Thread by @WhitneyEpi

🧵 1/ I really like the idea of “test to stay” in US K12 schools

There are actually several different policies called this, but a big one is testing to reduce K12 quarantines when a person/group is a close contact of positive case. I think that’s a great use of “test to stay”

https://twitter.com/michaelmina_lab/status/1446310004789760014

2/ One confusion I see in comments on Dr. Mina’s post is people thinking of very sensitive PCR testing, which can pick up infections in days when people are no longer contagious

“Test-to-stay” typically uses Rapid Antigen Testing: RAT finds those who are actively contagious

3/ One drawback is there will be occasional false positives with widespread use of rapid antigen tests. So a fast, easy protocol for additional testing to confirm (or refute) positives needs to be in place

4/ My kid’s elementary school does not have a test-to-stay program but has universal masking & follows CDC guidelines that others don’t have to quarantine if following the school’s masking, eating guidelines (school also has HEPA cleaners in every class, etc)

5/ I know this quarantine policy made some other parents in our COVID-conscious district nervous, but I think it’s working out well so far

Our school has had some cases but very few people considered “close contacts” who had to quarantine. No outbreaks

6/ A practical reason I like our elementary school’s universal masking policy is not having to worry about my kid being quarantined

(I know an alternative is getting rid of masking *and* quarantines, but not my preference: ending up with an outbreak not preferable to me)

7/ We do have once-a-week rapid antigen testing at school funded by our state’s department of health but it’s opt-in

Last I heard, only about 35% of kids’ parents had signed them up (including yours truly! 😁)

We get a text every Friday with the results: negative so far!

8/ There is one test-to-stay aspect of the school’s program: if a kid has a runny nose, etc, at school and is opted in to the testing, the school nurse can give them a rapid test. If negative, they won’t have to be sent home

9/ I know less about how that part of the testing is going or how often it’s being used, but I think it’ll be useful this winter.

10/ I’ve said before that I think #COVID19 policy is best when it’s context-specific. What’s working well in one place might be a total fail elsewhere

So here’s my context: COVID-averse, high vax & high-mask community in a lowish vax region. More details👇🏾 in @nytimes map pic

11/ Also I know I give #NIH a hard time re: funding priorities (still do!), but I wanted to highlight cool projects ongoing through RADx-UP, evaluating different testing schemes in schools. Overall RADx funded by ARA, the 3rd US COVID stimulus bill

nih.gov/news-events/ne…

12/ Here’s list of all the RADx-UP projects. I have quibbles about how program is framed, but each research project looks REALLY interesting!

Big objection: I wish they’d started these in July 2020, not July 2021. We’d have more tested strategies by now nih.gov/research-train…