CDC update June 30th
The CDC updated their “Interim Considerations for K-12 School Administrators for SARS-CoV-2 Testing” June 30th.
The recommendations come with the CDC disclaimer that they are a nonregulatory agency so they “assist K-12 schools in making decisions rather than establishing regulatory requirements.” It seems that most of their updates continue to stress that these recommendations are not to replace “any federal, state, local, territorial, or tribal health and safety laws, rules, and regulations with which schools must comply.”
In addition, as with any recommendations the CDC understands each school is different. They state that “Implementation should be guided by what is feasible, practical, and acceptable and be tailored to the needs of each community.”
So what do they recommend? Screening, testing, and contact tracing are all mentioned as ways to slow COVID-19 spread.
Screening is mentioned at the bottom of this document. They mention symptom checkers and/or temperature checks. Of course, either should be conducted safely with the privacy of the student in mind. It is mentioned that students infected with COVID-19 are asymptomatic so some cases will not be detected by either temp screen or symptoms. I was hoping for more information here on the types of screens but there was nothing new. Not surprising as we know children are the least to be affected by COVID-19. If you still go to their symptom checker link and if your child is under 18 they don’t give you an answer on what to do but send you to a general link to “keep children healthy”. If you really want to see symptoms of children with COVID-19 here is another CDC link of the symptoms of 291 pediatric patients. I believe symptom checkers may be different (based on what the school can accomplish) and look forward to guidance from other national leaders (ex AAP, NASN).
There are definitions and links to contact tracing but again, how can that be implemented in school? Contact tracing is something that happens after a case is discovered and people have to be trained to be a contact tracer. School staff are not required to be tracers.
The first thing they state is that “school staff are not expected to directly administer SARS-CoV-2 tests.” Make sense. However, those (school-based health centers, nurses, physicians) that can do tests “in their capacity” may do so. They understand not all centers can do these tests nor “should they be compelled to do so.”
Nasopharyngeal swabs are the best test for active disease. Antibody tests are not reliable to detect if a student has an active disease (they can spread). And the jury is still out to determine, even if you have antibodies, could you catch (and spread COVID-19) again.
Why not just test the entire school then? With everything mentioned above, it seems like a possible solution. As per this release, the CDC does not recommend testing of entire schools and staff at this time (it was in bold on their web site as well). According to the site, there has been not been any study that shows this helps and they state many issues may hinder the benefit such as “the lack of infrastructure to support routine testing and follow up in the school setting, unknown acceptability of this testing approach among students, parents, and staff, lack of dedicated resources, practical considerations related to testing minors and potential disruption in the educational environment.”
I hope all this helps and we wish you a safe return to schools.
–Dr. Robert Darzynkiewicz, Hazel Health’s Chief Medical Officer.