The COVID-19 Learning Network

A collaborative space for school and district leaders.

Created by the U.S. Department of Education, the CDC, and The Rockefeller Foundation, the Learning Network helps school and district leaders start or strengthen school COVID-19 testing and vaccination programs.

“How To” Webinars

Testing 101 Presentation + 45 mins Q&A

1/28 & 2/4, 1:30-2:30p EST

Join the U.S. Department of Education for a webinar to help schools and districts start or strengthen their school-based COVID-19 testing programs. Ask questions and hear directly from technical experts and school and district leaders who are regularly testing.

Discussion topics:

  1. Why is testing in schools important?

  2. What should I know before I start?

  3. What are some resources that can help me get started?

  4. What is Test to Stay and how are other schools doing it?

New! ESSER FAQs

Learn how ESSER funding can be used for COVID vaccines and testing in K-12 public schools.

Click here for more Department of Education resources on K-12 COVID relief funding

Session 1: Starting or growing your testing program and staffing

 

Key takeaways

Staffing concerns are one of the biggest barriers to schools starting and expanding in-school Covid-19 testing programs. Schools and districts commonly cite that nurses are already overworked, that schools are short staffed, and that testing programs require hiring new people, and hiring is a familiar challenge across the country right now.

Best practices to solve staffing challenges:

  • Use available funding streams (ie: ESSER) to hire contract staff

    • ESSER FAQs: Together, the last paragraph in A-3 and B-10 mean that ESSER funds can be used to contract with personnel to support testing

  • Hire contract staff for non-medical roles (contact tracing, admin tasks)

  • Leverage non-human resources (ie: text messages for contact tracing)

  • Consider using an ambulance company for on-site testing

  • Send sample collection kits home or provide testing outside of school hours

  • Consider nontraditional staffing:

    • Provide practicum hours for nursing students

    • Hire retired nursing staff

    • Have one central team visiting multiple (or even all) schools within a district

  • Engage community partners and parent/student volunteers for non-clinical tasks

Other learnings

  • Text messaging can be a huge time saver for contact tracing AND serves as a timestamp/record for quarantine notification for families

  • Implementing a test-to-stay model reduces missed days of in-person learning

  • There’s value in a variety of testing methodologies (PCR, antigen, LAMP) - each can be utilized at different times and in different contexts to support students staying in school 

“Our school district also hired two medical advisors to provide direct support for nurses when they encounter sticky situations and have detailed questions. It has been a huge help for our school-based nurses.”
— School Testing Coordinator
 

Key moments from Session 1

Session 2: Testing in the context of vaccine uptake

 

Key takeaways

Schools, districts, and states around the country emphasized that regular testing supports the health and safety of their community - even as vaccine coverage has increased. Testing programs continue in the context of increased vaccine uptake and help to support more in-person learning and extracurricular opportunities.

Best practices for testing in the context of vaccine uptake

  • Integrate state immunization records with student’s electronic health records

  • Use one consent process: “Just having one single consenting process, for one year...not having to consent multiple times, is most useful...”

  • Implement test to play (or test to participate): requires regular testing for students participating in sports or other extracurricular activities (or even field trips) regardless of vaccination status given increased exposure, although not recommended by CDC guidance

  • Implement test to stay: requires frequent testing of unvaccinated students, teachers, and staff who are identified as close contacts - as long as they remain asymptomatic and continue to test negative, they do not need to quarantine, although not recommended by CDC guidance.

  • Conduct routine screening for unvaccinated staff: requires staff who are not vaccinated to test regularly. In Tulsa, OK, this approach has been “critical” to prevent spread.

  • Provide access to on-site, rapid tests for symptomatic staff and students.

Other learnings

  • When students, parents, and staff see how vaccination can increase in-person school days, it can motivate more students to get vaccinated.

  • There are multiple ways of gathering student vaccination status: for larger systems, integrating school-based data systems with the state immunization registry may be the most streamlined approach; smaller schools may just be able to ask families directly.

  • Onsite testing and vaccination clinics can increase uptake and trust in vaccination and testing.

  • Communicating via text (i.e. quarantine/end dates, vaccine registration) helps families keep track, and is cost effective for schools.

  • Create consent forms that families sign once for ongoing testing, and make these forms as inclusive as possible to allow for changes in the testing model

    • Providing digital and hard copy consent forms increases opt-in rates and equitable access.

“Vaccination – whether we’re mandating it or encouraging it strongly – isn’t necessarily impacting our testing programs. We still really see a need for our testing programs to stay.”
— School Testing Coordinator
 

Key moments from Session 2

Session 3: Engaging families to increase buy-in for testing

 

Key takeaways

During our Week 3 sessions, Hattaway Communications presented findings from a nationally representative sample (from a study completed over the last 18 months):

  • The majority of parents/guardians would be at least somewhat likely to allow their

    students to be tested if testing were offered in schools.

  • 25% of parents/guardians are unaware of their schools’ mitigation strategies, and 10% believe that their schools are not doing anything.

We then discussed the importance of creating a unified and strategic communications plan to accurately inform families about school-based testing policies – particularly in the context of pandemic fatigue and continued spread of misinformation - and identified a number of ways to strategically engage families in a school or district’s testing program.

Best practices for engaging families to increase buy in for testing

  • Diversify the messenger and send a unified message: allow families to hear about the importance of testing from a variety of stakeholders. Utilize student ambassadors, community leaders, school nurses, and external health experts to spread the same message, so that families hear from people they trust.

  • Time your communications strategically: utilize key periods throughout the school year to provide information about the school or district’s testing program (think start of the school year, before and after holiday breaks, etc.).

  • Break down misconceptions that families may have about the types of tests being utilized and ensure everyone has the necessary background knowledge

  • Anchor, “why test?” in messaging that resonates with families

    • Do your part

    • Do it for them

    • Before it’s too late

Other learnings

  • Providing families with the science behind testing (and vaccines) is critical to stopping the spread of misinformation. This is particularly important for families of color who are disproportionately impacted by the pandemic.

“There seems to be a target on communities of color where misinformation is designed to hurt us. Our health director said, ‘the vaccine is not going to kill you, but the misinformation can’...” - District COVID-19 Testing Coordinator

  • Families’ initial willingness to test and their actual opt-in participation rates may not match up. To help solve for this, plan multiple ways to reach out to families to discuss testing such as one-on-one conversations, text messaging, and posting testing consent forms across multiple district web pages).

  • Incentives (e.g., gift cards and raffles) can increase buy-in for both students and their families. ESSER funds can be used to purchase incentives.

“School nurses are the faces of health in school communities...focus on this group as that is who parents trust.”
— State Dep't of Edu. Nurse Consultant
 

Key moments from Session 3

Session 4: Contact tracing, data management, and reporting

 

Key takeaways

Creating and implementing strong systems for contact tracing, data management, and reporting goes hand in hand with creating a robust school-based COVID-19 testing program. Schools and districts around the country are overcoming the challenges of limited staffing and access to resources to effectively monitor the presence of COVID-19 in their communities and break chains of transmission. 

Best practices for engaging families to increase buy in for testing

  • Streamline, centralize, and automate operations where possible - call centers can be an effective way to provide consistent information to families, and ESSER funds can cover staffing costs 

  • Utilize partnerships with local health departments to support contact tracing, which can free up school nursing staff to run on-site testing

  • Consider personalized reach-outs and 1:1 communication in smaller districts or schools to answer families’ individual questions and identify gaps in information

  • Use school-based strategies such as seating charts, QR codes on lunch tables, class rosters, and video footage of school buses to help identify close contacts

  • Find vendors and software applications that best support your school or districts’ reporting needs (resources listed below)

Other learnings

  • Identifying the positivity rate of close contacts in your community can provide valuable insight into the success of other mitigation strategies. We expect positivity to remain relatively low if robust mitigation strategies are implemented and adhered to.

  • Determining when to use automated outreach vs. personalized contact with families depends largely on the size and the needs of your school community. Centralized messaging can improve consistency while personalized calls can address families’ specific questions and concerns.

  • Finding and building data platforms that integrate with your state reporting systems significantly streamlines operations for school-based staff.

Session resources

Tools used in schools/districts for contact tracing & reporting

  • SimpleReport - free reporting tool built by CDC specifically for rapid PCR or antigen test, has to be done on-site at school:

  • Project Beacon - database and reporting software used by Tulsa Public Schools

  • Health Office Anywhere - Electronic Medical Record system used by Las Vegas Public Schools

  • WeHealth COVID Watch AZ - Contact tracing app used by the White Mountain Apache Tribe and communities across Navajo Nation

“Having our own nurses do the testing was incredibly important for us… [but it] stretches their capacity... Thankfully, we have a fantastic partnership with our local health department and their epidemiologists are doing all aspects of contact tracing. ”
— School District COVID-19 Testing Coordinator
 

Key moments from Session 4

Missed Session 4? View the intro presentation here and access key takeaways from the large group discussion below

Session 5: Running a dual program: school-located vaccination & testing

 

Key takeaways

Running school-located COVID vaccination and testing programs can help schools stay open safely - or as one district health coordinator noted, these programs can “keep students in, and keep COVID out”. School-based testing and vaccination can also dramatically increase accessibility to healthcare for students and families - particularly those who face additional barriers to accessing these services.

Best practices for running a dual program

  • Leverage existing infrastructure from other school health initiatives to set up COVID-19 vaccination programs

  • Seek vaccinating partners such as local public health departments, community health centers, pediatric healthcare providers, hospitals, or pharmacies to offer school-located vaccination clinics

  • Bring mobile clinics (e.g., you can contract with an ambulance provider) to school settings to offer additional vaccines and health services for students and families

  • Embed school staff (nurses, teachers, etc.) into vaccine clinics run by community organizations in order to offer a familiar face to students

  • Utilize school nurses to relay messages about the importance of vaccination and work with community partners to provide messaging in all primary languages spoken at home 

    “When we think about how to best engage families in both testing and vaccination, it really is about personal relationships. And so often, it’s the school nurse who is the face of the program.” - Testing Coordinator

  • Share data with families about the impact of vaccination on health outcomes (both specific to COVID as well as other diseases)

  • Include testing and vaccination consent forms in enrollment packets for new students

  • Make the vaccine environment an enjoyable experience - ensure operations are smooth, and have fun - food and drink, music, mascots, and other forms of entertainment

  • Incentivize vaccination efforts by connecting them to field trips, sports, and other extracurricular activities - consider other external incentives as well

  • Create a data sharing agreement with the state to streamline sharing of vaccination information with immunization registries

Other learnings

  • Schools have and will continue to be on the frontline of combating health inequities. The same efforts that teachers, staff and administrators use to increase equitable access to COVID-related health services can be applied to other health services, now and in the future.

    “The pandemic has exacerbated the unmet need our families have for [routine, non-COVID] vaccinations, and we have an opportunity with this COVID infrastructure to support our families beyond just COVID response and prevention... This will serve our kids moving forward.” - School Health Advisor

  • Some parents/guardians prefer the convenience of students being able to be vaccinated against COVID and other vaccine-preventable diseases at school. In places where parents/guardians do not need to be present, this can be helpful.

  • Having events where students and their families can get COVID vaccines can increase participation in these events.

“As we think about access to testing and immunizations, it’s important to remember that many students didn’t have access to [general preventative] services before the pandemic... This public health crisis has been exacerbated by poverty.”
— School District Health Coordinator
 

Key moments from Session 5

Session 6: Test to stay and close contact testing

 

Key takeaways

Test to Stay (TTS) programs around the country are maximizing the amount of time students can stay in school safely while minimizing the spread of COVID-19. Districts and schools implement TTS using a variety of testing modalities, cadences, and protocols: there is no “one size fits all” approach. TTS allows school-based close contacts of a positive case to remain in school rather than quarantining if they remain asymptomatic, participate in routine testing, and adhere to other prevention strategies.

Best practices for TTS and close contact testing

  • Communicate the benefit of TTS in minimizing quarantine time for students, which allows students to remain in school and allows guardians to go to work after a known exposure

  • Create the optimal testing environment for your school/district/community: consider exposure risk and subsequent risk of infection (with guidance from local public health officials) as well as staffing and testing resources in determining the frequency/cadence and the type of tests used

  • Ensure layered mitigation strategies (masking, social distancing, quarantining outside of the school setting) remain in place to minimize both secondary spread among close contacts of the positive case and tertiary spread from close contacts to others

  • Increase equitable access to testing for families by offering evening hours and mobile testing options in addition to in-school testing opportunities

  • Include follow-up phone calls, contact tracing, and data entry when you think about the staffing and time it will take to implement TTS

Other learnings

  • In some locations, students who ride the bus are not able to participate in TTS because social distancing, a key mitigation strategy that can prevent spread, may not be feasible. Consider other ways to ensure equitable access to TTS for these students so they can attend in-person learning as often as possible.

  • TTS programs can include vaccinated students if not feasible to exclude. Consider staffing and testing resources when determining who will be eligible to participate.  

  • Many TTS programs include teachers and staff. Including teachers and staff allows them to remain teaching in-person and this prevents classrooms and schools from closing.

“Thinking about the frequency in any testing program - it matters how many people might be exposed in that timeline vs. how quickly people become infectious.”
— Infectious Disease Epidemiologist
 

Key moments from Session 6

Session 7: Procurement

 

Key takeaways

The procurement process for testing is new to most schools and districts. The process can be complex and take time. But there are several tools and resources that can help administrators identify whom and what they need to support routine testing.

Best practices for TTS and close contact testing

  • Reach out to your state testing program for information about the vendors, supplies or services that are available to schools: ELC Reopening Schools: Support for COVID-19 Screening Testing to Reopen and Keep Schools Operating Safely | DPEI | CDC

  • Consider choosing a testing vendor based on the type of testing program you want to run and building in flexibility to meet changes in supply chain and school needs:

    • Pooled PCR; individual PCR; individual antigen; antigen cartridge and reader

    • Testing participants: all or some of the population; test to play; test to stay

  • Consider choosing a testing vendor that can provide the services (listed below) that you want to outsource. Also consider their willingness to integrate those services with the workflows that already exist (e.g., integrating a vendor’s results reporting software with a district’s electronic health records).

    • Personnel / Workforce

    • Program Management and Other Services

    • Data and Reporting

“We knew we were moving from opt in to opt out, we knew we needed robust data management, our parents were telling us they wanted more communication about testing results…and we wanted to make sure [the vendor] had ample testing supplies.”- Chief of Staff, Charter School Network

  • Consider costs: all together, sample collection, analysis, reporting, and staffing should run $12-25 per test. If it’s significantly above or below this range contact Mara Aspinall mara.aspinall@healthcatalysts.com

  • Consider how much experience vendors have operating in K-12 settings.

  • Work with your legal, medical, and regulatory team early on as their review processes can take time.  

  • Use this vetted questionnaire to complete a testing vendor needs assessment with key stakeholders like procurement officials, testing coordinators, and nurses.

  • Consider the benefits of creating a testing program that is “test agnostic”. This can give your school/district the flexibility to pivot to different types of tests based on supply chain bottlenecks.

  • Develop consent forms that flexible enough to cover a broad range of testing approaches and services (e.g., observed sample collection, student self-collection, provider-collection).

  • Use available financial resources from the national and state level to fund these programs.

    “There is no one-size-fits-all funding model. It depends how your state accesses certain funds, so you may need to try different routes depending on your state/region’s regulations.” - School District Testing Coordinator

“I’ve learned [through this pandemic] to not put all our testing eggs in one basket! It’s important to diversify our testing options and obtain tests from more than one vendor.”
— School District Health Coordinator
 

Key moments from Session 7

Session 8: Best Practices in School-Based Testing

 

Key takeaways

Coordinators of school-based testing programs around the country know what it takes to stand up a successful testing program. Their programs leverage traditional and nontraditional partners, ensure equitable access to appropriate and acceptable testing options, and are designed programs with sustainability in mind.

Best practices in school-based Covid testing

  • Work with local public health officials to determine the cadence (weekly, twice weekly etc.), type of testing (PCR, antigen, individual and/or pooled) and the testing model (Test to Stay, Test to Play, diagnostic only, and integration of screening testing) that will optimize resources and ensure that students can learn in person safely.   

“[Our weekly, pooled PCR testing program] helps us identify cases early so that we can prevent the spread of COVID-19 in our classrooms. It also has allowed for a significant reduction in quarantine so our students can have the in-person learning that they need.”

- District Health and Wellness Coordinator

  •  Use government funding to start, strengthen, or sustain your testing program (guidance on accessing available funding streams below)

  • Communicate with families through familiar channels (e.g., Facebook, enrollment packets, local radio) to build trust and increase buy-in for consent.

    • Highlight that testing programs allow students to minimize or skip quarantine

    • Translate and provide all information in languages spoken at home

    • Consider what communications should/can be individualized and what communication should/can be automated (e.g., robocall) and in what circumstances (e.g., using automated text messaging or individual phone calls to notify families of close contacts)

“We tried to make it as easy as possible for parents to participate…[for example], if we assume that all parents have access to email, that is not true. If we assume that a parent’s home language is English, that is not true. How can we provide them with translated consent forms and ways of accessing results via text?”

- Health and Safety Chief, Charter Network

  • Find partnerships in the community that are mutually beneficial (consider foundations, local hospitals, universities/colleges/technical schools) to reduce operational burdens on school staff. For example, in Tulsa a district recruited nurses-in-training who staffed testing while earning school credit for their work in the field.

  • Utilize nursing staff based on what your school community wants: in some districts, this means that nurses administer tests, in other districts, this means that nurses focus on providing clinical guidance and messaging to families via a central call center 

  • Find creative avenues to staff the rest of the testing program using other school-based staff, staffing agencies, or student nurses.

  • Centralize and streamline operations wherever possible. For example, providing critical information about quarantine dates and close contacts in writing (i.e., a text messaging notification system) or creating a call center to provide consistent messaging to all families and schools.

“We moved to a text notification system to help streamline the process [of contact tracing] in order to one, reduce the burden when multiple families needed to be called and two, to provide parents information in writing [to help them remember quarantine dates].”

- Manager of District Health

“We created a central call line where we were able to hire 50 nurses to contact trace and maintain consistent messaging to parents and school administrators. This allowed us to train a small number of nurses whose sole focus was COVID-19 and contact tracing, to provide resources to parents, and to take the burden off of school sites.”

- Chief Nurse/District Director

  •  Build trust in your testing program by following the science

“Our decision to follow the science and follow the most stringent health and safety protocols has really made sure that our students and school communities were as safe as possible…our educators and our families trusted the district to make sure their students were safe. And our educators felt safe as well because they knew we were advocating for them and for stringent health and safety protocols...it all comes down to relationships and a common goal.”
— District Union President
 

Key moments from Session 8

Missed Session 8? View the full presentation here and access key takeaways from the large group discussion below

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