NJ schools may use 'test-to-stay' option to keep unvaccinated students in class

Mary Ann Koruth
NorthJersey.com

Unvaccinated students will have a chance to remain in school and out of quarantine even after they come in close contact with a COVID-infected person, if schools adopt an optional testing approach offered by the state. 

The new "test-to-stay" option uses frequent testing to keep students who are not positive and not experiencing symptoms in school, according to new guidance from the New Jersey Department of Health

During a briefing on Monday, the day schools reopened after winter break, Gov. Phil Murphy said he had "no intention or plan" to close schools, despite an unprecedented surge in infections in the state and other parts of the country that began in mid-December.

The state released "test-to-stay" testing guidance on Jan. 1, when schools were still on winter break. Most public schools in the state reopened on Monday — though many have already gone remote to protect against the surge in COVID cases.

Currently, unvaccinated students must quarantine at home if contact tracing shows they were exposed to a COVID-positive person in school. The new test-to-stay method, which was released by the Centers for Disease Control and Prevention two weeks ago, would keep unvaccinated or partially vaccinated students who do not show COVID-related symptoms in school.

This would be done by testing them immediately after in-school exposure, and every other day for five to seven days, according to the latest state guidelines, in a process called "serial testing." Tests would be performed using rapid antigen testing, which provides immediate results. Test-to-stay requires students to quarantine at home only if they test positive during this time. Masks would still have to be worn in school, and students are expected to quarantine when not in school.

A wave of COVID cases, likely from the highly transmissible omicron variant, engulfed the state in December and, consequently, challenged schools statewide. Case numbers went from 16,626 on Dec. 25 to 29,740 on Jan. 1, with a transmission rate of 1.77 — that’s nearly two people infected for every positive case. 

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The surge in COVID cases caused many schools to switch to remote instruction for the first few weeks of January 2022. Many closed their buildings and offered remote classes even before the winter break, while others have opted for early dismissals and half-days, both before and after the break.

Meanwhile, schools in New York City, the nation's largest district, are using a simpler version of test-to-stay, to keep schools open despite a similarly enormous surge in infections. 

The New York Times reported that students will be sent home with rapid at-home tests when exposed to an infection in school and will return if they test negative or do not show symptoms.

Tests in New York City schools will be repeated after five days, with parents and students expected to self-report results. The new approach took effect Monday and was adopted in part to prevent learning disruptions among the large numbers of unvaccinated elementary school children who attend the city's public schools. Only children whose parents consent to the program can participate.

The main benefit of the New Jersey test-to-stay option is that it limits learning loss and keeps children in school, but state guidance leaves the decision on opting in to local school officials. Also, schools can offer the option only to students whose parents or guardians consent. Schools must have robust contact tracing and testing practices already in place. If they conduct testing on school grounds, they must get a government-approved waiver that allows them to administer, process and read the tests.

State guidelines also require students who participate in test-to-stay to wear masks at all times while in school, including outdoors, except when eating or drinking. It also requires them to maintain a 6-foot distance from others and refrain from all extracurricular activities.

These guidelines differ from current ones in use for the general student population. Even when transmission levels are high — as they are now — students are not required to wear masks outdoors when they are on school grounds, and required indoor distancing stands at 3 feet. 

“It’s difficult for the schools to practice this, and I think those guidelines are inadequate,” said Dr. Stanley Weiss, a biostatistician and epidemiologist at Rutgers School of Public Health. Original social distance standards drew from the assumption that droplets accounted for nearly all COVID spread. Weiss said this assumption is faulty. "With omicron, even 6 feet is likely insufficient. Improved ventilation systems are critical.”

The omicron variant is far more transmissible than previous variants, said Weiss. Higher levels of the virus in the upper respiratory tract and omicron's stronger affinity to human cell receptors can lead to fewer viral particles causing infections.  

In New Jersey, pediatric hospitalizations are the highest since the onset of the pandemic, state Health Commissioner Judy Persichilli said Monday.

Persichilli has asked pharmacies and testing sites to prioritize testing for children, to reduce the burden of COVID mitigation on schools. For schools that engage in on-site testing, all school testing vendors were asked to be in schools on the first day back from break.

The omicron variant is a cause for concern, more so among unvaccinated children, than previous variants were, Weiss said. “Children were relatively spared in the first phases of the COVID-19 pandemic. However, children are acquiring omicron and getting ill, especially with severe upper airway illness. Thus, parents should now reorient and take measures to reduce potential exposure of their kids.”

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The CDC has not urged schools to adopt test-to-stay, rather saying this is “another valuable tool” in addition to layered prevention strategies to mitigate COVID-19. Those include masking, social distancing, testing, ventilation, hand-washing and staying home when sick, with vaccination and boosters remaining the most effective way to prevent the spread of infection.

The CDC endorsed the option after trials in the United Kingdom showed that daily testing for close contacts instead of quarantining did not affect school absence or transmission of the virus, compared with when students quarantined at home. Similar studies were conducted in schools in Los Angeles, California and Lake County, Illinois, in fall 2021.

Mary Ann Koruth covers education for NorthJersey.com. To get unlimited access to the latest news about New Jersey's schools and how it affects your children, please subscribe or activate your digital account today.

Email: koruthm@northjersey.com

Twitter: @MaryAnnKoruth