WMJ Vol 121 Issue 1: COVID-19 Surveillance Testing in Secondary Schools: Findings and Barriers to Implementation

ABSTRACT

Problem Considered: K-12 schools have shown minimal spread of COVID-19 when mitigation measures are employed. This study sought to determine baseline asymptomatic COVID-19 rates in secondary schools as students returned to full-time in-person learning with universal masking in place and to evaluate the logistical obstacles of implementing surveillance testing.

Methods: An observational cohort study lasting 11 weeks during spring 2021 included 2,288 students and staff in Wood County, Wisconsin. SARS-CoV-2 nasal polymerase chain reaction testing was done on consenting students and staff to determine baseline disease burden. Teacher surveys collected data on student masking compliance and classroom distancing. Information about percent positivity, secondary transmission, quarantine and distancing policies, screening participation, costs, and volunteer hour requirements were obtained. Modified quarantine for fully masked in-classroom exposures was evaluated.

Results: Percent positivity averaged 3.0% (0%-16.2% weekly) among students and 1.72% (0%-6.9% weekly) among staff. Two cases of secondary transmission were suspected out of 163 individuals quarantined. An average of 15.6% of the school population consented to participate each week. Minimum classroom distance between students ranged from 2.7 to 5.5 feet. Student masking compliance was greater than 87%. The cost of the program was $106,400 and required approximately 300 volunteer hours. The modified quarantine policy, where students were allowed to continue to attend in-person school after exposure to a case of COVID-19 if the infected and exposed parties were masking, did not result in additional transmission.

Conclusions: In the setting of relatively high student masking compliance and limited distance between students, weekly secondary school screening of students and staff in an area of high community disease spread was found to be low yield, costly, and burdensome for the school district. Surveillance participation was low. A modified quarantine policy was not associated with increased in-school transmission. School funding may be better spent on targeted testing or other school expenses, especially with increasing vaccination rates.

Target Audience

The target audience for this journal-based activity is healthcare providers caring for the people and communities of Wisconsin and beyond.

Learning Objectives

As a result of this journal-based activity, learners will be able to:

  1. Explain the results of an observational cohort study lasting 11 weeks during Spring 2021 documenting baseline asymptomatic COVID-19 rates in secondary schools in Wood County, Wisconsin.
  2. Evaluate the logistical obstacles of implementing surveillance testing of middle and high school stu­dents in the context of mandatory masking and a modified quarantine policy.
  3. Discuss the study findings and the authors’ conclusions in light of the current situation with COVID-19 and the learner’s collaborative practice in the school or healthcare environment.
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit
  • 1.00 ANCC Contact Hours
  • 1.00 University of Wisconsin–Madison Continuing Education Hours
    • 1.00 Approved for AMA PRA Category 1 Credit™
Registration opens: 
09/21/2022
Course expires: 
09/20/2023
Cost:
$0.00
Rating: 
0

FACULTY DISCLOSURE

It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the  speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE).  In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.

For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.

Marianna Shershneva, MD, PhDAccreditation SpecialistNo relevant relationships with ineligible companies to discloseNo
Amy E Falk, MDAuthorNo relevant relationships with ineligible companies to discloseNo

Mikayla Decoster, BS

AuthorNo relevant relationships with ineligible companies to discloseNo

Zachary Wallace, BS

AuthorNo relevant relationships with ineligible companies to discloseNo

Peter Falk, OD

AuthorNo relevant relationships with ineligible companies to discloseNo
Sarah Steffen, MMPAuthorNo relevant relationships with ineligible companies to discloseNo

Alison Benda, BS

AuthorNo relevant relationships with ineligible companies to discloseNo

Tracy Beth Hoeg, MD, PhD

AuthorNo relevant relationships with ineligible companies to discloseNo

Stephanie M. Borchardt, MPH, PhD

ReviewerNo relevant relationships with ineligible companies to discloseNo

Jonathan Meiman, MD

ReviewerNo relevant relationships with ineligible companies to discloseNo

Madhulika Mathur, MD, MPH

ReviewerNo relevant relationships with ineligible companies to discloseNo
Robert Treat, PhDEditorNo relevant relationships with ineligible companies to discloseNo

Roberta Pawlak, PhD, RN, NEA-BC 

ReviewerNo relevant relationships with ineligible companies to discloseNo
    

*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.

The ACCME does not consider providers of clinical services directly to patients to be ineligible companies.

Discloser List CME Internal Report

Accreditation

Accreditation Statement

Jointly Accredited Provider LogoIn support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal.  The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


Credit Designation Statements

American Medical Association (AMA)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 ANCC contact hour.  

Continuing Education Units

The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.

Available Credit

  • 1.00 AMA PRA Category 1 Credit
  • 1.00 ANCC Contact Hours
  • 1.00 University of Wisconsin–Madison Continuing Education Hours
    • 1.00 Approved for AMA PRA Category 1 Credit™

Price

Cost:
$0.00
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