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Vermont will extend its universal masking recommendation for K-12 buildings at least until Nov. 1, administration officials announced Tuesday. And it will roll out several new testing programs within the next few weeks aimed at better handling the high volume of Covid-19 cases popping up in schools.
The state plans to offer free rapid antigen tests to give to unvaccinated, asymptomatic students considered close contacts to someone who has tested positive for Covid-19, Education Secretary Dan French said during the governor’s weekly press conference. Under the new “test-to-stay” program, those students would be allowed to remain in school instead of quarantining at home so long as they test negative daily for seven days following exposure. Symptomatic students would still be required to quarantine, as will close contacts who do not want to take the rapid tests.
Another “response test” program, meanwhile, will bring PCR testing onsite to schools to make it easier for students to get tested during an outbreak or after cases pop up, French said. PCR tests are generally more accurate but take longer to produce results.
All testing programs will be available free of charge to public and private schools.
“We're hopeful that most students, staff and families will consent to participate in these testing programs because testing is emerging as one of the best strategies we have to keep our students in school while at the same time keeping them safe from Covid-19,” French said.
K-12 schools have been crushed by Covid-19 cases in the first month of classes. The state reported Tuesday that at least 144 individuals had come to school while infectious during the past seven-day reporting period. That’s down from the 174 cases reported last week, but the past two weeks represent the highest and second-highest daily totals for school-related cases reported during the pandemic.
A high number of cases have translated into acute operational strain for schools, which, like most employers, are also facing workforce shortages. A surveillance testing program in schools has been slow to start, and contact tracing has so burdened schools that the state is now advising them to largely skip it if 80% of their eligible students are vaccinated.
Gov. Phil Scott’s administration has been criticized by many in the health care community for its handling of the Delta wave, and several medical associations at the start of the school year urged the governor to extend universal masking in schools.
But the decision to implement a test-to-stay program was immediately applauded by the Vermont-American Academy of Pediatrics, which is working with the state to design the program. Similar programs have also been implemented in Massachusetts, Utah, Delaware and England.
In a statement issued Tuesday, the academy pointed to evidence from a recently published randomized controlled trial in the United Kingdom. Results from that study found schools using a test-to-stay strategy had as little school transmission as schools quarantining students after exposure.
“There's good evidence and data from other test-to-stay programs that participation in these programs doesn't increase risk for in-school transmission and with the significant benefit of allowing kids to continue to attend class instead of having to quarantine at home for extended periods,” said Benjamin Lee, a pediatric infectious disease specialist at the University of Vermont Larner College of Medicine who is consulting the state on test-to-stay.
The fate of the state’s surveillance testing program in schools, meanwhile, remains unclear. The voluntary program was meant to screen large numbers of students and staff on a weekly basis, but a month into the school year, less than half of the state’s schools had yet to begin, citing too few staff to carry out the work.
On Friday, in a message to school superintendents, the Agency of Education announced it would be pausing implementation of the surveillance program while the state transitioned to its new testing initiatives. French stressed Tuesday that this was only temporary.
Given the pressure on schools, Rebecca Bell, the president of the Vermont-American Academy of Pediatrics, said she would support schools that chose to jettison broad-based surveillance testing in favor of test-to-stay. Prior experience with broad-based voluntary surveillance testing programs suggests families are less likely to participate compared to rapid testing, she said. That’s probably because rapid tests, not surveillance testing, allow for the concrete benefit of keeping a child in class.
But Bell, a pediatric critical care physician at UVM’s Children’s Hospital, said she’s still worried about schools having the capacity to handle yet more pandemic responsibilities without additional workforce help.
“That piece is really the piece that needs to be worked out,” she said.
Anne Sosin, a public health researcher and policy fellow at Dartmouth College’s Nelson A. Rockefeller Center, agrees that test-to-stay programs are a good way to safely reduce the need for quarantine in schools. But she also believes they should be used in conjunction with surveillance testing — not as an alternative. Surveillance programs find cases, she said, and test-to-stay programs help manage them with fewer disruptions to learning.
Massachusetts, she said, strongly encourages schools to use both surveillance testing and its test-to-stay program.
Like Bell, Sosin also said the primary concern is the operational strain schools are under as they attempt to manage such a high number of cases. But Sosin said the way to respond is not to triage and cut back on mitigation in schools but instead double down on interventions outside of K-12 settings.
“We need to focus on decreasing community transmission to reduce the cases coming into schools and giving schools more resources and support to conduct contact tracing,” Sosin said.
Jeanne Collins, a superintendent in the Rutland Northeast Supervisory Union, said she’s a “big fan” of the concept of using rapid tests to keep students in school instead of sending them home. But she said she’s worried about how schools will pull this off given how strained they already are.
Asked during the press conference about whether schools would be provided with more manpower to aid in the effort, French acknowledged that this latest program would be “challenging to implement” but said schools would simply have to try their best. The Agency of Education would soon be releasing flowcharts, he said.
“That,” Collins wrote of the exchange, “sums the year up.”
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