Study to Determine if Weekly Surveillance Testing for COVID-19 Infections is Needed in Schools

     By Kathleen Berger, Executive Producer for Science & Technology

    When returning to school during the pandemic, at a time when the Delta variant is a major concern, everything is considered. This includes all considerations for the vaccinated and the unvaccinated; wearing a mask or not wearing a mask; and social distancing of six feet apart or not. But what about the idea of surveillance testing for COVID-19 infections?

    “The C.D.C. has recommended that one of the mitigation strategies is screening testing,” explained Jason G. Newland, MD, MEd, professor of pediatrics, infectious diseases at Washington University School of Medicine in St. Louis. “We need better data. We need more data to say, ‘Is that true? Do we really need to go to this length of adding another layer of mitigation?’”

    To find out, the pediatric infectious diseases physician is now the principal investigator for The Safe Return to School project.

    “Evaluating whether or not weekly screening testing is needed in middle and high schools to prevent COVID-19 transmission, whether that is needed in all these schools all the time is not known,” said Newland. “We want to try to provide the scientific evidence that if you do weekly screening testing, does it or does it not reduce or really make COVID-19 transmission extremely low in our schools.”

    Funded by the National Institutes of Health, the study is focused on some school districts in St. Louis County north of Delmar Boulevard. The study refers to it as the “Delmar Divide.”

    “The project’s description from the National Institutes of Health was to do an underserved population and we wanted to really focus in on predominantly African American school districts as we wanted to understand and provide more access to testing to these areas,” he said.

    There are five participating school districts are in an area heavily impacted by COVID-19.  They include the Jennings School District, Pattonville School District, Normandy Schools Collaborative, Ferguson-Florissant School District, and The School District of University City.

    The first part of the study is to provide access to COVID-19 testing for all symptomatic individuals, to include all students, staff and household members of every school in the five school districts. Access to drive-through COVID-19 testing is available six days a week at designated school locations.

    But the primary study focus will be on 16 participating middle schools and high schools by examining this new level of weekly surveillance testing for COVID-19. Presently, Newland will not name the selected schools for testing.

    Of the 16 schools, eight of them are selected for weekly screenings for asymptomatic infections. This way, Newland will be able to compare the eight schools with weekly screenings to the eight schools that did not have the screenings offered.

    “We will follow any transmission that’s occurring in the school and we’ll be looking for transmission in all the schools to help see if there’s one testing strategy, if that testing strategy is better.”

    In the randomly selected eight schools, students and staff and their household members are asked to enroll to be tested weekly for asymptomatic COVID-19 infections during the entire 2021-2022 school year.

    “It’s voluntary, so there’s a consent process that’s taking a lot of time, we’re doing that currently,” Newland said.

    The study is not using the nasal swabs. It’s all saliva testing for the weekly surveillance screenings and for all the testing of symptomatic individuals in the five participating school districts.

    “It has Emergency Use Authorization. It’s authorized by the FDA to be used and we want to do saliva-based because we have heard from our community that, you know, one barrier is thinking that you’re going have something stuck up your nose all the time,” he explained. “The saliva test is as accurate as the, we would say, the swab that does the ‘brain tickler’. And we have seen that throughout in our laboratory and the experts that we’ve been working with.”

    The saliva testing was developed in another research lab at Washington University School of Medicine. The saliva samples taken in The Safe Return to School project are processed in the Washington University laboratory.

    Newland said he knows enrolling and maintaining study participants every week all year long will be challenging, but he believes saliva-based testing will make it easier.

    “One of the things we’ve learned already is the reason why people want to be tested and the reason why they want to get vaccinated is because they want to protect their families.”

    Newland said participation is encouraged to help the scientific community make recommendations. He said he just wants to see the science.

    “It (weekly surveillance testing) might not add any additional prevention of transmission,” he said. “In theory, it makes sense that adding testing weekly, you’re going to find more people before they potentially infect others. That makes complete sense.”

    “I’m not sure we need to add on weekly screening testing school wide to prevent COVID-19 transmission, but there might be certain groups within the school that it is necessary because it does eliminate potential outbreaks of COVID-19. Such groups could be athletic teams or it could be extracurricular activities like band or choir or drama. Maybe that’s where it has to focus, but we need more data,” Newland explained. “If we’re going to be doing a lot of testing, doing testing takes a lot of resources and a lot of work. I know we don’t have the science yet to say it’s worth the bang for the buck. And I think that’s what we’re trying to get at.”