A School-Based SARS-CoV-2 Testing Program: Testing Uptake and Quarantine Length After In-School Exposures.



Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related quarantines, which are required after close contact with infected individuals, have substantially disrupted in-person education for kindergarten through 12th grade (K-12) students. In recent recommendations, shortened durations of quarantine are allowed if a negative SARS-CoV-2 test result is obtained at 5 to 7 days postexposure, but access to testing remains limited. We hypothesized that providing access to in-school SARS-CoV-2 testing postexposure would increase testing and reduce missed school days.


This prospective cohort study was conducted in one large public K-12 school district in North Carolina and included 2 periods: preimplementation (March 15, 2021, to April 21, 2021) and postimplementation (April 22, 2021, to June 4, 2021), defined around initiation of an in-school SARS-CoV-2 testing program in which on-site access to testing is provided. Number of quarantined students and staff, testing uptake, test results, and number of missed school days were analyzed and compared between the preimplementation and postimplementation periods.


Twenty-four schools, including 12 251 in-person learners, participated in the study. During preimplementation, 446 close contacts were quarantined for school-related exposures; 708 close contacts were quarantined postimplementation. Testing uptake after school-related exposures increased from 6% to 40% (95% confidence interval: 23% to 45%) after implementation, and 89% of tests were conducted in-school. After in-school testing implementation, close contacts missed ∼1.5 fewer days of school (95% confidence interval: -2 to -1).


Providing access to in-school testing may be a worthwhile mechanism to increase testing uptake after in-school exposures and minimize missed days of in-person learning, thereby mitigating the pandemic's ongoing impact on children.





Published Version (Please cite this version)


Publication Info

Boutzoukas, Angelique E, Kanecia O Zimmerman, Tara K Mann, Ganga S Moorthy, Ashley Blakemore, Kathleen A McGann, Michael J Smith, Boen Nutting, et al. (2022). A School-Based SARS-CoV-2 Testing Program: Testing Uptake and Quarantine Length After In-School Exposures. Pediatrics, 149(12 Suppl 2). p. e2021054268J. 10.1542/peds.2021-054268j Retrieved from https://hdl.handle.net/10161/31155.

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Angelique Boutzoukas

Assistant Professor of Pediatrics

I am a pediatric infectious disease specialist and pediatric clinical researcher. My research interests are centered around finding the optimal ways to manage infections and minimize harms to patients. Recognizing the growing global threat of antibiotic resistance, I am particularly interested in finding the right dose and duration of antibiotics that children should receive to treat their infections, and studying the epidemiology and prevention of antibiotic resistant infections.   


Kanecia Obie Zimmerman

Wilburt C. Davison Distinguished Professor

Ganga Moorthy

Assistant Professor of Pediatrics

Kathleen Anne McGann

Professor of Pediatrics

Pediatric Infectious diseases; Pediatric HIV: Prevention of mother to child transmission of HIV

Medical Education; Pediatric Education; Pediatric Medical Student, Residency and Fellowship Training Programs;

Professional Coach/Coaching


Michael Joseph Smith

Professor of Pediatrics

I am the division chief of Pediatric Infectious Diseases at Duke.  My clinical and research efforts frocus on the prevention and treatmtent of infections in children.  I am the medical director of the pediatric antimicrobial stewardship program at Duke University Hospital and also serve as Co-Director of the Duke Vaccine and Trials Unit.


Daniel Kelly Benjamin

Kiser-Arena Distinguished Professor

Dr. Danny Benjamin is the Principal Investigator and Chair of the National Institute of Child Health and Human Development’s Pediatric Trials Network. The Network is responsible for designing and leading clinical trials of off-patent medicines in children of all ages across all therapeutic areas. The team has established, or is actively studying, the correct dosing and safety of more than 70 of the most commonly used medicines in children. Each of these trials is conducted under an Investigational New Drug (IND) application with guidance from the Food and Drug Administration for labeling.

The Pediatric Trials Network has directly impacted the healthcare of over 90% of American children.

Signature programs of the Network include clinical trials in premature, term infants, breast feeding mothers, and obese children. Over the past 10 years, Danny’s group has enrolled more premature infants, at more sites, in more clinical trials of off-patent anti-infectives under an IND than all other academic medical centers, pharmaceutical companies, and government agencies in the world, combined.

Danny is recognized by the National Institutes of Health as a premiere mentor and educator. His research program serves as a platform to train students and early career investigators. Danny’s group has a clinical research summer program for high school and college students that has a focus on trainees under-represented in medicine, and he is the primary mentor for medical students, residents, subspecialty fellows, and multiple junior faculty. He has been the primary or secondary mentor for 10 faculty who have received career development awards and who have then gone on to secure their own funding.

Danny's service to the community is expressed through his passion for coaching baseball. He has coached over 500 recreation league, travel league, and scholastic baseball games and he is the head coach of Smith Middle School, the 5-year reigning southern conference champions. Danny and his wife own a charitable non-profit that provides athletic and fitness opportunities for disadvantaged school-aged boys and girls.

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