Communities and education departments should take proactive measures, such as pool testing, to keep COVID transmission low and keep children in school.
By Karen Smith, for CalMatters
Dr. Karen Smith, an infectious disease specialist, is a partner at Healthy Community Ventures, a cooperative advisory society. She also served as director of the California Department of Public Health under Governor Jerry Brown.
While California schools have implemented programs to help keep children in class while keeping COVID-19 out, these new programs and protocols can be confusing.
As a former California public health official and a physician in internal medicine and infectious diseases, I have deep sympathy for the anxious place so many families are. I also know that if we work together, we can enhance our collective health – in all its mental, physical, economic and educational dimensions – as the school year goes on.
Consider the evolution of the epidemic this school year. We started with an early wave of cases in schools, coinciding with our return to school after a year of homeschooling. Since then, reported infections and hospitalizations have steadily declined, which is evidence of the effectiveness of multi-layered prevention strategies: vaccines, masks, sanitation, social distancing and testing.
However, young people still account for a significant amount of new infections today. The winter months — when more activities move inland, making distance more difficult — threaten to fuel spikes in COVID cases. This is the season when influenza and other respiratory infections are most common.
Without ongoing COVID testing strategies, this kit will make it difficult for parents and schools to know if a child’s runny nose is caused by a cold, COVID, influenza, or any of the other respiratory viruses we encounter every winter.
It would be very difficult to keep kids in school if we had to send every kid sniffed because we don’t know if it’s a simple cold or a life-threatening COVID infection.
Just as children suffer from illnesses, they also suffer isolation and interruption of learning if they cannot attend personal education. It is critical that we do everything we can to make sound and science-based decisions to keep more children in the school where they belong while protecting them and the community from COVID-19.
Amid all the uncertainty, one thing is certain: Communities and school districts must take proactive measures to keep coronavirus transmission low and keep children in school. This is most effectively done by capturing transmission from asymptomatic individuals before a few cases become rapidly spreading outbreaks.
The best way to gauge whether prevention efforts are keeping transmission low is to routinely test COVID among school students, even among those who are asymptomatic. This requires schools to switch from testing only symptomatic students to testing groups of students without symptoms.
So how do we do it in a way that doesn’t disrupt the classroom?
From the early days of the pandemic, I have been a proponent of “pool testing” in settings where COVID transmission is low. In a school setting, pool testing is the practice of regularly testing up to 25 children in a classroom, group or sports team, at the same time and combining those samples (without individual identification) into a single lab test that can detect the presence of the virus in the group.
If any group of samples is positive—and statistically, it will be significantly negative—all students in the positive group are tested individually to identify infected and non-infected ones, so that appropriate measures, such as quarantine, can be taken to limit transmission.
The combined test is easy, cost-effective, fast and less reliant on rapid antigen test kits that are in short supply.
In addition, pool testing is very effective in identifying asymptomatic infections that are the largest source of transmission, even without full participation within a group or classroom. There is a pooled testing program offered at no cost to all California public and charter schools from kindergarten through high school through the California Department of Public Health. The software also provides, at no cost in most cases, the personnel needed to take the exams. This can reduce the workload of already overburdened school staff.
Now that kids are fortunately back in school, a pooled COVID test can prove to be an essential tool to keep kids healthy and in school, by keeping COVID out of the classroom, and keeping us all confident that we’re doing our best to support one. Another during this unprecedented school year.