'Test-to-Stay' Measures Aim to Keep Students in Classrooms

As students head back to the classroom, schools are grappling with how to keep them safe from COVID-19 while maximizing in-person learning time.

Since the current school year began, tens of thousands of students have been sent into quarantine or self-isolation because of COVID-19 exposure.

Schools in some districts and states, including Massachusetts, California, and Utah, have adopted a “test-to-stay” or modified quarantine approach: Students who have been exposed to COVID-19 but are asymptomatic can stay in class, as long as they test negative for seven days.

“If you put this policy into effect in coordination with several other critical steps, you should have an excellent chance of catching anyone before they pose a significant additional risk of transmission to others,” Stanley Weiss, MD, an epidemiologist and professor at Rutgers New Jersey Medical School and Rutgers School of Public Health, tells Verywell.

Regular Testing Appears as Safe as Quarantine

Over 200,000 children tested positive for COVID-19 last week, accounting for around one in four new COVID-19 cases in the United States, according to the American Academy of Pediatrics (AAP).

Some school districts are calling for data indicating that students can remain in classrooms safely despite coronavirus exposure.

In a recent study, researchers conducted a randomized control trial of 201 schools in the United Kingdom, and found that allowing close contacts of infected students to stay in the classroom with regular testing was about as safe as asking them to quarantine.

Only about 2% of close-contact students ended up testing positive for the virus, but a lot more uninfected students were kept out of the classroom because of quarantine requirements.

States like Illinois, California, and Utah have laid out their test-to-stay plans to reduce classroom disruptions. In Massachusetts, for instance, exposed asymptomatic students can stay in school if they have negative antigen test results for seven days.

Regular surveillance testing of all individuals may also keep case numbers down. Schools in some states, including Maryland, New York and Colorado, offer free regular screenings for students and staff. Los Angeles public schools have made weekly testing mandatory.

The Centers for Disease Control and Prevention (CDC) says it “does not have enough evidence at this time” to recommend a modified quarantine for schools. The agency continues to recommend that close contacts be kept out of the classroom unless they are vaccinated and wear a mask.

Each district sets its own rules for quarantining K-12 students and substitutes for in-person learning. In places where virtual learning isn’t available, students may be left without instruction for up to two weeks while they isolate or quarantine.

A survey conducted by the CDC in 2020 found that both children and their parents were more likely to suffer emotionally when students received all-virtual instruction, and raised concerns about the possible effects on physical health.

“The [AAP] has been adamant that kids and teenagers need to be in school for academic, social, emotional, physical health, not to mention cognitive health,” Don Shifrin, MD, spokesperson for the AAP and emeritus clinical professor of pediatrics at University of Washington, tells Verywell. “We will do almost anything to keep kids physically present in school.”

The Logistics of Widespread Testing

Testing every exposed student can be resource- and labor-intensive.

Across the country, rapid antigen tests are sold out from many major retailers as schools and employers are increasingly requiring their students and employees to undergo regular testing.  

In his latest plan to control the pandemic, President Joe Biden said schools can draw on $10 billion allocated by the Department of Health and Human Services to increase COVID-19 testing for students, teachers, and staff.

“It's very difficult to find tests,” Shifrin says. “It is doubtful the schools could get a huge supply to individually test students during school time.”

“We understand that testing is important, but it’s extremely operationally challenging,” he adds.

Schools must also have a supply of tests on hand and employ a nurse or other staff who is able to administer tests to large groups of students.

Testing is only one of several tools for COVID-19 prevention. Schools should also ensure proper ventilation of classrooms and shared spaces, regularly disinfect surfaces, enforce a mask mandate, and recommend that every eligible student be vaccinated.

The CDC recommends quarantine if an unvaccinated person has been within six feet of an infected individual for a total of at least 15 minutes over a period of 24 hours. In schools where students are allowed to be seated within three feet of each other, it’s important to be transparent about what constitutes exposure, Shifrin says.

If the case load in a school gets too high, districts should come up with a contingency plan to return to virtual learning if transmission, Weiss adds.

“We have to be very sympathetic to the viewpoint of the students, their families, and teachers in terms of trying to provide in-person education,” he says. “But we also need to be prepared to continue that education, if need arises, through temporary virtual mechanisms once again.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.