Ontario County: Testing Exposed Children for COVID-19 at School

  • Ontario County Public Health and County Leadership have been meeting weekly with school superintendents to develop a plan to keep COVID-19-exposed students in the classroom through daily testing in the nurse’s office. At this point in time, staff has been trained and testing supplies have been delivered to all schools in Ontario County. The initiative will be closely monitored, and it will be adjusted if it becomes clear there is increased spread of COVID during the school day.

    Synopsis: Testing Exposed Children during the School Day

    Exposed children — except those exposed by a household member — who DO NOT have ANY symptoms of COVID-19 (cough, headache, fever, nausea, vomiting, diarrhea, loss of taste/smell, significant nasal discharge, sore throat, excessive fatigue) may remain in school if they test negative for COVID-19 during the school day and if masking is strictly enforced. Children with mild "sniffles" in the morning on a school day, may present to school for testing.

    Process:

    • Schools will test exposed children daily by rapid Polymerase Chain Reaction (pcr) through day seven.
    • If a school can’t accommodate rapid pcr testing and is considering use of rapid antigen testing (BinaxNOW cards), the school administrator will seek input from the Public Health Director. The school administrator must be aware of the following:
      • Antigen tests are less sensitive than pcr tests and are more likely to give false negative results, particularly in people without symptoms.
      • When antigen tests are used, the school should consider additional strategies to ensure excellent masking and distancing in class, on the bus, in PE, at lunch, and at recess.
      • The Public Health Director may curtail the use of antigen testing if clusters or outbreaks develop.
    • Children may remain in school and participate in extracurricular activities Mon-Fri if they test negative.
    • If on day seven, children are without symptoms and remain negative for COVID-19, they need no further testing and may resume all usual activities.
    • If there is a lag in beginning daily testing, children need at least 2 negative tests, 24-hours apart, to be released from quarantine (days 6-7, 7-8, 8-9). These should be pcr tests. If the final day falls on a weekend or holiday, test the child for the last time, on the first day back to school.

    ALSO: Guidance for Students Who Have Signs or Symptoms After COVID-19 Vaccination

    Common Questions About This Process

    Why can exposed children now remain in school?
    Keeping children in the classroom is a priority for you, your child, your child’s school, and Ontario County Public Health. After much thought and discussion, health department leadership believes it is reasonable for exposed students to be tested daily and kept in school if they are negative for COVID-19. In the unlikely event of a false negative, strict adherence to masking decreases the likelihood of spread during the school day. Children exposed at home by a COVID-positive household member may not attend school during quarantine due to the high risk of transmission among household contacts.

    Can ALL exposed students stay in school?
    Exposed students may attend school when ALL the following criteria are met.

    1. Their exposure did not occur in their home
    2. They have no symptoms
    3. Their school has enough staff and test kits to do daily testing
    4. Their parent or guardian has given the school permission to test their child
    5. They test negative every day

    Does a negative test mean they do not have to mask?
    No, masking remains very important. We are relying on masking to prevent spread in the event of a false negative test result.

    I’ve heard kids can test out of quarantine after day seven. What’s this about?
    The CDC allows for testing out of quarantine if the local health department is agreeable. In Ontario County, school children can test out after seven days if they test negative at school through day seven. Rationale: By day seven, if virus is growing in the body, most exposed people will either have symptoms or test positive. Those symptom-free and negative through day seven, are unlikely to have virus in their bodies. Repeating the test daily, lowers the likelihood of false negatives.

    What about weekends and holidays?
    Schools are not expected to test children on weekends and holidays. Testing should resume on the next school day.

    What if day seven falls on a weekend or holiday?
    The child should be tested a final time on the next school day.

    Can exposed students participate in school-sponsored weekend or holiday activities?
    If the exposed child needs to attend a school-sponsored event on a weekend or holiday, the school may provide testing on the day of the event. Alternatively, if rapid pcr testing is available in the
    community (pharmacy, urgent care) and the student provides a negative test result the day of the event, they may attend if masked. If testing is not available, the student may not attend. If masking is not possible while within 6-feet of others, the student may not attend.

    Can exposed students participate in non-school sponsored evening, weekend, or holiday activities?
    Non-school activities outside of the home during quarantine are not allowed. This includes social events, private lessons, non-school sports, playdates, sleepovers, clubs, etc.

    Rationale:
    The decision to allow children to attend school during quarantine was made knowing masking and social distancing are monitored and enforced during the school day. It is impossible for the health department to know if these measures are in place outside of school.

    If a child tests positive or get symptoms in the 48 hours after such an activity, all who had close, unmasked contact with them for >15 minutes will be considered exposed and will require a 10-day quarantine.

    Does my exposed child have to stay away from other household members?

    Exposed children should stay away from other family members to the extent possible based on age and developmental level. If it is impossible to stay apart, other household members will need to quarantine if the child goes on to develop symptoms or tests positive for COVID-19. Masking at home will decrease the likelihood of spread.

    What if the exposed child has symptoms?
    A child who becomes ill between the end of the school day and the following morning, should not be sent to school the next day. A medical provider should evaluate and test this child for COVID-19. A doctor’s note including a specific, alternative diagnosis may be accepted by the school if criteria to return (per school policy) is met. Daily testing should resume when the student returns to school.

    What if this student returns after day seven?

    If the student returns after day seven but before day 11, the child needs a final test on their first day back.

    If an exposed child becomes sick at school, can they be tested prior to going home?
    In this case, the child may be tested prior to being sent home, if the school has testing supplies and staff available. If positive, the case will be reported to the health department and a 10-day isolation will begin. If negative, the child may go back to school when school criteria for return are met. Daily testing should resume and continue through day seven.

    What if this student returns after day seven?
    If the student returns after day seven but before day 11, the child needs a final test on their first day back.

    Will I be contacted by a New York State Contact Tracer?
    Yes, when your child is identified as a contact, they are assigned to a NYS Contact Tracer. This individual will call your home and take a short history (about 15 minutes) and they will set you up with a daily texting program. You will receive a text every day through day ten, even if your child tests out of quarantine after day seven. Please answer their texts through day ten. This is very important as in some people symptoms may take longer than seven days to develop. This step provides an added safety net. Calls from contact tracers may be identified as unknown numbers or may be from a 518 Area Code. If you do not answer, they will call back. Please answer these calls.

    Your school district is aware children may test out of quarantine in seven days and this is acceptable to Ontario County Public Health. The County is working with the NY State Department of Health and the New York State COVID-19 Investigation and Contact Tracing Unit to streamline this process. You may receive conflicting information from the NY State Contact Tracer assigned to your child or family. This is a temporary situation and will be resolved soon. Please follow the instructions in this document and those given to you by your school.

    How long will this program last?
    The grant that covers testing expires in July 2022 and testing of school contacts will continue as long as schools are willing, test kits are available, and funds remain. Staff and testing supplies are expensive and though we’ve planned well, there is a possibility that funds will run out prematurely due to the volume of testing.