SAN ANTONIO – One Thursday, Ciara Brown, a junior at Fox Tech High School in San Antonio, stepped over to a small white table, pulled down her face mask, and took a test that is still far from standard in American schools: one Cotton wipe your nose.
“Testing is super easy,” she said. “It’s not as scary as I thought – it’s not a big thing going up in your brain.”
The United States has struggled with Covid testing since the early days of the pandemic. Now, nearly two years after – and weeks after another school year disrupted by Covid – school systems across the country are grappling with the role of testing in keeping children safe and teaching.
Some, like Ciara in Texas, have gone all-in; others do not offer any Covid tests at all. Still others say they want to do more testing but don’t have the resources or have stumbled through obstacles and delays.
The numerous school districts in the San Antonio area reflect the political divides of the nation. Some districts have taken several precautionary measures, including testing, to protect themselves from the virus. Some have only a few defenses.
Even though the worst of the early testing supply shortages have lessened and states have received federal funds, including $ 10 billion from the American Rescue Plan, to implement school-based Covid testing programs, many school districts are still stalling.
“Testing is much more than just wiping your nose or spitting into a test tube,” said Dr. Laura Faherty, pediatrician and researcher at RAND Corporation who has studied school-based Covid tests.
A series of tests in Texas
School systems like Ms. Brown’s, which have managed to establish large-scale testing programs, are a case study of how much effort is involved.
The San Antonio Independent School District offers weekly tests for every student and staff member, an obligation that requires supervisors to collect nasal swabs three days a week on the area campus. A single collective event can last hours.
But the program, a partnership with the nonprofit Community Labs, is largely voluntary, and despite the district’s best efforts, many families have not signed up; Around 30 percent of the students take part.
Ms. Brown, who has two immunocompromised family members, was eager to sign up. “I couldn’t live with myself if I knew it was because of me if they got Covid,” she said. “Knowing that I can protect you, myself, friends and even strangers is all that is really important to me.”
But in the Independent School District of Boerne, where masks are optional, testing is also optional and only possible by appointment in the campus clinic.
While the district says anyone who is sick should not come to school, symptomatic individuals will not be referred for tests or even sent home unless they are “unable to attend class”.
Dr. Heather Riebel, a pediatric cardiologist who has treated Covid patients, said she was “so careful” not to bring the virus home. Now she worries that her children are likely to get infected at school.
She took her fifth grader out of school this fall after being exposed to the virus five times in a week. “It’s extremely disheartening,” said Dr. Riebel. (District officials did not respond to numerous interview requests.)
Elsewhere in San Antonio, the Northside Independent School District has struck a middle ground: rapid testing of students and staff who are symptomatic, even though students can only be tested with parental consent.
Superintendent Brian Woods hasn’t ruled out the possibility of major screening if cases increase. But the district is facing a severe staff shortage, making it difficult to expand testing at this time. “We’re not there yet,” he said.
The district is running a contact tracing, but the rollout has been bumpy. A primary school can consult the cafeteria cameras to identify close contact between the students. But they didn’t work the day Andrea Ochoa’s 10-year-old daughter was having lunch with a student who later tested positive.
Ms. Ochoa, who has autoimmune problems, did not find out about the exposure from her daughter until the following week.
“I’m not upset that a child got sick,” said Ms. Ochoa. “But I don’t want young child gossip to be the way we parents find out how to stand up for our children.”
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San Antonio is a patchwork microcosm of programs in schools across the country, even as the federal government puts more resources into testing.
“While some of the logistics are getting easier, there is a fairly fragmented school district-to-school district approach to whether and how tests are used,” said Dr. Faherty.
In Illinois, all public schools outside of Chicago are eligible for free SHIELD tests: weekly saliva tests developed by the University of Illinois at Urbana-Champaign.
But neighboring Iowa turned down the $ 95 million it was allocated for testing under the US rescue plan. The state’s Department of Education says other resources are available for schools; Some districts distribute take-away test kits that are available free of charge from the state laboratory.
Even in countries with coordinated programs, participation can be spotty. As of September 21, only 24 percent of Virginia’s public school departments had signed up for their federally funded testing program, which offers regular pooled PCR testing and access to home testing kits.
Elsewhere, the spike of cases in late summer embarrassed schools.
“It’s about catching up,” said Dr. Richard Besser, President of the Robert Wood Johnson Foundation and former Associate Director of the Centers for Disease Control and Prevention. “You cannot ask schools to implement large-scale testing protocols when the school year has already started, when the materials, staff and logistics are not in place.”
The Illinois SHIELD program has been bombarded with last-minute registrations; on September 21, 43 percent of participating public schools voted after August 23, a SHIELD representative said.
The start of the program takes three to six weeks; A few weeks into the school year, most participating schools have not yet started testing.
Chicago Public Schools has its own repeatedly delayed program. The district initially said that when schools opened on Aug. 30, weekly screening would be available for every student. The district now says the program will be fully operational by the end of September, attributing the delay to the need to conduct background checks on test company employees.
The local parents have expressed frustration with the postponement of schedules and slow updates. “There is no clear line of communication,” said Debora Land, who has a second grammar school in the district and is the parents’ representative on her local school board. “Parents asked: ‘What is your plan, what is your plan, what is your plan?'”
By September 17, only 3 percent of students had enrolled for the test program, the district said.
In New Orleans, the district has actively encouraged families to sign up for its weekly PCR testing program – which offers multilingual online enrollments and enrolls in a state program that pays students to take Covid tests, said district spokesman Richard Rainey.
But local schools had to weather both Delta and Ida, a Category 4 hurricane that turned off the city’s energy, temporarily closed public schools, and suspended testing. “We quickly turned around after the storm passed to resume the program within a week,” said Mr. Rainey.
It takes a village
The increasing demand for tests has also tightened supply. In Fresno, California, the school district could not replenish its inventory of rapid antigen tests and therefore had to cut tests for student athletes.
However, the biggest challenge for many schools is staffing. The Berkeley Unified School District used government funds to hire seven employees for its Covid testing team – and then jumped into its own coffers to hire 14 more.
For many districts in lower-income parishes, this type of financial outlay may be impossible. “We need to ensure that the resources are available, especially in the hardest-hit communities,” said Dr. Better.
Protocols that work at low transfer rates can become untenable as transfer rates increase. Alachua County, Florida, allows quarantined students to return to school earlier if they test negative for the virus on the fifth day of their quarantine.
During the worst spike in August, nurses at some schools tested up to 40 to 50 quarantined students each morning.
Schools had to hope that during the hour or two it might take to test all of these students, nobody needed medical attention, Superintendent Carlee Simon said. “As if a child doesn’t have an asthma attack or everyone needs an EpiPen.” She added, “Our nurses had a full-time job before Covid. Covid is a job now. “
The workload has eased, but 15 nurses quit in the first month of school.
In Grapevine, Texas, the school district’s testing center saw so much demand in early September that appointments were booked days in advance. Amy Taldo, who runs the site, said she lacked the staff to expand. “I need an army,” she said.
And testing is just the first step. In the San Antonio Independent, a brigade of nurses runs a tedious contact tracing protocol when students or employees test positive.
To determine the close contacts of an individual high school student, Lynn Carpenter, a district nurse, asks all of her teachers for detailed seating plans. “I need to know, are they at desks, are they at tables, how far are the tables apart?” She said.
If the student is an athlete, coaches will also be called with questions about training and games. “It just foams like that,” she said.
Ms. Carpenter, who works in a windowless, bare-walled office sometimes takes several days to process a single case. She had calls from seriously ill employees, some of whom burst into tears. “It’s a heartbreaking job,” she said.
A vaccine for children ages 5-11 could be approved as early as next month to further protect elementary schools. But even then, it could be months before most young children are vaccinated – and many may never get the vaccinations, said Dr. Better.
So the schools are pushing what they have: limited staff and limited time.
“I think it’s a very worthwhile thing we’re doing,” said Ms. Carpenter. “I’m just looking forward to this day, when that’s behind us and I can go home.”