Can test-to-stay keep kids in schools safely? A Maryland system is finding out


For Jessica Hasson, a mother of two in Maryland, keeping children healthy during the pandemic is a priority - but keeping them in school is, too.

"Anything that we can do to give children some normalcy and consistency is a great thing," said Hasson, a clinical psychologist who lives in Gaithersburg.

She and others say one way to accomplish that safely is the growing school approach of "test-to-stay." The Centers for Disease Control and Prevention recently recommended the practice, which allows unvaccinated students exposed to the coronavirus by a classmate to get tested regularly at school to make sure they are not infected. If they are negative, they stay in school.

The Montgomery County school system, where Hasson's son is in fifth grade, conducted a trial run of the practice this fall and plans to expand test-to-stay in the new year. Nationally, a handful of states have recommended the practice, said Mara Aspinall, a professor at Arizona State University who has studied the issue.

And support for it is growing as the highly contagious omicron variant spreads, threatening a spike in quarantines.

"I expect schools will increasingly adopt it next semester," Aspinall said. "It helps kids stay in school and assure everyone in the school community that classrooms are as safe as possible."

The CDC released two studies - in Illinois and California - showing the effectiveness of the approach, with CDC Director Rochelle Walensky describing test-to-stay as "a promising and now proven practice" that "works to keep unvaccinated children in school safely."

In Montgomery, home to the state's largest school system, the protocols were in use at seven schools as of mid-December. Students exposed to a virus-positive classmate were able to do rapid testing each morning for five school days, if they had parental permission, rather than simply go home.

The result was significant: a combined 240 days of in-person learning spared from quarantine, said Earl Stoddard, assistant chief administrative officer for Montgomery County and part of the leadership team on the effort. What's more, none of the students who stayed in school tested positive, he said.

"It was definitely successful," he said. "We're going to need to do more of it."

Stoddard said that while omicron appears to cause less serious illness, the variant's high transmissibility will result in more cases, which under current CDC guidelines could mean more potential quarantines - "thus making test-to-stay more important,"

In the Washington region, test-to-stay is still new - and untried in school systems in Arlington, Alexandria and Prince George's counties. School officials in Fairfax County submitted a request to be part of a test-to-stay pilot program Virginia is planning for the new year, a spokeswoman said.

School system officials in Montgomery say the practice is being used for exposures during eating or drinking, essentially lunch time - when masks are off but there is no forced exhalation as would happen during sports activities. There has been a limited number of such cases, schools spokesman Christopher Cram said.

For all of the promise of test-to-stay, there are challenges, too. Nationally, some school systems have struggled to find sufficient staffing to coordinate testing, acquire the necessary stock of rapid tests and gather parental permission for the testing, Aspinall said.

In Montgomery, rapid tests are not an obstacle, according to Stoddard. "The biggest challenge, by leaps and bounds, is staffing," he said. The county has 75 extra contract employees, all in nursing, to bolster testing and other health efforts in schools, he said, and expects to bring more into schools in January.

"The limitations have often been the availability of personnel, as in people who are interested in doing this type of testing are available and are ready to come on board rapidly," Stoddard said Wednesday.

Still, supporters of the practice say there needs to be greater urgency, claiming Montgomery County has been too slow to roll out the practice in its 209 schools and too tight-lipped about how the effort is going.

Jennifer Reesman, a parent leader who has testified before the Montgomery County school board on the issue, says the pace has cost students important in-school hours that could have helped with pandemic learning losses. Every day and every hour of instruction counts, she said.

Data released this fall in Montgomery County showed a decrease of 35 percentage points in literacy readiness among second-graders and a decrease of 26 percentage points on math measures among fifth-graders for the year that ended in June compared with 2019, the last regular school year that ended before the pandemic.

"Test-to-stay is an incredibly equitable and effective program," said Reesman, urging it be deployed "far more widely" and used for other circumstances beyond lunch. "We should not have entire-class or entire-grade quarantines in high-vaccinated Montgomery County," she said. "We are a tool-rich county. We're just not using the tools we have very wisely."

Stoddard attributed the slow ramping up of test-to-stay to a desire to scrutinize a new program to ensure it would not create new risks. He also said nurses have not been easy to come by so many months into the pandemic.

At New Hampshire Estates Elementary, in Silver Spring, PTA President Kea Anderson said nearly half of K-2 students were in quarantine the Tuesday before winter break, following 13 days of accumulating cases. She posted a tweet asking how to bring test-to-stay into the high-needs school.

"Test-to-stay is kind of a mystery," Anderson said. "How do we get it? I don't know."

For school families, quarantines are highly disruptive, she said: "It's not easy for many of our families to switch to virtual learning because they can't stay home or arrange care at a moment's notice."

Montgomery, like many school systems, also uses other strategies to reduce quarantines. When students are properly masked and one tests positive, quarantines are not mandated for close contacts, as long as they are enrolled in - or sign up for - the school system's coronavirus-screening program. In those cases, students continue to attend in-person classes but can't participate in high-risk activities and are expected to quarantine outside of school.

Nationally, some school systems eased up on quarantine rules starting last school year.

Jennifer Martin, president of the Montgomery County Education Association, the 14,000-member teachers union, said it was too early to comment on the efficacy of test-to-stay, which many teachers don't know enough about yet. But broadly speaking, Martin said, teachers recognize that students have gone through a lot and learn best in person. "If we are safe together, we want to be together," she said.

Hasson, the mother of two in Gaithersburg, said that as a psychologist she worries about the mental health toll of more missed school days for students. She thinks test-to-stay will help.

"There is no way to have zero risk," Hasson said. "But this would allow the student to continue to go to school, while minimizing the risk of an outbreak."