For example: If all the third-grade students are in one pool and the pooled test is negative, then it can be assumed that all third-grade students are negative. If the pooled test is positive, students are then quarantined and individually tested to narrow down the positive case(s). Because of this step, pools should be 5 to 25 people per pool–small enough that individual testing can be done quickly in the case of a positive test result.
With weekly testing, this reduces the potential spread of COVID-19 even in the event that a pool tests positive. And students who test negative within a positive pool can return to school immediately, reducing or eliminating any lost in-person time. Approximately 1.5 percent of pools across the country currently test positive. This approach allows the majority of students and teachers to safely return to full-time in-classroom learning while minimizing the risk of a major outbreak.
Do all students need to participate?
CDC data shows infection and hospitalization rates among U.S. children ages 14-17 rising, with children 6-13 closer to the national average. While vaccinations for younger groups may slow this trend, vaccines are not yet approved for children under 12. According to district supervisors already doing pooled testing, most parents participate because regular, proactive testing offers peace of mind that students are less likely to get ill or bring COVID-19 home to other family members.
Schools should clearly communicate the testing process and protocol to parents, also explaining that there is no cost to participate, and your test provider can provide materials to aid in this communication. Schools may want to consider additional options, like mandating vaccines or masks for students who opt out of testing. But state- and district-level policies may differ on vaccines and masks so make sure you have a clear understanding of all options available. Accommodations also may need to be addressed for any students with special requirements.
How do schools administer the tests?
The K-12 National Testing Action Program (NTAP) recommends weekly testing of individual pools. Depending on the size of the school, tests can be administered all on the same day, or staggered by pool. School personnel can be easily trained to operate and monitor on-site sample collection, and most students can perform the nasal swab collection themselves with adult oversight. For students, the nasal swab is less invasive than the familiar deep swab available at testing sites, so it is easy for younger students, even kindergartners, to use. To date, thousands of schools are already testing regularly. For additional resources, view this checklist that the CDC and Shah Foundation have developed to help schools get started.
How fast do schools get the test results?
Training and setup to do pooled testing typically take a few weeks. Once school personnel are familiar with the process, pools can be created, collected, and administered in a matter of minutes. Pooled samples are packaged according to the instructions from the testing facility and samples are sent immediately to the lab. The Helix lab maintains, on average, a 24-hour turnaround time for samples, meaning that results are available quickly in order to act on any positive pool result or individual test. The lab also has the ability to conduct rapid follow-up for individual testing.
The National Institutes of Health (NIH) Rapid Acceleration of Diagnostics (RADx) program is working with clinical labs to ensure that school testing is available across the U.S. The country’s largest COVID-19 testing labs have been engaged, allowing hundreds of thousands of samples to be tested every day.
How do teams get started with pooled COVID-19 testing?
In order to effectively roll out and manage pooled COVID-19 testing, districts and schools should first create a plan for testing. It’s important to consider your own student make-up, volume of students, and ages in order to design a program that works for all students. Keep in mind that smaller pools are easier to manage in case a pool needs to be individually tested. Younger students may need more oversight than older ones. Also, plan to pool students into groups that have minimal cross-contact.
School administrators should identify a testing oversight team, a weekly testing team, and include all relevant health and safety team members. Before starting any testing, make sure to contact parents or guardians to confirm participation, and put a plan in place for any non-participants or students with other needs. Designate sample collection areas within the school and create any signage or instructional information needed to help students administer their own swabs. Testing partners can assist with set-up as needed.
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