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FAQ on Pooled Testing

 

Why is MRSD providing pooled testing for students and staff? 

The number of positive COVID-19 cases in our schools and community have been increasing significantly and pooled testing of students and staff is an excellent way to help curtail spread. Studies have shown that pooled testing weekly for a month can reduce COVID rates by well over 50%.

 

There have been many classes, cohorts, and even one entire school that have had to pivot to remote learning in recent weeks. If we want to keep our schools open and safe for in-person learning, pooled testing is a fast and efficient way to do so.

 

By identifying asymptomatic individuals via pooled testing, it’s then possible to isolate those individuals before they unknowingly spread the virus to classmates, others in the school setting, family members, and more. By reducing community spread (through pooled testing), we can greatly reduce the number of cases in our schools and the number of instances where we need to pivot to remote learning. 

 

Pooled testing is a preventative, precautionary screening tool that helps identify asymptomatic cases and thus limits the number of individuals those asymptomatic cases can transmit the virus to. Learn more about the Department of Education’s pooled testing program here.

 

What is the specific timeframe for pooled testing?

MRSD will start pooled testing on Monday, February 22, and test once per week through March 22. During each classroom’s morning meeting/homeroom/first block, students and staff in that class will quickly self-swab (with students PreK-grade 1 swabbed by nurses) and deposit the swabs in a grouped container. Those samples will be sent for PCR testing, with results back in 24-48 hours. If the pooled group is negative, no more testing action needs to be taken. In the rare cases where a pooled sample may come back positive, then each individual in the group/class would get a BinaxNOW rapid test to quickly identify the positive case(s). At that point, the class would be isolated to prevent further spread, and any positive individuals and identified close contacts would be guided on further steps.

 

What test is used for the pooled testing?

The pooled samples are tested using a molecular PCR test in partnership with Concentric. Learn more here.

 

Is pooled testing mandatory?

No. In order for pooled testing to be successful, however, it requires widespread participation. Otherwise, positive cases could go unidentified and thus continue to cause further spread. 

 

Is pooled testing safe?

Yes. Pooled testing is currently being used by many schools, businesses, and organizations, both in Massachusetts and around the country. See a video of pooled testing in action here.

 

How accurate are the pooled tests?

Pooled tests are highly accurate in identifying that there is a positive individual within the pool group, as molecular tests are highly accurate at detecting the virus that causes COVID-19. In validation studies, the Concentric test was able to correctly identify 96% of positive tests detected by the “gold standard” PCR test using a deep nasal swab and 100% of negatives (meaning that there were no false positives). 

 

Isn’t the nasal swab test deep and painful, especially for children? 

The type of swabbing needed for pooled testing is not the deep swab that some may be familiar with. This swabbing is not any more uncomfortable than wiping or blowing one’s nose. Students grade 2 and up, as well as staff, will administer their own swabs and be instructed on safe swabbing. The swabs are the length of Q-tips and are inserted only just inside one’s nose and gently swabbed in a circular motion 4 times in each nostril (see below). Students in PreK-grade 1 will be swabbed by our nurses.

Self swab instructions

MRSD’s practice is to ask students or staff awaiting COVID-19 test results to stay home pending those results - won’t this mean all students and staff have to stay home after every pooled test?

No, that practice applies to tests that were needed because the individual was symptomatic or had a known possible exposure. Pooled testing is a proactive screening tool. The goal is to screen widely for cases and then be able to isolate any asymptomatic positive cases before any further spread. 

 

Should household members of individuals in a positive pool be considered “possibly exposed” while waiting for follow-up testing to be completed?

No. Members of a positive pool do not have to quarantine prior to receiving the results of their follow-up tests, unless they are symptomatic. Similarly, household contacts of individuals in a positive pool do not need to quarantine, unless the individual is confirmed to have COVID-19 through follow-up testing. Individuals or close contacts of individuals who do receive a positive follow-up test result should follow the protocols for responding to COVID-19.

 

If a pooled test comes back positive, does everyone in that class need to immediately quarantine and pivot to remote learning?

If the district is informed of a positive pool, we will use Abbott BinaxNOW rapid antigen testing to help determine who in the pool is positive (and who is negative). This will allow staff, students, and families to have the information they need to be safe. In most situations, the district will still temporarily shift those in the classroom with the positive individual to remote learning, to make sure that no one exposed to the positive individual has become infected. If local health officials determine that the positive individual was not in the classroom while infectious, only the positive individual would be quarantined -- this latter situation has happened in every one of our schools in the past months.

 

What are the benefits and drawbacks of pooled testing?

Pooled testing is an excellent way to identify asymptomatic positive cases in a group setting. It is efficient and provides information on a fast turnaround. It allows larger groups such as schools to widely test and quickly identify cases, eliminating further spread and the need for more widespread closures. It is not well suited for symptomatic individuals or for those who have had a known exposure. Pooled testing also is not very effective if COVID rates are exceedingly high, where all or most pooled tests are coming back positive -- Monomoy is not at an exceedingly high level, and we’d like to keep it that way.

 

Is the Abbott BinaxNOW accurate enough to be used as a follow up to the pooled test, especially for asymptomatic children?

Yes. The Massachusetts Department of Public Health endorses its use in follow-up testing. This study provides further details: https://www.medrxiv.org/content/10.1101/2021.01.09.21249499v1. No test is 100% accurate. BinaxNOW tests are extremely effective at picking up those individuals with high viral loads (assumed to be most infectious) and are adequate for this purpose if PCR tests are available to follow up on individuals if a positive pool returns no positive BinaxNOW results. Anyone who develops symptoms consistent with COVID-19 should get tested (with a PCR test), even if they have recently received a negative result. 

 

Why does this program use a rapid test to confirm results when the district asks for a PCR test in other situations?

PCR tests are the most reliable and recommended testing tool. The initial pooled samples are tested using a PCR test. Then, if the pool group is positive, the program uses a rapid test to quickly identify positive individuals in the pool. This allows for results to be rapidly available to impacted individuals and their families, rather than waiting another 2-4 days for an individual (rather than pooled) PCR test. 

 

If a class receives a negative pooled test, can that group relax mask and distance guidelines?

No. Pooled testing is an effective screening tool, but a negative pooled test is not license to stop masking or distancing. Wearing a mask and maintaining distance from those not in your household are the most effective ways to prevent spread of COVID-19. 

 

Won’t it take too much of the teacher’s time to manage pooled testing?

The paperwork and logistics will be coordinated by district administrative staff. The nursing staff will manage the administration of any Abbott BinaxNOW rapid antigen tests. Within the classroom, most students can swab themselves and deposit the swab in the collection tube in under a minute.

 

Is there a cost to families or staff for pooled testing?

No, this program is fully funded by the Department of Education through March 28. At that point, MRSD will evaluate the effectiveness of the program and make a decision about continued participation.