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Mass. relaxes contact tracing in schools that offer rapid tests to students and staff

Governor Charlie Baker (center) announced a plan to provide schools with rapid at-home COVID-19 antigen tests to staffers and students on a weekly basis while Lt. Governor Karyn Polito and Secondary Education Commissioner Jeffrey Riley looked on at a press conference on Tuesday.Jonathan Wiggs/Globe Staff

Governor Charlie Baker announced Tuesday his administration would allow schools to stop “test-and-stay” and contact-tracing efforts if they join a new state initiative offering weekly rapid at-home COVID-19 tests to staffers and students.

The move, which was praised by school leaders and the state’s largest teachers’ union, was aimed at relieving overburdened school nurses and other employees at a time of high COVID cases and data showing low spread in schools. State education leaders credited the test-and-stay program, which administered rapid tests to students and staff exposed to COVID at school to avoid quarantine, with saving about half-a-million days of in-person learning.

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“School nurses and others have done an incredible job around the clock to make this [test and stay] program operate as effectively as it has here in Massachusetts,” Baker said. “And it’s been massively successful in avoiding days lost at home. But the current state of the pandemic requires that we adapt our efforts to meet the times.”

Schools can choose to opt into the new rapid-test program or they can remain with test-and-stay, the governor said, adding that will free up schools to focus on people with symptoms.

“This new at-home testing program is frankly a game-changer,” said education Commissioner Jeff Riley. “Providing this option for at-home rapid testing will allow school nurses to spend more time identifying symptomatic individuals and focus their efforts on other aspects of COVID-19 management in our schools.”

Starting this week, schools can sign up to receive at-home rapid antigen tests for weekly use, with tests for staff arriving the week of Jan. 24 and those for families ready during the week of Jan. 31.

The at-home tests will ship directly to school districts, packaged in kits containing two tests apiece, officials said. Participating students and staff will receive one kit every two weeks, and families will have to give consent to receive the tests.

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If someone tests positive at home, officials said, families should inform their school. The statement said schools will report positive cases to the state as part of the weekly COVID-19 reporting system already in place.

The announcement by the Baker administration comes as some medical and educational experts increasingly express that schools should shift away from resource-intensive efforts to contain a highly infectious virus that is mild in the vast majority of children who contract it.

But other scientists, teachers’ unions, and some students’ families have argued that the state should double down on these efforts in the middle of a surge to protect high-risk people, including in low-income communities where vaccination rates lag. They also point out that no one knows the long-term impacts of COVID infections.

Contact-tracing efforts have overwhelmed schools in recent weeks, as COVID cases among students and staff skyrocketed amid the Omicron surge. School nurses, who already were overburdened, often shouldered the duty of tracking students who were close contacts of COVID-positive students while they were infectious.

Newton Public Schools announced earlier this month that it would no longer be able to offer contact-tracing in middle and high schools, where students mingle more than in elementary schools, and dozens of infectious students could interact with more than 1,000 others.

The test-and-stay program — which allows students and staff exposed to COVID in school to attend classes with daily negative rapid tests — has been widely praised. However, the state’s exclusion of vaccinated students from the program has led to questions among parents about its usefulness, given that vaccinated people can still become infected and the state’s vaccination rate for children has climbed.

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State education officials said data collected through the test-and-stay program showed more than 90 percent of asymptomatic close contacts tested negative, suggesting in-school transmission was very rare.

Helen Jenkins, an associate professor of infectious disease at Boston University and parent of schoolchildren in Cambridge, said she supported the shift. While test-and-stay was “critical” to help students stay in school instead of unnecessarily quarantining at home, she said, “the data are very compelling” that it’s no longer needed.

“We need to consider the substantial burden it places on schools in terms of time and resources it takes to do contact tracing and carry out these tests,” Jenkins said. “The benefits do not appear to outweigh these burdens at this stage.”

Jenkins said it’s crucial that schools provide families easily understandable guidance, preferable in their home languages, on how to conduct at-home tests. She also said the state should make “even more effort” to ensure all communities have easy access to vaccines and good quality information on vaccination.

But some other experts weren’t so happy about weekly testing.

Other countries deploy rapid tests in schools daily. Once a week is insufficient because Omicron can cause days of peak contagiousness in someone within just one to four days of them being exposed to the virus, said Dr. Julia Koehler, an infectious disease clinician and assistant professor of pediatrics at Harvard Medical School.

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“A weekly testing schedule is completely inadequate to control viral spread in schools,” Koehler said. “By the time the infection has been detected four or five days later [after exposure], the virus has already been passed along to other children.”

Koehler added that the state’s mantra that schools are the safest place for children is “simply not true,” given the experience of many families she knows whose schoolchildren spread the virus to babies or older relatives.

“Schools could be safe but we haven’t invested the resources everywhere, not just where families can pay themselves to keep their children safe,” Koehler said.

While rapid antigen tests are less sensitive at detecting infections in people without symptoms, the plan “looks like a reasonable approach,” given the evidence that the Omicron surge is receding, said Dr. David Hamer, a professor of global health at Boston University School of Public Health and School of Medicine.

“As we move to lower transmission, I think we should be prioritizing testing of symptomatic students, teachers, and staff,” Hamer said, adding that classroom transmission has appeared to be minimal.

School leaders lauded the plan as a relief to nurses who have grown overwhelmed with tracing mounting positive cases, said Tom Scott, executive director of the Massachusetts Association of School Superintendents. Shifting testing from schools to homes also will relieve school staff, he said.

“It’s a great solution to a big problem,” Scott said. “We’re burdening people beyond the point of exhaustion.”

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The state’s largest educators’ union was was pleased. Massachusetts Teachers Association president Merrie Najimy praised the plan as “an important move” that will add testing for students and staff, something teachers want. She said the state should boost participation by automatically enrolling everyone in the testing program with the choice to opt out, rather than making people sign up. And she said educators still want contact tracing, but the state should provide staff, even nursing students, to help school nurses.

“Contact tracing is a necessary tool,” Najimy said. “We know we are safest when we can test and trace where there have been infections.”

Boston Public Schools proposed a similar change last week during a conversation with state officials, a spokesman said. He said the district would notify staff and families this week about its plans.

A parents group, BPS Families for COVID Safety, said the new program was flawed as it pressured districts to give up some mitigation measures to add new ones, burdened parents who may not understand how to conduct tests, and didn’t include high-quality masks or more school vaccination clinics. Boston has seen lower rates of participation in school testing programs than many suburban districts, the group added.

“The new DESE policy has serious problems and does not offer the layered approach that we need to make schools safe,” the group said.

Meanwhile, hospital capacity in Massachusetts continues to swell amid the Omicron-fueled surge.

In an effort to help medical operators struggling with absent workers, the Baker administration late Friday announced several emergency actions. The health care system is facing a critical staffing shortage, fueled by many resignations from burnout during the pandemic, and resulting in the loss of approximately 700 medical/surgical and intensive care hospital beds since the beginning of 2021, the administration said.

Among the new changes, physician assistants will be allowed to practice independently without physician supervision, creating less paperwork and freeing supervisors to care for more patients. Additionally, it allows dialysis centers to relax staffing requirements while still maintaining sufficient direct care staff.

While officials have repeatedly urged the public to get vaccinated, they’ve also been highlighting the need to mask up in indoor public settings.

Dr. Rochelle Walensky, director of the CDC, tweeted over the weekend that masks should cover your nose and mouth.

“Any mask is better than no mask,” Walensky tweeted.

Walensky also tweeted that some masks are better than others.

Material from prior Globe stories was used in this report. Tiana Woodard of the Globe Staff contributed.


Travis Andersen can be reached at travis.andersen@globe.com. Follow him on Twitter @TAGlobe. Naomi Martin can be reached at naomi.martin@globe.com.