Test-to-Stay After SARS-CoV-2 Exposure: A Mitigation Strategy for Optionally Masked K-12 Schools.

dc.contributor.author

Campbell, Melissa M

dc.contributor.author

Benjamin, Daniel K

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Mann, Tara K

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Fist, Alex

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Blakemore, Ashley

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Diaz, Kylee S

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Kim, Hwasoon

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Edwards, Laura J

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Rak, Zsolt

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Brookhart, M Alan

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Moore, Zack

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Tilson, Elizabeth Cuervo

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Kalu, Ibukun

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Boutzoukas, Angelique E

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Moorthy, Ganga S

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Uthappa, Diya

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Scott, Zeni

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Weber, David J

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Shane, Andi L

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Bryant, Kristina A

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Zimmerman, Kanecia O

dc.date.accessioned

2024-06-10T00:49:37Z

dc.date.available

2024-06-10T00:49:37Z

dc.date.issued

2022-11

dc.description.abstract

Objectives

We evaluated the impact of a test-to-stay (TTS) program on within-school transmission and missed school days in optionally masked kindergarten through 12th grade schools during a period of high community severe acute respiratory syndrome coronavirus 2 transmission.

Methods

Close contacts of those with confirmed severe acute respiratory syndrome coronavirus 2 infection were eligible for enrollment in the TTS program if exposure to a nonhousehold contact occurred between November 11, 2021 and January 28, 2022. Consented participants avoided school exclusion if they remained asymptomatic and rapid antigen testing at prespecified intervals remained negative. Primary outcomes included within-school tertiary attack rate (test positivity among close contacts of positive TTS participants) and school days saved among TTS participants. We estimated the number of additional school-acquired cases resulting from TTS and eliminating school exclusion.

Results

A total of 1675 participants tested positive or received at least 1 negative test between days 5 and 7 and completed follow-up; 92% were students and 91% were exposed to an unmasked primary case. We identified 201 positive cases. We observed a tertiary attack rate of 10% (95% confidence interval: 6%-19%), and 7272 (89%) of potentially missed days were saved through TTS implementation. We estimated 1 additional school-acquired case for every 21 TTS participants remaining in school buildings during the entire study period.

Conclusions

Even in the setting of high community transmission, a TTS strategy resulted in substantial reduction in missed school days in optionally masked schools.
dc.identifier

188760

dc.identifier.issn

0031-4005

dc.identifier.issn

1098-4275

dc.identifier.uri

https://hdl.handle.net/10161/31153

dc.language

eng

dc.publisher

American Academy of Pediatrics (AAP)

dc.relation.ispartof

Pediatrics

dc.relation.isversionof

10.1542/peds.2022-058200

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Humans

dc.subject

Incidence

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Schools

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COVID-19

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SARS-CoV-2

dc.title

Test-to-Stay After SARS-CoV-2 Exposure: A Mitigation Strategy for Optionally Masked K-12 Schools.

dc.type

Journal article

duke.contributor.orcid

Benjamin, Daniel K|0000-0002-0764-8585

duke.contributor.orcid

Rak, Zsolt|0000-0003-4015-7443

duke.contributor.orcid

Boutzoukas, Angelique E|0000-0002-9477-1492

duke.contributor.orcid

Moorthy, Ganga S|0000-0003-3191-1117

duke.contributor.orcid

Zimmerman, Kanecia O|0000-0003-3748-6932

pubs.begin-page

e2022058200

pubs.issue

5

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Staff

pubs.organisational-group

Clinical Science Departments

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Institutes and Centers

pubs.organisational-group

Pediatrics

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Pediatrics, Critical Care Medicine

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Pediatrics, Infectious Diseases

pubs.organisational-group

Duke Clinical Research Institute

pubs.organisational-group

University Institutes and Centers

pubs.organisational-group

Duke Global Health Institute

pubs.publication-status

Published

pubs.volume

150

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