Every week, about two-thirds of teachers and staff in the White River School District, south of Enumclaw, voluntarily head to the school gymnasium or commons. There, nurses with swabs in hand test them for COVID-19.
Results are ready in just 15 minutes. In the past two months, about a dozen staff and students in this district of 3,700 children have received a positive result on the rapid test. Many weeks, everyone is in the clear.
Testing is voluntary and is mostly for teachers and staff. The district initially offered tests to elementary school students but is now using them more sparingly, such as when students return from breaks.
White River, which is teaching 85% of its students in person, is among 13 Washington school districts piloting coronavirus testing on school grounds. Quick coronavirus tests are among the many tools — and one of the most expensive — that school officials are considering as they reopen school buildings.
The biggest lesson, district staff say, is that testing alone does not prevent coronavirus spread in schools, although it does offer peace of mind because school officials can act quickly if a test comes back positive. Testing has also underscored that COVID-19 doesn’t spread readily in a school setting. And, some school officials are convinced it isn’t worth the cost.
“If you do testing it can be an early warning sign if there is going to be an increase in transmission,” said Charissa Fotinos, deputy chief medical officer at the Washington State Health Care Authority, which oversees state health care programs. “It’s not the only answer to getting kids back in school, but it can be very helpful in guiding decisions.”
Some districts have enough tests on hand to use them as a surveillance tool. When positive cases crop up, staff immediately quarantine whoever is infected and begin to trace the person’s close contacts. Other districts, such as Spokane, offer testing at school to help bridge an access gap for families who lack transportation or face other barriers to getting a test.
The initial pilots were intended to offer school staff and families access to same-day testing, Fotinos said. An additional 55 districts are considering launching testing, she said, but none of these districts are located in or near Seattle. State officials say they don’t keep records on the number of tests schools have provided, or how many have come back positive.
But data from two other school districts suggest that, as White River has found, cases in schools are rare. Eatonville and Peninsula school districts, which also piloted coronavirus testing in the fall, together recorded 18 positives out of nearly 5,000 rapid tests. A Jan. 13 report on all three pilot programs suggests that only .2% of those tested were infected.
The findings are preliminary, and health officials are preparing a final report on the pilots this month. The initial data fits with recent peer-reviewed studies that suggest coronavirus isn’t common in schools and is unlikely to spread within their walls. The findings also align with a fall report from the Institute for Disease Modeling that suggested testing wouldn’t add much preventive benefit if schools have other safety measures in place.
There’s no dedicated funding stream for testing in schools, so districts are piecing together funds through partnerships with local and state health agencies. The White River, Peninsula and Eatonville pilots, for instance, were created through a partnership with the Tacoma-Pierce County Health Department and funded through $7.8 million in federal CARES Act funding.
Since they launched in the fall, the three districts have tested more than 4,000 people using nearly 10,000 tests.
In White River, tests are one part of a lengthy list of safety protocols, including using a hybrid model that includes some in-person learning and allows for social distancing. There is an emphasis on hand-washing and mask-wearing, and a requirement that staff and students attest that they don’t have coronavirus symptoms if they come on campus.
Jer Argo, director of business and operations for the district, said judging the success of the effort is difficult.
“When you are testing hundreds and hundreds — thousands — per week, and it’s crickets, you’re not getting any positive results back, from a financial standpoint it would be hard to justify continuing to do that,” he said. The district has used tests that range in cost from $5 to more than $100 apiece.
But testing has offered an “added sense of security for many staff members who are nervous,” he said. The effort has identified a small number of people who were asymptomatic — people who may have unknowingly infected others had they not received a test.
Some districts are using testing to supplement broader community efforts to track cases and help infected people find care.
Spokane Public Schools began drive-thru polymerase chain reaction (PCR) testing on Jan. 11. Unlike more rapid versions, PCR tests return results within 48 hours but are generally more reliable than their faster counterparts. The district wanted to offer testing to staff, students and their families since some people in the community have struggled to get tested elsewhere.
Those families often lack transportation, health insurance or a primary care provider, said Rebecca Doughty, the district’s director of health services.
Case counts are high in Spokane, she said, so “we’re just getting a handle on the flow of the increases in cases coming in. Maybe drinking from the fire hose a little bit.”