Adding a weekly testing regimen can reduce in-school infections by 50% and increase confidence in safety for staff and families
Half of teachers who quit teaching due to Covid-19 report that they would be willing to return if there were regular Covid-19 testing or widespread vaccination
New York | February 4, 2021 – With the Biden administration’s goal of reopening schools in the first 100 days, new evidence from RAND Corporation and Mathematica, commissioned by The Rockefeller Foundation, finds that regular Covid-19 testing in primary and secondary educational settings is critical to getting students and teachers back to in-person instruction. The reports include early results from six K-12 testing pilots, funded by the Foundation and facilitated by a Memorandum of Understanding (MOU) between the Foundation and the U.S. Department of Health and Human Services (HHS), and an independent assessment of school testing programs across the country. Among other things, the reports found that weekly testing of all students, teachers, and staff can reduce in-school infections by an estimated 50 percent and would give teachers the peace of mind to return to the classroom, but managing the complex logistics of an effective testing program requires significant resources.
“We want schools to be the safest place in a community next to the home, and widespread in-school Covid-19 testing helps make that possible,” said Dr. Rajiv J. Shah, President of The Rockefeller Foundation. “The classroom is so important for a child’s development, not only for educational reasons, but to restore free school meals, to give children a social outlet, and to provide myriad school-based services that are vital, especially for low-income children.”
Last week, CDC called for schools to reopen as soon as possible with precautions such as masking, social distancing, and testing in place. The new Foundation-supported reports review testing programs across the country that took a variety of Covid-19 precautions, including screening testing.
“As the pandemic continues to evolve and new variants and additional challenges emerge, combining proactive prevention measures like masking and distancing with science-based testing protocols can both protect students, teachers, and staff from Covid-19 and detect new cases before they spread,” said Andrew Sweet, Managing Director of Covid-19 Response and Recovery at The Rockefeller Foundation. “When evidence-based measures are implemented at schools, families, teachers, and staff should feel safe coming back to in-person learning.”
Building the Evidence for Reopening Schools
As a result of the MOU between the Foundation and HHS signed in October 2020, the government agency supplied 140,000 Abbott BinaxNOW Covid-19 antigen tests to support six pilot projects in Louisville, Ky.; Los Angeles; New Orleans; Tulsa, Okla.; the District of Columbia; and State of Rhode Island. The Mathematica report studied the efforts of the pilots to implement testing protocols developed by the Duke-Margolis Center for Health Policy and the Johns Hopkins Center for Health Security with support from the Foundation. Based on early learnings from the schools that have implemented or plan to use the antigen tests to screen for the virus in their schools, as well as results from statistical models designed to estimate the potential value of regular testing, the pilots surfaced several key considerations about the acceptability and feasibility of designing and setting up school-based testing programs, as well as the potential effectiveness of these programs. They include:
- Weekly screening testing of all students, teachers, and staff can reduce in-school infections by an estimated 50 percent.
- Screening only teachers and staff is less effective, with estimated reductions in in-school infections ranging from 5 percent for monthly testing to 20 percent for twice weekly testing.
- The logistical and regulatory requirements for conducting screening testing in schools are complex and challenging to navigate, and schools would benefit from substantial support and coordination from local, state, and national education and public health authorities.
- Community engagement in program design is essential for acceptance.
- Clear communications about the testing program, delivered by trusted messengers, is needed to help the school community understand the strengths and limitations of the program and encourage them to participate.
“Our report provides cross-cutting considerations and implications to guide other schools and districts across the country that are considering implementing antigen testing,” said Divya Vohra, Researcher at Mathematica. “Our findings can help schools and public health leaders decide how to add antigen testing to their suite of strategies to mitigate the spread of Covid-19.”
The RAND Corporation report serves as a compilation of promising practices from a review of Covid-19 testing programs implemented by K-12 schools nationwide and a deep dive of 10 schools, districts, and states who were early adopters of Covid-19 testing. It includes recommendations to school leaders, district officials, and policymakers on how to make widespread Covid-19 testing in schools feasible, acceptable, and effective.
The experiences of early adopters of Covid-19 testing show that regular testing can be effectively integrated into schools’ Covid-19 response plans and can help families and staff feel comfortable participating in in-person instruction. In a RAND survey of nearly 1,000 former public-school teachers (included in the report), roughly half of teachers who quit teaching due to Covid-19 report that they would be willing to return if there were widespread vaccination or regular Covid-19 testing.
However, even for the most well-resourced districts and schools, launching a Covid-19 testing program was a major undertaking that required access to rapid-turnaround tests, additional staffing or strong partners for logistical support, technical assistance for the design and execution of testing programs, and a strategy for successfully engaging the school community to participate in testing. Among the recommendations to support Covid-19 testing in schools, the report calls for:
- Expanding federal and state funding, streamlining requirements to reduce barriers, convening learning networks, and continued investment in new testing solutions that are convenient to administer and ease the logistical burden on schools.
- Conveying clear, consistent, and science-based messages on the importance of testing to reduce risk and creating support services for teachers and families to get tested and isolate due to a positive test result.
- Providing practical guidance on how to implement a testing program, expanding laboratory capacity and access to tests that return results rapidly, promoting use of standardized performance indicators and data platforms to support decisionmaking, and providing resources for local public health departments to better respond to positive tests.
“Our research found that schools saw a lot of value in testing and went to great lengths to make it possible,” said Laura Faherty, Project Lead and a Physician Policy Researcher at RAND Corporation, a nonprofit research organization. In addition, in order “to make testing widespread and equitable, schools will need funding and technical assistance so that they can launch testing programs similar to what these early adopters were able to put in place,” said Benjamin Master, Project Co-lead at RAND Corporation.
Reopening Schools Equitably – An Urgent Priority
Remote learning is not a substitute for in-school instruction. The Covid-19 pandemic has exposed the already existing disparities in our nation’s public education system. Students, especially those most underserved, are deeply suffering – they are socially isolated, missing meals, facing abuse and neglect, and falling behind in school.
“After nearly one full year of disrupted learning, it has never been more urgent to safely reopen schools,” said Mike Magee, CEO of Chiefs for Change, a bipartisan network of state and district education leaders supported by The Rockefeller Foundation. “Children need in-person instruction and the face-to-face support they get at school. We must ensure schools have the resources to bring children back into the classroom, and that those resources are distributed equitably—with an emphasis on helping the children who have suffered the most during the pandemic, including students of color, those from low-income families, and children with disabilities.”
School reopening is an incredibly complex issue and schools, especially in underserved communities, need funding and support. Testing in schools is expected to cost about $8.5 billion per month for the remainder of the Spring 2021 school year, according to The Rockefeller Foundation’s most recent National Testing Action Plan, released in December 2020. The costs of such a plan are considerable, but according to some estimates, the investment could add back at least $350 billion in lost revenue and growth. Momentum is growing to dramatically expand screening testing in K-12 schools, and The Rockefeller Foundation is developing a detailed testing playbook that will be released later in February 2021 to provide detailed guidance to districts and schools on how to set up testing programs. By building on the important insights and implementation lessons from the early adopters of Covid-19 testing in schools, the United States can now tackle the challenge of reopening K-12 schools with the urgency it deserves.
About The Rockefeller Foundation
The Rockefeller Foundation advances new frontiers of science, data, and innovation to solve global challenges related to health, food, power, and economic mobility. As a science-driven philanthropy focused on building collaborative relationships with partners and grantees, The Rockefeller Foundation seeks to inspire and foster large-scale human impact that promotes the well-being of humanity throughout the world by identifying and accelerating breakthrough solutions, ideas, and conversations. For more information, sign up for our newsletter at rockefellerfoundation.org and follow us on Twitter @RockefellerFdn.
Mathematica applies expertise at the intersection of data, methods, policy, and practice to improve well-being around the world. We collaborate closely with public- and private-sector partners to translate big questions into deep insights that improve programs, refine strategies, and enhance understanding.
About RAND Corporation
The RAND Corporation is a non-profit, non-partisan research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous.
The Rockefeller Foundation
+1 (917) 373-9530
+1 (609) 945-3378
+1 (703) 414-4795