Implementing Covid-19 Routine Testing in K-12 Schools: Lessons and Recommendations from Pilot Sites
- Modeling results showed that routine testing can greatly reduce or eliminate within-school Covid-19 transmission. For higher-risk schools relying on testing to reduce within-school transmission, pooled PCR testing is generally the most effective strategy. Serial antigen testing is a close second. However, the most effective strategies for decreasing transmission also increase the number of in-person school days lost, and schools will need to weigh this tradeoff.
- Community engagement and buy-in from key stakeholders are critical to the success of a testing program. Effective communication and simplified informed consent processes can a long way in building trust in testing programs and boosting participation rates.
- Schools will need guidance, coordination, and resources from federal and state authorities to start or continue routine testing programs, which are challenging and resource-intensive to implement.
In the 2020–2021 school year, many schools and districts around the country implemented routine Covid-19 testing to proactively detect cases among teachers, students, and staff and stop the spread of the virus. Even as public attention has turned to vaccines, testing remains essential for making schools a safe and trusted environment because it offers an important layer of protection. Furthermore, new federal funding provides school districts with the resources necessary to implement and sustain routine testing programs through the coming school year. The Rockefeller Foundation’s K–12 Testing Protocol Demonstration Project included six sites (states, cities, and school districts) partnering with Duke-Margolis Center for Health Policy and Johns Hopkins University to implement routine Covid-19 testing in 335 locations across the country between September 2020 and June 2021. As the learning partner for this effort, Mathematica drew on the experiences of pilot sites to identify key lessons about the acceptability, feasibility, and effectiveness of routine testing programs, and used agent-based modeling to understand the potential effectiveness of different routine testing strategies for reducing within-school COVID-19 transmission and minimizing lost in-person school days. The findings may provide useful insights for other schools interested in implementing routine Covid-19 testing programs. As part of this work, Mathematica also developed a K–12 testing impact estimator, based on modeling results, that schools and districts can use with their public health partners to assess the potential impact of different testing strategies under various contexts.