293 - Assessing Testing Strategies for Safe Return to K-12 Schools in an Underserved Population

Poster Number: 293
Publication Number: 293.215

Samantha Hayes, Washington University in St. Louis School of Medicine, Roanoke, IL, United States; Sara Malone, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States; Brittany Bonty, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Summer M. Reyes, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States; Sydney A. Reyes, Washington University in St. Louis School of Medicine, Olympia Fields, IL, United States; Christina Evans, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States; Sewuese Akuse, Washington University in St Louis, St Louis, MO, United States; Tremayne E. Watterson, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States; Jasmine R. Prater, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States; Jamee T. Shelley, Washington State University Elson S. Floyd College of Medicine, St. Louis, MO, United States; Grace Yuan, Washington University in St. Louis School of Medicine, St. Louis, CA, United States; Ian T. Lackey, Washington University in St. Louis School of Medicine, Highland, IL, United States; Albert Lai, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States; Stephanie A. Fritz, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Jason G. Newland, Washington University in St. Louis, St. Louis, MO, United States

Background: Weekly screening testing is a CDC recommended mitigation strategy to prevent SARS-CoV-2 transmission in schools, though limited data support this strategy.

Objective: The objective of this study was to assess the impact of weekly SARS-CoV-2 screening testing on school-based transmission in middle and high schools.

Design/Methods: 16 middle and high schools from five school districts in underserved communities were cluster randomized to: (1) screening plus symptomatic testing or (2) symptomatic testing only. Individuals eligible to enroll in screening testing included students or staff who attended a school randomized to screening, and their household members. Test kits were provided and collected each week at the participants' schools. Students, staff, and household members in all schools were eligible for symptomatic testing. Designated saliva collection sites were located in each school district. The detection of SARS-CoV-2 was conducted through an EUA-approved saliva-based PCR test.

Results: From 5/2021-12/2021, 5,812 tests were performed amongst 2022 individuals. 135 individuals (141 tests) had a positive SARS-CoV-2 result, within which 14 were enrolled in weekly testing and 121 enrolled in symptomatic testing (Figure 1).  Within symptomatic testing, 2,010 tests were conducted during this 8-month period. Of the 504 individuals enrolled in weekly screening testing, 14.1% (n=71) were students, 58.3% (n=294) were staff members, and 27.6% (n=139) were household members (Figure 2). In all but one school district, there was less than 7% of eligible staff and students who were enrolled for weekly screening. On average, 63.31% of enrollees tested 13 of 16 weeks during the Fall semester (Figure 3). Conclusion(s): Screening testing is a feasible mitigation strategy to keep schools open. This testing strategy assists in identifying individuals who are positive if required for all participants. Low enrollment could suggest some acceptability concerns with this strategy, although those who enrolled had high retention rates. While weekly testing has the potential to limit COVID-19 transmission within K-12 schools, additional mitigation strategies should still be implemented to ensure school safety.  
Figure 1: Positives Over Time During the Study
Figure 2: Enrollment Breakdown within Surveillance