As COVID-19 cases surge in North Carolina and schools begin implementing expanded reopening plans, a new pilot program for COVID-19 testing promises to give schools a new tool to slow or prevent the spread of the virus on their campuses.
The N.C. Department of Health and Human Services program offers more than 50,000 rapid antigen tests to schools across the state.
“This program gives us another tool in our toolkit to slow the spread of COVID-19 across our state and to keep children in the classroom, which we know is vital not only to their academic growth but also to their health and emotional development,” said DHHS Secretary Mandy Cohen in a statement on the program.
To receive the tests, each educational agency had to confirm to its local health department that the school can obtain parent/guardian permission before testing students, maintain adequate supplies of personal protective equipment, have trained personnel or assistance from a local health provider to administer tests and report test results to state and local public health agencies.
Participating schools must also be operating with some form of in-person learning.
Seventeen public school districts and 11 charter schools were selected to receive the tests in the first phase of the program.
Tests will be available in schools in Alamance, Bladen, Buncombe, Cabarrus, Catawba, Durham, Forsyth, Gaston, Harnett, Johnston, Lenoir, Lincoln, Madison, Mecklenburg, Pasquotank, Surry and Wilson counties.
Four school applicants were unable to participate because they did not meet some of the required criteria, including not having enough resources in their area due to the strain on local health departments, according to Kelly Haight Connor, DHHS communications manager.
“Given the large surge in COVID-19 numbers, some local communities that would have liked to commit to participating in the pilot could not do so due to limited capacity,” she said.
Getting actionable results
The federal government provided the Abbott BinaxNOW COVID-19 Ag Card point-of-care SARS-CoV-2 diagnostic tests to all 50 states. The nasal swab test provides results in 15 minutes without laboratory processing. Distribution in North Carolina began in December.
The tests are to be used for students and staff exhibiting symptoms of the virus or who have been exposed to someone with COVID-19. Rapid-result antigen tests are considered less accurate than polymerase chain reaction, or PCR, testing, with the latter detecting the virus’s genetic material and the former identifying the presence of specific proteins from the virus.
Even with limited accuracy, having rapid tests on hand has helped Wilson County to contact trace and stop further virus spread more efficiently, said Dr. Kim Almkuist, who oversees two clinics at Forest Hills Middle School and Beddingfield High School as part of the Wilson Area School-Based Health Centers.
“Having the rapid test really helps with contact tracing,” Almkuist said.
“If they’re having symptoms and we do a rapid test and it’s positive, we can immediately identify their contacts so we’re not waiting two or three days. We can go ahead and send those students home, and that helps with the spread of COVID.”
But Almkuist said that while the tests are an important tool, they’re just a first step in detecting and tracking the virus.
“The COVID test is an antigen test — it’s not as accurate as a PCR test, so we ask them to call and register for their PCR test so we can collect demographic data,” she said.
A critical time
Partnerships between health departments and schools, like the one in Wilson, are critical for the program. In some cases, area health departments will support the schools with staff and facilities to administer tests to students and school staff.
“We have a really strong relationship with our health department, and we collaborate with them daily,” said Amy Widderich, a lead nurse in the Alamance-Burlington School System.
“COVID-19 cases in Alamance County are pretty high — we’re one of the red counties — and we looked at that and the fact that we’re blessed to have a nurse in almost every school. And we added a nurse to every school because of COVID.”
For some schools, like Lincoln Charter with campuses in Lincolnton and Denver, the tests could not have come at a better time. The largest nonvirtual charter school in the state, with a student population of more than 2,200, endured an outbreak of COVID-19 following the Thanksgiving holiday, forcing a return to virtual learning.
And just after Christmas, the school reported the death of physical education teacher and coach Jamie Seitz after he was hospitalized with COVID-19.
“It’s been a challenging year,” said Lincoln Charter Chief Administrator Jonathan Bryant, who recommended that the school continue with remote-only learning through Jan. 19. The school’s board rejected that proposal and opted to resume in-person learning on Jan. 11.
For Lincoln Charter, the 600 tests it received as part of the pilot program will be critical in preventing another outbreak once in-person instruction resumes.
“We’re obviously very concerned with keeping our staff and students healthy and in the classroom,” Bryant said. “One point of emphasis for us will be staff members, and if they are concerned or have reason to be concerned, we want to err on the side of caution.”
As members of the first phase of the pilot begin testing, DHHS will assess results and make determinations for the second phase of the program.
“The overall goal is to get rapid antigen testing available in as many schools as possible,” Haight Connor said.
“The state will be closely monitoring the implementation and findings from phase one of this pilot to determine future distributions. Schools will be one of many testing site options. The state, local health departments, health care providers and other community partners continue to offer testing throughout the state, as well.”
In the meantime, schools in the pilot program see these tests as just another part of a tiered approach to preventing and stopping the spread of the virus on their campuses.
“This is really just another tool in our toolkit, having that layered approach to returning to the classroom safely,” Widderich said.
“We ask families to self-monitor at home and stay home if they’re sick — that’s the first layer. Then, when they come to school, we screen them, and that’s the second layer. Hopefully, most kids who come to school won’t have any signs of illness, but if they do, with an antigen test we can get results in 15 minutes, so if a child is positive, we can quickly isolate and mitigate that spread.”