A test for
School
Reopening
by Alisha Kirby and Kimberly Sellery
Proposed guidance on COVID-19 testing presents major hurdle
When the U.S. Food and Drug Administration issued the first emergency use authorization for a COVID-19 vaccine back in December, there was a sudden and palpable sense of relief from parents, educators and education officials that the reopening of school sites was forthcoming.

The reality on the ground is much more complicated, however. Due to a shortage of available vaccines and often-fumbled distribution, it will be a while before all teachers, school staff and other essential workers are fully vaccinated — let alone students under the age of 16, for whom a vaccine has not even been approved for use.

For now, local educational agencies that reopen campus for small cohorts of higher-needs students or in a hybrid learning model must continue to rely on mitigation strategies that dictate good hygiene practices, social distancing, the proper use of personal protective equipment and regular testing.

nurse testing
A test for
School
Reopening
by Alisha Kirby and Kimberly Sellery
Proposed guidance on COVID-19 testing presents major hurdle
When the U.S. Food and Drug Administration issued the first emergency use authorization for a COVID-19 vaccine back in December, there was a sudden and palpable sense of relief from parents, educators and education officials that the reopening of school sites was forthcoming.

The reality on the ground is much more complicated, however. Due to a shortage of available vaccines and often-fumbled distribution, it will be a while before all teachers, school staff and other essential workers are fully vaccinated — let alone students under the age of 16, for whom a vaccine has not even been approved for use.

For now, local educational agencies that reopen campus for small cohorts of higher-needs students or in a hybrid learning model must continue to rely on mitigation strategies that dictate good hygiene practices, social distancing, the proper use of personal protective equipment and regular testing.

IT

is that last, critical factor that has proven to be a significant challenge for districts. Currently, most LEAs are providing surveillance testing for staff only, typically once every two months, and are doing so based on the July 17, 2020, guidance from the California Department of Public Health.

COVID-19 testing for students and staff is central to the Gov. Gavin Newsom’s proposed Safe Schools for All reopening plan and is likely to be a factor in any widescale reopening plan introduced by lawmakers and CDPH officials. Ramping up testing to cover all staff and students will require an unrealistic amount of infrastructure, staffing, new billing operations, private and state lab capacity, testing contracts, collection and transportation of tests, and additional employee negotiations due to changes in working conditions. In addition, the use of Proposition 98 funds for public health initiatives is inappropriate and would detract from much-needed resources for student social-emotional health and accelerated learning.

Proposed testing cadence unrealistic for most LEAs
In late-October 2020, the Napa Valley Unified School District began offering a hybrid model in which students learn in person for part of the day and online at home for the remainder. Initially, about 45 percent of the district’s 17,000 students were attending in person, but in-person attendance dwindled down to 31 percent following a winter surge in positive cases of the virus.

If the district were to test all of its employees as well as students attending class in person using the proposed cadence, it would be managing a volume of anywhere from 9,000 to 10,000 results on a weekly basis, said Rosanna Mucetti, superintendent of Napa Valley USD.

Ramping up testing to cover all staff and students will require an unrealistic amount of infrastructure, staffing, new billing operations, private and state lab capacity, testing contracts, collection and transportation of tests, and additional employee negotiations
Measurements
“I just want to be really candid and honest that, I don’t think that we have infrastructure to manage that type of volume. I think in smaller environments, testing weekly for students and staff may be possible, but when you start talking about scaling employees and students in larger systems, there wouldn’t even be time to respond to that data,” Mucetti said during a CSBA-hosted webinar on how Gov. Gavin Newsom’s proposed budget would affect LEAs.

Her advice? Focus on strong implementation of other safety mitigation strategies. Napa Valley USD has not seen any COVID-19 transmission on campuses due to the strict culture of adherence to social distancing, to mask wearing, to the daily health screeners and other safety protocols, she explained. The newest guidance released by the Centers for Disease Control and Prevention concurs with Napa Valley USD’s lived experience. The agency released on Feb. 12 its Operational Strategy for K-12 Schools through Phased Mitigation, which emphasizes the use of layered mitigation strategies to provide the most protection. Those five key strategies, which do not include vaccinations or testing, are: universal and correct use of masks, physical distancing should be maximized to the greatest extent possible, handwashing and respiratory etiquette, cleaning and maintaining healthy facilities, and contact tracing in combination with isolation and quarantine.

“I’m not saying that testing isn’t great, I think if we can do it, we can take it to scale, and it’s funded, and we have infrastructure to manage that volume of data, phenomenal. It will ensure more safety. But I don’t know if that’s actionable,” Mucetti said.

Size, community trust are challenges to scaling up testing
The size of a district plays a large role in the struggles that schools face in scaling up COVID-19 testing. A small district in which staff already tend to wear many hats is unlikely to have the ability to stretch its workforce further.

Kern County’s 1,000-pupil Taft Union High School District staff is already going above and beyond, said Superintendent Blanca Cavazos. The district brought English learners and special and alternative education services back to campus in October, followed by the rest of the students in stages as case rates in the county declined. As case rates increased, fewer students participated in the half-day hybrid model, Cavazos said. At one time, the district’s food services staff was sent home to quarantine, and other staff members stepped in to serve meals before going back to their normal duties.

Taft Union would have to hire someone to manage the testing process — from efficiently distributing the tests to employees, to collecting and sending them to a facility to analyze the tests, to tracking and reporting positive cases. Until February, the process had been handled by Quest Diagnostics, which was contracted through Self Insured Schools of California — a Joint Powers Authority administered by the Kern County Superintendent of Schools Office. The district is going to move to using the CDPH’s Valencia Branch Laboratory.

“We’re basically testing all staff every other month at this point, so the idea of doing it weekly is daunting to say the least. And the idea of students? I just don’t know how we can do that,” Cavazos said. “If they have a choice, my thought is students might test if someone in the family has tested positive, or if they’ve been sick themselves. But there’s no guarantee that they would test every week or follow our cadence that we have for the adults right now.”

The cost of testing also presents a challenge. “I’m going to just acknowledge right out of the gate that testing is expensive. And if you haven’t been in the conversations about that, cost per test, per student, per employee can really be a big number,” said Dr. Debra Schade, a Solana Beach USD trustee and CSBA Director, Region 17.

“when you start talking about scaling employees and students in larger systems, there wouldn’t even be time to respond to that data.”
—Rosanna Mucetti, superintendent,
Napa Valley USD
Measurements
Her 3,100 K-6 district is one of the few at the time of this writing that is testing both staff and students. Solana Beach USD conducted ‘return to campus testing’ for everyone in September when it opened campuses for in-person instruction through a hybrid model, and again in January after the holiday break. Asymptomatic testing, which covers about 50 percent of the students and staff every week, is also conducted on a rotating schedule.

The district worked with University of California, San Diego scientists to establish a testing model and signed a memorandum of understanding with UC San Diego health to provide onsite COVID-19 PCR testing. About 80 percent of the district population is participating, Schade said. “We became a demonstration model. We worked hand in hand, debriefed after every testing so that other districts would be able to take that and use that, and now San Diego USD is doing the same.”

Valencia
Laboratory
On Oct. 30, 2020, Gov. Gavin Newsom announced the opening of the California Department of Public Health Valencia Branch Laboratory, commonly known as the Valencia Lab, designed to increase the state’s COVID-19 testing capacity and reduce test turnaround time.

Nearly 150 LEAs had partnered with the lab as of Feb. 3, Paula Villescaz, California Department of Health and Human Services Assistant Secretary and San Juan Unified School District trustee said during a CDPH webinar that day.

Polymerase chain reaction (PCR) tests cost $55 per test but will come down to as low as $38 the more people participate, Villescaz said. Additionally, schools could opt to use their own courier to send in samples, or use the state’s courier network to avoid the additional cost. The “goal is to ensure that testing is not a barrier to staying open or opening your school sites,” Villescaz said.

Learn more about the Valencia Lab and how to become a district partner: https://bit.ly/3pcsTsq

Compton USD has also worked with a local health partner to meet testing needs. St. John’s Well Child & Family Center — which has provided services to students and families on campus since 2013 — has made testing available to all Compton USD staff and families, as well as surrounding communities. “Over 160,000 residents have had the opportunity to receive testing, and in many instances, free of charge,” said district board President Micah Ali.

Unlike smaller districts such as Taft Union, Compton USD’s issue isn’t a lack of manpower. Rather, like so many Black communities, Compton harbors a deep mistrust of healthcare providers and doctors, Ali said — a lingering issue since the Tuskegee experiment (a highly unethical study on Black participants between 1932 and 1972 by the United States Public Health Service and the CDC).

“To bridge this mistrust and provide some stability to an otherwise contentious relationship with healthcare providers, we’ve built a phenomenal relationship [with St. John’s],” Ali said. “Coupling the school system, already a trusted partner with families, with a trusted healthcare provider is a recipe for success.”

That being said, Ali noted that the state has to step up when it comes to helping districts safely reopen schools. The Governor’s initial plan to reopen was a great starting point, but there were numerous areas which could be improved upon, he said. “The use of Prop 98 funds for testing is inappropriate and a non-starter. The state should assume the full costs for COVID testing,” he said.

There must also be attention and focus on providing more equity-focused solutions to address inequities in learning loss as a result of virtual schooling, Ali said. That is why, in addition to bringing back small cohorts of students in October focusing on special education, English learners and preschoolers, the board passed a resolution directing the superintendent to intentionally include Black students in the in-person cohort population. Learning centers were created for middle school and high school students in which they receive instruction virtually from a classroom, on site, that is monitored and supported by educators.

“What is more, and I must underscore, an important part of making this happen, of course, is robust testing and contact tracing protocols and our proactive, ongoing advocacy for prioritizing teachers and classified staff as essential workers who should receive the vaccine,” Ali said.

The next frontier: Vaccines
Five of California’s largest unions representing school employees released a seven-page paper on Feb. 3 with their demands for a statewide school reopening plan. Among their suggested requirements is a call for the state to offer vaccinations to school employees before they return for in-person instruction and make it a priority to vaccinate all employees in schools that have opened already. Though stopping short of requiring all educators be vaccinated prior to reopening campuses, CSBA and its management partners have advocated in meetings and correspondence with Gov. Newsom, administration officials and legislators for the state to prioritize school staff in the distribution of vaccines and provided extensive recommendations that must be included in a statewide school reopening plan.

Though no agreement has been reached between lawmakers and the Governor as of this writing, numerous legislators — including Assembly Education Committee Chair Patrick O’Donnell (D–Long Beach) — have come out in support of Assembly Bill 86, the Legislature’s Safe and Open Schools plan. As of Feb. 18, the $6.5 billion proposal includes increased COVID-19 testing and prioritizes vaccinations for teachers, as well as $2 billion in reopening funds to assist with opening schools for in-person instruction this spring.

Newsom announced Feb. 19 that the state would begin to dedicate 10 percent of all first doses that arrive in California for teachers, effective March 1. The state was already prioritizing teachers in the current tier of vaccine distribution but due to limited supply many counties were still focused on residents 65 and older.

Once enough doses are available, LEAs have signaled they are ready and willing to offer support in local vaccination efforts. Both Taft Union and Compton are among the districts in California that have offered up their facilities to local health departments as vaccination sites.

“I think the most important thing to know right now is that we’re in line, but the if vaccine supply does not increase, it could be the end of the summer before all teachers in California get vaccinated,”
—Dr. Debra Schade, Solana Beach USD trustee and CSBA Director, Region 17
Ruler
School districts are perfect partners, as they have the space and ideal locations throughout the community to help officials reach many in the community, said Ali. The partnership with St. John’s Well Child & Family Center will help to ensure that Compton residents receive the vaccine as soon as possible once it becomes available for all.

“Black and brown communities have been among the hardest hit and most impacted by the COVID-19 pandemic — our students have had to not only learn through a distance learning model that we know is not ideal for most students, they’ve had to learn in the household with parents or relatives sick from COVID,” Ali said. “They’ve had to learn in households where there were individuals who had died as a result of COVID. They’ve had to learn in households impacted by unprecedented economic hardship. Some of them have had to learn in the household that may have not have the stability or emotional support that they had at school. What the virus has caused is a petri dish of trauma for our students.”

Cavazos of Taft Union HSD said the local healthcare district has agreed to check out the district’s facilities, and that she herself has volunteered to assist in things like helping people get in line or fill out their forms or move from one place to the other so that medical personnel would have their hands free to focus on the vaccines. Specifically, she would like to see teachers get their vaccines so that everyone feels safer returning to campus.

State and local officials have said that while everyone wants to see teachers vaccinated and has made doing so a priority, there simply are not enough doses available. The state is receiving less than 600,000 doses a week from the federal government, Gov. Newsom said at a Feb. 9 press event.

“I think the most important thing to know right now is that we’re in line, but the if vaccine supply does not increase, it could be the end of the summer before all teachers in California get vaccinated,” said Solana Beach USD’s Dr. Schade, who also serves on the Community Vaccine Advisory Committee for the state representing CSBA. Students younger than 16 are unlikely to be vaccinated before 2022.

Napa Valley USD started vaccine distribution the week of Jan. 18, and while there has been a lot of joy surrounding the effort, Mucetti said the 2,000-employee district was only able to secure 750 vaccines.

“What has us under tremendous distress is that we know that there’s issues with supply, and so we may have been able to accomplish this first wave, but we would need another couple waves in order to get all of our employees vaccinated,” she explained. Still, Mucetti said employees reported getting that first dose “as one of the happiest set of days since the pandemic.”

Cavazos said she is looking forward to the day that everyone in the Taft Union HSD community can receive the vaccine, and that children can return to learning in-person without the concern that another quarantine or major shift in protocol is looming.

“It’s like that scene in Mission Impossible, where he has to avoid all of these laser beams,” Cavazos said. “That’s how I feel things are in education, having to maneuver through all of those things in order to just try to provide instruction to our students.”

Due to the constantly changing landscape of school reopenings, please see the CSBA blog (http://blog.csba.org) and the weekly update emails for the latest information.

Kimberly Sellery is managing editor and Alisha Kirby is a staff writer for California Schools.