocol is supposed to be used in concert with other measures, including vaccination, now available to children over age 5. “In both studies, masks were worn consistently and correctly,” Walensky said. Republican governors have in some cases banned masking in schools, while Democrats have insisted on the measure.
Researchers did acknowledged “barriers to implementation,” in particular “resources that are not available for some schools.” That could include nurses to conduct the tests, as well as the diagnostic tests themselves.
“Test to Stay is an important tool to keep children in school; however, the effectiveness of TTS programs has been limited by insufficient investment of resources in implementation,” Dartmouth College public health expert Anne Sosin told Yahoo News in a text message. “Lack of sufficient attention to program implementation and investment in program staffing will limit the effectiveness of TTS programs and exacerbate educational disparities.”
Ideally, Test to Stay would use tests that return results within minutes. But such rapid tests have been difficult to find, especially in large quantities, despite recent investments by the Biden administration.
“Antigen tests are key for TTS,” Stanford’s Bhattacharya told Yahoo News. Maryland has made rapid testing supply a priority, with Gov. Larry Hogan recently securing a supply of 500,000. But the state is far more exception than rule.
Laboratory tests are widely available — and more accurate than their at-home counterparts — but the several days it takes to receive results makes them an impractical tool to determine if a child should attend school on a given day.
“Coming up on day three of waiting on a negative PCR so my kid can return to school,” went a recent lament from Emily Oster, a Brown University economist who has been a forceful advocate for in-person instruction. “This is unacceptable. I have resources/can work from home. But a lot of people do not.”
The mere fact that schools are open has made this school year a marked improvement over the one that preceded it, with children no longer learning on Zoom. Studies have found that remote learning, which many educators and public health officials believe went on much longer than needed, turned out to be an educational and social debacle few are eager to repeat.
Quarantines for school-based exposure were seen as a means to keep schools open while addressing safety concerns, especially with the Delta variant sweeping across the Southeast as classes began in August. The CDC recommended 14-day quarantines for exposure, a guidance some states simply disregarded and others reworked to meet their own goals.
In response to parents’ frustrations, New Jersey cut its quarantine period to seven days on the same day that the CDC released its new strategy to prevent quarantines.