Test-to-Stay After Exposure to SARS-CoV-2 in K-12 Schools.

dc.contributor.author

Campbell, Melissa M

dc.contributor.author

Benjamin, Daniel K

dc.contributor.author

Mann, Tara

dc.contributor.author

Fist, Alex

dc.contributor.author

Kim, Hwasoon

dc.contributor.author

Edwards, Laura

dc.contributor.author

Rak, Zsolt

dc.contributor.author

Brookhart, M Alan

dc.contributor.author

Anstrom, Kevin

dc.contributor.author

Moore, Zack

dc.contributor.author

Tilson, Elizabeth Cuervo

dc.contributor.author

Kalu, Ibukunoluwa C

dc.contributor.author

Boutzoukas, Angelique E

dc.contributor.author

Moorthy, Ganga S

dc.contributor.author

Uthappa, Diya

dc.contributor.author

Scott, Zeni

dc.contributor.author

Weber, David J

dc.contributor.author

Shane, Andi L

dc.contributor.author

Bryant, Kristina A

dc.contributor.author

Zimmerman, Kanecia O

dc.contributor.author

ABC SCIENCE COLLABORATIVE

dc.date.accessioned

2024-06-10T00:49:49Z

dc.date.available

2024-06-10T00:49:49Z

dc.date.issued

2022-05

dc.description.abstract

Objectives

We evaluated the safety and efficacy of a test-to-stay program for unvaccinated students and staff who experienced an unmasked, in-school exposure to someone with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Serial testing instead of quarantine was offered to asymptomatic contacts. We measured secondary and tertiary transmission rates within participating schools and in-school days preserved for participants.

Methods

Participating staff or students from universally masked districts in North Carolina underwent rapid antigen testing at set intervals up to 7 days after known exposure. Collected data included location or setting of exposure, participant symptoms, and school absences up to 14 days after enrollment. Outcomes included tertiary transmission, secondary transmission, and school days saved among test-to-stay participants. A prespecified interim safety analysis occurred after 1 month of enrollment.

Results

We enrolled 367 participants and completed 14-day follow-up on all participants for this analysis. Nearly all (215 of 238, 90%) exposure encounters involved an unmasked index case and an unmasked close contact, with most (353 of 366, 96%) occurring indoors, during lunch (137 of 357, 39%) or athletics (45 of 357, 13%). Secondary attack rate was 1.7% (95% confidence interval: 0.6%-4.7%) based on 883 SARS-CoV-2 serial rapid antigen tests with results from 357 participants; no tertiary cases were identified, and 1628 (92%) school days were saved through test-to-stay program implementation out of 1764 days potentially missed.

Conclusion

After unmasked in-school exposure to SARS-CoV-2, even in a mostly unvaccinated population, a test-to-stay strategy is a safe alternative to quarantine.
dc.identifier

186808

dc.identifier.issn

0031-4005

dc.identifier.issn

1098-4275

dc.identifier.uri

https://hdl.handle.net/10161/31154

dc.language

eng

dc.publisher

American Academy of Pediatrics (AAP)

dc.relation.ispartof

Pediatrics

dc.relation.isversionof

10.1542/peds.2021-056045

dc.rights.uri

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

dc.subject

ABC SCIENCE COLLABORATIVE

dc.subject

Humans

dc.subject

Quarantine

dc.subject

Schools

dc.subject

COVID-19

dc.subject

SARS-CoV-2

dc.subject

COVID-19 Testing

dc.title

Test-to-Stay After Exposure to SARS-CoV-2 in 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

e2021056045

pubs.issue

5

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Staff

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Institutes and Centers

pubs.organisational-group

Pediatrics

pubs.organisational-group

Pediatrics, Critical Care Medicine

pubs.organisational-group

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

149

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Test-to-Stay After Exposure to SARS-CoV-2 in K-12 Schools.pdf
Size:
776.82 KB
Format:
Adobe Portable Document Format