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What is “Test to Stay” and Can It Limit COVID Quarantines in Schools?

test to stay
(Image credit: Photo by Mika Baumeister on Unsplash)

In Mississippi, as many as 15 percent of school children have been quarantined since the beginning of the school year. 

Though it is an extreme example of how intense school quarantines can get, Mississippi is not alone. Across the country, tens of thousands of students have already been quarantined. 

With many districts phasing out or significantly scaling back their remote school offerings, these quarantines have the potential to widely disrupt education this year. 

In Massachusetts, education officials hope to avoid these types of disruptions to in-person learning by implementing a “test to stay” policy. ” 

Unvaccinated asymptomatic students who came in contact with someone with COVID are permitted to keep attending school provided they test negative using a rapid antigen COVID test. The students are required to take a test each school day until a week after their initial exposure. They also must be masked at all times while attending school, except when eating or drinking. 

A Good Strategy for Keeping Kids in School 

The CDC conducted a study of a similar testing program last year at Utah schools and concluded it was an effective way to allow more students to participate in in-person learning. Many public health experts agree. 

“The strategy seems to work really well,” says J. Lucian Davis, an MD and epidemiologist, at Yale School of Public Health. “Testing in the classroom doesn't necessarily decrease the prevalence of cases, however, you get rid of all these lost days. So you have the same amount of COVID that's in the classroom, but a much larger number of kids are there.” 

He adds, “it's really great to see people trying to adapt what was done to Utah for other states. Hopefully, they'll have an evaluation process that comes out of the experience of Massachusetts, so that others can learn from how they did.” 

“Test to stay is simple -- and evidence based!” tweeted Michael Mina, an epidemiologist and physician at Harvard’s school of public health and medical school. “Instead of quarantine, rapid test at-home each AM before school. It is 1 minute of hands on time in the morning before breakfast or after brushing your teeth. If negative, go to school. Do that for 7 days instead of quarantine.” 

Potential Limitations  

Amber D'Souza, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, is worried about the potential for false negatives from the rapid tests. “Initial data suggest test performance of these rapid tests is lower in people without symptoms [and] may have false negatives in one out of three of those COVID cases,” she says. “A school strategy of testing COVID contacts daily with a rapid test and allowing them to stay in school has an advantage of allowing those exposed kids who do not have infection to remain in person at school. However, it has the disadvantage that some exposed children who have coronavirus may have a false-negative test and thus could spread the infection at school.” 

D’Souza adds, daily testing helps reduce the dangers from false negatives since it’s unlikely that a student would have two false-negative tests back-to-back, but warns the strategy has risk and should only be implemented along with additional mitigation efforts. “In settings with other precautions like masking and distancing this strategy can be a good option, but when other precautions are not in place this strategy introduces risk,” she says.  

Erik Ofgang

Erik Ofgang is a journalist, author and educator. His work has appeared in the Washington Post, The Atlantic and Associated Press. He currently teaches at Western Connecticut State University’s MFA program. While a staff writer at Connecticut Magazine he won a Society of Professional Journalism Award for his education reporting. He is interested in how humans learn and how technology can make that more effective.