Feasibility and Functionality of SARS-CoV-2 Rapid Testing in K-12 School Health Offices

The COVID-19 pandemic created unprecedented opportunities to introduce rapid SARS-CoV-2 antigen testing (RSAT) into kindergarten through 12th grade (K-12) school settings. We evaluated the feasibility and functionality of Sofia Fluorescent Immunoassay Flu + SARS in 1 school district across the 2021-2022 academic year.

Seven schools in the Oregon School District (Oregon, Wisconsin) were supplied with RSAT analyzers and test kits, along with minimal training of health office staff. We assessed RSAT utilization among schools, rate of invalid results, and comparability to 952 190 reverse transcription-polymerase chain reaction tests performed countywide during the same time period. A feedback survey was distributed to all 13 health office staff to assess respondents' perceptions regarding the feasibility and acceptability of RSAT in the Oregon School District.

Over the school year, 1226 RSATs were performed; SARS-CoV-2 was detected in 103 specimens. Percent positivity was similar to the county level (8.4 vs 9.2%; chi-square = 0.74; P = 0.39). Cross-correlation of weekly positive tests between the Oregon School District and Dane County was maximal with no lag (rs = 0.69; P < 0.001). Health office staff indicated Sofia2 RSAT was easy to perform, and 92.3% reported interest in continuing to utilize RSAT in the upcoming school year.

Implementing a RSAT protocol is feasible and acceptable for monitoring SARS-CoV-2 cases in K-12 school settings. High rates of compliance and confidence in results demonstrate program effectiveness. Continuing to use RSAT in school settings after the urgency of the pandemic subsides could help address future outbreaks of SARS-CoV-2 and other respiratory viruses within schools and in the larger community.