Schools must have a testing strategy for COVID | Opinion

Bringing our children back to the classroom safely will require a layered protection approach. Masks are one part of that approach. So is continued ongoing testing, says Myles Spar, M.D., of Vault Medical Services.

By Myles Spar

There should be no doubt that Gov. Phil Murphy’s decision to mandate masks for school children and their teachers is the right public health decision. As the governor correctly said, to not mandate the use of masks puts children at risk.

From higher education down to K-12, schools at this very moment are taking steps that frankly, none of us had hoped would be necessary. We had hoped to be returning to life without masks, tests and social distancing. Unfortunately, all measures are trending in the wrong direction, as the more contagious Delta variant becomes widespread throughout the country. Statewide positivity here in New Jersey continues to increase, as does the number of children needing to be hospitalized from the Delta variant.

Vaccination is still the best option available to us to defeat this virus. And thanks in part to the more than 341 million vaccine doses administered in the United States, the Centers for Disease Control and Prevention (CDC) has strongly recommended that K-12 schools return to in-person learning after an unprecedented period of at-home and hybrid environments. I’m pleased to see that Governor Murphy agrees with that priority and is actively working on how to do that while keeping teachers, students, and staff safe.

There are still many people who are unable to be vaccinated, including children under the age of 12. Bringing our children back to the classroom safely will require a layered protection approach. Masks are one part of that approach. So is continued ongoing testing. Despite the guidance from the CDC and other federal institutions, implementing these measures ultimately fall on individual school districts, including a number of barriers and challenges.

Over the past 16 months, we’ve seen schools try just about every approach when it comes to testing. All across the United States, school leaders grappled with the right testing program that fits their needs and their budgets.

There is no “one size fits all solution” to school testing. There are a range of testing models that can be used to ensure the health and safety of a student body, but regardless of which model a school employs, that model should be adapted and modified as time progresses to adapt to a school’s changing needs.

Through our early partnership with Rutgers University, which developed the first FDA-authorized at-home saliva test for COVID-19, we’ve continually worked to employ the best approaches in schools across the country. While there’s clearly no single right way to do school testing, we’ve compiled some lessons and strategies based on what has worked (or didn’t work) and offer some of those lessons here.

The frequency of testing matters. It’s a crucial component of a strong surveillance system. This includes testing at the beginning of the year, an ongoing testing plan throughout the year, widespread testing when an outbreak is identified, and testing after long holiday breaks. Relying on infrequent testing, or only implementing voluntary or reactionary testing has been shown to be ineffective strategies.

There are also important considerations when it comes to the student body and school resources. We’ve seen with younger students, the biggest challenge is supervision for proper sample collection. For older students, they need supervision for compliance, to make sure they’re really taking the test the proper way. Schools also have limited resources, so it’s important to keep in mind whether a strategy like pooled testing can help bring down costs.

And of course, school leaders need to be continually plugged into local community considerations. What are the best ways to foster parent participation? What are the current levels of community transmission and percent vaccinated in your county?

There’s no easy answer - and certainly no single right answer. But every school should have a surveillance testing program in place. We saw what happened last fall and throughout the winter.

We have to do better. School leaders should learn from the mistakes and successes of previous waves in this pandemic. They must have a testing strategy in place, to better serve our students, their families, teachers, and staff.

Myles Spar, M.D., is the national medical director of Vault Medical Services.

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