At the beginning of the turbulent 2020-21 school year, Missouri authorities made a big bet. They secured about a million quick Covid tests for schools from kindergarten to high school in the state, hoping to quickly identify sick students and staff.
The Trump administration has spent $ 760 million to raise $ 760 million in rapid response antigen testing from Abbott Laboratories, including 1.75 million assigned to Missouri, a method that seems appropriate to the state. Instructed to use them in. Nearly 400 Missouri Charters, private and public school districts have been applied. Interviews with school officials and documents obtained by Kaiser Health News in response to requests for public records provided one test per person, taking into account supply constraints.
What started as an ambitious plan landed poundingly. Few tests were used. Schools reported using only 32,300, according to state data updated in early June.
The Missouri initiative is a window to the complexity of the Covid test in schools from kindergarten to high school, even before the proliferation of highly infectious delta variants of the coronavirus.
The epidemic of delta variants is about how to safely send children (mostly unvaccinated) who have suffered from high aversion to pandates and low vaccination rates, especially in Missouri. Has plagued the community with emotional battles. Once classes begin, schools need to weigh tests and other strategies to limit the Covid-19 epidemic. The test kit may not be fully supplied.
Missouri educators explained that the test, which began in October, is a blessing for eradicating infected people and reassuring teachers. However, interviews and documents obtained by KHN quickly revealed the logistical challenges. Dozens of schools or districts that applied for prompt examinations listed only one medical professional to manage them. Authorities were hesitant to place too many orders because the expedited inspection was initially set to expire after 6 months. Others are concerned that the test may give inaccurate results and that onsite testing of people with Covid symptoms may spread the infection.
“We were nervous” about the sick children on campus, said Kelly Garrett, executive director of KIPP St. Louis, a charter school with 2,800 students and 300 staff. .. Elementary school students returned to Japan in November. Booked 120 tests for “emergency” situations.
Related: “School nurses here face a moral dilemma because they are in place and the protocols coming from the state do not match their values,” said one expert. ..
Robert Milner, Principal of Hope Leadership Academy, a charter school in Kansas City, said: It’s not that simple. According to Milner, the school was able to mitigate the Covid-19 by taking measures such as temperature checks, mask requirements, physical distance, and even removing the air dryer in the bathroom. In addition, there are “other options for sending a family” in the community for testing.
Public school director Lindel Whittle wrote in a district exam application that “there are no plans to do this exam for everyone, and it’s not our job.” The district’s Iberia RV requested 100 rapid inspections in its October application. This is enough to provide one for each staff member.
“We are a school, not a healthcare provider,” Whittle writes.
“We weren’t shutting down.”
Last year, as the limits of distance learning became apparent, authorities called for a return to school. At some point, Governor Mike Parson said children would inevitably get the virus at school, but “they would get over it.” Despite the increasing number of childhood Covid cases due to delta variants, districts across the country are increasingly being pressured to return to full-time classroom instruction.
Experts say that despite the huge investment in rapid antigen testing, testing in schools from kindergarten to high school is generally limited.Recently, the Biden administration has distributed and increased $ 10 billion through the U.S. Rescue Program. Routine Covid screening At schools in Missouri, including $ 185 million.
Missouri has established a program in which schools from kindergarten to high school regularly test asymptomatic individuals. It relies on a contract with Ginkgo Bioworks, a biotechnology company that provides test materials, training and staff. As of mid-August, only 19 agencies were interested, said Lisa Cox, a spokesman for the Department of State’s Department of Health and Senior Services.
Unlike the Covid test, which uses polymerase chain reaction technology, which can take days to produce results, the rapid antigen test returns results within minutes. Trade-offs: Research has shown that accuracy is low.
Still, for Harry Russell, a high school teacher at Jackson, who is the president of the Missouri Teachers Association, it was a relief to have a quick test, and she wanted them to be tested sooner. Her district, Jackson R-2, applied for it in December and went into use in January, a few months after the school reopened.
“The timeline was tough.” We couldn’t quickly test the students we were thinking of, “she said. “Some of them have just been quarantined.
“In the end, we were facing each other, so I think I was always worried. I wasn’t shutting down,” said Russell, who needed a mask in the classroom. “Testing gives us some control over what we can’t control.”
Allison Dolak, principal of Immanuel Lutheran Church & School in Wentzville, said that small parochial schools have a way to use quick Covid tests for students and staff, but that was tricky.
Dolak said applying for a test is an “easy thing” that helps keep the door open.
“If we hadn’t taken those tests, there would have been so many kids who would have had to learn online,” she said. From time to time, schools in the suburbs of St. Louis had to call on their parents, who were nurses, to take care of them. Drac managed several himself in the parking lot. According to state data in early June, the school took 200 tests and used 132. No masking was needed.
Many schools said they would only test staff, according to the application form obtained by KHN. Missouri initially instructed schools to use Abbott’s rapid tests for symptomatic people, but tests were even more restricted.
Undoubtedly, some of the reasons the tests were limited are not bad — in an interview, educators said they screened for symptoms and suppressed the infection by requiring a mask. Missouri currently allows testing of symptomatic and asymptomatic people.
“There aren’t many tests done in the kindergarten-to-high school space,” he said. Dr. Tinatan, Professor of Pediatrics, Fineberg School of Medicine, Northwestern University. “Children are screened for symptoms before going to school and are tested if they do.”
At least 64 schools and districts tested had not conducted any of them as of early June, according to state dashboard data self-reported by schools.
According to interviews and documents obtained by KHN, the other people who applied have decided not to comply with their orders or to oppose conducting the test.
One was in the Maplewood-Richmond Heights district of St. Louis County, which led people to leave school for testing.
“The antigen test was decent, but there were some false negatives,” said Vince Estrada, director of student services, in an email. “For example, if a student is exposed to a person with COVID-19 and has a negative antigen test at school, he still needs to undergo a PCR test.” Space for testing and availability of nurses are also an issue. He said it was.
Molly Tikner“Many of our school districts store and manage tests,” said the Secretary-General of the Show-Me School-Based Health Alliance in Missouri, which focuses on access to medical services at schools. I don’t have the ability to do it. “
“Many” tests returned unused
Sherry Weldon, administrator of the Livingston County Health Center in northwestern Missouri, said public health agencies have conducted inspections of school staff in both public and private counties. “No school wants to take it for itself,” she said. “They were just like, oh, God, no.”
Weldon of the registered nurse said he returned “a lot” of unused tests at the end of the school year, but then reordered some to provide quick tests to the public.
As of mid-August, state health bureau spokesman Cox said the state had collected 139,000 unused tests from schools from kindergarten to high school.
According to Cox, the recovered tests have been redistributed and Abbott’s rapid antigen test has been extended to one year, but authorities have not tracked the number. The school does not need to report the number of expired antigen tests to the state.
“Of course, there were expired exams,” said Mallory McGowin, a spokesman for the Department of State’s Department of Elementary and Secondary Education.
Health officials have also sent rapid tests to long-term care facilities, hospitals and prisons, among other places. As of mid-August, the state distributed 1.5 million of the 1.75 million antigen tests obtained from the federal government. After considering tests not used by schools from kindergarten to high school, the state shipped 131,800 tests as of August 17. “It was immediately apparent,” Cox said. .. “
Asked if the school is ready to process the test, McGowin said having such resources is both a “real opportunity” and a “real challenge.” But “at the local level, there are so many people who support the Covid protocol,” she said.
Doctor Yvonne MaldonadoHead of Pediatric Infectious Diseases at Stanford University, said the school’s Covid test could “make a big difference.” However, more important strategies for limiting spread are masking, increased ventilation, and vaccination of more people.
“The test is icing on the cake,” she said.