HARRISBURG – Nearly six months into the school year, the majority of Pennsylvania schools have not signed up for a free on-site COVID-19 test program provided by the state Department of Health.
While participation in the program has doubled since the fall, only 750 of the state’s more than 5,000 charter, private and public schools are enrolled on February 16th. Of the total number of tests about half are active while others are still in the onboarding process.
“It’s not enough,” Acting Health Minister Keara Klinepeter said during a news briefing in early February, adding that the state continues to “make further outreach” to encourage participation.
School test programs across the country have struggled to gain momentum over the fall and winter, while officials juggled competing crises: outbreaks driven by the delta and omicron variants, and exhausted school staff.
“I do not think Pennsylvania is unique in this case,” said Christine Pitts, a political fellow with the Center for Reinventing Public Education research organization, which has tracked state and school responses throughout the pandemic.
About 25 percent of Pennsylvania’s 500 public school districts use the state’s program, which is administered by Ginkgo Bioworks, a Boston-based biotech company. Some schools in the southeastern part of the state use a different testing program independent of the state Department of Health.
Health authorities initially estimated that the federally funded Gingko program could cost the state up to $ 87 million for services, including testing, medical and administrative support, and program fees. A spokesman for the state Department of Health said Gingko billed for only $ 8.2 million per year. January 25, another sign of the program’s slow rollout.
When asked why more schools are not enrolling, Klinepeter returned the question to local schools: “I would ask you to ask schools why they do not participate, why they do not do their part to protect children and teachers.”
‘Their plates are so full’
For some schools, the answer to Klinepeter’s question is not political, but practical.
Charleroi, about 30 miles south of Pittsburgh, is one of 12 school districts in Washington County – which has 14 public school districts – that choose not to participate in the state’s test program. Superintendent Edward Zelich said his staff is stretched so thin, “I do not have the heart to say we will add one more thing now.”
Zelich said the rural district, which serves about 1,400 students, has used other tools to keep people safe. It requires students and staff to wear masks while the county is in what the CDC identifies as a “high” level of COVID-19 transmission. The district also hosted several vaccination clinics during the fall and winter. School nurses diligently track close contacts with students or staff who have tested positive for the virus, and even pull security camera footage from the cafeteria to see who a student might have socialized with. Since the start of the school year, about 820 students and staff have had to be quarantined after being tested positive or exposed to the virus.
Asking district nurses to take on COVID-19 tests would increase their work tenfold, Zelich said. In addition to the two building nurses, the district has recently hired a third nurse to float between the offices for additional support.
“Their plates are so full,” he said.
On an average day at Charleroi Elementary School, which serves students in pre-K to fifth grade, school nurse Heather Fox-Sutek can see as many as 40 students.
Buds and scratches, upset stomach and fever, administration of blood sugar tests or dispensing of scheduled medication – COVID-19 is just one of the many ailments on her radar. At least one of the 750 students in her custody appears to be in her office at all times.
“There’s still the possibility that something could go very wrong because we have children who are medically fragile,” she said, adding that it is impossible to predict when she might have to drop everything and respond to a medical emergency. such as a student having a seizure. or an allergic reaction.
It does not take into account the hundreds of hearing, vision, height and weight screenings she is required by the state to administer during the school year. and then there’s the paperwork: immunization records, medical notes, and student health plans.
When COVID-19 hit, remedial measures such as contact tracing and communication of quarantine protocols to families also fell to Fox-Sutek and Dana Cannon, the district’s two full-time nurses.
Cannon, who works in middle and high school, described the responsibility added by the coronavirus pandemic – identifying close contacts with sick students or staff, calling parents, administering changed quarantine guidelines and bringing the bad news of postponed events – as “everything else job, ”one that can be emotionally draining.
It’s just not realistic to add COVID-19 testing in school, she said.
“It’s overwhelming,” Cannon said. “In theory, that would be good. We simply do not have enough manpower.”
A look into the program
Schools in Pennsylvania have struggled to deal with outbursts among staff and students caused by the aggressive delta and omicron variants since the beginning of the school year.
Cases among school-age children aged five to 18 rose steadily through the fall before rising in late December, just as students were due to return from the holiday season, state data show.
About 43 percent of children ages 5 to 19 in counties under the jurisdiction of the Department of Health, excluding Philadelphia, have received at least one dose of vaccine, according to data provided by the Department of Health in early February.
“For the children who are not vaccinated, it poses a risk, and so yes, I’m worried. And yes, we continue to work to increase pediatric use,” Klinepeter said.
Many schools have switched between personal and virtual teaching as they deal with staff absenteeism and a severe, nationwide shortage of substitute teachers. Confusion over how to implement the state Department of Health’s mask mandate for schools and child care centers exacerbated many of these problems.
Some schools challenged the authority of the Ministry of Health to issue the mandate, and state legislators – in their capacity as parents – took the former health secretary to court. Pennsylvania’s Supreme Court in December ruled in their favor, knocking the rule down and leaving masking decisions to local leaders. Further legal disputes in some public school districts have followed.
It was against this background that the State Department of Health in July hired Ginkgo to administer its test program at the school. Funded by a CDC grant for the 2021-22 school year, the program was designed to capture outbreaks early and keep students in the classrooms. Schools are eligible to participate free of charge and can choose from several testing options, including rapid antigen testing and weekly pooled testing. Some students or staff may opt out.
Exactly how testing is implemented differs from school to school.
Students and teachers at schools that use pooled testing are typically tested weekly. Each person swipes their own nostrils, and the samples from specific groups – such as a homeroom class – are mixed together. The results are returned within a day or two and show if the virus is present in this group. If the result is negative, there is probably no one in the group who is ill. However, if the overall test is positive, someone in that group may have COVID-19. At that time, follow-up testing is required.
Mt. The Lebanon School District, which serves about 5,300 students in the southwestern suburbs of Pittsburgh, was one of the earliest users of the program and has used pooled tests. It is one of Allegheny County’s 18 public school districts – out of 43 – using the state’s program.
“During our participation over the past 15 weeks, we have found that the program is beneficial in detecting asymptomatic individuals,” said Kristen James, a spokeswoman for the district.
Others, like the California Area School District in Washington County, hold quick antigen tests on hand for any student or staff member who requests one. The district in January also began using the test-to-stay model, which allowed students exposed to the virus to stay in class as long as they wore a mask and repeatedly tested negative.
The small rural area on the eastern outskirts of Washington County borders the Charleroi School District, and for several months was the only one in the county to use the state program. Another district, Avella Area, started the onboarding process in early February.
Having tests available at the school eases the burden for families who may have trouble tracking a home test or finding an appointment at a pharmacy, which can take several days or require a long drive, said California Area Inspector Laura Jacob.
Jacob said she and two other administrative staff perform all tests and contact tracking for the district, which is mask-free for its 910 students. They have administered about 1,500 tests since the fall, she said.
“The kids want to stay in school,” she said. “I want to keep the staffing fairly consistent. I can not get children to learn if I do not have them here, so for me it is all worth the work and effort.”
On the other side of the state, the Philadelphia School District has continued to partner with the Children’s Hospital of Philadelphia PolicyLab to participate in another school test program called Project Ace-IT. Because it received separate federal funding for the COVID-19 relief effort, the district is not eligible to use the state testing program.
As of mid-January, Project Ace-IT had enrolled 48 public school districts in southeastern Chester, Delaware and Montgomery Counties – up from 43 this fall – along with several technical schools, intermediate units and private schools for a total of 742 individual test sites, he said. Christina Procacci, Project Ace-IT operations manager.
The health authorities have not yet decided whether the state program will be extended to next school year.
Spotlight PA is an independent, party-political newsroom run by The Philadelphia Inquirer in collaboration with PennLive / The Patriot-News, TribLIVE / Pittsburgh Tribune-Review and WITF Public Media.