SARS-CoV-2 Screening Testing Programs for Safe In-person Learning in K-12 Schools

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Control

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening testing is recommended for schools.
• Limited information exists on the implementation of school-based testing programs.

Purpose of the Study:

• To describe the implementation and outcomes of SARS-CoV-2 screening testing programs in K-12 schools.
• To evaluate the cost-effectiveness and yield of different testing strategies.

Main Methods:

• K-12 students and staff participated in voluntary screening testing during the delta and omicron variant waves.
• Testing included school-based rapid antigen/PCR, at-home rapid antigen, and off-site nucleic acid amplification tests.
• Two program structures were compared: a public health initiative and a research study.

Main Results:

• Nearly 5700 tests were conducted on over 1600 individuals across ten schools.
• Costs per test ranged from $70 to $132, with costs per positive result between $4818 and $7076.
• SARS-CoV-2 positivity rates in schools were generally lower than community rates.

Conclusions:

• Voluntary SARS-CoV-2 screening testing in K-12 schools is expensive.
• These programs rarely detect asymptomatic positive individuals, particularly in universally masked environments.
• The findings suggest a need to re-evaluate the utility of widespread screening testing in schools.