Test-to-Stay Implementation in 4 Pre-K-12 School Districts

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Educational Policy

Background:

• COVID-19 significantly disrupted children's education globally.
• School-based transmission mitigation strategies are crucial for maintaining in-person learning.

Purpose of the Study:

• To evaluate the impact of the Test to Stay (TTS) policy on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission.
• To assess the potential of TTS in preserving in-person learning in US school districts.

Main Methods:

• Analysis of data from 4 US school districts (September 13–November 19, 2021).
• Inclusion of index cases, close contacts, TTS participation rates, and testing results.
• Calculation of secondary and tertiary attack risks and theoretical in-person learning days saved.

Main Results:

• TTS participation ranged from 22% to 79% across districts.
• Secondary attack risk among TTS participants: 2.2%–11.1%; Tertiary attack risk: 0%–17.6%.
• Estimated 976–4650 days of in-person learning were potentially saved.

Conclusions:

• Test to Stay is effective in preserving in-person learning.
• Factors influencing TTS participation include testing access, communication, and resources.
• Continued layered prevention and consideration of community transmission are vital for TTS success.