Pooled testing would prevent COVID from spreading to schools

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In summary

Communities and school districts need to take proactive measures, such as pool testing, to keep COVID transmission low and children in school.

By Karen Smith, Special at CalMatters

Infectious Disease Specialist Dr. Karen Smith is a partner in Healthy Community Ventures, a consultative collaboration. She also served as Director of the California Department of Public Health under Governor Jerry Brown.

While California schools have programs in place to help keep kids in the classroom while keeping COVID-19 out, these new programs and the protocols in place can be confusing.

As a former California State Public Health Officer and Doctor of Internal Medicine and Infectious Diseases, I have a deep empathy for the anxious place many families find themselves in. I also know that if we work together we can promote our collective health – in all of its mental, physical, economic and educational dimensions – throughout the school year.

Consider the evolution of the pandemic this school year. We started with a first wave of cases in schools, coinciding with our return to school after a year of home schooling. Since then, reported infections and hospitalizations have steadily declined, testifying to the effectiveness of prevention strategies on several levels: vaccines, masks, sanitation, social distancing and testing.

Nevertheless, young people still represent a large part of new infections today. The winter months – when more activity takes place indoors, making it harder to stay away – threaten to fuel spikes in COVID cases. This is also the season when the flu and other respiratory infections are on the rise.

Without continued COVID testing strategies, this combination will make it difficult for parents and schools to tell if a child’s runny nose is due to a cold, COVID, the flu, or any of the other respiratory viruses that we know every winter.

It’s going to be very difficult to keep the kids in school if we have to send every kid home with a sniffle because we don’t know if it’s a simple cold or a COVID infection putting life threatening.

Just as children suffer from illnesses, they also suffer from isolation and disrupted learning if they cannot attend school in person. It is paramount that we do everything we can to make sound, science-based decisions that keep more children in 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 steps to keep COVID transmission low and children in school. The most effective way to do this is to detect transmission from symptomless individuals before a few cases become a rapidly spreading epidemic.

The best way to determine whether prevention efforts are keeping transmission low is to systematically test for COVID in a school population, even among those who are asymptomatic. This forces schools to take tests only on students with symptoms to tests on groups of students without symptoms.

So how do we do this in a way that doesn’t disrupt classrooms?

Since the early days of the pandemic, I have been a proponent of “cluster testing” in circumstances where COVID transmission is low. In a school setting, pooled testing involves regularly testing up to 25 children in a classroom, cohort or sports team at the same time and combining these samples (without individual identification) into a single laboratory test that can detect the presence of the virus in the group.

If a group of samples is positive – and, statistically, they will be extremely negative – all students in the positive group are individually tested to identify who is infected and who is not, so that appropriate action, such as quarantine, is carried out. can be taken to limit transmission.

Pooled testing is easy, economical, fast, and much less reliant on rare antigen rapid test kits.

In addition, pooled testing is very effective in identifying asymptomatic infections that are the main source of transmission, even without full participation in a group or classroom. There is a bundled testing program offered free of charge to all California K-12 public and charter schools through the California Department of Public Health. The program also provides, in most cases at no cost, the personnel required to perform the tests. This can reduce the workload of already overworked school staff.

Now that the kids are happily back to school, clustered COVID testing can prove to be a vital tool in keeping kids healthy and in school, keeping COVID out of classrooms, and helping us. keeping all of us confident that we are doing all we can to support one another during this unprecedented school year.


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